You’re about to biopsy a renal lesion; should you ablate at the same time? In this episode of the BackTable Podcast, host Michael Barraza talks with Dr. Steven Huang from MD Anderson Cancer Center about building an efficient and effective renal biopsy and ablation service line.
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This podcast is supported by:
Varian IntelliBlate
https://www.varian.com/products/interventional-solutions/microwave-ablation-solutions
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SYNPOSIS
Dr. Huang first covers referral patterns and the typical pathway that patients take to end up in his clinic. The discussion covers the types of lesions he treats, imaging requirements, and criteria for patient eligibility. He emphasizes the importance of shared decision making when deciding between active surveillance, interventional treatment, and partial nephrectomy. Dr. Huang explains his preferred procedural approach and ablation modalities, including cryo, microwave (MWA), and radiofrequency ablation (RFA). He shares his experiences with challenging cases and integrating new technologies like histotripsy and the Siemens interventional package. They also discuss the possibility of a preoperative embolization for larger lesions that could be susceptible to the heat sink effect. Both experts emphasize the importance of collaboration with urologists and ensuring patient safety and expectations. They also touch on the future of the field, discussing the use of AI and robotics.
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TIMESTAMPS
00:00 - Introduction
02:17 - Training Programs at MD Anderson
03:23 - Referral Patterns for Renal Ablations
07:25 - Patient Management and Virtual Consultations
10:59 - Ablation Techniques and Device Selection
26:44 - Challenges and Complications
27:25 - Approach to Lesions Near Renal Vasculature
28:02 - Patient Expectations and Urologist Collaboration
33:26 - Post-Procedure Care and Patient Recovery
35:30 - Managing Recurrences and Multiple RCCs
47:17 - Closing Remarks
