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Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
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Intraoperative Imaging Techniques to Support Complete Tumor Resection in Partial Nephrectomy.

Marlène C H Hekman1, Mark Rijpkema2, Johan F Langenhuijsen3

  • 1Department of Urology, Radboudumc, Nijmegen, The Netherlands; Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, The Netherlands.

European Urology Focus
|July 30, 2017
PubMed
Summary

Intraoperative imaging, including ultrasonography and fluorescence imaging, aids in kidney tumor removal during nephron-sparing surgery (NSS). However, its effectiveness in ensuring negative surgical margins requires further investigation.

Keywords:
Complete tumor resectionImage-guided surgeryPartial nephrectomyRenal cell carcinomaResection margin

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Area of Science:

  • Urology
  • Surgical Oncology
  • Medical Imaging

Background:

  • Nephron-sparing surgery (NSS) for complex kidney tumors presents challenges in achieving complete tumor resection.
  • Establishing negative surgical margins is crucial for successful oncological outcomes.
  • Intraoperative imaging modalities offer potential solutions for enhancing tumor visualization and resection accuracy.

Purpose of the Study:

  • To review and discuss intraoperative imaging techniques applicable to NSS of renal tumors.
  • To evaluate the potential of these techniques in achieving complete tumor resection and negative surgical margins.

Main Methods:

  • Systematic literature search of PubMed for English articles published after 2005 on intraoperative imaging in NSS of renal cell carcinoma.
  • Reference search of retrieved articles was conducted.

Main Results:

  • Included studies focused on ultrasonography, fluorescence imaging, augmented reality, optical coherence tomography, and ex vivo MRI.
  • Ultrasonography is established for tumor localization and margin assessment.
  • Fluorescence imaging shows promise for differentiating tumor tissue, but detecting positive margins is unclear.
  • Augmented reality requires further development to address tissue deformation issues.
  • Limited patient numbers and lack of randomized controlled trials characterize current evidence.

Conclusions:

  • Ultrasonography is currently utilized in partial nephrectomy, while fluorescence imaging and augmented reality are emerging techniques.
  • The definitive added value of intraoperative imaging in achieving negative surgical margins during NSS needs further clinical validation.
  • Continued research is necessary to fully establish the role of these advanced imaging modalities in urological surgery.