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CME Test Questions: August 2015
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Meta-Analysis: Microwave vs RF Ablation for Hepatic Lesions
31. Izzo F. Other thermal ablation techniques: microwave and interstitial laser ablation of liver tumors. Ann Surg Oncol 2003; 10(5):491–497. 32. Wang Y, Luo Q, Li Y, Deng S, Wei S, Li X. Radiofrequency ablation versus hepatic resection for small hepatocellular carcinomas: a metaanalysis of randomized and nonrandomized controlled trials. PloS one 2014; 9:e84484.
Huo and Eslick
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JVIR
33. Nakazawa T, Kokubu S, Shibuya A, et al. Radiofrequency ablation of hepatocellular carcinoma: correlation between local tumor progression after ablation and ablative margin. Am J Roentgenol 2007; 188:480–488. 34. Wang X, Sofocleous CT, Erinjeri JP, et al. Margin size is an independent predictor of local tumor progression after ablation of colon cancer liver metastases. Cardiovasc Intervent Radiol 2013; 36:166–175.
CME TEST QUESTIONS: AUGUST 2015
Examination available at http://learn.sirweb.org/. To take the online JVIR CME tests, please log into the SIR Learning Center with your SIR user name and password. Nonmembers: If you do not already have an SIR username and password, please click on “Create an Account” to gain access to the SIR Learning Center. Once in the Learning Center, click on the “Publication” activity type for a listing of all available JVIR CME Tests. Each test will be available online for 3 years from the month/date of publication. The CME questions in the August 2015 issue are derived from the article “Microwave Ablation Compared to Radiofrequency Ablation for Hepatic Lesions: A Meta-Analysis” by Huo and Eslick. 1. In this meta-analysis, the authors compare the efficacy and complications of radiofrequency (RF) ablation versus microwave (MW) ablation for hepatic tumors. Theoretical advantages of MW ablation over RF ablation including all of the following EXCEPT: a. Higher intratumoral temperature and creation of larger and faster ablation volumes b. Improved convection profile with less charring c. Less susceptibility to heat-sink effect from an adjacent vessel d. Lower risk of hemorrhage in patients with cirrhosis e. Overall decreased risk of burn injuries due to the absence of grounding pads 2. When matched for patient demographics and tumor characteristics, this meta-analysis showed that MW ablation fared significantly better than RF ablation for hepatocellular carcinoma and liver metastases for a. 1-, 3-, and 5-year overall survival b. 6-year overall survival c. 1-, 3-, and 5-year disease-free survival d. The local recurrence rate
3. This meta-analysis revealed that there were no significant differences in morbidity and mortality between the two modalities. The approximate overall complication rate for both modalities was a. o 5% b. 5%–10% c. 10%–15% d. 4 15% 4. Subgroup analysis between the two modalities demonstrated that MW ablation had a statistically better local control than RF ablation when the a. Ablative device used internal cooling b. Wattage applied exceeded 65 Watts c. Tumor size exceeded the Milan criteria d. Ablation time exceeded 10 minutes 5. In this meta-analysis the authors referenced a recent meta-analysis that compared RF ablation and resection. This meta-analysis demonstrated improved results with resection for which one of the following? a. Disease-free survival b. Local recurrence rate c. Adequacy of tumor-free margins d. 5-year overall survival
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Meta-Analysis: Microwave vs RF Ablation for Hepatic Lesions
31. Izzo F. Other thermal ablation techniques: microwave and interstitial laser ablation of liver tumors. Ann Surg Oncol 2003; 10(5):491–497. 32. Wang Y, Luo Q, Li Y, Deng S, Wei S, Li X. Radiofrequency ablation versus hepatic resection for small hepatocellular carcinomas: a metaanalysis of randomized and nonrandomized controlled trials. PloS one 2014; 9:e84484.
Huo and Eslick
’
JVIR
33. Nakazawa T, Kokubu S, Shibuya A, et al. Radiofrequency ablation of hepatocellular carcinoma: correlation between local tumor progression after ablation and ablative margin. Am J Roentgenol 2007; 188:480–488. 34. Wang X, Sofocleous CT, Erinjeri JP, et al. Margin size is an independent predictor of local tumor progression after ablation of colon cancer liver metastases. Cardiovasc Intervent Radiol 2013; 36:166–175.
CME TEST QUESTIONS: AUGUST 2015
Examination available at http://learn.sirweb.org/. To take the online JVIR CME tests, please log into the SIR Learning Center with your SIR user name and password. Nonmembers: If you do not already have an SIR username and password, please click on “Create an Account” to gain access to the SIR Learning Center. Once in the Learning Center, click on the “Publication” activity type for a listing of all available JVIR CME Tests. Each test will be available online for 3 years from the month/date of publication. The CME questions in the August 2015 issue are derived from the article “Microwave Ablation Compared to Radiofrequency Ablation for Hepatic Lesions: A Meta-Analysis” by Huo and Eslick. 1. In this meta-analysis, the authors compare the efficacy and complications of radiofrequency (RF) ablation versus microwave (MW) ablation for hepatic tumors. Theoretical advantages of MW ablation over RF ablation including all of the following EXCEPT: a. Higher intratumoral temperature and creation of larger and faster ablation volumes b. Improved convection profile with less charring c. Less susceptibility to heat-sink effect from an adjacent vessel d. Lower risk of hemorrhage in patients with cirrhosis e. Overall decreased risk of burn injuries due to the absence of grounding pads 2. When matched for patient demographics and tumor characteristics, this meta-analysis showed that MW ablation fared significantly better than RF ablation for hepatocellular carcinoma and liver metastases for a. 1-, 3-, and 5-year overall survival b. 6-year overall survival c. 1-, 3-, and 5-year disease-free survival d. The local recurrence rate
3. This meta-analysis revealed that there were no significant differences in morbidity and mortality between the two modalities. The approximate overall complication rate for both modalities was a. o 5% b. 5%–10% c. 10%–15% d. 4 15% 4. Subgroup analysis between the two modalities demonstrated that MW ablation had a statistically better local control than RF ablation when the a. Ablative device used internal cooling b. Wattage applied exceeded 65 Watts c. Tumor size exceeded the Milan criteria d. Ablation time exceeded 10 minutes 5. In this meta-analysis the authors referenced a recent meta-analysis that compared RF ablation and resection. This meta-analysis demonstrated improved results with resection for which one of the following? a. Disease-free survival b. Local recurrence rate c. Adequacy of tumor-free margins d. 5-year overall survival