Brian Welch

Most lumps or nodules in the thyroid are not harmful and don't need treatment. But sometimes, they can grow bigger and cause problems. There's a treatment called radiofrequency ablation (RFA), which uses heat to make the nodules smaller. Learn more: mayocl.in/409l4I2

We’ve had very promising results from image-guided cryoablation of Abdominal Wall #Endometriosis mayoclinic.org/medical-profes… @MayoRadiology @MayoGynecology

Radiofrequency Ablation of Benign & Malignant Thyroid Nodules Navin PJN et al New Tools & Procedures doi.org/10.1148/rg.220… @patrickjnavin @ANKurupMD @MayoRadiology @MayoClinicEndo @Welch_IO @mrcastro123 @mattcallstrom #RGphx 15/20

@WBrinjikji Range @DavidEpstein Loonshots @SafiBahcall

@ajgunnmd @VarianMedSys @swstav @danbrownIO @DrCliffWeiss @StevenSRaman_MD @DHidlayVIR @masi_zachary @FiveNada @GarnonJulien @GeorgiadesMD @AustinBourgeois @TheRealDoctorOs Great case. @JayMorris_MD led the way with the V probes in our practice. Very helpful in bone/soft tissue cases where backstop is critical. Also can help in kidney if patient is thin to avoid subcostal/intercostal nerve injury and associated risk for flank bulge/hernia.

Left upper pole #kidneycancer treated by interventional radiology (#IRad) with image-guided cryoablation using @VarianMedSys V probes. These probes allow you to adjust the length of your ablation zone. Have you all used before? What’s been your experience? @swstav @danbrownIO

Percutaneous Image-Guided Thermal Ablation of Adrenal Metastasis from Melanoma: A Single-Institution Experience. ow.ly/jkyz50G8WtT @MayoRadiology #irad @Welch_IO

Superstar @WBrinjikji @danieladamoMD @MayoRadiology @MayoClinicSOM @JayMorris_MD @MayoMN_IRadRes @ecehman

@ajgunnmd @xraytatum @DaveJohnsonMD @bonesz @AbhiKumar47 @masi_zachary @DHidlayVIR @StevenSRaman_MD @dcmadoff @bsc_io @shiv_smith @SIR_ECS @TimMcClureMD @FiveNada @swstav @agraif @NCCN @ASCO @AmerUrological Alot of heterogeneity out there now--thermal modality, operator technique (lap vs perc, number of needles), and method of intraprocedural monitoring. Hopefully continuing to develop good data will only help.

@Welch_IO @xraytatum @DaveJohnsonMD @bonesz @AbhiKumar47 @masi_zachary @DHidlayVIR @StevenSRaman_MD @dcmadoff @bsc_io @shiv_smith @SIR_ECS @TimMcClureMD @FiveNada @swstav @agraif The literature consists of retrospective case series. I agree that it’s positive but clearly not strong enough to warrant consideration (yet) from @NCCN, @ASCO, or @AmerUrological. In #IRad, we need to continue to develop the data that will move the needle for referrers & payors.

Exophytic, lower pole, T1b renal cell carcinoma treated in a single session as an outpatient by interventional radiology (#IRad) using a combination of embolization (alcohol & ethiodol) and percutaneous cryoablation with a complete response on follow up.

@ajgunnmd @xraytatum @DaveJohnsonMD @bonesz @AbhiKumar47 @masi_zachary @DHidlayVIR @StevenSRaman_MD @dcmadoff @bsc_io @shiv_smith @SIR_ECS @TimMcClureMD @FiveNada @swstav @agraif @NCCN @ASCO @AmerUrological Good discussion and agree. Its a slow process similar to the T1a journey (i.e. early 2010s AUA guidelines vs today) but promising data with longer term follow up emerging from experienced centers for both cryoablation and MWA.

@ajgunnmd @xraytatum @DaveJohnsonMD @bonesz @AbhiKumar47 @masi_zachary @DHidlayVIR @StevenSRaman_MD @dcmadoff @bsc_io @shiv_smith @SIR_ECS @TimMcClureMD @FiveNada @swstav @agraif The literature signal is pretty clear/strong. 1 probe per cm tumor, work with a collaborative multidisciplinary team (Urology, Anesthesia, etc), and liberal use of adjunctive techniques (stent, embo, hydrodisplacment) --> great oncologic outcomes. Don't think T1b a mystery.

@xraytatum @DaveJohnsonMD @bonesz @AbhiKumar47 @masi_zachary @DHidlayVIR @StevenSRaman_MD @dcmadoff @bsc_io @shiv_smith @SIR_ECS Without better data to inform, I have been defaulting to embolization + ablation for T1b tumors. #IRad @bonesz @TimMcClureMD @FiveNada @swstav @agraif

@DrMJoyner @kncukier @antonioregalado @edcaesar @mer__edith @GaryMarcus No ‘skin in the game’ @WBrinjikji @nntaleb

Body intervention spotlight: We have an amazing ablation in practice with world leaders in the field including @JayMorris_MD, neurointerventionalist extraordinare! Residents can rotate through this booming practice that does 10-20 cases per week in our hybrid suite. #radres #irad

@frbaffour @WBrinjikji I’m afraid 2041 more realistic for that matchup in the final 😰

@frbaffour @WBrinjikji Arsenal 3 Bayern 1?

Safety and Efficacy of Retrograde Pyeloperfusion for Ureteral Protection during Renal Tumor Cryoablation | ow.ly/jHGR50AOfp5 #irad @JoeTMarion

Interventional radiology (#IRad) can help control local sites of metastatic #cancer, helping keep patients off #chemotherapy. This #patient with ovarian cancer in the liver was treated by image-guided microwave ablation @uab_ir. Do you think we got it? #nocancerleftbehind

@JuliusChapiro @ajgunnmd @SIO_Central @dcmadoff @freez_IR @md_rogue Great discussion and agree. While guidelines still restrictive (esp EAU), we have had some success in the Urology literature. sciencedirect.com/science/articl… "For cT1a patients, clinically relevant differences between PN and ablation are unlikely" Interesting T1b data too

@ajgunnmd @radiology_rsna @SIO_Central @dcmadoff @freez_IR @md_rogue @RSNA @MountSinaiIR @UABUrology @ccp1983 @RaisBahrami It’s great. A urological journal would not publish such data though and that’s sad. We need a prospective trial / registry and for it to be published in a urological journal.

Excellent publication in @radiology_rsna showing cancer-specific survival after image-guided ablation of kidney #cancer by #IRad of 94%, 91%, 88%, & 88% at 3, 5, 10, & 15 years, which is essentially the same as #surgery. Check it out here: bit.ly/2X19Ypf

@DrJnotJulius Agree with @danieladamoMD. Great technique we use frequently. Initial CT images can also help with localization/get you in the ballpark given some of these are highly mobile and small. Nice case.

I must admit before fellowship, I never knew people performed lung biopsies with ultrasound. Quick, safe, and effective.

Safety Update: COVID-19 Convalescent Plasma in 20,000 Hospitalized Patients #MayoAnesResearch in @MayoProceedings by @DrMJoyner et al. Earlier admin in #COVID-19 is may reduce mortality & is safe @amklompas @JuanGRipoll1 @MSextonMD @ACasadevall1 mayocl.in/2E1hmdr