Radiomics-Based Prediction Model for Outcome of Radioembolization in Metastatic Colorectal Cancer

Portal-hypertension develops in patients with advanced chronic liver diseases (CLD), especially cirrhosis and is associated with complications, such as gastrointestinal bleeding and ascites resulting in high mortality. The transjugular intrahepatic portosystemic shunt (TIPS) is a treatment option for portal-hypertension, aiming to decrease portal venous pressure by establishing an artificial passage for blood from the gastrointestinal tract to the liver vein. This study focuses on the differences in the molecular composition of plasma samples from patients with portal-hypertension before and after TIPS intervention to identify and characterise mediators influencing gut-liver cross-talk.

Nuklearmedizin-NuclearMedicine

Ziel/Aim: F-18-Tetrafluorborat (TFB) ist ein vielversprechendes PET-Radiopharmakon mit exzellenten Eigenschaften für die Bildgebung des Natrium-Iodid-Symporters (NIS) bei Patienten mit differenziertem Schilddrüsenkarzinom (DTC). Ziel dieser Studie war der Vergleich des TFB-PET mit der Hochdosis posttherapeutischen Iod-131-Ganzkörperszintigraphie/SPECT/CT (TxWBS-SPECT/CT) bei Patienten mit einem Rezidiv des DTC und zum FDG-PET in entdifferenzierten Läsionen.Methodik/Methods: Insgesamt wurden 26 Patienten die eine hochdosierte Radioiodtherapie (RAI) mit Iod-131 (5, 0–10, 2 GBq) zwischen Mai 2020 und November 2022 erhielten in diese retrospektive Studie eingeschlossen. Alle Patienten wurden vor der Therapie mittels TFB-PET/CT 40 Minuten nach Injektion im median von 321 MBq F-18-TFB untersucht. Zum Vergleich der Tracer-Kinetik wurden zusätzlich 23/26 Patienten nach 90 …

Der zeitliche Verlauf des akuten Leberversagens umfasst eine große Zeitspanne, die in➤ Tab. 52.1 dargestellt ist. Prinzipiell kann das akute Leberversagen in ein hyperakutes, akutes und subakutes Stadium unterteilt werden. Hinsichtlich des zeitlichen Verlaufs kann sich ein akutes Lebersagen neben der hochakuten Form langsam über einen Zeitraum von bis zu 26 Wo. Entwickeln (O’Grady et al. 1993).

RöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren

Zielsetzung Untersuchung eines Panels von Prolifertions-und Angiogenesmarkern auf deren potentiell prognostische Wertigkeit nach CT-gesteuerter high-dose rate Brachytherapy (HDR-BT) von Hepatozellulärem Karzinom (HCC).Material und Methoden Plasma vor und 48h nach HDR-BT (1x15 Gy) von 24 HCC-Patienten wurde mittels Proximity Extension Assay (Olink proteomics Target 96 immuno-oncology) analysiert. Die untersuchten Angiogenesemarker waren ANG-1, ANG-2, VEGF-A, VEGFR-2 und PDGF-B. Die Proliferationsmarker waren EGF, FGF-2, HGF und PlGF. Eine Fold change (FC), errechnet zwischen dem Wert nach HDR-BT im Verhältnis zur Baseline wurde errechnet. Für die Überlebensanalyse wurden Patienten anhand des FC Medians für jeweils jedes Protein in zwei Gruppen aufgeteilt. Zusätzlich wurden alle Patienten mit FC≥ 1.3 bei≥ 3 Proteinen gegen alle verbleibenden Patienten …

Zeitschrift für Gastroenterologie

Background Acute-on-chronic liver failure (ACLF) is a life-threatening clinical syndrome characterized by the rapid deterioration of liver function in individuals with pre-existing chronic liver disease. While various factors contribute to ACLF, emerging evidence suggests that viral infections can serve as potent triggers. Herpesviruses, including CMV, EBV and HSV are highly prevalent viruses. Key factors linking the viruses to ACLF include their abilities to induce cytokine storms, activate immune cells and trigger a pro-inflammatory state.Methods We analysed blood samples from 212 patients registered in the ACLF-I-study for viremia of the herpesviruses CMV, EBV and HSV by multiplex-PCR. Patients’ charts were reviewed for additional clinical data.Results Higher prevalences of CMV (45% vs. 30%), EBV (10% vs. 6%) and HSV1 (8% vs. 1%) as well as higher viral loads of> 1000 copies/ml regarding CMV (8% vs. 3 …

In the traditional view, the occurrence of cirrhosis‐related complications, such as hepatic encephalopathy, formation of ascites or variceal haemorrhage, marks the transition to the decompensated stage of cirrhosis. Although the dichotomous stratification into a compensated and decompensated state reflects a prognostic water‐shed moment and remains to hold its prognostic validity, it represents an oversimplification of clinical realities. A broadening understanding of pathophysiological mechanisms underpinning decompensation have led to the identification of distinct prognostic subgroups, associated with different clinical courses following decompensation. Data provided by the PREDICT study uncovered three distinct sub‐phenotypes of acute decompensation (AD). Moreover, acute‐on‐chronic liver failure (ACLF) has been established as a distinct clinical entity for many years, which is associated with a high …

Es erfolgte eine Auswertung und Diskussion der aktuellen Literatur zur Lebertransplantation bei akut-auf-chronischem Leberversagen (ACLF). Das ACLF stellt eine akute Verschlechterung der Leberfunktion bei vorbestehender Lebererkrankung dar und geht, stadienabhängig, mit zunehmendem Multiorganversagen einher. Die 28-Tages-Mortalität reicht bis weit über 70 % im Stadium 3 und bedingt eine rasche intensivmedizinische Therapie unter Einbeziehung eines interdisziplinären, transplantationsmedizinisch erfahrenen Teams. Unter optimierten Bedingungen bietet die Lebertransplantation Langzeitüberlebensraten, die mit anderen Indikationen vergleichbar sind. Diese zu erreichen, setzt eine differenzierte Spenderauswahl, die Wahl des geeigneten Zeitpunktes zur Transplantation im Rahmen eines dynamischen Krankheitsverlaufes und die Anwendung geeigneter chirurgischer Techniken voraus.

Zeitschrift für Gastroenterologie

Ziele In dieser Studie soll der Zusammenhang zwischen US-definierter Sarkopenie und akuter Dekompensation (AD) und Mortalität bei Patienten mit chronischen Lebererkrankungen untersucht werden.Methodik 63 Patienten mit chronischer Lebererkrankung und klinisch signifikanter portaler Hypertension wurden eingeschlossen. Primärer Endpunkt waren die AD und das Akut-auf-chronische Leberversagen innerhalb eines Jahres. Die ventrale Muskeldicke der Oberschenkelmuskulatur wurde mittels Linearschallkopf gemessen und ein Cut-off-Wert für die Muskeldicke zur Definition von Sarkopenie bestimmt.

JHEP Reports

BackgroundData on the prevalence and characteristics of so called rare HCV genotypes (GT) in larger cohorts is limited. This study investigates the frequency of rare GT and resistance-associated substitutions and the efficacy of retreatment in a European cohort.MethodsA total of 129 patients with rare GT1-6 were included from the European resistance database. NS3, NS5A and NS5B were sequenced and clinical parameters and retreatment efficacies were collected retrospectively.ResultsOverall 1.5% (69/4656) of DAA-naïve and 4.4% (60/1376) of DAA-failure patients were infected with rare GT. While rare GT were almost equally distributed throughout GT1-6 in DAA-naïve patients, we detected mainly rare GT4 (47%, 28/60 GT4; of these n=17, subtype 4r) and GT3 (25%, 15/60 GT3, of these n=8, subtype 3b) among DAA-failures. 62% (37/60) of DAA failures had not responded to first-generation regimes and the …

Nuklearmedizin-NuclearMedicine

Ziel/Aim: Bakterielle Infektionen haben oft ein unspezifisches klinisches Erscheinungsbild. Die Unterscheidung zwischen infektiösen und nicht-infektiösen Herden und deren Lokalisation sind jedoch wichtig für eine optimale Therapie. Um bakterielle Infektionen spezifisch bildgebend darzustellen, bearbeiten wir neben der spezifischen Aufnahme von besonderen Kohlenhydraten auch das bakteriell spezifische Eisentransportsystem (via Siderophore), wobei Eisen durch Ga-68 ersetzt wird.Methodik/Methods: In einer konvergenten Totalsynthese wurde aus kommerziell erhältlichen Bausteinen Salmochelin B (C-glykosyliertes Enterobaktin) als Präkursor erhalten. Nach radioaktiver Markierung mit Ga-68 wurde [68 Ga] Ga-RMA693 sowohl auf Stabilität in humanem und murinem Serum als auch in vitro auf die Spezifität der Aufnahme in E. coli-Stämmen getestet. Anschließend wurde die Biodistribution beurteilt und in …

Case Reports

Fibro-adipose vascular anomaly (FAVA) is characterized by intramuscular vascular malformation with secondary overgrowth of further mesenchymal elements, particularly fibro-adipose tissue. A rare disease complicated by nonspecific, overlapping clinical and imaging features, FAVA is often misdiagnosed, causing a dilemma in its diagnostic and therapeutical management. We present a case of FAVA of the lower extremity.

Endoscopy

Aims This retrospective single-center study aimed to identify risk factors associated with infectious complications following endoscopic retrograde cholangiopancreatography (ERCP) in liver transplant recipients.Methods The study involved a retrospective analysis of 285 elective ERCP interventions performed in 88 liver transplant patients at a tertiary care center. Our analysis included univariable and multivariable regression analyses, cox regression, and log-rank tests to assess the influence of various factors on the incidence of infectious complications. The primary outcome measure for this study was the occurrence of an infection after ERCP. Infection was defined by established criteria (Development of otherwise unexplained fever exceeding 38 C within three days following the procedure, leading to the initiation of antibiotic therapy).Results Among the 285 ERCP interventions, cases presented isolated …

Internal and Emergency Medicine

Pathophysiology of portal vein thrombosis (PVT) in cirrhosis is still not entirely understood. Elevated levels of lipopolysaccharides (LPS) in portal circulation are significantly associated with hypercoagulation, increased platelet activation and endothelial dysfunction. The aim of the study was to investigate if LPS was associated with reduced portal venous flow, the third component of Virchow’s triad, and the underlying mechanism. Serum nitrite/nitrate, as a marker of nitric oxide (NO) generation, and LPS were measured in the portal and systemic circulation of 20 patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS) procedure; portal venous flow velocity (PVV) was also measured in each patient and correlated with NO and LPS levels. Serum nitrite/nitrate and LPS were significantly higher in the portal compared to systemic circulation; a significant correlation was found between LPS …

Die Gastroenterologie

Ein Teil der Patienten mit Leberzirrhose entwickelt auf dem Boden einer hepatischen Dekompensation ein (Multi‑)Organversagen. Klinisch zeigt sich ein Syndrom, das durch eine massive systemische Inflammation und eine hohe Mortalität gekennzeichnet ist. Dieses wird als akut-auf-chronisches Leberversagen (ACLF) bezeichnet. Zu den häufigen Auslösern zählen neben Alkoholkonsum bakterielle oder virale Infektionen. Auch wenn es bislang keinen internationalen Konsens hinsichtlich der Definition des ACLF gibt, so ist es doch als eigene Krankheitsentität, insbesondere in Abgrenzung zur hepatischen Dekompensation, anerkannt. Zur Diagnosestellung wurden Scores erarbeitet, die die einzelnen Organsysteme abbilden. Eine spezifische Therapie ist derzeit nicht verfügbar. Der frühen Identifikation und konsequenten Therapie von Auslösern kommt entsprechend besondere Bedeutung zu. Aufgrund der teils …

RöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren

Zielsetzung Die transarterielle Chemoembolisation (TACE) hat sich als Standardverfahren zur Behandlung des hepatozellulären Karzinoms (HCC) im intermediären Stadium (BCLC B) etabliert. In den aktuellen Leitlinien besteht jedoch kein Konsens über die beste Auswahl einer bestimmten TACE-Technik. Ziel dieser Studie war der Vergleich von Sicherheit, Wirksamkeit und progressionsfreiem Überleben (PFS) der konventionellen TACE (cTACE), der medikamentenfreisetzenden Bead-TACE (DEB-TACE) und der TACE mit abbaubaren Stärkemikrosphären (DSM-TACE).Material und Methoden Diese retrospektive Studie umfasste n= 192 Patienten mit HCC, die sich zwischen 2008 und 2021 in unserem Zentrum mindestens einer TACE mit Follow-up nach 4-6 Wochen ohne Zwischentherapien unterzogen. TACE-Indikationen waren BCLC Stadium B, Bridging/Downstaging (B/D) zur Lebertransplantation (LT) oder …

Zeitschrift für Gastroenterologie

Background Acute-on-chronic liver failure (ACLF) poses a significant clinical challenge, and its etiology, including the role of hepatitis B (HBV) and D virus (HDV) coinfection, remains an area of active research.Methods We conducted a monocentric, retrospective data analysis of patient records, focusing on virological data, disease characteristics, and sociodemographic factors. The cohort included 570 patients admitted to the intensive care unit (ICU) with ACLF from 2015 to 2022. Statistical analyses, including Kaplan-Meier survival curves and a log-rank test, were performed to assess differences in survival among these groups.Results In our cohort of ACLF patients a subset (n= 10) had active HDV coinfection alongside patients with active HBV monoinfection (n= 15), HBsAg loss (n= 37) and Anti-HBc only (n= 8), representing 40% of the patients with replicative HBV infection (n= 25). These patients were younger …

American Journal of Physiology-Cell Physiology

17-β-hydroxysteroid dehydrogenase 13 (HSD17B13), a lipid droplet-associated enzyme, is primarily expressed in the liver and plays an important role in lipid metabolism. Targeted inhibition of enzymatic function is a potential therapeutic strategy for treating steatotic liver disease (SLD). The present study is aimed at investigating the effects of the first selective HSD17B13 inhibitor, BI-3231, in a model of hepatocellular lipotoxicity using human cell lines and primary mouse hepatocytes in vitro. Lipotoxicity was induced with palmitic acid in HepG2 cells and freshly isolated mouse hepatocytes and the cells were coincubated with BI-3231 to assess the protective effects. Under lipotoxic stress, triglyceride (TG) accumulation was significantly decreased in the BI-3231-treated cells compared with that of the control untreated human and mouse hepatocytes. In addition, treatment with BI-3231 led to considerable improvement …

International Journal of Molecular Sciences

Acute-on-chronic liver failure (ACLF) is associated with increased mortality. Specific therapy options are limited. Hypoxia-inducible factor 1 alpha (HIF-1α) has been linked to the pathogenesis of chronic liver disease (CLD), but the role of HIF-1α in ACLF is poorly understood. In the current study, different etiologies of CLD and precipitating events triggering ACLF were used in four rodent models. HIF-1α expression and the intracellular pathway of HIF-1α induction were investigated using real-time quantitative PCR. The results were verified by Western blotting and immunohistochemistry for extrahepatic HIF-1α expression using transcriptome analysis. Exploratory immunohistochemical staining was performed to assess HIF-1α in human liver tissue. Intrahepatic HIF-1α expression was significantly increased in all animals with ACLF, regardless of the underlying etiology of CLD or the precipitating event. The induction of HIF-1α was accompanied by the increased mRNA expression of NFkB1 and STAT3 and resulted in a marked elevation of mRNA levels of its downstream genes. Extrahepatic HIF-1α expression was not elevated. In human liver tissue samples, HIF-1α expression was elevated in CLD and ACLF. Increased intrahepatic HIF-1α expression seems to play an important role in the pathogenesis of ACLF, and future studies are pending to investigate the role of therapeutic HIF inhibitors in ACLF.

CardioVascular and Interventional Radiology

PurposeTo evaluate improvement in local vascular perfusion of the lower limbs on intravoxel incoherent motion (IVIM) imaging after endovascular therapy (EVT).Materials and MethodsIVIM imaging was performed on 20 lower limbs of 16 patients with lower extremity arterial diseases before and after EVT. To estimate IVIM, diffusion-weighted lower-limb axial images (number of slices = 25 and slice thickness = 3.5 mm) were acquired using different b values (0, 300, and 1000 s/mm2). IVIM imaging with the simplified IVIM techniques was performed. The perfusion-related coefficient (D* [10−3 mm2/s]), perfusion fraction (f [%]), and D*f product (10−3 mm2/s %) were calculated before and 2–3 days after EVT. The ankle brachial index (ABI), mean D* (10−3 mm2/s), mean f (%), and mean D*f product (10−3 mm2/s %) before and after EVT were compared.ResultsSuccessful revascularization was achieved in all cases …

CardioVascular and Interventional Radiology

PurposeTo report technical feasibility and clinical efficacy of iliac vein stent placement in adolescent patients with May–Thurner Syndrome (MTS).Materials and MethodsSingle-institution retrospective review of the medical record between 2014 and 2021 found 63 symptomatic patients (F = 40/63; mean age 16.1 years, 12–20 years) who underwent left common iliac vein (LCIV) stent placement for treatment of LCIV compression from an overriding right common iliac artery, or equivalent (n = 1, left IVC). 32/63 (50.7%) patients presented with non-thrombotic iliac vein lesions (NIVL). 31/63 (49.2%) patients presented with deep vein thrombosis of the lower extremity and required catheter-directed thrombolysis after stent placement (tMTS). Outcomes include technically successful stent placement with resolution of anatomic compression and symptom improvement. Stent patency was monitored with Kaplan–Meier …

CardioVascular and Interventional Radiology

PurposeRadiation pneumonitis is a serious complication of radioembolization. In holmium-166 ([166Ho]) radioembolization, the lung mean dose (LMD) can be estimated (eLMD) using a scout dose with either technetium-99 m-macroaggregated albumin ([99mTc]MAA) or [166Ho]-microspheres. The accuracy of eLMD based on [99mTc]MAA (eLMDMAA) was compared to eLMD based on [166Ho]-scout dose (eLMDHo-scout) in two prospective clinical studies.Materials and MethodsPatients were included if they received both scout doses ([99mTc]MAA and [166Ho]-scout), had a posttreatment [166Ho]-SPECT/CT (gold standard) and were scanned on the same hybrid SPECT/CT system. The correlation between eLMDMAA/eLMDHo-scout and LMDHo-treatment was assessed by Spearman’s rank correlation coefficient (r). Wilcoxon signed rank test was used to analyze paired data.ResultsThirty-seven patients with …

CardioVascular and Interventional Radiology

PurposeThe aim of this study was to analyze the impact of calcification on the 12 and 24 months outcomes of the Eluvia™(Boston Scientific®) drug-eluting stent (DES) for femoropopliteal occlusive disease using three different calcium scoring systems.

CardioVascular and Interventional Radiology

PurposeSarcopenia is associated with a decreased kinetic growth rate (KGR) of the future liver remnant (FLR) after portal vein embolization (PVE). However, little is known on the increase in FLR function (FLRF) after PVE. This study evaluated the effect of sarcopenia on the functional growth rate (FGR) after PVE measured with hepatobiliary scintigraphy (HBS).MethodsAll patients who underwent PVE at the Amsterdam UMC between January 2005 and August 2017 were analyzed. Functional imaging by HBS was used to determine FGR. Liver volumetry was performed using multiphase contrast computed tomography (CT). Muscle area measurement to determine sarcopenia was taken at the third lumbar level (L3).ResultsOut of the 95 included patients, 9 were excluded due to unavailable data. 70/86 (81%) patients were sarcopenic. In the multivariate logistic regression analysis, sarcopenia (p= 0.009) and FLR …

CardioVascular and Interventional Radiology

PurposeRadiation pneumonitis is a serious complication of radioembolization. In holmium-166 ([166Ho]) radioembolization, the lung mean dose (LMD) can be estimated (eLMD) using a scout dose with either technetium-99 m-macroaggregated albumin ([99mTc]MAA) or [166Ho]-microspheres. The accuracy of eLMD based on [99mTc]MAA (eLMDMAA) was compared to eLMD based on [166Ho]-scout dose (eLMDHo-scout) in two prospective clinical studies.Materials and MethodsPatients were included if they received both scout doses ([99mTc]MAA and [166Ho]-scout), had a posttreatment [166Ho]-SPECT/CT (gold standard) and were scanned on the same hybrid SPECT/CT system. The correlation between eLMDMAA/eLMDHo-scout and LMDHo-treatment was assessed by Spearman’s rank correlation coefficient (r). Wilcoxon signed rank test was used to analyze paired data.ResultsThirty-seven patients with …

CardioVascular and Interventional Radiology

PurposeTo evaluate the benefit of a contrast-enhanced computed tomography (CT) radiomics-based model for predicting response and survival in patients with colorectal liver metastases treated with transarterial Yttrium-90 radioembolization (TARE).Materials and MethodsFifty-one patients who underwent TARE were included in this single-center retrospective study. Response to treatment was assessed using the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) at 3-month follow-up. Patients were stratified as responders (complete/partial response and stable disease, n= 24) or non-responders (progressive disease, n= 27). Radiomic features (RF) were extracted from pre-TARE CT after segmentation of the liver tumor volume. A model was built based on a radiomic signature consisting of reliable RFs that allowed classification of response using multivariate logistic regression. Patients were assigned to …

CardioVascular and Interventional Radiology

PurposeTo evaluate the relationship between prospectively generated ablative margin estimates and local tumor progression (LTP) among patients undergoing microwave ablation (MWA) of small renal masses (SRMs).Materials and MethodsBetween 2017 and 2020, patients who underwent MWA for SRM were retrospectively identified. During each procedure, segmented kidney and tumor shapes were coregistered with intraprocedural helical CT images obtained after microwave antenna placement. Predicted ablation zone shape and size were then overlaid onto the resultant model, and a model-to-model distance algorithm was employed to calculate multiple ablative margin estimates. LTP was modeled as a function of each margin estimate by hazard regression. Models were evaluated using hazard ratios and Akaike information criterion. Receiver operating characteristic curve area under the curve was also …

CardioVascular and Interventional Radiology

PurposeIn arterial disease, the presence of two or more serial stenotic lesions is common. For mild lesions, it is difficult to predict whether their combined effect is hemodynamically significant. This study assessed the hemodynamic significance of idealized serial stenotic lesions by simulating their hemodynamic interaction in a computational flow model.Materials and MethodsFlow was simulated with SimVascular software in 34 serial lesions, using moderate (15 mL/s) and high (30 mL/s) flow rates. Combinations of one concentric and two eccentric lesions, all 50% area reduction, were designed with variations in interstenotic distance and in relative direction of eccentricity. Fluid and fluid–structure simulations were performed to quantify the combined pressure gradient.ResultsAt a moderate flow rate, the combined pressure gradient of two lesions ranged from 3.8 to 7.7 mmHg, which increased to a range of 12.5–24.3 …

CardioVascular and Interventional Radiology

PurposeTo evaluate the impact of pre-transjugular intrahepatic portosystemic shunt (TIPS) hepatic encephalopathy (HE) on developing post-TIPS HE.Materials and MethodsIn this retrospective, single center observational study, all patients who underwent successful TIPS placement between January 2005 and May 2020 with data pertaining to HE in their chart were included. Patient demographics and procedural details were recorded. Clinical outcomes post-TIPS, were collected and compared across patients with and without pre-TIPS HE.ResultsOf 326 included patients, 159 (159/326, 48.8%) had a history of pre-TIPS HE. In total those without a history of HE were more likely to develop HE during follow up (136 (136/167, 81.4%) vs 107 (107/159, 67.3%), p = 0.001). When evaluating for predictors of developing HE within 3 months of TIPS placement, no significant variables were found on logistic regression …

CardioVascular and Interventional Radiology

This study adds to the growing body of evidence affirming radioembolization as a valuable tool for the treatment of NETs. A key strength of this study is the comparatively long follow-up period, with a median of almost three years, which provides useful data on longterm toxicity in this patient cohort. This initiative is to be applauded, since the collection of high-quality evidence in NET patients is challenging, due to both the rarity of the disease and it’s heterogeneity—with biological behavior influenced heavily by tumor grade and organ of origin. Authors studied grade 2 NETs originating from a wide range of primary sites (pancreas, lung, gut and unknown) and found a high objective response rate in 23/32 (72%) of patients, accompanied by 13 severe adverse events. It is noteworthy that no instances of liver abscesses were reported in this series, despite the inclusion of 7 patients with biliodigestive stents or …

CardioVascular and Interventional Radiology

PurposeTo evaluate factors affecting the diagnostic yield (percent of biopsy samples leading to a pathologic diagnosis) of lesional bone biopsies in patients with hematologic malignancies.Materials and MethodsThis retrospective study included 206 lesional bone biopsies in 182 patients with a hematologic malignancy between January 2017 and December 2022. The parameters that were reviewed to evaluate diagnostic yield included biopsy device type (manual vs. electric-powered drill), number of biopsy cores acquired, core biopsy needle gauge, preliminary intra-procedural sample adequacy (touch preparation cytology determining if samples are adequate for final pathologic examination), lesion morphology on Computed Tomography (CT), and presence of crush artifact.ResultsReview of 206 lesional biopsies showed overall diagnostic yield to be 89.8% (185/206). The two statistically significant factors …

CardioVascular and Interventional Radiology

PurposeRadiation pneumonitis is a serious complication of radioembolization. In holmium-166 ([166Ho]) radioembolization, the lung mean dose (LMD) can be estimated (eLMD) using a scout dose with either technetium-99 m-macroaggregated albumin ([99mTc]MAA) or [166Ho]-microspheres. The accuracy of eLMD based on [99mTc]MAA (eLMDMAA) was compared to eLMD based on [166Ho]-scout dose (eLMDHo-scout) in two prospective clinical studies.Materials and MethodsPatients were included if they received both scout doses ([99mTc]MAA and [166Ho]-scout), had a posttreatment [166Ho]-SPECT/CT (gold standard) and were scanned on the same hybrid SPECT/CT system. The correlation between eLMDMAA/eLMDHo-scout and LMDHo-treatment was assessed by Spearman’s rank correlation coefficient (r). Wilcoxon signed rank test was used to analyze paired data.ResultsThirty-seven patients with …

Cardiovascular and interventional radiology

PurposeAntiangiogenic agents have been used for many years as a first-line systemic treatment for advanced HCC. Embolization with cytostatic drugs on the other hand is the first-line treatment for intermediate HCC. The two types of drugs have not been combined for intraarterial delivery yet. The loading and release dynamics and the in vitro effect of their combination are tested in this experimental study.Materials and MethodsDrug-eluting beads were loaded with doxorubicin, sunitinib and sunitinib analogue piperazine (SAP) alone and with their combinations. Diameter change, loading, release, and effect in cellular proliferation were assessed.ResultsThe average microsphere diameter after loading was 473.7 µm (μm) for Doxorubicin, 388.4 μm for Sunitinib, 515.5 μm for SAP, 414.8 μm for the combination Doxorubicin/Sunitinib and 468.8 μm for the combination Doxorubicin /SAP. Drug release in 0.9% NaCl was …

CardioVascular and Interventional Radiology

PurposeTo evaluate the benefit of a contrast-enhanced computed tomography (CT) radiomics-based model for predicting response and survival in patients with colorectal liver metastases treated with transarterial Yttrium-90 radioembolization (TARE).Materials and MethodsFifty-one patients who underwent TARE were included in this single-center retrospective study. Response to treatment was assessed using the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) at 3-month follow-up. Patients were stratified as responders (complete/partial response and stable disease, n= 24) or non-responders (progressive disease, n= 27). Radiomic features (RF) were extracted from pre-TARE CT after segmentation of the liver tumor volume. A model was built based on a radiomic signature consisting of reliable RFs that allowed classification of response using multivariate logistic regression. Patients were assigned to …

CardioVascular and Interventional Radiology

Cardiovasc Intervent Radiol https://doi. org/10.1007/s00270-024-03665-5 physician and service distribution [2, 3]. Our study, therefore, aimed to explore the current perception of IR among radiology residents in Tanzania, examining the influence of a half-day educational intervention comprising lectures and workshops on IR basics. We conducted a study in Tanzania to assess the perceptions of radiology residents toward IR. Our methods involved delivering an IR lecture series to radiology trainees, led by local and international interventional radiologists. The study’s efficacy was measured through pre-and post-lecture surveys, focusing on residents’ exposure to IR, their interest levels, and their awareness of relevant pathologies. The results were telling: Of the 68 residents, 44 (64.8%) and 40 (58.8%) completed the pre-and post-lecture surveys, respectively. Initially, only a quarter reported having hands-on IR …

CardioVascular and Interventional Radiology

BackgroundThe number of fluoroscopically guided interventions (FGI) has increased significantly over time. However, little attention has been paid to possible stochastic radiation effects. The aim of this retrospective study was to investigate the number of patients who received cumulative effective doses over 100 mSv during FGI procedures.Material and MethodsFive thousand five hundred and fifty four classified FGI procedures were included. Radiation dose data, retrieved from an in-house-dose-management system, was analysed. Effective doses and cumulative effective doses (CED) were calculated. Patients who received a CED > 100 mSv were identified. Radiology reports, patient age, imaging and clinical data of these patients were used to identify reasons for CED ≥ 100 mSv.ResultsOne Hundred and thirty two (41.1% female) of 3981 patients received a CED > 100 mSy, with a mean CED of 173.5 ± …

CardioVascular and Interventional Radiology

PurposeTo evaluate the safety, technical success and short-term effectiveness of polyurethane-covered stent (PK Papyrus, BioTronik, Berlin) in the treatment of pulmonary arteriovenous malformations (PAVMs) that are not amenable to embolotherapy.Materials and MethodsIn this IRB-approved, retrospective study, data from patients who received polyurethane-covered stents for exclusion of PAVMs were analyzed. The study included 5 patients (all women) with a median age of 40 years (range 25–60). Patients presented with hypoxemia, TIAs, and/or epistaxis; 4 were confirmed to have HHT. All had multiple PAVMs diagnosed on chest CT and underwent embolization with other devices in addition to the polyurethane-covered stent. The indication for stent placement in all cases was a short and/or tortuous feeding artery. Safety was assessed by immediate or short-term complications, e.g., migration, stent thrombosis …

CardioVascular and Interventional Radiology

Patients undergoing stent reconstruction for thoracic central venous obstruction (TCVO) may require long-term central venous catheters (CVCs) for dialysis, chemotherapy, hydration, or nutrition [1]. The presence of venous stent constructs may pose a challenge in placement and function of CVCs. This report describes three patients who underwent chest port catheter placement through central venous stent interstices. Institutional review board approval was not required for preparation of this report.

Cardiovascular and interventional radiology

Purpose Intermediate-stage hepatocellular carcinoma (HCC) is usually treated with locoregional therapy using transarterial chemoembolization (TACE). Transarterial radioembolization (TARE) using β-emitting yttrium-90 integral to the glass matrix of the microspheres is an alternative to TACE. This retrospective case-control study compared the outcomes and safety of TARE versus TACE in patients with unresectable HCC. Materials and Methods Patients with unresectable HCC without portal vein thrombosis treated with TARE between 2005 and 2008 (n = 61) were retrospectively frequency-matched by age, sex, and liver dysfunction with TACE-treated patients (n = 55) in the Mayo Clinic Hepatobiliary Neoplasia Registry. Imaging studies were reviewed, and clinical and safety outcomes were abstracted from the medical records …