In vivo imaging and pharmacokinetics of percutaneously injected ultrasound and X-ray imageable thermosensitive hydrogel loaded with doxorubicin versus free drug in swine.

Intratumoral injections often lack visibility, leading to unpredictable outcomes such as incomplete tumor coverage, off-target drug delivery and systemic toxicities. This study investigated an ultrasound (US) and x-ray imageable thermosensitive hydrogel based on poloxamer 407 (POL) percutaneously delivered in a healthy swine model. The primary objective was to assess the 2D and 3D distribution of the hydrogel within tissue across three different needle devices and injection sites: liver, kidney, and intercostal muscle region.

Imaging and Pharmacokinetics of Percutaneously Injected Ultrasound and X-ray Imageable Thermosensitive Hydrogel loaded with Doxorubicin versus Free Drug in Swine.

Intratumoral injections often lack visibility, leading to unpredictable outcomes such as incomplete tumor coverage, off-target drug delivery and systemic toxicities. This study investigated an ultrasound (US) and x-ray imageable thermosensitive hydrogel based on poloxamer 407 (POL) percutaneously delivered in a healthy swine model. The primary objective was to assess the 2D and 3D distribution of the hydrogel within tissue across three different needle devices and injection sites: liver, kidney, and intercostal muscle region.

Ultrasound and x-ray imageable poloxamer-based hydrogel for loco-regional therapy delivery in the liver.

Intratumoral injections have the potential for enhanced cancer treatment efficacy while reducing costs and systemic exposure. However, intratumoral drug injections can result in substantial off-target leakage and are invisible under standard imaging modalities like ultrasound (US) and x-ray. A thermosensitive poloxamer-based gel for drug delivery was developed that is visible using x-ray imaging (computed tomography (CT), cone beam CT, fluoroscopy), as well as using US by means of integrating perfluorobutane-filled microbubbles (MBs).

X-ray imageable, drug-loaded hydrogel that forms at body temperature for image-guided, needle-based locoregional drug delivery.

Liver cancer ranks as the fifth leading cause of cancer-related death globally. Direct intratumoral injections of anti-cancer therapeutics may improve therapeutic efficacy and mitigate adverse effects compared to intravenous injections. Some challenges of intratumoral injections are that the liquid drug formulation may not remain localized and have unpredictable volumetric distribution.

X-ray imageable, drug-loaded hydrogel that forms at body temperature for image-guided, needle- based locoregional drug delivery.

Liver cancer ranks as the fifth leading cause of cancer-related death globally. Direct intratumoral injections of anti-cancer therapeutics may improve therapeutic efficacy and mitigate adverse effects compared to intravenous injections. Some challenges of intratumoral injections are that the liquid drug formulation may not remain localized and have unpredictable volumetric distribution.

Smartphone Augmented Reality Outperforms Conventional CT Guidance for Composite Ablation Margins in Phantom Models.

Purpose: To develop and evaluate a smartphone augmented reality (AR) system for a large 50-mm liver tumor ablation with treatment planning for composite overlapping ablation zones.

Materials And Methods: A smartphone AR application was developed to display tumor, probe, projected probe paths, ablated zones, and real-time percentage of the ablated target tumor volume. Fiducial markers were attached to phantoms and an ablation probe hub for tracking.

Hydrogel drug delivery systems for minimally invasive local immunotherapy of cancer.

Although systemic immunotherapy has achieved durable responses and improved survival for certain patients and cancer types, low response rates and immune system-related systemic toxicities limit its overall impact. Intratumoral (intralesional) delivery of immunotherapy is a promising technique to combat mechanisms of tumor immune suppression within the tumor microenvironment and reduce systemic drug exposure and associated side effects. However, intratumoral injections are prone to variable tumor drug distribution and leakage into surrounding tissues, which can compromise efficacy and contribute to toxicity.

Precision Imaging Guidance in the Era of Precision Oncology: An Update of Imaging Tools for Interventional Procedures.

Interventional oncology (IO) procedures have become extremely popular in interventional radiology (IR) and play an essential role in the diagnosis, treatment, and supportive care of oncologic patients through new and safe procedures. IR procedures can be divided into two main groups: vascular and non-vascular. Vascular approaches are mainly based on embolization and concomitant injection of chemotherapeutics directly into the tumor-feeding vessels.

Lifesaving embolization in a massive lumbar artery bleeding: Interventional radiology management.

Vertebral fractures are the most frequent fractures associated with osteoporosis. Thus far, there are no reported cases in literature analyzing intervertebral bleeding as a result of an osteoporotic vertebral fracture. The authors report a case of an 85-year-old woman in hemorrhagic shock for an unusual vertebral fracture causing a massive bleeding, which was contained by the vertebral ligament system inside the body of L4, treated with an endovascular approach.

Giant intracranial aneurysm following radiation therapy: literature review with a novel case discussion.

Background: The aim of this paper is to report the results of our review of the literature of published cases of intracranial aneurysms appearing after radiotherapy, and to present our case to add it to the current literature, in order to discuss the role of inflammation.

Methods: We searched the PubMed database using combinations of the following MeSH terms: intracranial aneurysm, radiosurgery, radiotherapy, inflammatory changes in aneurysmal walls from 1967 to 2019.

Results: 51 studies, for a total cohort of 60 patients, are described.

Cooled radiofrequency ablation technology for painful bone tumors.

Bone metastases are a common cause of cancer-related debilitating pain, especially when -localized in the vertebral column and not responsive to standard treatment. In such cases, various treatment options are available; among these is Radiofrequency, whose role has been rapidly growing over the past few years. In this study, we used the innovative Osteocool RF Ablation System (Medtronic) on a patient with a painful bone metastasis localized in the 5th lumbar vertebra, with encouraging results.

Glue embolization of a pial arteriovenous fistula of the spinal artery.

There are no clear guidelines about the treatment Pial Arteriovenous Fistulae (PAVF). For high-risk and severally symptomatic fistulae surgery is the first choice of treatment, including feeding artery ligation, surgical resection, radiosurgery and endovascular embolization techniques. We described a case of a patient with a symptomatic PAVF at the craniocervical junction fed by the anterior spinal artery, successfully treated with endovascular approach consisting of glue embolization of the feeding vessel.

Branch vessel occlusion in aneurysm treatment with flow diverter stent.

Flow diverter placement for treatment of intracranial aneurysms gained growing consensus in the past years. A major concern among professionals is the side branch coverage which leads in some cases to vessel occlusion. However, the lost vessel patency only infrequently is accompanied by a new onset of neurological deficits secondary to ischaemic lesions.

Prostatic artery embolization in patients with benign prostatic hyperplasia: perfusion cone-beam CT to evaluate planning and treatment response.

This proof of concept is to evaluate the utility of perfusion cone-beam computed tomography (CT) in patients undergoing prostatic artery (PA) embolization (PAE) for benign prostatic hyperplasia (BPH) with moderate or severe-grade lower urinary tract symptoms (LUTS). PAE is a novel minimally invasive therapy and is both safe and effective procedure with low risks and high technical successes, making this procedure as the best alternative to surgery. A lot of technical changes would compromise clinical outcomes after procedure, including a variable prostate vascular anatomy, thin PA, and extensive atherosclerotic disease.

Flow diverting devices in acute ruptured blood blister aneurysms: a three centric retrospective study.

Background: Blood blister aneurysms (BBAs) are a rare tiny subset of intracranial aneurysms, located at the nonbranching site of an artery, representing a therapeutic challenge from both surgical and endovascular approach. Flow-diverting efficacy, by preserving flow through the parent artery, was approved for its use in unruptured cerebral aneurysms, but no consensus was reached on its use for BBAs ruptured in the acute setting. We report a multicenter experience of use of flow diversion in acute setting of ruptured BBA, to analyze the safety and efficacy of these devices.

Efficacy, safety and usability of bronchial artery embolization using a new anti-reflux microcatheter in the management of haemoptysis.

Purpose: Haemoptysis (Hp) is a potentially life-threatening medical condition. We investigated the safety, efficacy and usability of bronchial artery embolization using a new anti-reflux microcatheter in patients with haemoptysis.

Materials And Methods: The study was held as a single-center retrospective study.

Software-assisted US/MRI fusion-targeted biopsy for prostate cancer.

Background: Prostate cancer is the first cancer diagnosis in men. European Association of Urology  (EAU) Guidelines for Prostate Cancer underline the importance of screening, performed through PSA testing on all men with more than 50 years of age and before on men with risk factors. The diagnosis is still histopathologic, and it is done on the basis of the findings on biopsy samples.

Percutaneous lung microwave ablation versus lung resection in high-risk patients. A monocentric experience.

Background And Aim Of Work: Lung microwave ablation (MWA) is considered an alternative treatment in high-risk patients, not suitable for surgery. The aim of our study is to compare MWA and pulmonary lobectomy in high-risk, lung cancer patients.

Methods: This was a single-center, propensity score--weighted cohort study.

Interventional radiology management of high flow priapism: review of the literature.

Introduction: High-flow priapism is a persistent partial penile tumescence, related to high flow arterial blood into the corpora. In the treatment of high flow priapism, super-selective embolization is considered treatment of choice when conservative treatment fails as reported in the "EAU Guidelines on Priapism", but there are only few series reporting the outcome, the efficacy of different embolic materials and these studies are uncontrolled and relatively small.

Objectives: The aim of this study is to review the literature to outline the state of the art of this interventional treatment and to analyse the outcome of the different embolic agents.

Use of perfusional CBCT imaging for intraprocedural evaluation of endovascular treatment in patients with diabetic foot: a concept paper.

Diabetes mellitus (DM) is one of the most common metabolic diseases worldwide; its global burden has increased rapidly over the past decade, enough to be considered a public health emergency in many countries. Diabetic foot disease and, particularly diabetic foot ulceration, is the major complication of DM: through a skin damage of the foot, with a loss of epithelial tissue, it can deepen to muscles and bones and lead to the amputation of the lower limbs. Peripheral arterial disease (PAD) in patients with diabetes, manifests like a diffuse macroangiopathic multi-segmental involvement of the lower limb vessels, also connected to a damage of collateral circulation; it may also display characteristic microaneurysms and tortuosity in distal arteries.

Image-guided percutaneous mechanical disc decompression for herniated discs: a technical note.

Interventional radiology plays a key role in the treatment of symptomatic herniations of intervertebral discs. Through image-guided techniques, it is possible to use minimally invasive procedures with a percutaneous approach that are usually proposed before classic surgery. Thanks to imaging guidance, it is possible to significantly increase accuracy and decrease complication rates.

Bedside vascular access procedures for COVID-19 patients.

This report aims to illustrate how to perform a venous access to a COVID-19 patient at the bedside. The decision on the type of venous access, the selection of the material necessary to perform the procedure, and the preparation of the operators are described. The described approach can reduce costs, speed up execution times, and make the operator's work safer.