Radioembolization as a Treatment Strategy for Metastatic Colorectal Cancer to the Liver: What Can We Learn from the SIRFLOX Trial?

In the setting of liver metastases from colorectal cancer (CRC), radioembolization with yttrium-90 has been used to treat chemotherapy refractory disease with a growing interest to establish its efficacy in prospective trials combined with first- and second-line chemotherapy. SIRFLOX is an ongoing, multi-center, phase 3 randomized trial comparing first-line chemotherapy alone or in combination with yttrium-90 radioembolization in patients with CRC who have isolated liver metastases or liver-dominant metastases. Preliminary results from SIRFLOX demonstrate that radioembolization combined with first-line chemotherapy is safe and feasible.

Transthoracic Computed Tomography-Guided Lung Nodule Biopsy: Comparison of Core Needle and Fine Needle Aspiration Techniques.

Purpose: To determine if there is a statistically significant difference in the computed tomography (CT)-guided trans-thoracic needle biopsy diagnostic rate, complication rate, and degree of pathologist confidence in diagnosis between core needle biopsy (CNB) and fine needle aspiration biopsy (FNAB).

Methods: A retrospective cohort design was used to compare the diagnostic biopsy rate, diagnostic confidence, and biopsy-related complications of pneumothorax, chest tube placement, pulmonary hemorrhage, hemoptysis, admission to hospital, and length of stay between 251 transthoracic needle biopsies obtained via CNB (126) or FNAB (125). Complication rates were assessed using imaging and clinical follow-up.

Percutaneous autologous pancreatic islet cell transplantation for traumatic pancreatic injury.

Context: Traumatic pancreatic injury with pancreatic duct disruption is surgically managed with at least a partial pancreatectomy, often leading to poor blood glucose control and the subsequent development of diabetes mellitus. Autologous β-islet cell transplantation may therefore help to preserve pancreatic endocrine function.

Case Description: We describe 3 patients with pancreatic duct disruption from traumatic pancreatic injury who were treated with a partial pancreatectomy followed by autologous β-islet cell transplantation via a percutaneous transhepatic approach.

Dynamic arterial and valsalva-augmented venous phase multidetector CT for orbital vascular lesions: a pictorial review*.

Purpose: To describe the value and purpose of a new method of dynamic arterial and Valsalva-augmented venous phase CT angiographic assessment of vascular orbital lesions.

Methods: Description of a dynamic arterial and Valsalva-augmented venous phase multidetector CT protocol currently being used at the institution of the authors for investigation of orbital vascular lesions. Research ethics approval was not required by the institution because this is a 1-case report, with a pictorial review of imaging findings in various representative orbital vascular lesions.

Renal hyperperfusion injury resulting in transient proteinuria post renal artery angioplasty for fibromuscular dysplasia.

Renovascular hypertension (RVH) can be treated utilizing medical, surgical or endovascular techniques. We present a case in which severe exacerbation of pre-existing proteinuria followed percutaneous transluminal angioplasty of a highly stenotic renal artery to relieve RVH caused by fibromuscular dysplasia. We propose that the worsening proteinuria post-angioplasty was caused by a transient renal hyperperfusion injury that overcame the glomerular autoregulatory mechanisms, thereby leading to raised intraglomerular pressures and loss of proteins through the glomerular filtration barrier until the vascular autoregulatory ability of the glomeruli was successfully re-established.

Lung nodules in children: video-assisted thoracoscopic surgical resection after computed tomography-guided localization using a microcoil.

Background: Lung nodules that develop in children with cancer may represent metastatic disease or other conditions potentially requiring aggressive treatment. Thoracoscopic methods have been used for nodule resection; however, lesions deep in the lung parenchyma can be difficult to visualize. Fluoroscopic-guided thoracoscopic surgical resection after computed tomography (CT)-guided localization using microcoils has been described in the adult literature and has the potential to assist in the resection of deep pulmonary nodules in children.