Publications by authors named "Bruno Odisio"
Objective: To evaluate the relevance of established surgical risk calculators (SRCs) for predicting complications in patients undergoing percutaneous lung cryoablation (PLC).
Methods: The institution's database was queried for PLC procedures from March 2015 to May 2024, excluding those patients with concomitant local therapies or five or more lesions treated in a single setting. Demographics, frailty metrics as defined by the surgical literature, and procedural variables were collected.
Purpose: To develop a machine-learning algorithm to improve hepatic resection selection for metastatic colorectal cancer patients by predicting post-PVE outcomes.
Material & Methods: This multicenter retrospective study (2000-2020) included 200 consecutive patients with CRC liver-metastases planned for PVE before surgery. Radiomic features and lab values were collected.
Background: Liver venous deprivation (LVD) is known to induce better future liver remnant (FLR) hypertrophy than portal vein embolization (PVE). The role of LVD, compared with PVE, in inducing FLR hypertrophy and allowing safe hepatectomy for patients with extensive colorectal liver metastases (CLM) and high-risk factors for inadequate hypertrophy remains unclear.
Methods: Patients undergoing LVD (n = 22) were matched to patients undergoing PVE (n = 279) in a 1:3 ratio based on propensity scores, prior to planned hepatectomy for CLM at a single center (1998-2023).
Article Synopsis
- The study investigates the effectiveness of radiation therapy (RT) for intrahepatic cholangiocarcinoma (iCCA) and explores a new approach to assess treatment response using quantitative measures rather than traditional size-based methods.
- By analyzing CT scans from 154 patients, researchers found that changes in viable tumor volume after RT are better indicators of overall survival (OS) compared to standard RECIST criteria, with a notable threshold of a 33% reduction in viable volume signaling optimal treatment response.
- The findings highlight the potential for personalized RT approaches based on individual tumor characteristics, suggesting that mathematical models derived from CT imaging can improve patient outcomes by identifying optimal treatment protocols.
Identification of A0 minimum ablative margins for colorectal liver metastases: multicentre, retrospective study using deformable CT registration and artificial intelligence-based autosegmentation.
Br J Surg
August 2024
Article Synopsis
- Several new software methods have been developed to assess the minimum ablative margin during thermal ablation of colorectal liver metastases, aiming to enhance patient outcomes in a multi-institutional context.
- This retrospective study analyzed 400 cases of thermal ablation over 13 years, focusing on minimum ablative margins and their correlation with local disease progression rates.
- Results showed that a minimum ablative margin of 5 mm or more significantly reduces the risk of local tumor progression, confirming the importance of this margin across various institutions.
Image-guided ablation procedures have become a mainstay in cancer therapy. Typically performed from a percutaneous approach, thermal-based ablation procedures rely heavily on imaging guidance both prior to and during the procedure itself. Advances in imaging as they relate to ablation procedures are as important to successful treatments as advancements in the ablation technology itself.
View Article and Find Full Text PDFArticle Synopsis
- Treatment options for recurrent or metastatic soft-tissue sarcoma (STS) are limited after initial therapies, which is where percutaneous cryoablation could serve as a minimally invasive alternative for local control.
- A study conducted on 141 patients showed that among 217 cryoablation procedures, the procedure had a low complication rate of 2% and achieved adequate coverage for 82% of tumors.
- The 1-year local progression-free survival rate was 86%, with overall survival rates of 89% at 1 year and 80% at 2 years, suggesting effective outcomes for patients with treatment-refractory STS.
Article Synopsis
- Interventional oncology involves procedures like tumor characterization and destruction, which can be complex due to difficult access and risk factors.
- Various robotic systems have been developed to minimize human error and variability during these procedures, aiming to improve accuracy and reduce risks associated with radiation exposure.
- This review compiles evidence on the clinical effectiveness and safety of these robotic tools in treating nonhepatic malignancies, highlighting their potential benefits for patient outcomes.
Article Synopsis
- * By utilizing contrast-enhanced CT images from three patients, the researchers simulated temperature distribution during MWA, aiming to predict effective ablation zones for better treatment planning.
- * Results showed a strong correlation between predicted and actual ablation zones, with Dice scores ranging from 0.73 to 0.86, demonstrating that these 3D models can enhance accuracy in MWA strategies and treatment outcomes.
Background: Our purpose is to evaluate the long-term oncologic efficacy and survival rates of MRI-guided cryoablation for patients with biopsy-proven cT1a renal cell carcinoma (RCC).
Materials And Methods: We retrospectively reviewed our renal ablation database between January 2007 and June 2021 and only included patients with solitary-biopsy-proven cT1a RCC (≤4 cm) who underwent MRI-guided cryoablation. We excluded patients with genetic syndromes, bilateral RCC, recurrent RCC or benign lesions, those without pathologically proven RCC lesions and patients who underwent radiofrequency ablation or CT-guided cryoablation.
Background: Liver-directed treatments - ablative therapy (AT), surgical resection (SR), liver transplantation (LT), and transarterial chemoembolization (TACE) - improve the overall survival of patients with early-stage hepatocellular carcinoma (HCC). Although racial and socioeconomic disparities affect access to liver-directed therapies, the temporal trends for the curative-intent treatment of HCC remain to be elucidated.
Methods: This study performed chi-square, logistic regression, and temporal trends analyses on data from the Nationwide Inpatient Sample from 2011 to 2019.
A Single-Center Experience with a Shear-Thinning Conformable Embolic.
J Vasc Interv Radiol
August 2024
Article Synopsis
- The study assessed the use of a new embolic agent, Obsidio conformable embolic (OCE), for managing acute bleeding through transarterial embolization in 11 patients.
- Technical success was achieved in all cases, with a 100% rate of successfully stopping bleeding in various conditions, including tumor bleeding and hematuria.
- The procedure had a favorable safety profile, with no complications or unintended embolization observed, indicating OCE's effectiveness and safety for such interventions.
Purpose: To evaluate outcomes following percutaneous image-guided ablation of soft tissue sarcoma metastases to the liver.
Materials And Methods: A single-institution retrospective analysis of patients with a diagnosis of metastatic soft tissue sarcoma who underwent percutaneous image-guided ablation of hepatic metastases between January 2011 and December 2021 was performed. Patients with less than 60 days of follow-up after ablation were excluded.
With the rapidly evolving field of image-guided tumor ablation, there is an increasing demand and need for tools to optimize treatment success. Known factors affecting the success of (non-)thermal liver ablation procedures are the ability to optimize tumor and surrounding critical structure visualization, ablation applicator targeting, and ablation zone confirmation. A recent study showed superior local tumor progression-free survival and local control outcomes when using transcatheter computed tomography hepatic angiography (CTHA) guidance in percutaneous liver ablation procedures.
View Article and Find Full Text PDFBackground: Postoperative hepatic insufficiency (PHI) is the most feared complication after hepatectomy. Volume of the future liver remnant (FLR) is one objectively measurable indicator to identify patients at risk of PHI. In this review, we summarized the development and rationale for the use of liver volumetry and liver-regenerative interventions and highlighted emerging tools that could yield new advancements in liver volumetry.
View Article and Find Full Text PDFManual delineation of liver segments on computed tomography (CT) images for primary/secondary liver cancer (LC) patients is time-intensive and prone to inter/intra-observer variability. Therefore, we developed a deep-learning-based model to auto-contour liver segments and spleen on contrast-enhanced CT (CECT) images. We trained two models using 3d patch-based attention U-Net ([Formula: see text] and 3d full resolution of nnU-Net ([Formula: see text] to determine the best architecture ([Formula: see text].
View Article and Find Full Text PDFObjectives: To evaluate the technical success and outcomes of renal biopsies performed under magnetic resonance imaging (MRI) using a closed-bore, 1.5-Tesla MRI unit.
Materials And Methods: We retrospectively reviewed our institutional biopsy database and included 150 consecutive MRI-guided biopsies for renal masses between November 2007 and March 2020.
Article Synopsis
- CT hepatic arteriography (CTHA) is very effective at detecting colorectal liver metastases (CLMs) but struggles with specificity for small, incidental lesions due to pseudolesions and ambiguous imaging signatures.
- A study involving 22 patients highlighted the identification of incidental ring-hyperenhancing liver micronodules (RHLMs) during CTHA, revealing that 41.7% of CTHA images contained these nodules, with many subsequently confirmed as CLMs.
- The research suggests that RHLMs detected in CTHA may serve as an early indicator for small CLMs, which could help in improving the accuracy of liver ablation procedures.
Article Synopsis
- The study aimed to evaluate how effectively two different image registration methods—deformable (DIR) and rigid (RIR)—can quantify minimal ablative margins (MAM) in patients undergoing thermal ablation for colorectal liver metastasis (CLM).
- Out of 72 patients analyzed, DIR showed better registration accuracy (0.96-0.98) compared to RIR (0.67-0.98), along with a higher predictive capability for local tumor outcomes, evidenced by a higher AUC (0.89 vs. 0.72).
- The results suggest that DIR is a superior method for quantifying MAM during intraprocedural CT imaging, thus improving the prediction of local tumor outcomes after thermal
Interventional oncology (IO) is the field of Interventional Radiology that provides minimally invasive procedures under imaging guidance for the diagnosis and treatment of malignant tumors. Sophisticated devices can be utilized to increase standardization, accuracy, outcomes, and "repeatability" in performing percutaneous Interventional Oncology techniques. These technologies can reduce variability, reduce human error, and outperform human hand-to-eye coordination and spatial relations, thus potentially normalizing an otherwise broad diversity of IO techniques, impacting simulation, training, navigation, outcomes, and performance, as well as verification of desired minimum ablation margin or other measures of successful procedures.
View Article and Find Full Text PDFBackground: Early recurrence following hepatectomy for colorectal liver metastases (CLM) is associated with worse survival; yet, impact of further local therapy is unclear. We sought to evaluate whether local therapy benefits patients with early recurrence following hepatectomy for CLM.
Methods: Clinicopathologic and survival outcomes of patients managed with hepatectomy for CLM (1/2001-12/2020) were queried from a prospectively maintained database.
Article Synopsis
- The study focuses on the importance of using personalized medicine approaches, particularly survival prediction models, rather than relying solely on generalized evidence from clinical trials, highlighting the relevance of patient-specific outcomes.
- Bayesian parametric survival models were developed and assessed against traditional models like Cox Proportional Hazards and Random Survival Forest, demonstrating their effectiveness with less complexity in parameter tuning and lower risk of overfitting.
- The research indicates that Bayesian models not only perform comparably to existing models but also offer the advantage of refining predictions through Bayes rule without the need for full retraining, thus enhancing their practicality in medical settings.
Intraprocedural Versus Initial Follow-up Minimal Ablative Margin Assessment After Colorectal Liver Metastasis Thermal Ablation: Which One Better Predicts Local Outcomes?
Invest Radiol
April 2024
Objectives: The aim of this study was to investigate the prognostic value of 3-dimensional minimal ablative margin (MAM) quantified by intraprocedural versus initial follow-up computed tomography (CT) in predicting local tumor progression (LTP) after colorectal liver metastasis (CLM) thermal ablation.
Materials And Methods: This single-institution, patient-clustered, tumor-based retrospective study included patients undergoing microwave and radiofrequency ablation between 2016 and 2021. Patients without intraprocedural and initial follow-up contrast-enhanced CT, residual tumors, or with follow-up less than 1 year without LTP were excluded.
Study Protocol STEREOLAB: Stereotactic Liver Ablation Assisted with Intra-Arterial CT Hepatic Arteriography and Ablation Confirmation Software Assessment.
Cardiovasc Intervent Radiol
December 2023
Article Synopsis
- This study evaluates a standardized method for thermal ablation of colorectal liver metastases (CRLM), focusing on technical effectiveness and local tumor progression-free survival (LTPFS).
- The trial will include up to 50 patients, assessing various factors like minimal ablative margins, adverse events, and anesthesia time over a follow-up period of up to 2 years.
- The STEREOLAB trial aims to implement a precise workflow using advanced imaging and guidance techniques to improve ablation outcomes for CRLM patients.