Recently elucidated energy catabolism pathways provide opportunities for novel treatments in hepatocellular carcinoma.

It has long been known that tumors depend on energy production pathways that are different from those of normal cells. These unique pathways require the expression and function of tumor-specific enzymes. Some of these glycolytic enzymes, as well as other modulators of tumor behavior, have recently been elucidated.

Percutaneous management of bile duct strictures and injuries associated with laparoscopic cholecystectomy: a decade of experience.

Background: The 1990s were associated with a dramatic increase in bile duct injuries with the widespread use of laparoscopic cholecystectomy (LC). Interventional radiology has an integral role in diagnosing and managing these injuries. Definitive percutaneous management with balloon dilatation might be possible in select patients with intact biliary-enteric continuity, but longterm data are limited.

The outcome of liver transplantation in patients with hepatocellular carcinoma in the United States between 1988 and 2001: 5-year survival has improved significantly with time.

Purpose: We hypothesized that the outcome of liver transplantation in patients with hepatocellular carcinoma (HCC) has improved over the past decade because of the application of published criteria for patient selection. In this study, we compared the outcome of liver transplantation in patients with and without HCC at different time periods using the United Network for Organ Sharing data.

Patients And Methods: We excluded children, patients with multiple organ transplantation or retransplantation, and those with incomplete survival data.

Initial experience in small animal tumor imaging with a clinical positron emission tomography/computed tomography scanner using 2-[F-18]fluoro-2-deoxy-D-glucose.

The feasibility of small animal imaging using a clinical positron emission tomography/computed tomography (PET/CT) scanner with [F-18]-fluoro-2-deoxy-D-glucose (FDG) was evaluated. As tumor-bearing small animal models, rabbits with VX-2 liver tumors, rats with mammary tumors on the back, and mice with LS174T human colon tumor xenografts were prepared. Two-dimensional PET, CT, and fused PET/CT images were obtained and reconstructed with a combined PET/CT system using a conventional protocol for humans and dedicated high-resolution mode protocols specialized for each species.

Thrombolytic therapy in the setting of arterial line-induced ischemia.

Purpose: To evaluate the use of percutaneous transcatheter thrombolysis in the treatment of thrombosis due to radial artery cannulation.

Methods And Results: Seven patients (4 women; age range 41-62 years) with symptomatic cannulation-induced thrombosis and failure to improve after systemic anticoagulation underwent 8 catheter-directed thrombolytic infusions at our institution over a 3-year period. Access was either antegrade through the brachial artery or retrograde through the femoral artery.

Chemoembolization of hepatocellular carcinoma: results of a metaanalysis.

Transcatheter arterial chemoembolization is considered the mainstay of therapy for unresectable hepatocellular carcinoma. The purpose of this study was to assess the impact of such treatment on survival by performing a metaanalysis of all available randomized clinical trials comparing this form of therapy to supportive care. A MEDLARS search was conducted covering the years 1970 to 2002.

Perineal application of cosmetic talc and risk of invasive epithelial ovarian cancer: a meta-analysis of 11,933 subjects from sixteen observational studies.

Objective: Prior epidemiological studies suggest an association between perineal cosmetic talc use and increased risk of epithelial ovarian cancer. A meta-analysis was performed to evaluate this suspected association.

Materials And Methods: Using previously described methods, a protocol was developed for a meta-analysis examining the association between perineal talc use versus non-use and the development of invasive epithelial ovarian cancer.

Spontaneous renal artery dissection: treatment with coil embolization.

A 47-year-old man presented with nonspecific left flank pain and severe hypertension as a result of a spontaneous dissection of an accessory renal artery. Because of the progressive increase in the size of the dissection flap and uncontrollable hypertension, treatment with segmental embolization of the true and false lumen of the accessory renal artery was performed with successful clinical outcome. This case report will address the salient clinical features of spontaneous renal artery dissections and treatment options.

Can ethanol therapies injure the bile ducts?

Administration of ethanol, whether applied directly to tissue or via an intra-arterial route, has been widely used to treat a variety of hepatic disorders, most importantly hepatocellular carcinoma. Animal studies, however, have demonstrated that intravascular hepatic ethanol therapy causes significant bile duct injury, and therefore, many centers have used intravascular ethanol applications with caution. A case of extensive bile duct injury in a 35-year-old female with a symptomatic hepatic hemangioma treated with ethanol embolization is presented.

Transcatheter arterial chemoembolization of liver tumors: effects of embolization protocol on injectable volume of chemotherapy and subsequent arterial patency.

The purpose of this study was to determine whether transcatheter arterial chemoembolization (TACE) protocol affects the total volume of chemotherapy injected into the liver as well as subsequent arterial patency. A total of 160 patients with primary or secondary liver cancer were treated with 3 different chemoembolization protocols at a single institution. Data were analyzed retrospectively.

Pancreaticoduodenectomy: role of interventional radiologists in managing patients and complications.

Although the mortality rate after pancreaticoduodenectomy has decreased, the morbidity rate remains high. Major morbidity is often managed with the aid of interventional radiologists. The objective of this study was to evaluate the cooperative roles of interventional radiologists and pancreatic surgeons in complex pancreatic surgery, specifically pancreaticoduodenectomy.

Phase II study of the efficacy and safety of cisplatin-epinephrine injectable gel administered to patients with unresectable hepatocellular carcinoma.

Purpose: To study the efficacy and safety of percutaneous cisplatin-epinephrine (CDDP-EPI) injectable gel in patients with localized unresectable hepatocellular carcinoma (HCC).

Patients And Methods: Eligible patients had histologically proven HCC, no prior treatment except for surgery, and no more than three tumors (each measured < or = 7 cm, total tumor volume < or = 200 cm(3)). They were treated percutaneously under ultrasound or computed tomography (CT) guidance, with up to 10 mL of CDDP-EPI gel (1 mL contains 4 mg of CDDP and 0.

Metastatic breast carcinoma presenting as a large pulmonary embolus: case report and review of the literature.

Involvement of the pulmonary vasculature by carcinoma of the breast typically occurs in the form of microscopic tumor emboli involving the small arteries, arterioles, or capillaries. Obstruction of a large pulmonary artery by a tumor embolus has not been reported. We describe a patient with a history of breast carcinoma diagnosed 5 years previously who sought treatment for dyspnea and a large mass in the right pulmonary artery suggestive of a pulmonary embolus.

Pulmonary embolization of bovine collagen.

A bovine collagen matrix is sometimes used as a delivery medium during direct intratumoral injection of a chemotherapeutic agent. The bovine collagen enhances the dose and duration of local drug delivery and limits systemic toxicity. Although this strategy is advocated as a means of easy and effective delivery of chemotherapeutic drugs, the associated risks are not well defined.

Chemoembolization of hepatocellular carcinoma--what to tell the skeptics: review and meta-analysis.

Transcatheter arterial chemoembolization (TACE) has become the standard treatment for patients with unresectable hepatocellular carcinoma (HCC). When untreated, patients with inoperable HCC have a median survival of three months. Given the widespread use of chemoembolization, accurate evidence of the impact of TACE on patient survival is critical.

Percutaneous peritoneal dialysis catheter placement for the management of end-stage renal disease: technique and comparison with the surgical approach.

As the incidence of end-stage renal disease is increasing, so is the pressure on the health care system to promote less expensive and burdensome management solutions. Peritoneal dialysis (PD) has been increasingly used and is especially suited for patients who, in exchange for meticulous care and technique, enjoy more independence and fewer clinic visits than their counterparts on hemodialysis. Both the efficiency and the complication profile of the percutaneously placed PD catheters are comparable to that of surgically implanted ones.

Influence of a new prophylactic antibiotic therapy on the incidence of liver abscesses after chemoembolization treatment of liver tumors.

Intrahepatic abscess is a complication of transcatheter arterial chemoembolization (TACE) treatment in patients who have a history of biliary reconstructive surgery. This study followed eight patients who underwent chemoembolization after biliary surgery. These patients were divided into two groups.

Chemoembolization for hepatocellular carcinoma: where does the truth lie?

Hepatocellular carcinoma (HCC) remains one of the most highly lethal cancers in the world. It continues to be plagued by a shortage of effective therapeutic options and consequently is a major cause of death, especially in eastern Asia and sub-Saharan Africa. In the United States, the incidence of HCC has been rapidly and steadily increasing in the past 20 years because of the concomitant epidemic rise in hepatitis C virus infection.

Yttrium-90 microspheres: radiation therapy for unresectable liver cancer.

Hepatocellular carcinoma (HCC) constitutes a difficult health challenge because of its poor prognosis and limited treatment options. Most available therapies are used only for palliation. The use of yttrium-90 microspheres is a new intraarterial therapy consisting of beta-irradiating microspheres measuring 20-30 micro m in diameter that can be delivered directly to the tumors.

Mitochondrial bound type II hexokinase: a key player in the growth and survival of many cancers and an ideal prospect for therapeutic intervention.

Despite more than 75 years of research by some of the greatest scientists in the world to conquer cancer, the clear winner is still cancer. This is reflected particularly by liver cancer that worldwide ranks fourth in terms of mortality with survival rates of no more than 3-5%. Significantly, one of the earliest discovered hallmarks of cancer had its roots in Bioenergetics as many tumors were found in the 1920s to exhibit a high glycolytic phenotype.