Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing.

There is no noninvasive method to estimate lung shunting fraction (LSF) in patients with liver tumors undergoing Yttrium-90 (Y90) therapy. We propose to predict LSF from noninvasive dynamic contrast enhanced (DCE) MRI using perfusion quantification. Two perfusion quantification methods were used to process DCE MRI in 25 liver tumor patients: Kety's tracer kinetic modeling with a delay-fitted global arterial input function (AIF) and quantitative transport mapping (QTM) based on the inversion of transport equation using spatial deconvolution without AIF.

Safety and Efficacy of Microwave Ablation for Hepatocellular Carcinoma in the Setting of Transjugular Intrahepatic Portosystemic Shunt.

This retrospective analysis reviews five patients with transjugular intrahepatic portosystemic shunt (TIPS) who underwent percutaneous microwave ablation of hepatocellular carcinoma between January 2017 and September 2020. Mean tumor diameter was 2.0 cm (range 1.

Role of interventional radiology in the treatment of COVID-19 patients: Early experience from an epicenter.

Objective: To highlight the role of interventional radiology (IR) in the treatment of patients hospitalized with coronavirus disease 2019 (COVID-19).

Methods: Retrospective review of hospitalized patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and had one or more IR procedures at a tertiary referral hospital in New York City during a 6-week period in April and May of 2020.

Results: Of the 724 patients admitted with COVID-19, 92 (12.

CT-Guided Fine-Needle Aspiration Biopsy of Pulmonary Nodules 8 mm or Less Has a Higher Diagnostic Accuracy than Positron Emission Tomography-CT.

Purpose: To compare diagnostic accuracy of CT-guided fine-needle aspiration biopsy (FNA-B) with positron emission tomography (PET)-CT for pulmonary nodules ≤ 8 mm.

Materials And Methods: A retrospective review of all CT-guided lung FNA-Bs performed between 2011 and 2014 at a single institution was undertaken to evaluate patients who had FNA-B and PET-CT imaging of nodules of ≤ 8 mm. Patients without surgical pathology or 2-year follow-up CT scans were excluded.

Bone biopsy protocol for advanced prostate cancer in the era of precision medicine.

Background: Metastatic biopsies are increasingly being performed in patients with advanced prostate cancer to search for actionable targets and/or to identify emerging resistance mechanisms. Due to a predominance of bone metastases and their sclerotic nature, obtaining sufficient tissue for clinical and genomic studies is challenging.

Methods: Patients with prostate cancer bone metastases were enrolled between February 2013 and March 2017 on an institutional review board-approved protocol for prospective image-guided bone biopsy.

Decision Making in Interventional Oncology: Ablative Options in the Lung.

Image-guided ablation is safe and effective for the treatment of both primary and metastatic tumors in the lung. This article reviews the three most commonly used ablative options: radiofrequency ablation, microwave ablation, and cryoablation. We describe the advantages of each ablation modality in the lung and how to choose the most appropriate ablation device based on patient and tumor characteristics.

Catheter-directed Intraportal Delivery of Endothelial Cell Therapy for Liver Regeneration: A Feasibility Study in a Large-Animal Model of Cirrhosis.

Purpose To demonstrate the feasibility of imaging-guided catheter-directed delivery of endothelial cell therapy in a porcine model of cirrhosis for liver regeneration. Materials and Methods After approval from the institutional animal care and use committee, autologous liver endothelial cells were grown from core hepatic specimens from swine. Cirrhosis was induced in swine by means of transcatheter infusion of ethanol and iodized oil into the hepatic artery.

Screening for hepatocellular carcinoma in high-risk populations.

Screening for hepatocellular carcinoma (HCC) should be implemented in the high-risk population. High-risk population includes patients with cirrhosis of any etiology, patients with chronic hepatitis B virus with or without cirrhosis, and patients with chronic hepatitis C virus with cirrhosis. A randomized controlled trial of over 18,000 high-risk individuals demonstrated that biannual screening reduced HCC-related mortality by 37%.

Brachial Artery Access.

Low brachial artery access is a safe alternative approach for the interventionalist when the femoral artery approach is not feasible or desirable. One important advantage of upper extremity access is the favorable route of entry from above into the caudally oriented visceral arteries. Although the risk of complications is low for experienced operators, meticulous attention to technique and knowledge of local anatomy are imperative to safely use brachial artery access.

Pleural puncture that excludes the ablation zone decreases the risk of pneumothorax after percutaneous microwave ablation in porcine lung.

Purpose: To test the hypothesis that the geometry of probe placement with respect to the pleural puncture site affects the risk of pneumothorax after microwave (MW) ablation in the lung.

Materials And Methods: Computed tomography-guided MW ablation of the lung was performed in 8 swine under general anesthesia and mechanical ventilation. The orientation of the 17-gauge probe was either perpendicular (90°) or parallel (< 30°) with respect to the pleural puncture site, and the ablation power was 30 W or 65 W for 5 minutes.

Alternative to surgery in early stage NSCLC-interventional radiologic approaches.

Interventional radiologists have a variety of techniques in their armamentarium to treat pulmonary tumors. While most therapies are targeted to metastasis or palliation, percutaneous thermal ablation represents a potential therapy for not only palliation, but to treat inoperable early stage disease. Although radiofrequency ablation (RFA) is the most studied of these ablative techniques, newer technologies of thermal ablation, such as microwave and cryoablation have emerged as additional options.

Distinguishing benign and life-threatening pneumatosis intestinalis in patients with cancer by CT imaging features.

Objective: The purpose of this study is to determine the overall proportion of clinically worrisome and benign pneumatosis intestinalis (PI) occurring in patients with cancer and to evaluate associated risk factors and CT features.

Materials And Methods: We retrospectively studied the CT examinations of 84 patients treated at our tertiary cancer center. Reviewers who were blinded to clinical data and classification analyzed PI in terms of location, pattern (linear, cystic, or both), and associated CT features, including pneumoperitoneum, portomesenteric venous air, bowel wall thickening, bowel dilatation, and ascites.