Orthotopic hepatocellular carcinoma: molecular imaging-monitored intratumoral hyperthermia-enhanced direct oncolytic virotherapy.

Objective: To validate the feasibility of molecular imaging-monitored intratumoral radiofrequency hyperthermia (RFH) enhanced direct oncolytic virotherapy for hepatocellular carcinoma (HCC).

Methods: This study included in vitro experiments using luciferase-labeled rat HCC cells and in vivo validation experiments on rat models with orthotopic HCCs. Both cells and HCCs in four groups (n = 6/group) were treated by: (1) combination therapy of oncolytic virotherapy (T-VEC) plus RFH at 42 °C for 30 min; (2) oncolytic virotherapy alone; (3) RFH alone; and (4) saline.

Segmental Yttrium-90 Radioembolization versus Segmental Chemoembolization for Localized Hepatocellular Carcinoma: Results of a Single-Center, Retrospective, Propensity Score-Matched Study.

Purpose: To compare segmental radioembolization with segmental chemoembolization for localized, unresectable hepatocellular carcinoma (HCC) not amenable to ablation.

Materials And Methods: In a single-center, retrospective study (2010-2015), 101 patients with 132 tumors underwent segmental radioembolization, and 77 patients with 103 tumors underwent segmental doxorubicin-based drug-eluting embolic or conventional chemoembolization. Patients receiving chemoembolization had worse performance status (Eastern Cooperative Oncology Group 0, 76% vs 56%; P = .

Effectiveness of hepatitis C antiviral treatment in a USA cohort of veteran patients with hepatocellular carcinoma.

Background & Aims: Hepatitis C virus (HCV) treatment for patients with hepatocellular carcinoma (HCC) was uncommon before direct-acting antiviral (DAA) medications. Real-world effectiveness of DAAs for HCV in patients with HCC is unclear. We describe rates of sustained virologic response (SVR) with DAA regimens by HCV genotype in patients with a history of HCC.

Characteristics and outcomes of transjugular intrahepatic portosystemic shunt recipients in the VA Healthcare System.

Background And Aims: Transjugular intrahepatic portosystemic shunt (TIPS) placement is an effective treatment for complications of portal hypertension. We aimed to describe post-TIPS mortality and its predictors in the modern era of covered stents.

Patients And Methods: We identified patients with cirrhosis who underwent TIPS insertion at Veterans Affairs Healthcare facilities nationally from 2004 to 2014 (n=703), most of which (95%) were performed as elective procedures.

Cone-Beam CT with Fluoroscopic Overlay Versus Conventional CT Guidance for Percutaneous Abdominopelvic Abscess Drain Placement.

Purpose: To compare technical success and procedure time for percutaneous abscess drain placement with fluoroscopic cone-beam computed tomography (CT) and two-axis needle guidance versus conventional CT guidance.

Materials And Methods: A total of 85 consecutive patients undergoing abdominopelvic abscess drain placement guided by fluoroscopic cone-beam CT or conventional CT were retrospectively reviewed over a 2-year period. Forty-three patients underwent drain placement with cone-beam CT using XperGuide navigation and 42 underwent placement with conventional 64-slice CT.

Irreversible Electroporation in Patients with Hepatocellular Carcinoma: Immediate versus Delayed Findings at MR Imaging.

Purpose: To assess the postprocedure findings of irreversible electroporation (IRE) in patients with hepatocellular carcinoma (HCC) at magnetic resonance (MR) imaging.

Materials And Methods: This retrospective study was Institutional Review Board approved, and informed consent was waived. Twenty patients with HCC were treated with IRE over a 2.

Intra-Arterial Thrombolysis for Hepatic Artery Thrombosis following Liver Transplantation.

Purpose: Hepatic artery thrombosis (HAT) is a major cause of morbidity and death following liver transplantation. The purpose of this study was to evaluate the safety and efficacy of intra-arterial thrombolysis (IAT) in liver transplant recipients with HAT.

Materials And Methods: Adult liver transplant recipients who underwent attempted IAT for HAT were identified.

Traumatic renal vein pseudoaneurysm.

Traumatic renal injury is infrequent, occurring in ∼1% to 3% of trauma cases, with major renal vein injury an even more rare traumatic entity. Conservative, operative, and endovascular management strategies have been infrequently reported in the literature. We report a patient with traumatic renal vein injury with pseudoaneurysm formation that was successfully treated with endovascular stenting.

Outcomes of Locoregional Tumor Therapy for Patients with Hepatocellular Carcinoma and Transjugular Intrahepatic Portosystemic Shunts.

Purpose: Locoregional therapy for hepatocellular carcinoma (HCC) can be challenging in patients with a transjugular intrahepatic portosystemic shunt (TIPS). This study compares safety and imaging response of ablation, chemoembolization, radioembolization, and supportive care in patients with both TIPS and HCC.

Methods: This retrospective study included 48 patients who had both a TIPS and a diagnosis of HCC.

Utilization of angiography and embolization for abdominopelvic trauma: 14 years' experience at a level I trauma center.

Objective: The objective of our study was to evaluate the long-term trends in the use of angiography and embolization for abdominopelvic injuries.

Materials And Methods: Utilization rates for pelvic and abdominal angiography, arterial embolization, and CT were analyzed for trauma patients with pelvic fractures and liver and kidney injuries admitted to a level 1 trauma center from 1996 to 2010. Multivariable linear regression was used to evaluate trends in the use of angioembolization.

Endovascular interventions for traumatic portal venous hemorrhage complicated by portal hypertension.

Life-threatening hemorrhage rarely occurs from the portal vein following blunt hepatic trauma. Traditionally, severe portal bleeding in this setting has been controlled by surgical techniques such as packing, ligation, and venorrhaphy. The presence of portal hypertension could potentially increase the amount of hemorrhage in the setting of blunt portal vein trauma making it more difficult to control.

Hepatobiliary oncologic emergencies: imaging appearances and therapeutic options.

During the course of their disease, many patients with cancer may require urgent care related to hepatobiliary disease. Cross-sectional imaging of these patients is usually performed initially, and the radiologist plays a pivotal role in the initial diagnosis. In this article, we discuss the commonly seen hepatobiliary oncologic emergencies, briefly review imaging diagnosis, and discuss in detail the management options for these conditions.

Frequency of external iliac artery branch injury in blunt trauma: improved detection with selective external iliac angiography.

Purpose: To assess the utility of selective external iliac artery (EIA) angiography and the frequency of injury to branches of the EIA in cases of blunt pelvic trauma.

Materials And Methods: A retrospective review of pelvic angiograms in 66 patients with blunt pelvic trauma was conducted over a 12-month period. Pelvic and femur fracture patterns were correlated to the presence of EIA injury.

Safety and efficacy of drug-eluting bead chemoembolization for hepatocellular carcinoma: comparison of small-versus medium-size particles.

Purpose: To compare safety and imaging response with 100-300 μm and 300-500 μm doxorubicin drug-eluting bead (DEBs) to determine optimal particle size for chemoembolization of hepatocellular carcinoma (HCC).

Materials And Methods: DEB chemoembolization using 100-300 μm (n = 39) or 300-500 μm (n = 22) LC beads loaded with 50 mg of doxorubicin was performed in 61 patients with HCC. Patient age, sex, etiology of liver disease, degree of underlying liver disease, tumor burden, and performance status were similar between the groups.

Postembolization syndrome after hepatic transarterial chemoembolization: effect of prophylactic steroids on postprocedure medication requirements.

Purpose: To evaluate the impact of prophylactic use of dexamethasone and scopolamine on analgesic and antiemetic agent requirements after transarterial chemoembolization.

Materials And Methods: A total of 148 patients underwent 316 rounds of chemoembolization for hepatocellular carcinoma at a single institution over a 17-month period. Patient charts were retrospectively reviewed for demographic data, procedural technique, and use of analgesic and antiemetic medications.

Proximal interruption of the pulmonary artery: Transcatheter embolization for emergent management of massive hemoptysis.

Transcatheter embolization is the first-line treatment for massive hemoptysis and recurrent intractable hemoptysis. Proximal interruption of the pulmonary artery is a rare congenital anomaly characterized by hypertrophy and neovasculsarity of bronchial and nonbronchial aortopulmonary collaterals; hemoptysis complicates a minority of cases. We present a case of unilateral proximal interruption of the left pulmonary artery associated with a right-sided aorta, presenting in adulthood with hemoptysis.

Spontaneous regression of hepatocellular carcinoma in a cirrhotic patient: possible vascular hypothesis.

Spontaneous regression of hepatocellular carcinoma is extremely rare, and the exact pathogenesis leading to this remarkable phenomenon remains unclear. We describe a case of spontaneous regression of an incidentally discovered hepatocellular carcinoma in a 63-year-old man with hepatitis C cirrhosis. The regression followed a series of events, in particular, an upper gastrointestinal haemorrhage.

Imaging and percutaneous treatment of vascular anomalies.

Vascular anomalies are an extensive group of malformations of the arterial, venous, and lymphatic systems, either in isolation or, more often, in combination. Although mostly congenital, they can occasionally be acquired as well. They present a challenge both for workup and therapy.