Stereotactic Percutaneous Electrochemotherapy as a New Minimal Invasive Treatment Modality for Primary and Secondary Liver Malignancies.

: To report on the first results of safety, efficacy, and outcome of CT-navigated stereotactic percutaneous electrochemotherapy (SpECT) in patients with primary and secondary liver malignancies. : This retrospective study included 23 consecutive lesions in 22 patients who underwent SpECT for primary and secondary malignant liver lesions with locally curative intention. The endpoints were primary technique efficacy (PTE), local tumor progression (LTP), time to progression (TTP), and occurrence of adverse events.

Differentiating Well-Differentiated from Poorly-Differentiated HCC: The Potential and the Limitation of Gd-EOB-DTPA in the Presence of Liver Cirrhosis.

This study uses magnetic resonance imaging (MRI) to investigate the potential of the hepatospecific contrast agent gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) in distinguishing G1- from G2/G3-differentiated hepatocellular carcinoma (HCC). Our approach involved analyzing the dynamic behavior of the contrast agent in different phases of imaging by signal intensity (SI) and lesion contrast (C), to surrounding liver parenchyma, and comparing it across distinct groups of patients differentiated based on the histopathological grading of their HCC lesions and the presence of liver cirrhosis. Our results highlighted a significant contrast between well- and poorly-differentiated lesions regarding the lesion contrast in the arterial and late arterial phases.

Attosecond chronoscopy of the photoemission near a bandgap of a single-element layered dielectric.

We report on the energy dependence of the photoemission time delay from the single-element layered dielectric HOPG (highly oriented pyrolytic graphite). This system offers the unique opportunity to directly observe the Eisenbud-Wigner-Smith (EWS) time delays related to the bulk electronic band structure without being strongly perturbed by ubiquitous effects of transport, screening, and multiple scattering. We find the experimental streaking time shifts to be sensitive to the modulation of the density of states in the high-energy region ( ≈ 100 eV) of the band structure.

Volume-Assisted Estimation of Remnant Liver Function Based on Gd-EOB-DTPA Enhanced MR Relaxometry: A Prospective Observational Trial.

In the context of liver surgery, predicting postoperative liver dysfunction is essential. This study explored the potential of preoperative liver function assessment by MRI for predicting postoperative liver dysfunction and compared these results with the established indocyanine green (ICG) clearance test. This prospective study included patients undergoing liver resection with preoperative MRI planning.

Different Ultrasound Shear Wave Elastography Techniques as Novel Imaging-Based Approaches for Quantitative Evaluation of Hepatic Steatosis-Preliminary Findings.

Background: Modern ultrasound (US) shear-wave dispersion (SWD) and attenuation imaging (ATI) can be used to quantify changes in the viscosity and signal attenuation of the liver parenchyma, which are altered in hepatic steatosis. We aimed to evaluate modern shear-wave elastography (SWE), SWD and ATI for the assessment of hepatic steatosis.

Methods: We retrospectively analyzed the US data of 15 patients who underwent liver USs and MRIs for the evaluation of parenchymal disease/liver lesions.

Water-Fat Separated T1 Mapping in the Liver and Correlation to Hepatic Fat Fraction.

(1) Background: T1 mapping in magnetic resonance imaging (MRI) of the liver has been proposed to estimate liver function or to detect the stage of liver disease, among others. Thus far, the impact of intrahepatic fat on T1 quantification has only been sparsely discussed. Therefore, the aim of this study was to evaluate the potential of water-fat separated T1 mapping of the liver.

Application of A U-Net for Map-like Segmentation and Classification of Discontinuous Fibrosis Distribution in Gd-EOB-DTPA-Enhanced Liver MRI.

We aimed to evaluate whether U-shaped convolutional neuronal networks can be used to segment liver parenchyma and indicate the degree of liver fibrosis/cirrhosis at the voxel level using contrast-enhanced magnetic resonance imaging. This retrospective study included 112 examinations with histologically determined liver fibrosis/cirrhosis grade (Ishak score) as the ground truth. The T1-weighted volume-interpolated breath-hold examination sequences of native, arterial, late arterial, portal venous, and hepatobiliary phases were semi-automatically segmented and co-registered.

High resolution flow with glazing flow for optimized flow detection in transjugular intrahepatic portosystemic stent shunt (TIPS): First results.

Background: Ultrasound follow-up of transjugular intrahepatic portosystemic shunt (TIPS) is challenging due to the bent course of the stent-graft.

Objective: Aim of this retrospective study was to assess to which extent the combination of HR flow with Glazing Flow improves hemodynamic assessment in the ultrasound follow-up of TIPS.

Methods: Comparative studies with CCDS and High Resolution (HR)-Flow with Glazing Flow were evaluated regarding image quality and artifacts on a 5-point scale (0 = cannot be assessed up to 5 = maximum image quality without artifacts).

Update on Percutaneous Local Ablative Procedures for the Treatment of Hepatocellular Carcinoma.

Background: Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide. Because many hepatocellular carcinomas are already unresectable at the time of initial diagnosis, percutaneous tumor ablation has become established in recent decades as a curative therapeutic approach for very early (BCLC 0) and early (BCLC A) HCC. The aim of this paper is to provide a concise overview of the percutaneous local ablative procedures currently in use, based on their technical characteristics as well as clinical relevance, taking into account the current body of studies.

Quantitative analysis of liver function: 3D variable-flip-angle versus Look-Locker T1 relaxometry in hepatocyte-specific contrast-enhanced liver MRI.

Background: Gd-EOB-DTPA, a liver specific contrast agent with T1- shortening effects, is routinely used in clinical magnetic resonance imaging (MRI) for detection and characterization of focal liver lesions. Gd-EOB-DTPA-enhanced T1 relaxometry has recently received increasing attention as a tool for the quantitative analyses of liver function. However, this T1 relaxometry technique is limited due to various artifacts caused by B1 inhomogeneities and motion artifacts.

Quantification of contrast agent uptake in the hepatobiliary phase helps to differentiate hepatocellular carcinoma grade.

This study aimed to assess the degree of differentiation of hepatocellular carcinoma (HCC) using Gd-EOB-DTPA-assisted magnetic resonance imaging (MRI) with T1 relaxometry. Thirty-three solitary HCC lesions were included in this retrospective study. This study's inclusion criteria were preoperative Gd-EOB-DTPA-assisted MRI of the liver and a histopathological evaluation after hepatic tumor resection.

Prediction of transarterial chemoembolization (TACE) outcome by pre- and postinterventional 13C-methacetin breath test.

Background And Objective: Liver function is one of the most important parameters for the outcome of transarterial chemoembolization (TACE). The liver maximum capacity (LiMAx) test is a bedside test that provides a real-time option for liver function testing. The objective of this pilot study was to investigate the suitability of the LiMAX test for predicting the TACE outcome.

Dynamic perfusion analysis in acute ischemic stroke: A comparative study of two different softwares.

Background: In clinical practice, decisions often must be made rapidly; therefore, automated software is useful for diagnostic support. Perfusion computed tomography and follow-up evaluation of perfusion data are valuable tools for selecting the optimal recanalization therapy in patients with acute ischemic stroke.

Objective: This study aimed to compare commercially available software used to evaluate stroke patients prior to thrombectomy.

Gene expression changes in male and female rhesus macaque 60 days after irradiation.

Purpose: Transcriptome changes can be expected in survivors after lethal irradiation. We aimed to characterize these in males and females and after different cytokine treatments 60 days after irradiation.

Material And Methods: Male and female rhesus macaques (n = 142) received a whole-body exposure with 700 cGy, from which 60 animals survived.

Liver stiffness assessed by shear-wave elastography declines in parallel with immunoregulatory proteins in patients with chronic HCV infection during DAA therapy.

Background: A rapid decline of liver stiffness (LS) was detected by non-invasive methods in patients with chronic hepatitis C (HCV) infection during treatment with direct-acting antivirals (DAA).

Objective: To investigate the influence of inflammation on LS.

Methods: We prospectively examined LS by sonographic shear-wave elastography in 217 patients during DAA therapy from treatment initiation (BL) to 12 weeks after end of therapy (SVR12).

A 3D Deep Neural Network for Liver Volumetry in 3T Contrast-Enhanced MRI.

Purpose:  To create a fully automated, reliable, and fast segmentation tool for Gd-EOB-DTPA-enhanced MRI scans using deep learning.

Materials And Methods:  Datasets of Gd-EOB-DTPA-enhanced liver MR images of 100 patients were assembled. Ground truth segmentation of the hepatobiliary phase images was performed manually.

Similar complication rates for irreversible electroporation and thermal ablation in patients with hepatocellular tumors.

Background To compare the frequency of adverse events of thermal microwave (MWA) and radiofrequency ablation (RFA) with non-thermal irreversible electroporation (IRE) in percutaneous ablation of hepatocellular carcinoma (HCC). Patients and methods We retrospectively analyzed 117 MWA/RFA and 47 IRE procedures (one tumor treated per procedure; 144 men and 20 women; median age, 66 years) regarding adverse events, duration of hospital and intensive care unit (ICU) stays and occurrence of a post-ablation syndrome. Complications were classified according to the Clavien & Dindo classification system.

Long-term survival after percutaneous irreversible electroporation of inoperable colorectal liver metastases.

Background: For colorectal liver metastases (CRLM) that are not amenable to surgery or thermal ablation, irreversible electroporation (IRE) is a novel local treatment modality and additional option.

Methods: This study is a retrospective long-term follow-up of patients with CRLM who underwent IRE as salvage treatment.

Results: Of the 24 included patients, 18 (75.

Diagnostic performance of Gd-EOB-DTPA-enhanced MRI for evaluation of liver dysfunction: a multivariable analysis of 3T MRI sequences.

Objective: The aim of this study was to evaluate the diagnostic performance of a multiparametric gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MRI examination for the estimation of liver dysfunction classified by the Model for End-Stage Liver Disease (MELD) score.

Results: Liver dysfunction can be assessed by different methods. In a logistic regression analysis, T1- and T2-weighted images were affected by impaired liver function.

Efficacy of dynamic enhancement effects on Gd-EOB-DTPA-enhanced MRI for estimation of liver function assessed by 13C- Methacetin breath test.

Purpose: Contrast enhanced magnetic resonance imaging (MRI) is able to assess liver function by characteristic changes of signal intensity (SI).The aim was to evaluate dynamic contrast-enhanced SI-indices of the abdominal aorta, portal vein and liver.

Methods: 72 patients underwent Gd-EOB-DTPA-enhanced MRI and a 13C-methacetin-based liver breath test (13C-MBT) for evaluation of liver function.

Proof of principle: Estimation of liver function using color coded Doppler sonography of the portal vein.

Background: The diagnostic value of Doppler ultrasonography of the portal vein for the evaluation of liver function is still contradictory.

Objective: Aim of this study was to test the relationship between clinical liver function tests based on MRI and breath testing and blood flow in the portal vein.

Methods: The portal vein velocity was measured by color coded Doppler ultrasonography (CCDS) and tested against the relative enhancement (RE), a MRI-based index of liver function.

Evaluation of two-point Dixon water-fat separation for liver specific contrast-enhanced assessment of liver maximum capacity.

Gadoxetic acid-enhanced magnetic resonance imaging has become a useful tool for quantitative evaluation of liver capacity. We report on the importance of intrahepatic fat on gadoxetic acid-supported T1 mapping for estimation of liver maximum capacity, assessed by the realtime C-methacetin breathing test (C-MBT). For T1 relaxometry, we used a respective T1-weighted sequence with two-point Dixon water-fat separation and various flip angles.

Hepatobiliary MRI: Signal intensity based assessment of liver function correlated to C-Methacetin breath test.

Gadoxetic acid (Gd-EOB-DTPA) is a paramagnetic MRI contrast agent with raising popularity and has been used for evaluation of imaging-based liver function in recent years. In order to verify whether liver function as determined by real-time breath analysis using the intravenous administration of C-methacetin can be estimated quantitatively from Gd-EOB-DTPA-enhanced MRI using signal intensity (SI) values. 110 patients underwent Gd-EOB-DTPA-enhanced 3-T MRI and, for the evaluation of liver function, a C-methacetin breath test (C-MBT).