Publications by authors named "Paul Haste"

Purpose: Pre-treatment [Tc]TcMAA-based radioembolization treatment planning using multicompartment dosimetry involves the definition of the tumor and normal tissue compartments and calculation of the prescribed absorbed doses. The aim was to compare the real-world utility of anatomic and [Tc]TcMAA-based segmentation of tumor and normal tissue compartments.

Materials And Methods: Included patients had HCC treated by glass [Y]yttrium microspheres, ≥ 1 tumor, ≥ 3 cm diameter and [Tc]TcMAA SPECT/CT imaging before treatment.

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  • - Determining the best treatment plan for rectal cancer is complicated, involving choices between curative or palliative surgery and considering impact on bowel function and quality of life, especially for distal rectal cancer patients.
  • - Patients with rectal cancer face a higher risk of pelvic recurrence compared to those with colon cancer, making careful patient selection and a multidisciplinary treatment approach essential for better outcomes.
  • - Recent updates to the NCCN Guidelines for Rectal Cancer include new treatment options like endoscopic submucosal dissection for early cases, revisions to the total neoadjuvant therapy strategy, and a nonoperative "watch-and-wait" option for patients who respond well to initial therapy.
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  • Colorectal cancer (CRC) ranks as the fourth most common cancer and the second deadliest in the U.S.
  • Treatment for advanced metastatic CRC includes multiple active drugs used alone or in combination, depending on patient-specific factors.
  • The paper reviews the systemic therapy recommendations for metastatic CRC as outlined in the NCCN Guidelines for Colon Cancer.
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Objectives: Total pancreatectomy with islet autotransplant (TPIAT) is important therapy for select chronic pancreatitis (CP) patients. The specialized technique of islet isolation limits widespread TPIAT use. We hypothesized that remote islet isolation provides satisfactory islet yield and perioperative outcomes.

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Purpose: Investigate reproducibility of two segmentation methods for multicompartment dosimetry, including normal tissue absorbed dose (NTAD) and tumour absorbed dose (TAD), in hepatocellular carcinoma patients treated with yttrium-90 (Y) glass microspheres.

Methods: TARGET was a retrospective investigation in 209 patients with < 10 tumours per lobe and at least one tumour ≥ 3 cm ± portal vein thrombosis. Dosimetry was compared using two distinct segmentation methods: anatomic (CT/MRI-based) and count threshold-based on pre-procedural Tc-MAA SPECT.

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Objective: We sought to determine the clinical and imaging outcomes after placement of the OptionELITE inferior vena cava (IVC) filter (Argon Medical Devices, Plano, TX).

Methods: The clinical characteristics and imaging findings of patients who had undergone OptionELITE filter placement at six affiliated hospitals between January 1, 2013 and April 19, 2019, were analyzed. Data were obtained from the Radiology Information System, imaging database, and electronic medical records.

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Purpose: In light of recently published clinical reports and trials, the TheraSphere Global Dosimetry Steering Committee (DSC) reconvened to review new data and to update previously published clinical and dosimetric recommendations for the treatment of hepatocellular carcinoma (HCC).

Methods: The TheraSphere Global DSC is comprised of health care providers across multiple disciplines involved in the treatment of HCC with yttrium-90 (Y-90) glass microsphere-based transarterial radioembolization (TARE). Literature published between January 2019 and September 2021 was reviewed, discussed, and adjudicated by the Delphi method.

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Purpose: To investigate the relationships between tumor absorbed dose (TAD) or normal tissue absorbed dose (NTAD) and clinical outcomes in hepatocellular carcinoma (HCC) treated with yttrium-90 glass microspheres.

Methods: TARGET was a retrospective investigation in 13 centers across eight countries. Key inclusion criteria: liver-dominant HCC with or without portal vein thrombosis, < 10 tumors per lobe (at least one ≥ 3 cm), Child-Pugh stage A/B7, BCLC stages A-C, and no prior intra-arterial treatment.

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Transarterial radioembolization with yttrium-90 ( Y) is a mainstay for the treatment of liver cancer. Imaging the distribution following delivery is a concept that dates back to the 1960s. As β particles are created during Y decay, bremsstrahlung radiation is created as the particles interact with tissues, allowing for imaging with a gamma camera.

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Portal vein thrombosis (PVT) is an important cause of noncirrhotic portal hypertension. Noncancerous extrinsic compression of portal vein to drive PVT formation is rare, but important to identify. A 64-year-old female with idiopathic hepatic artery pseudoaneurysm (HAPA) rupture 7 months prior presented with acute-onset hematemesis and melena and was found to have prehepatic portal hypertensive variceal bleeding.

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Purpose: Transjugular intrahepatic portosystemic shunt (TIPS) creation is most commonly performed for patients with refractory ascites or variceal hemorrhage. While TIPS have also been created prior to planned abdominal operation to decrease morbidity related to portal hypertension, there are limited data supporting its effectiveness in that indication. The goal of this study was to determine if preoperative TIPS creation allows for successful abdominal operation with limited morbidity.

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Purpose: To evaluate the effectiveness and safety of yttrium-90 transarterial radioembolization (TARE) for the treatment of primary and metastatic soft tissue sarcoma (STS) of the liver.

Materials And Methods: A retrospective review of 39 patients with primary (n = 2) and metastatic (n = 37) hepatic STS treated with TARE at 4 institutions was performed. Fourteen STS subtypes were included, with leiomyosarcoma being the most common (51%).

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Numerous initiatives are in place to support value based care in radiology including decision support using appropriateness criteria, quality metrics like radiation dose monitoring, and efforts to improve the quality of the radiology report for consumption by referring providers. These initiatives are largely data driven. Organizations can choose to purchase proprietary registry systems, pay for software as a service solution, or deploy/build their own registry systems.

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  • - The study aimed to see if technetium-99 labeled macroaggregated albumin (Tc-MAA) could predict how well yttrium-90 (Y) distributes and how it appears on imaging in patients with hepatocellular carcinoma (HCC) during radioembolization treatments.
  • - Researchers reviewed the records of 83 HCC patients who underwent specific imaging techniques to compare the absorbed doses to tumors and healthy liver tissue, finding acceptable agreements for healthy tissue but not for tumors.
  • - The results indicated that while Tc-MAA correlated with Y distribution in healthy liver areas, it was not a reliable predictor for the dose to liver tumors or their imaging responses, signifying limitations in using Tc-MAA for treatment monitoring.
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