Bioinspired intratumoral infusion port catheter improves local drug delivery in the liver.

Tumor immune modulation can be achieved using intratumoral injection of different immunomodulators during different phases of the cancer-immunity cycle. Intratumoral infusion catheters have been used in brain tumors, but these are not suitable outside the brain, where breathing motion results in catheter migration. Here, we use microstereolithography to manufacture a barbed sidehole catheter, modeled after the barbs in a bee stinger, where the barbs maintain the catheter position in the tumor, and sideholes within the barbs infuse drug into tumor tissue.

Temperature Distribution on Classical Two Needles IRE Setup Versus a Single Needle Prototype.

Objectives: Irreversible Electroporation (IRE) is a non-thermal minimally invasive cancer therapy used in the treatment of liver tumors. However, the therapy entails an electrical current flux which can be high enough to cause a noticeable temperature increase. Therefore, the analysis of the heat distribution is important: during any IRE treatment, the target area is intended to be treated with non-thermal effects, where existing thermal effects should not damage nearby sensitive structures.

Comparison of Complications in Patients with Ductal Cholangiocarcinoma (CCC) and Patients with Colorectal Liver Metastases (CRLMs) After Portal Vein Embolization (PVE): A Matched Cohort Study.

Purpose: To compare complications in patients with cholangiocarcinoma (CCC) and patients with colorectal liver metastases (CRLMs) after portal vein embolization (PVE) and to identify possible predictive factors.

Material And Methods: Retrospective analysis of consecutive patients, who underwent PVE between July 2011 and March 2020. The study groups were matched for sex and age.

Computed Tomography Angiography and Conventional Angiography for the Diagnosis and Treatment of Non-variceal Gastrointestinal Bleeding at a Tertiary Cancer Center.

Introduction: To evaluate the diagnostic value of computed tomography angiography (CTA) and conventional angiography (CA) and the therapeutic value of transarterial embolization for acute gastrointestinal bleeding in patients with malignancy.

Methods: A retrospective review of 100 patients who underwent CTA and/or CA for gastrointestinal bleeding at a comprehensive cancer center between the years 2011-2021 was performed. Clinical and patient outcome data were collected and analyzed using Kruskal-Wallis tests for continuous variables and chi-square tests or Fisher's exact tests (whichever is appropriate) for categorical variables in univariate analysis.

The prevalence and incidence of thrombotic primary antiphospholipid syndrome in adults aged 18-49 years: A population-based study in a mountain community in northern Italy.

Objective: To estimate prevalence and incidence of thrombotic Primary Antiphospholipid Syndrome (PAPS) in the general population aged 18-49 years.

Methods: The study was carried out in Valtrompia, a valley in northern Italy, in 2011-2015. The identification of PAPS cases leveraged three integrated sources: 1) Rheumatology Unit at the University Hospital; 2) General Practitioners; 3) hospital discharge codes of patients admitted for thrombotic events.

Operator radiation exposure during radioembolisation of the liver: transfemoral versus transradial access using real-time dose monitoring.

In this study, operator radiation exposure is compared utilising transradial access (TRA) versus transfemoral access (TFA) during transarterial radioembolisation (TARE) of liver tumors. Patients who underwent Y90 TARE between May 2017 and April 2018 were included. Electronic medical records and interventional data were collected and the following parameters evaluated: technical success, fluoroscopy time, operator radiation exposure and rate of operator radiation exposure per fluoroscopy time.

Plant-based model for the visual evaluation of electroporated area after irreversible electroporation and its comparison to in-vivo animal data.

Electroporation (EP) is widely used in medicine, such as cancer treatment, in form of electrochemotherapy or irreversible electroporation (IRE). For EP device testing, living cells or tissue inside a living organism (including animals) are needed. Plant-based models seem to be a promising alternative to substitute animal models in research.

Temporary Vascular Occlusion with Retrievable Microvascular Plugs to Protect Normal Liver during Yttrium-90 Radioembolization.

This case series describes a technique to protect nondiseased liver parenchyma during transarterial radioembolization (TARE) using microvascular plugs to occlude nontarget vessels temporarily and protect normal liver. This technique, defined as temporary vascular occlusion, was performed in 6 patients, with complete vessel occlusion obtained in 5 of the 6 patients and partial occlusion with flow reduction in 1 of the 6 patients. A statistically significant (P = .

Long loop technique with bifemoral access as salvage technique for repositioning of dislodged port catheters.

Background: Repositioning of dislocated port systems' catheters is usually performed with a pigtail catheter and/or a goose snare. In case of an inaccessible port catheter tip due to thrombosis, this classic approach may be not successful. For these cases, we describe a long loop bailout technique with bifemoral access.

Artificial Intelligence for Clinical Interpretation of Bedside Chest Radiographs.

Background Supine chest radiography for bedridden patients in intensive care units (ICUs) is one of the most frequently ordered imaging studies worldwide. Purpose To evaluate the diagnostic performance of a neural network-based model that is trained on structured semiquantitative radiologic reports of bedside chest radiographs. Materials and Methods For this retrospective single-center study, children and adults in the ICU of a university hospital who had been imaged using bedside chest radiography from January 2009 to December 2020 were reported by using a structured and itemized template.

Calcification of the visceral aorta and celiac trunk is associated with renal and allograft outcomes after deceased donor liver transplantation.

Purpose: Atherosclerosis affects clinical outcomes in the setting of major surgery. Here we aimed to investigate the prognostic role of visceral aortic (VAC), extended visceral aortic (VAC+), and celiac artery calcification (CAC) in the assessment of short- and long-term outcomes following deceased donor orthotopic liver transplantation (OLT) in a western European cohort.

Methods: We retrospectively analyzed the data of 281 consecutive recipients who underwent OLT at a German university medical center (05/2010-03/2020).

Augmented Reality-Assisted CT-Guided Puncture: A Phantom Study.

Purpose: To investigate the feasibility of a novel augmented reality system for CT-guided liver interventions and to compare it with free-hand interventions in a phantom setting.

Methods And Materials: A newly developed augmented reality interface was used, with projection of CT-imaging in multiplanar reconstruction and live rendering of the needle position, a bull`s eye view of the needle trajectory and a visualization of the distance to the target. Punctures were performed on a custom-made abdominal phantom by three interventional radiologists with different levels of expertise.

Reliability as a Precondition for Trust-Segmentation Reliability Analysis of Radiomic Features Improves Survival Prediction.

Machine learning results based on radiomic analysis are often not transferrable. A potential reason for this is the variability of radiomic features due to varying human made segmentations. Therefore, the aim of this study was to provide comprehensive inter-reader reliability analysis of radiomic features in five clinical image datasets and to assess the association of inter-reader reliability and survival prediction.

An accelerometer-based guidance device for CT-guided procedures: an improved wireless prototype.

Introduction: The aim of the study was to demonstrate the feasibility of a prototype for accelerometer-based guidance for percutaneous CT-guided punctures and compare it with free-hand punctures.

Material And Methods: The prototype enabled alignment with the CT coordinate system and a wireless connectivity. Its feasibility was tested in a swine cadaver model: 20 out-of-plane device-assisted punctures performed without intermittent control scans (one-step punctures) were evaluated regarding deviation to target and difference between planned and obtained angle.

Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology.

Purpose: Comparison of puncture deviation and puncture duration between computed tomography (CT)- and C-arm CT (CACT)-guided puncture performed by residents in training (RiT).

Methods: In a cohort of 25 RiTs enrolled in a research training program either CT- or CACT-guided puncture was performed on a phantom. Prior to the experiments, the RiT's level of training, experience playing a musical instrument, video games, and ball sports, and self-assessed manual skills and spatial skills were recorded.

Stent Graft Placement by Pseudoaneurysm of the Hepatic Arteries: Efficacy and Patency Rate in Follow-up.

Purpose: To investigate efficacy and patency status of stent graft implantation in the treatment of hepatic artery pseudoaneurysm.

Materials And Methods: A retrospective analysis of patients who had undergone endovascular treatment of hepatic artery pseudoaneurysms between 2011 and 2020 was performed. Medical records were examined to obtain patients' surgical histories and to screen for active bleeding.

Perioperative and long-term outcome after ascending aortic and arch repair with elephant trunk and open thoracoabdominal aortic aneurysm repair.

Objective: To describe the outcome of open thoracoabdominal aortic aneurysm (TAAA) repair following previous aortic arch repair including elephant trunk (ET) or frozen elephant trunk (FET) for acute and chronic pathologies.

Methods: This was a retrospective, observational, multicenter study including 32 patients treated between 2006 and 2019 in two aortic centers using identical surgical protocols. Assessment focused on perioperative and long-term outcome, namely in-hospital morbidity and mortality, as well as procedure-related reintervention rate and aortic-related mortality rate.

Advancing diagnostic performance and clinical usability of neural networks via adversarial training and dual batch normalization.

Unmasking the decision making process of machine learning models is essential for implementing diagnostic support systems in clinical practice. Here, we demonstrate that adversarially trained models can significantly enhance the usability of pathology detection as compared to their standard counterparts. We let six experienced radiologists rate the interpretability of saliency maps in datasets of X-rays, computed tomography, and magnetic resonance imaging scans.

Safety and efficacy of right portal vein embolization in patients with prior left lateral liver resection.

Background: In patients with bilobar metastatic liver disease, surgical clearance of both liver lobes may be achieved through multiple-stage liver resections. For patients with extensive disease, a major two-staged hepatectomy consisting of resection of liver segments II and III before right-sided portal vein embolization (PVE) and resection of segments V-VIII may be performed, leaving only segments IV ± I as the liver remnant.

Purpose: To describe the outcome following right-sided PVE after prior complete resection of liver segments II and III.

Endovascular Revascularization with Stent Implantation in Patients with Acute Mesenteric Ischemia due to Acute Arterial Thrombosis: Clinical Outcome and Predictive Factors.

Purpose: To determine 30-day-mortality rates and identify predictors for survival in patients undergoing endovascular revascularization for acute mesenteric ischemia (AMI) due to occlusion of the celiac (CA) or superior mesenteric artery (SMA) from arterial thrombosis in the setting of atherosclerosis at the vessel origin.

Materials And Methods: A retrospective analysis on patients who underwent acute endovascular revascularization to treat AMI caused by thrombotic occlusion of the CA and/or SMA between January 2011 and December 2019 was conducted. 30-day-mortality rates were calculated.

Induction of Contralateral Hepatic Hypertrophy by Unilobar Yttrium-90 Transarterial Radioembolization versus Portal Vein Embolization: An Animal Study.

Purpose: To compare hepatic hypertrophy in the contralateral lobe achieved by unilobar transarterial radioembolization (TARE) versus portal vein embolization (PVE) in a swine model.

Methods: After an escalation study to determine the optimum dose to achieve hypertrophy after unilobar TARE in 4 animals, 16 pigs were treated by TARE (yttrium-90 resin microspheres) or PVE (lipiodol/n-butyl cyanoacrylate). Liver volume was calculated based on CT before treatment and during 6 months of follow-up.

Predictors of Occlusion of Hepatic Blood Vessels after Irreversible Electroporation of Liver Tumors.

Purpose: To examine predictors of midterm occlusion in portal and hepatic veins within or adjacent to the ablation zone after irreversible electroporation (IRE) of liver tumors.

Materials And Methods: This retrospective cohort analysis included 39 patients who underwent CT-guided IRE of liver tumors. Vessels within or adjacent to the ablation zone were identified on CT images acquired immediately after the procedure, and the positional relationships with the ablation zone (within/adjacent), locations (proximal/distal), and diameters (< 4 mm or ≥ 4 mm) were evaluated.

Recanalization and Stenting of the Celiac and the Superior Mesenteric Artery Supported by Use of a Steerable Introducer Sheath: Report on 2 Years' Experience.

Purpose: To compare technical parameters and success of recanalization of celiac (CA) or superior mesenteric artery (SMA) with usage of steerable vs not steerable introducer sheaths.

Methods: A retrospective analysis was performed on all consecutive patients who underwent recanalization with stent implantation of CA or SMA between 2015 and 2019. Data regarding technical success (successful stent placement with restoration of sufficient blood flow by the first attempt without changing kind of introducer sheath or access site), indication for treatment, vascular access, kind of introducer sheath, fluoroscopy time and radiation dose were collected.

Percutaneous transhepatic biliary drainage (PTBD) in patients with dilated vs. nondilated bile ducts: technical considerations and complications.

Objectives: The aim of this study was to compare success, technical complexity, and complication rates of percutaneous transhepatic biliary drainage (PTBD) in patients with dilated vs. nondilated bile ducts.

Methods: In a retrospective analysis, we evaluated all consecutive PTBD performed in our department over a period of 5 years.