Purpose: To asses angiographic and computed tomographic success criteria during and after transcatheter arterial drug-eluting bead chemoembolization (DEB-TACE) in patients with hepatocellular carcinoma (HCC) and its impact on progression-free survival (PFS) and overall survival (OS).
Methods: In this retrospective single-center study, 50 patients with unresectable HCC having undergone DEB-TACE from January 2010 to July 2015 were assessed. The angiographic endpoint was classified by Subjective Angiographic Chemoembolization Endpoint (SACE) scale. Relative tumor density in arterial (D) and portal venous phase (D) computed tomography post- versus pre-DEB-TACE were calculated, respectively. Tumor response according to modified Response Criteria in Solid Tumors (mRECIST) was assessed. Univariate Kaplan-Meier and Cox regression analysis were carried out.
Results: SACE scores I, II, III, and IV were found in 1 (2%), 20 (40%), 15 (30%), and 14 (28%) patients, respectively. Median OS and PFS were 14.2 and 5.5 months, respectively. Death rates at 6 months, 1 year and 2 years were 24%, 38%, and 52%, respectively. SACE score during DEB-TACE significantly correlated with local and overall mRECIST results (local: p < 0.001, r = 0.49, overall: p = 0.042, r = 0.29) and inversely correlated with D (p = 0.005, r = - 0.40). In univariate analysis, progressive disease (PD) according to mRECIST and increase of D and D were associated with significantly shorter PFS. Modified RECIST independently predicted OS (hazard ratio for complete remission vs. PD = 0.15, 95% confidence interval 0.03-0.68, p = 0.014).
Conclusions: A direct impact of SACE on PFS or OS could not be shown. However, SACE significantly correlated with local and overall mRECIST tumor response that again significantly predicted OS. We therefore postulate an indirect impact of SACE on OS. Consequently, complete embolization should be attempted.
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http://dx.doi.org/10.1007/s00261-019-02128-7 | DOI Listing |
Vascular
January 2025
Department of Vascular Surgery, University Hospital Leipzig, Leipzig, Germany.
Background: Peripheral artery disease (PAD) outcomes often rely on the expertise of individual vascular units, introducing potential subjectivity into disease staging. This retrospective, multicenter cohort study aimed to demonstrate the ability of artificial intelligence (AI) to provide disease staging based on inter-institutional expertise by predicting limb outcomes in post-interventional pedal angiograms of PAD patients, specifically in comparison to the inframalleolar modifier in the Global Limb Anatomic Staging System (IM GLASS).
Methods: We used computer vision (CV) based on the MobileNetV2 model, implemented via TensorFlow.
Invest Radiol
December 2024
From the Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany (T.W., S.K.M., F.K.W., B.C.M.); Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (L.S.B.); and Institute for Laboratory Animal Science and Central Animal Facility, Hannover Medical School, Hanover, Germany (I.B., R.R.).
Objectives: The aim of this study was to evaluate the impact of a prototype grid with a 29:1 ratio (r29) and a 15:1 (r15) grid on the image quality (IQ) and radiation dose in abdominal angiography.
Materials And Methods: Six typical abdominal angiographic image scenarios were created in 4 pigs. Polymethylmethacrylate and aluminum plates were used to add 10 cm of patient equivalent thickness to simulate different body types.
Eur J Radiol
December 2024
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Mental Health and Neuroscience Research Institute (MHeNs), University Maastricht, Maastricht, the Netherlands.
Background: Both CT angiography and CT perfusion involve the administration and tracking of a contrast medium bolus for different purposes. In this study, we aim to compare the diagnostic accuracy and subjective image quality of CTP-angiographic reconstructions with conventional CTA for occlusion detection in ischemic stroke patients.
Methods: In this retrospective study, patients with a final diagnosis of ischemic stroke and who underwent both CTA and CTP from September 2020 up to and including September 2021 were included.
Neurochirurgie
November 2024
Department of Diagnostic and Interventional Neuroradiology, Hull University Teaching Hospitals, Kingston upon Hull, HU3 2JZ, England, United Kingdom.
Objective: Tortuosity of the internal carotid artery is believed to contribute to the formation of intracranial aneurysms, although there is scant literature on its role as a risk factor for rupture specifically. Therefore, this study investigated the influence of cervical internal carotid artery (cICA) tortuosity on rupture of aneurysms of the anterior cerebral circulation.
Methods: Angiographic imaging studies from patients who underwent endovascular embolisation for anterior circulation aneurysms at a tertiary centre were identified.
Sci Rep
September 2024
Division of Interventional Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Catheter-based embolization has become a widely adopted minimally-invasive treatment for a broad range of applications. However, assessment of embolization endpoints requires x-ray fluoroscopic monitoring, exposing patients and physicians performing embolization procedures to harmful ionizing radiation. Moreover, x-ray fluoroscopy assessment of embolization endpoints is low sensitivity, subjective, and may not reflect the actual physiology of blood flow reduction, thus providing little oversight of the embolization procedure.
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