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1.
Rodolfo Pini Gianluca Faggioli Giuseppe Indelicato Enrico Gallitto Chiara Mascoli Andrea Stella Mauro Gargiulo 《Journal of vascular and interventional radiology : JVIR》2019,30(4):503-510
Purpose
To compare perioperative and long-term outcomes of endovascular aneurysm repair (EVAR) with flared limbs (FLs) vs iliac branch devices (IBDs) for common iliac artery aneurysm to determine possible differences in outcome.Materials and Methods
From 2012 to 2017, all patients with standard EVAR with FLs and aortoiliac anatomy fit for implantation of IBDs were retrospectively selected and compared with patients with standard EVAR and IBDs. The study included 150 patients with 162 iliac treatments: 105 (65%) FLs and 57 (35%) IBDs. Iliac complications (ICs), including internal iliac artery (IIA) loss, limb thrombosis, and type 1b or type 3 endoleak, were considered at 30 days and in the follow-up period.Results
Procedural time and volume of contrast medium were significantly higher in IBD vs FL procedures (90 min ± 33 vs 70 min ± 25, P = .01; 130 mL ± 40 vs 80 mL ± 20, P = .01). Perioperative rate of ICs was similar between IBDs and FLs (0% vs 3.8% [4 IIA loss], P = .25). During 35-month median follow-up, there were 10 ICs, all in FLs group (4 IIA perioperative loss, 4 type 1b endoleak, 2 limb occlusion). By Kaplan-Meier analysis, survival free of ICs was significantly higher in IBD group after 4 years of follow-up (1 y 100% vs 96%, P = .36; 2 y 100% vs 94%, P = .14; 3 y 100% vs 91%, P = .07; 4 y 100% vs 87%, P = .03; 5 y 100% vs 78%, P = .02).Conclusions
IBDs and FLs have similar perioperative results. IBDs require longer procedural time and greater contrast medium volume; however, they are associated with lower ICs after 4 years of follow-up. 相似文献2.
Muhammad Zamir Michael Jenkins Nicholas Burfitt Colin Bicknell Richard Gibbs Mohamad Hamady 《Journal of vascular and interventional radiology : JVIR》2019,30(4):546-553
Purpose
To review short-term and midterm results of the fenestrated Anaconda stent graft in management of patients with pre-existing endovascular aortic stent graft and persistent type 1a endoleak.Materials and Methods
This single-center retrospective study assessed all consecutive patients with type 1a endoleak and pre-existing endovascular aneurysm repair (EVAR) treated with fenestrated Anaconda stent grafts. Ten patients (9 males; mean age 78 y) with mean follow-up of 22.4 months ± 13 were included. Average aneurysm size was 80.1 mm (range, 62–101 mm). Mean time for conversion to fenestrated EVAR following original EVAR was 53.7 months (range, 22–101 months; median 54 months). Technical and clinical success; anatomic features, including aortic tortuosity, side vessel angulation, and stenosis; complications; and reinterventions were recorded.Results
The technical success rate was 90%. There was no open conversion and no 30-day mortality, leading to a clinical success rate of 100%. Five of 10 patients demonstrated an aortic tortuosity index of grade 2 or 3. Additional hostile anatomy that made side vessel catheterization challenging was observed in 15 vessels (45%) with a stenosis of ≥ 50% (related to atherosclerotic disease or struts of indwelling prosthesis) and 21 vessels (66%) with ≤ 70° angulation. Two reinterventions, renal artery stent angioplasty and renal artery covered stent extension, were observed at 2 and 13 months.Conclusions
Use of the fenestrated Anaconda endograft in patients with type 1a endoleaks following previous EVAR is safe, feasible, and offers some technical features that facilitate overcoming certain anatomic difficulties. 相似文献3.
Fabien Lareyre Claude Mialhe Carine Dommerc Juliette Raffort 《Journal of vascular and interventional radiology : JVIR》2019,30(4):539-545
Purpose
To evaluate impact of polar renal artery coverage on early renal function after chimney endovascular aneurysm repair (EVAR).Materials and Methods
Consecutive patients who underwent chimney EVAR for treatment of asymptomatic juxtarenal abdominal aortic aneurysm were retrospectively included. Estimated glomerular filtration rate (eGFR) was recorded before the intervention and at 1-, 5-, 7-, and 30-day follow-up. Patients without a polar renal artery were compared with patients with an uncovered polar renal artery and patients with a polar renal artery covered by the endograft.Results
Among 76 patients who underwent chimney EVAR, 15 (19.7%) had a polar renal artery. Four patients (5.3%) had an uncovered polar renal artery and 11 (14.5%) had a covered polar renal artery. The median polar renal artery diameter was 3.3 mm (interquartile range, 2.2–3.8 mm). Preoperative eGFR was similar between the 3 groups (65.5 mL/min/1.73 m2, 61.1 mL/min/1.73 m2, and 53 mL/min/1.73 m2, P = .488). For the 3 groups, postoperative eGFR tended to decrease after the intervention compared with preoperative values, and this decrease reached statistical significance at 5 days and 30 days in patients without a polar renal artery. No significant difference was observed between the 3 groups at any time point. No correlation was observed between the diameter of the covered polar renal artery and eGFR changes postoperatively.Conclusions
Polar renal artery coverage during chimney EVAR does not significantly impair early renal postoperative function, suggesting the safety of the procedure. 相似文献4.
So-Yeon Park Seonghee Kang Jong Min Park Hyun Joon An Do Hoon Oh Jung-in Kim 《Brachytherapy》2019,18(2):224-232
Purpose
The purpose of this study was to develop a patient-specific elastic skin applicator and to evaluate its dosimetric characteristics for high-dose-rate (HDR) brachytherapy.Methods and Materials
We simulated the treatment of a nonmelanoma skin cancer on the nose. An elastic skin applicator was manufactured by pouring the Dragon Skin (Smooth-On Inc., Easton, PA) with a shore hardness of 10A into an applicator mold. The rigid skin applicator was printed using high-impact polystyrene with a shore hardness of 73D. HDR plans were generated using a Freiburg Flap (FF) applicator and patient-specific rigid and elastic applicators. For dosimetric assessment, dose-volumetric parameters for target volume and normal organs were evaluated. Global gamma evaluations were performed, comparing film measurements and treatment planning system calculations with various gamma criteria. The 10% low-dose threshold was applied.Results
The V120% values of the target volume were 56.9%, 70.3%, and 70.2% for HDR plans using FF, rigid, and elastic applicators, respectively. The maximum doses of the right eyeball were 21.7 Gy, 20.5 Gy, and 20.5 Gy for the HDR plans using FF, rigid, and elastic applicators, respectively. The average gamma passing rates were 82.5% ± 1.5%, 91.6% ± 0.8%, and 94.8% ± 0.2% for FF, rigid, and elastic applicators, respectively, with 3%/3 mm criterion.Conclusions
Patient-specific elastic skin applicator showed better adhesion to irregular or curved body surfaces, resulting in better agreement between planned and delivered dose distributions. The applicator suggested in this study can be effectively implemented clinically. 相似文献5.
Hyo-jae Lee Jin Woong Kim Young Hoe Hur Sung Bum Cho Byung Chan Lee Byung Kook Lee Eu Chang Hwang Yong Soo Cho Hyun Ju Seon 《Journal of vascular and interventional radiology : JVIR》2019,30(3):284-292.e1
Purpose
To retrospectively compare long-term outcomes of conventional chemoembolization plus radiofrequency (RF) ablation vs those of surgical resection in patients with a single 3–5-cm hepatocellular carcinoma (HCC).Materials and Methods
From January 2008 to December 2017, 139 of 623 patients who underwent surgical resection and 60 of 186 patients who underwent chemoembolization/RF ablation in a single center were compared with respect to local tumor progression (LTP), intrahepatic distant recurrence (IDR), disease-free survival (DFS), overall survival (OS), major complications, and hospital stay before and after propensity-score matching.Results
Mean follow-up periods were similar in the chemoembolization/RF ablation and surgical resection groups (41.9 mo vs 48.4 mo). Three (5%) and 17 (28.3%) patients in the chemoembolization/RF ablation group and 12 (8.6%) and 57 (41.0%) patients in the surgical resection group showed LTP and IDR (P = .366 and P =.114, respectively). At 1, 3, and 5 years, respective DFS rates were 88.1%, 65.3%, and 49.0% for chemoembolization/RF ablation and 84.2%, 58.2%, and 46.5% for surgical resection (P = .294). Moreover, respective OS rates were 95.0%, 73.5%, and 54.0% for chemoembolization/RF ablation and 97.1%, 87.4%, and 75.0% for surgical resection (P = .055). After matching (n = 52), therapeutic outcomes remained similar (P = .370, P = .110, P = .230, and P = .760, respectively). Surgical resection was associated with higher complication rates (P = .015) and longer hospital stays (8.4 d ± 3.7 vs 16.9 d ± 7.0; P < .001).Conclusions
Conventional chemoembolization combined with RF ablation may be feasible for single 3–5-cm HCCs, with comparable therapeutic outcomes vs surgical resection and shorter hospital stays. 相似文献6.
James C. Campbell Sora C. Yoon Lars J. Grimm 《Journal of the American College of Radiology》2019,16(2):240-243
Purpose
The purpose of this study is to quantify the relationship between author gender and publication topic, as well as the impact of gender-related research.Methods
We reviewed all original research publications in Radiology, American Journal of Roentgenology, and Academic Radiology from 2011 through 2015. For each article, we recorded the gender of all authors and the last author H-index, years in practice, and academic rank. The total citations and citation rate (citations per year) were calculated for each article. Articles were categorized as gender-neutral, women’s health, or men’s health.Results
There were 1,934 publications involving 11,657 authors. Women represented 30% of first, 25% of last, and 28% of all authors. There were 1,596 (83%) gender-neutral, 276 (14%) women’s health, and 61 (3%) men’s health articles. Women’s health articles were associated with a female first (odds ratio [OR] = 5.0, P < .001) and last author (OR = 6.4, P < .001), as well as more female authors (male = 1.4, female = 3.6, P < .001). Men’s health articles were associated with a male first (OR = 2.6, P = .004) and last author (OR = 2.2, P = .03). There were significantly more citations for men’s (43.5 ± 54.9, P < .001) and women’s health (27.6 ± 37.5, P < .008) articles than gender-neutral articles (21.9 ± 28.9). Similarly, the article citation rate was higher for men’s (10.6 ± 11.3, P < .001) and women’s health (6.8 ± 8.5, P = .004) articles than gender-neutral publications (5.3 ± 7.0).Conclusion
Radiology researchers publish more often on topics related to their own gender. Furthermore, men’s and women’s health research generates more citations than gender-neutral research. 相似文献7.
Gerson M. Struik Jean-Philippe Pignol Inger-Karine Kolkman-Deurloo Jeremy Godart Gerda M. Verduijn Linetta B. Koppert Erwin Birnie Ali Ghandi Taco M. Klem 《Brachytherapy》2019,18(2):204-210
Purpose
Accelerated partial breast irradiation is a treatment option for selected patients with early-stage breast cancer. Some accelerated partial breast irradiation techniques lead to skin toxicity with the skin dose as a main risk factor. Biodegradable spacers are effective and safe in prostate brachytherapy to protect the rectum. We hypothesize that a subcutaneous spacer injection reduces the skin dose in breast brachytherapy.Methods and Materials
Ultrasound-guided spacer injections, either hyaluronic acid (HA) or iodined polyethylene glycol (PEG), were performed on fresh mastectomy specimens. Success was defined as a spacer thickness of ≥5 mm in the high-dose skin area. Usability was scored using the system usability scale. Pre and postinjection CT scans were used to generate low-dose-rate seed brachytherapy treatment plans after defining a clinical target volume. Maximum dose to small skin volumes (D0.2cc) and existence of hotspots (isodose ≥90% on 1 cm2 of skin) were calculated as skin toxicity indicators.Results
We collected 22 mastectomy specimens; half had HA and half had PEG injection. Intervention success was 100% for HA and 90.9% for PEG (p = NS). Hydrodissection was feasible in 81.8% with HA and 63.6% with PEG. Median system usability scale score was 97.5 for HA and 82.5 for PEG (p < 0.001). Mean D0.2cc was 80.8 Gy without spacer and 53.7 Gy with spacer (p < 0.001). Skin hotspots were present in 40.9% without spacer but none with spacer (p < 0.001).Conclusions
A spacer injection in mastectomy specimens is feasible. An extra 5 mm space is always achieved, thereby potentially reducing the skin dose dramatically in low-dose-rate seed breast brachytherapy. 相似文献8.
Philip Yuguang Wu Terry Pang Wai Wong Yan Yee Chloe Yip Tien Yee Amy Chang Lai Kwan Lucy Chan Michael Chi Hang Lee Lai Yau Ada Law Mei Wan Rebecca Yeung Sung Inda Soong 《Brachytherapy》2019,18(2):171-179
Background
Paradigm has shifted from 2D to image-guided adaptive brachytherapy (IGABT) for locally advanced cervix cancer (LACC). Increasing reports from pioneering institutions and large retrospective multicenter series have demonstrated improvements in outcome and reduction in toxicity with IGABT. However, there is scarcity of data on magnetic resonance (MR)-IGABT in Chinese patients.Purpose
To evaluate the clinical outcome of MR-IGABT for LACC in a single institution in Hong Kong.Material and Methods
Patients with FIGO stage IB-IVA LACC treated with definitive external beam radiotherapy +/? concurrent cisplatin followed by MR-IGABT from January 2015 to January 2018 were included. Brachytherapy planning and dose reporting followed the GEC-ESTRO recommendations. Dosimetric and clinical outcomes including local control (LC), pelvic control (PC), cancer-specific survival, overall survival (OS), and toxicity were analyzed.Results
Forty-two consecutive patients were included. 71% were FIGO stage IIB or above; 52% had pelvic node involvement. Median high-risk clinical target volume (HRCTV) was 34.7 cm3 (12.3–155.1 cm3). Median dose to HRCTV D90 was 88.5 Gy (63.4–113.4 Gy) (EQD210). Median doses to the D2cc of bladder, rectum, sigmoid, and small bowel were 83.1 Gy, 67.5 Gy, 69.0 Gy, and 68.9 Gy (EQD23), respectively. Median followup was 20.3 months (4.0–35.1 months). 24-month actuarial LC, PC, cancer-specific survival, and OS were 90%, 84%, 90%, and 90%, respectively. Stratification by clinical variables showed that FIGO stage had significant impact on LC and dose to HRCTV on both LC and PC. Treatment was well tolerated without any severe late toxicity.Conclusions
Intermediate-term results from systematic MR-IGABT for LACC demonstrate very promising outcomes with minimal toxicity. This fills the gap in evidence for MR-IGABT in Chinese patients. 相似文献9.
Ning Lyu Yanan Kong Tao Pan Luwen Mu Shaolong Li Yaru Liu Haijing Deng Jibin Li Ming Shi Li Xu Rongping Guo Minshan Chen Peihong Wu Ming Zhao 《Journal of vascular and interventional radiology : JVIR》2019,30(3):349-357.e2
Purpose
To compare treatment with hepatic arterial infusion of chemotherapy (HAIC) in patients with advanced hepatocellular carcinoma (HCC) with both extrahepatic spread (EHS) and intrahepatic tumor and patients with intrahepatic tumor only.Materials and Methods
This single-center retrospective study comprised 116 patients with advanced HCC with both intrahepatic tumor and EHS (EHS group; n = 50) or with intrahepatic tumor only (non-EHS group; n = 66) treated with HAIC including oxaliplatin, fluorouracil, and leucovorin between June 2014 and July 2016. Overall survival (OS) and radiologic responses to treatment were determined and compared between the 2 groups.Results
Both the objective response rate and the clinical benefit rate were higher in the non-EHS group than in the EHS group (37.9% vs 16% objective response rate, P = .010; 81.8% vs 62% clinical benefit rate, P = .017). Median OS was not statistically different between the 2 groups (14.8 months vs 9.8 months, P = .068). Subgroup analysis of OS found that patients with lung metastases survived for a shorter time (OS 7 months) than patients with other metastatic sites (P = .003) and patients free of metastases (P = .001).Conclusions
HAIC is a potential treatment option for advanced HCC with limited extrahepatic metastases in a population with hepatitis B virus infection. 相似文献10.
Kyung Ah Kim Sun Young Choi Min Uk Kim Seung Yon Baek Sang Hui Park Kwon Yoo Tae Hun Kim Hwi Young Kim 《Journal of vascular and interventional radiology : JVIR》2019,30(3):358-369
Purpose
To evaluate efficacy of cone-beam CT–based liver perfusion mapping obtained immediately following conventional transarterial chemoembolization of hepatocellular carcinoma (HCC) for assessing tumor vascularity, technical success of chemoembolization, and treatment response.Materials and Methods
From July 2015 to June 2016, 35 patients with 57 HCCs who underwent cone-beam CT with post-processing software via conventional transarterial chemoembolization for HCC and follow-up examination were included. Three reviewers evaluated technical success on angiography, unenhanced cone-beam CT, contrast-enhanced cone-beam CT, and cone-beam CT–based liver perfusion mapping after transarterial chemoembolization per tumor and per patient. Parenchymal blood volume (PBV) was measured. Treatment response was determined on follow-up CT, MR imaging, or histopathology according to modified Response Evaluation Criteria In Solid Tumors. Diagnostic performance for detection of a viable tumor was evaluated using multiple logistic regression with C-statistics.Results
Treatment response was 38, 17, 2, and 0 for complete response, partial response, stable disease, and progressive disease per tumor and 18, 15, 2, and 0 per patient. In multiple logistic regression, unenhanced cone-beam CT, contrast-enhanced cone-beam CT, cone-beam CT–based liver perfusion mapping, mean value of PBV, and maximum value of PBV of tumor were significant in response assessment for per tumor and per patient (per tumor, all P < .001; per patient, P = .015, P = .001, P < .001, P = .020, and P = .032). Mean value of PBV of tumor was excellent for evaluating technical success with the highest C-statistic (0.880 and 0.920 for per tumor and per patient), followed by that of visual assessment of cone-beam CT–based liver perfusion mapping (0.864 and 0.908).Conclusions
Cone-beam CT–based liver perfusion mapping provided reliable images to evaluate technical success after transarterial chemoembolization of HCC by qualitative visual assessment and quantitative perfusion values. 相似文献11.
Ramsey Al-Hakim J. Cody Hedge Younes Jahangiri John A. Kaufman Roberto Galuppo Khashayar Farsad 《Journal of vascular and interventional radiology : JVIR》2019,30(3):421-424
Purpose
To investigate the efficacy of palmar warming to induce radial artery vasodilation.Materials and Methods
After informed consent was obtained, healthy volunteers (n = 45) were randomized 2:1 in palmar warming and control groups, respectively, for this prospective, randomized, single-blind clinical trial (NCT03620383). The palmar warming group was given a warm, commercially available, air-activated heat pack (Kobayashi Consumer Products LLC, Dalton, Georgia) to hold in the left hand for palmar warming. The control group was given a deactivated version of the same heat pack. Left radial artery cross-sectional area (CSA) measurements were obtained at baseline and in 5-minute intervals up to 20 minutes in both groups. Differences in the trends of changes in the radial artery CSA between palmar warming and control groups were examined with the age- and sex-adjusted repeated measure analysis of variance. Propensity score-matched treatment effect analysis was conducted to quantify the effect of heat on radial artery CSA.Results
The palmar warming group and the control group were significantly different in terms of subject sex (males/females: 7/23 and 10/5, respectively; P = .005) and baseline CSA (2.5±0.2 mm2 vs 3.2±0.3 mm2, respectively; P = .014). Radial artery CSA showed an increasing trend over time in the palmar warming group compared to a stable trend over time in the control group (P < .0001). Propensity score-matched comparison showed a 43.9% increase (95% confidence interval: 34.1%–53.8%) in CSA in the palmar warming group compared to the control group (P < .0001).Conclusions
The palmar warming technique is effective at dilating the radial artery and may be a beneficial technique to facilitate transradial access. 相似文献12.
Elena Marchiori Monika Herten Michel Bosiers Arne Schwindt Theodosios Bisdas Martin Austermann Giovanni Torsello Konstantinos Stavroulakis 《Journal of vascular and interventional radiology : JVIR》2019,30(4):531-538
Purpose
To evaluate the effectiveness and durability of intra-arterial aneurysm sac embolization for the treatment of type Ia endoleak after endovascular aneurysm repair (EVAR).Materials and Methods
From February 2011 to December 2016, 22 patients underwent embolization of a type Ia endoleak after EVAR. Four patients (18%) were treated during the index EVAR and 18 (82%) in follow-up. Five patients (23%) were treated urgently and 17 (77%) electively. The embolization was performed with the use of liquid embolic agent, coils, and/or plugs. Adjunctive neck procedures were performed in 55% (n = 12) of the patients. The primary endpoint of this study was freedom from sac enlargement. Key secondary endpoints were technical success and freedom from endoleak-related reinterventions.Results
Technical success was 100%. The 30-day mortality was 5% (n = 1; acute coronary syndrome). At a mean follow-up of 15.4 months (range 0.1–65.4) the freedom from sac enlargement rate was 76% (16 out of 21). Reintervention-free survival rates at 6, 12, and 24 months were 80%, 68% and 68%, respectively.Conclusions
In patients with persistent type Ia endoleak the embolization of the aneurysm sac with or without adjunctive neck procedures can be safely performed, leading to acceptable clinical and radiologic outcomes. 相似文献13.
Kichang Han Ki Woong Yoon Jin Hyoung Kim Gyoung Min Kim 《Journal of vascular and interventional radiology : JVIR》2019,30(3):428-434
Purpose
To evaluate the safety and efficacy of bronchial artery embolization (BAE) in patients with primary lung cancer-related hemoptysis and to identify factors associated with hemoptysis-free survival.Methods
Data from 84 patients with primary lung cancer (non-small cell [n = 74] and small cell [n = 10]) who underwent BAE from 1997 to 2018 for the management of hemoptysis were retrospectively reviewed. Of these, 53 patients had stage IV lung cancer. The hemoptysis volume prior to initial BAE was trivial (blood-tinged sputum) in 21 patients, moderate (< 300 mL per 24 hours) in 34 patients, and massive (> 300 mL per 24 hours) in 29 patients.Results
Technical success, defined as the ability to selectively embolize the abnormal vessel, was achieved in 83 patients (98.8%), and clinical success was achieved in 69 (82.1%) patients. Polyvinyl alcohol particles were used to embolize in 51 patients, gelfoam in 15 patients, and gelfoam plus microcoils in 17 patients. Hemoptysis recurred in 20 patients (23.8%) during follow-up. The median hemoptysis-free survival and overall survival periods were both 61 days. In the clinical-success and clinical-failure groups, the median overall survival period was 99 and 9 days, respectively (P < .001). In multivariable analysis, massive hemoptysis (P = .012) and cavitary lung mass (P = .019) were predictive factors for shortened hemoptysis-free survival.Conclusions
BAE is a safe and effective approach to control hemoptysis, although the prognosis in primary lung cancer patients presenting with hemoptysis is generally poor. Massive hemoptysis and cavitary lung mass are significant predictors of shortened hemoptysis-free survival. 相似文献14.
Edwin A. Takahashi Chad J. Fleming James C. Andrews 《Journal of vascular and interventional radiology : JVIR》2019,30(3):435-439
Purpose
To determine if there is a correlation between intrahepatic tumor volume and future liver remnant (FLR) hypertrophy after portal vein embolization (PVE).Materials and Methods
Forty-four consecutive patients with hepatocellular carcinoma or metastatic colorectal cancer who underwent PVE from 2009 to 2017 and who had complete imaging follow-up were retrospectively reviewed. To maximize the accuracy of tumor volume measurements, 11 patients were excluded for having more than 5 intrahepatic tumors. Volumetric analyses of the patient livers before and after PVE, as well as pre-embolization intrahepatic tumor burden, were performed.Results
A significant inverse correlation was observed between tumor volume and FLR hypertrophy after PVE (Spearman ρ = -0.53, P = .002). Initial FLR volume was also inversely correlated with subsequent hypertrophy (P = .01). Fourteen patients received neoadjuvant chemotherapy 1 month prior to intervention. The number of chemotherapy cycles did not affect hypertrophy (P = .57). Patients with cirrhosis experienced less FLR hypertrophy than patients without cirrhosis (P = .02).Conclusions
Patients with large intrahepatic tumor burden may experience limited FLR hypertrophy. 相似文献15.
Rika Yoshimatsu Takuji Yamagami Miki Nishimori Kenta Ogi Yoriko Murata Hitomi Iwasa Kenji Kajiwara Tomoaki Yamanishi Hiroki Minamiguchi Takashi Karashima Keiji Inoue 《Journal of vascular and interventional radiology : JVIR》2019,30(3):460-465
Purpose
To evaluate the influence of percutaneous cryoablation for renal cell carcinoma on function of the affected kidney.Materials and Methods
Between June 2016 and September 2017 at our institution, 12 inoperable patients underwent 15 cryoablation sessions for 17 small renal tumors. Of these, 9 patients who underwent 11 sessions of cryoablation were the focus of this study. For those patients, time-dependent changes in postoperative renal function were investigated by a retrospective review of clinical records. Evaluated were the estimated glomerular filtration rate (eGFR) and scintigraphy using 99m technetium-mercaptoacetyltriglycine (99mTc-MAG3) before and 1 week, 1–2 months, and more than 6 months after cryoablation.Results
Mean baseline eGFR was 76.88 ± 29.82 mL/min/1.73 m2 (mean ± standard deviation; range, 23.4–112.5). Mean eGFR 1 week, 1–2 months, and more than 6 months after cryoablation were 74.56 ± 26.68 mL/min/1.73 m2 (21.0–101.1), 69.5 ± 25.28 mL/min/1.73 m2 (24.1–105.6), and 75.08 ± 26.25 mL/min/1.73 m2 (29.0–107.3), respectively. Changes were statistically insignificant (P = .6044, P = .6699, and P = .9038, respectively). Regarding split renal function, the mean baseline contribution of the affected kidney determined by 99mTc-MAG3 was 47.27% ± 6.14 (38.8%–57.0%). Mean contributions of the affected kidney 1 week after, 1–2 months after, and more than 6 months after cryoablation were 44.40% ± 5.37 (38.3%–53.6%), 44.57% ± 6.52 (34.35%–55.0%), and 45.41% ± 7.77 (34.4%–56.5%), respectively. Differences from baseline were significant for the earliest 2 periods (P = .0473 and P = .0334, respectively) but not the later period (P = .2532).Conclusions
Results suggested that total renal function does not worsen after cryoablation; however, function of the affected kidney worsened after cryoablation but later partially recovered. 相似文献16.
Nikolaos Galanakis Thomas G. Maris Nikolaos Kontopodis Christos V. Ioannou Elias Kehagias Nikolas Matthaiou Antonios E. Papadakis Adam Hatzidakis Konstantinos Perisinakis Dimitrios Tsetis 《Journal of vascular and interventional radiology : JVIR》2019,30(4):560-568
Purpose
To evaluate foot perfusion in patients with critical limb ischemia (CLI) using quantitative perfusion multi–detector-row CT and estimate perfusion parameter changes before and after percutaneous transluminal angioplasty (PTA).Materials and Methods
This prospective study investigated 13 patients (10 men; median age, 72 y; range, 51–84 y) with CLI who underwent CT foot perfusion examinations with a 128-slice dual-energy CT scanner 1 day before and 1 week after PTA. Key parameters such as permeability surface (PS), blood volume (BV), and blood flow (BF) were analyzed and compared statistically. The studies were also examined by a second observer to determine interobserver reproducibility.Results
Revascularization was technically successful in all patients, and mean ankle–brachial index increased from 0.36 ± 0.16 to 0.75 ± 0.22. After revascularization, mean BV increased from 1.55 mL/100 g ± 0.83 to 4.51 mL/100 g ± 1.53, BF increased from 16.28 mL/100 g/min ± 4.97 to 31.49 mL/100 g/min ± 6.86, and PS increased from 3.1 mL/min/100 g ± 1.95 to 8.67 mL/min/100 g ± 3.85 (P < .05). Patients with poor response to revascularization who finally underwent amputation presented lower post-PTA perfusion parameters values than patients with significant clinical improvement (P < .05). All measurements demonstrated very good interobserver reproducibility, and intraclass correlation coefficients were 0.91 for BV, 0.94 for BF, and 0.95 for PS. The mean effective dose of the examination was estimated at 0.29 mSv.Conclusions
CT foot perfusion is a reproducible technique that may be a useful modality for the estimation of PTA outcome. Significant restitution of perfusion parameters was observed after successful revascularization. 相似文献17.
Ricardo Yamada Beatriz Bassaco Lea Dufour Heather Collins Michael Bret Anderson Christopher Hannegan Marcelo Guimaraes 《Journal of vascular and interventional radiology : JVIR》2019,30(3):390-395
Purpose
To assess the safety and efficacy of single-session transarterial embolization and radiofrequency (RF) ablation for hepatic tumors with the use of needle navigation software.Materials and Methods
Retrospective analysis was conducted of 24 patients with liver cancer undergoing embolization followed by RF ablation between May 2014 and August 2017. Twelve patients each underwent (i) embolization and computed tomography (CT)–guided RF ablation during different sessions (group 1) and (ii) embolization followed by RF ablation with cone-beam CT and Needle Assist software in 1 session (group 2). Median age (70.5 y [range, 58–78 y] vs 70.5 y [range, 50–82 y]; P = .76) and performance status (0/1) were comparable between groups. Median tumor size was significantly larger in group 2 (2 cm [range, 1.0–7.3 cm] vs 3.2 cm [range, 1.1–9.6 cm]; P < .03). Procedure time, effective dose, and number of scans were examined. Efficacy was assessed by modified Response Evaluation Criteria In Solid Tumors after 1 month. Safety was assessed by Society of Interventional Radiology adverse event classification.Results
Group 1 had a mean of 8.5 CT scans, vs a mean of 5.0 cone-beam CT scans in group 2 (P < .001). Median procedure times were 110 min in group 1 and 199.5 min in group 2 (P < .001). Median effective doses were 68.8 mSv in group 1 and 55.4 mSv in group 2 (P = .38). There was no difference in complete response between groups (66.7% vs 63.6%; P = 1).Conclusions
Transarterial embolization followed by RF ablation with cone-beam CT and needle guidance software in a single session seems to be safe and effective. 相似文献18.
Peiman Habibollahi Sara Pourhassan Shamchi John M. Choi Terence P. Gade S. William Stavropoulos Stephen J. Hunt Mandeep Dagli Deepak Sudheendra Jeffery I. Mondschein Michael C. Soulen Gregory J. Nadolski 《Journal of vascular and interventional radiology : JVIR》2019,30(3):323-329
Purpose
To evaluate long-term outcomes of patients with hepatocellular carcinoma (HCC) who show a complete response (CR) vs non-CR on pretransplantation imaging studies or pathologic evaluation of liver explants after locoregional therapy (LRT) before liver transplantation.Materials and Methods
Patients listed for liver transplantation for HCC (March 1998 to December 2010) undergoing LRT with available multiphase MR/CT imaging before transplantation were included. Pathologic response was evaluated based on liver explant pathology. A total of 108 patients (17 women; 16%) met the inclusion criteria.Results
Radiologic CR was achieved in 65 patients (60%) vs non-CR in 43 (40%), and pathologic CR was achieved in 36 patients (33%) vs non-CR in 72 (67%). Mean 5-year overall survival (OS) from the time of listing and recurrence-free survival (RFS) after liver transplantation were significantly better for patients with pathologic CR vs non-CR on explant pathology (OS, 83.3% vs 65.2% [28% difference; P = .046]; RFS, 80.6% vs 62.5% [29% difference; P = .045]). Mean 5-y OS and RFS were not significantly different between patients with radiologic CR or non-CR on pretransplantation imaging (OS, 75.4% vs 65.1% [P = .12]; RFS, 74% vs 62.8% [P = .17]).Conclusions
Achievement of a pathologic CR vs non-CR in response to LRT before liver transplantation for HCC is associated with improved OS from time of listing and improved RFS after liver transplantation. However, current imaging paradigms fall short of accurate delineation of response to LRT, resulting in poor correlation of outcomes between pathologic and radiologic CR. 相似文献19.
Marcelina G. Perez Magali Fassiotto Jonathan Altamirano Gloria L. Hwang Yvonne Maldonado Shellie Josephs Daniel Y. Sze Nishita Kothary 《Journal of vascular and interventional radiology : JVIR》2019,30(4):579-583
Purpose
To investigate the current state of gender diversity among invited coordinators at the Society of Interventional Radiology (SIR) Annual Scientific Meeting and to compare the academic productivity of female interventional radiologists to that of invited male coordinators.Materials and Methods
Faculty rosters for the SIR Annual Scientific Meetings from 2015 to 2017 were stratified by gender to quantify female representation among those asked to lead and coordinate podium sessions. To quantify academic productivity and merit, H-index, publications, and authorship by females over a 6-year period (2012–2017) were statistically compared to that of recurring male faculty.Results
From 2015 to 2017, women held 7.1% (9/126), 4.3%, (8/188), and 13.7% (27/197) of the available coordinator positions for podium sessions, with no representation at the plenary sessions, and subject matter expertise was concentrated in economics and education. Academic productivity of the top quartile of published female interventional radiologists was statistically similar to that of the invited male faculty (H-index P = .722; total publications P = .689; and authorship P = .662).Conclusions
This study found that senior men dominate the SIR Annual Scientific Meeting, with few women leading or coordinating the podium sessions, despite their established academic track record. 相似文献20.
Nassir Rostambeigi Patrick Scanlon Siobhan Flanagan Nicholas Frank Reza Talaie Rafael Andrade Jafar Golzarian Prashant Shrestha 《Journal of vascular and interventional radiology : JVIR》2019,30(3):453-459
