scholarly journals Additive role of dynamic subtraction MRI in assessment of unresolved HCC post-radiofrequency ablation

Author(s):  
Hany El-Assaly ◽  
Mohamed Farouk Hussein Abdallah ◽  
Wael Maher Mohamed ◽  
Mohamed Ibrahim Youssef

Abstract Background Malignant Hepatocellular carcinoma (HCC) is one amongst the foremost widespread cancers within the world. Radiofrequency ablation (RFA) is that the most generally used substitute tool for hepatic carcinoma treatment. Monitoring tumoral response to loco-regional therapy is a vital mission in oncological imaging. Dynamic contrast enhanced MR and recently added subtraction imaging technique improve assessment of the ablated hepatic focal lesions. The aim of this study is that the evaluation of the role of Subtraction MRI within the detection of recurrent or residual tumoral viability after RF ablation. Results Fifty patients were conducted during this retrospective study, all underwent RFA for 76 hepatic focal lesions and underwent Dynamic MRI study 1 month after ablation. Subtraction imaging was then performed. MRI images were interpreted by two readers who are experienced in hepatic imaging. The primary reader interpreted the standard Dynamic MRI and was blinded to the subtraction sequences; the second reader interpreted both Dynamic and Subtraction MRI images. the primary reader detected 49 resolved cases by dynamic MRI, while the second reader detected residual activity in 6 cases out of 49 via subtraction dynamic MRI (added value). The second reader agreed with first reader in 43 cases (agreement).The first reader detected 27 residual cases by dynamic MRI. The second reader disagreed with first reader in 11 cases appeared resolved out of 27 via subtraction dynamic MRI (added value). The second reader agreed with first reader in residual activity in 16 cases (agreement).The statistical analysis of those results revealed a big additive value of the subtraction imaging to the dynamic MRI (P < 0.001) with moderate degree of agreement between the 2 diagnostic tools (Kappa value = 0.491). This implies that Subtraction MRI significantly improves the reader confidence level within the assessment of treatment response following loco-regional therapies for HCC. Conclusion Dynamic Subtraction MRI is a powerful detector for real enhancement in treated HCC lesions after radiofrequency ablation and hence increasing the degree of readers’ confidence and accuracy of treated lesions in follow-up studies. So it's recommended to feature this powerful tool as a routine to any or all Dynamic MRI studies of the Liver.

2011 ◽  
Vol 14 (2) ◽  
pp. 138 ◽  
Author(s):  
Anit Parihar ◽  
Pallavi Aga ◽  
RavindraKumar Garg ◽  
Navdeep Khurana ◽  
Ragini Singh

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francesca Mancini ◽  
Gianmarco Gasperini ◽  
Omar Rossi ◽  
Maria Grazia Aruta ◽  
Maria Michelina Raso ◽  
...  

AbstractGMMA are exosomes released from engineered Gram-negative bacteria resembling the composition of outer membranes. We applied the GMMA technology for the development of an O-Antigen (OAg) based vaccine against Shigella sonnei, the most epidemiologically relevant cause of shigellosis. S. sonnei OAg has been identified as a key antigen for protective immunity, and GMMA are able to induce anti-OAg-specific IgG response in animal models and healthy adults. The contribution of protein-specific antibodies induced upon vaccination with GMMA has never been fully elucidated. Anti-protein antibodies are induced in mice upon immunization with either OAg-negative and OAg-positive GMMA. Here we demonstrated that OAg chains shield the bacteria from anti-protein antibody binding and therefore anti-OAg antibodies were the main drivers of bactericidal activity against OAg-positive bacteria. Interestingly, antibodies that are not targeting the OAg are functional against OAg-negative bacteria. The immunodominant protein antigens were identified by proteomic analysis. Our study confirms a critical role of the OAg on the immune response induced by S. sonnei GMMA. However, little is known about OAg length and density regulation during infection and, therefore, protein exposure. Hence, the presence of protein antigens on S. sonnei GMMA represents an added value for GMMA vaccines compared to other OAg-based formulations.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dominik J. Wettstein ◽  
Stefan Boes

Abstract Background Price negotiations for specialty pharmaceuticals take place in a complex market setting. The determination of the added value of new treatments and the related societal willingness to pay are of increasing importance in policy reform debates. From a behavioural economics perspective, potential cognitive biases and other-regarding concerns affecting outcomes of reimbursement negotiations are of interest. An experimental setting to investigate social preferences in reimbursement negotiations for novel, oncology pharmaceuticals was used. Of interest were differences in social preferences caused by incremental changes of the patient outcome. Methods An online experiment was conducted in two separate runs (n = 202, n = 404) on the Amazon Mechanical Turk (MTurk) platform. Populations were split into two (run one) and four (run two) equally sized treatment groups for hypothetical reimbursement decisions. Participants were randomly assigned to the role of a public price regulator for pharmaceuticals (buyer) or a representative of a pharmaceutical company (seller). In run two, role groups were further split into two different price magnitude framings (“real world” vs unconverted “real payoff” prices). Decisions had real monetary effects on other participants (in the role of premium payers or investors) and via charitable donations to a patient organisation (patient benefit). Results 56 (run one) and 59 (run two) percent of participants stated strictly monotone preferences for incremental patient benefit. The mean incremental cost-effectiveness ratio (ICER) against standard of care (SoC) was higher than the initial ICER of the SoC against no care. Regulators stated lower reservation prices in the “real world” prices group compared to their colleagues in the unconverted payoff group. No price group showed any reluctance to trade. Overall, regulators rated the relevance of the patient for their decision higher and the relevance of their own role lower compared to sellers. Conclusions The price magnitude of current oncology treatments affects stated preferences for incremental survival, and assigned responsibilities lead to different opinions on the relevance of affected stakeholders. The design is useful to further assess effects of reimbursement negotiations on societal outcomes like affordability (cost) or availability (access) of new pharmaceuticals and test behavioural policy interventions.


2021 ◽  
Author(s):  
Peter Horwich ◽  
Brent A. Chang ◽  
Ameya A. Asarkar ◽  
Gregory W. Randolph ◽  
Cherie‐Ann O. Nathan

2021 ◽  
Vol 25 ◽  
pp. 101170
Author(s):  
Mohd Fandi Al Khafiz Kamis ◽  
Mohd Naim Mohd Yaakob ◽  
Ezamin Abdul Rahim ◽  
Ahmad Sobri Muda ◽  
Mohamad Syafeeq Faeez Md Noh

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 593
Author(s):  
Srikanth Umakanthan ◽  
Maryann M Bukelo

Global genomic studies have detected the role of genomic alterations in the pathogenesis of Epstein–Barr virus (EBV)-associated tumors. EBV oncoproteins cause a vital shift of EBV from an infectious virus to an oncogenic form during the latent and lytic phase within the lymphoid B cells and epithelial cells. This epigenetic alteration modulates the virus and host genomes and inactivates and disrupts numerous tumor suppressors and signaling pathways. Genomic profiling has played the main role in identifying EBV cancer pathogenesis and its related targeted therapies. This article reviews the role of genetic changes in EBV-associated lymphomas and carcinomas. This includes the prolific molecular genesis, key diagnostic tools, and target-specific drugs that have been in recent clinical use.


Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 756
Author(s):  
Francesca Coppola ◽  
Valentina Giannini ◽  
Michela Gabelloni ◽  
Jovana Panic ◽  
Arianna Defeudis ◽  
...  

While cross-sectional imaging has seen continuous progress and plays an undiscussed pivotal role in the diagnostic management and treatment planning of patients with rectal cancer, a largely unmet need remains for improved staging accuracy, assessment of treatment response and prediction of individual patient outcome. Moreover, the increasing availability of target therapies has called for developing reliable diagnostic tools for identifying potential responders and optimizing overall treatment strategy on a personalized basis. Radiomics has emerged as a promising, still fully evolving research topic, which could harness the power of modern computer technology to generate quantitative information from imaging datasets based on advanced data-driven biomathematical models, potentially providing an added value to conventional imaging for improved patient management. The present study aimed to illustrate the contribution that current radiomics methods applied to magnetic resonance imaging can offer to managing patients with rectal cancer.


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