Radiopaque and biodegradable beads fabricated with Lipiodol and polycaprolactone for transarterial chemoembolization

MRS Advances ◽  
2019 ◽  
Vol 4 (20) ◽  
pp. 1187-1192
Author(s):  
Yutaka Okamoto ◽  
Kenta Bito ◽  
Terumitsu Hasebe ◽  
Tomohiro Matsumoto ◽  
Atsushi Hotta
Keyword(s):  
Microfluidic Device ◽  
Transarterial Chemoembolization ◽  
Ct Scanning ◽  
Flow Rate Ratio ◽  
Embolic Agent ◽  
Ct Number ◽  
Weight Loss Data ◽  
Fluoroscopic Imaging ◽  
Ethiodized Oil ◽  
The Mean

AbstractEmbolic beads for transarterial chemoembolization (TACE) should possess radiopacity and biodegradability at the same time, to be visualized in a body under fluoroscopy and CT scanning to avoid complicating disease. In this study, we fabricated radiopaque and biodegradable beads composed of Lipiodol (LPD) (ethiodized oil) and polycaprolactone (PCL), a biocompatible and biodegradable polymer. LPD/PCL beads were first fabricated with a home-made microfluidic device. By changing the flow-rate ratio in the microfluidic device, the mean diameter of LPD/PCL beads could be well controlled. The radiopacity was evaluated by the fluoroscopic imaging and the CT number measurements. Furthermore, the biodegradability was evaluated by collecting the weight loss data of LPD/PCL immersed in lipase/PBS solution and PBS. The results showed that LPD/PCL beads obtained in this study had sufficient radiopacity and biodegradability, which would be an alternative embolic agent for TACE.

scholarly journals Comparison of the Number of Image Acquisitions and Procedural Time Required for Transarterial Chemoembolization of Hepatocellular Carcinoma with and without Tumor-Feeder Detection Software

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Jin Iwazawa ◽  
Shoichi Ohue ◽  
Naoko Hashimoto ◽  
Takashi Mitani
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Therapeutic Efficacy ◽  
Single Session ◽  
Feeder Vessel ◽  
Vessel Detection ◽  
Procedural Time ◽  
The Mean ◽  
Detection Software ◽  
Time Required

Purpose. To compare the number of image acquisitions and procedural time required for transarterial chemoembolization (TACE) with and without tumor-feeder detection software in cases of hepatocellular carcinoma (HCC).Materials and Methods. We retrospectively reviewed 50 cases involving software-assisted TACE (September 2011–February 2013) and 84 cases involving TACE without software assistance (January 2010–August 2011). We compared the number of image acquisitions, the overall procedural time, and the therapeutic efficacy in both groups.Results. Angiography acquisition per session reduced from 6.6 times to 4.6 times with software assistance (P<0.001). Total image acquisition significantly decreased from 10.4 times to 8.7 times with software usage (P=0.004). The mean procedural time required for a single session with software-assisted TACE (103 min) was significantly lower than that for a session without software (116 min,P=0.021). For TACE with and without software usage, the complete (68% versus 63%, resp.) and objective (78% versus 80%, resp.) response rates did not differ significantly.Conclusion. In comparison with software-unassisted TACE, automated feeder-vessel detection software-assisted TACE for HCC involved fewer image acquisitions and could be completed faster while maintaining a comparable treatment response.

Curative treatment for low-grade arteriovenous malformations

2019 ◽  
Vol 12 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Arthur Wang ◽  
Grace K Mandigo ◽  
Neil A Feldstein ◽  
Michael B Sisti ◽  
E Sander Connolly ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Functional Outcomes ◽  
Arteriovenous Malformations ◽  
Combined Treatment ◽  
Curative Treatment ◽  
Embolic Agent ◽  
Preoperative Embolization ◽  
Low Grade ◽  
The Mean

BackgroundSpetzler-Martin (SM) grade I-II (low-grade) arteriovenous malformations (AVMs) are often considered safe for microsurgery or radiosurgery. The adjunctive use of preoperative embolization to reduce surgical risk in these AVMs remains controversial.ObjectiveTo assess the safety of combined treatment of grade I-II AVMs with preoperative embolization followed by surgical resection or radiosurgery, and determine the long-term functional outcomes.MethodsWith institutional review board approval, a retrospective analysis was carried out on patients with ruptured and unruptured SM I-II AVMs between 2002 and 2017. Details of the endovascular procedures, including number of arteries supplying the AVM, number of branches embolized, embolic agent(s) used, and complications were studied. Baseline clinical and imaging characteristics were compared. Functional status using the modified Rankin Scale (mRS) before and after endovascular and microsurgical treatments was compared.Results258 SM I-II AVMs (36% SM I, 64% SM II) were identified in patients with a mean age of 38 ± 17 years. 48% presented with hemorrhage, 21% with seizure, 16% with headache, 10% with no symptoms, and 5% with clinical deficits. 90 patients (68%) in the unruptured group and 74 patients (59%) in the ruptured group underwent presurgical embolization (p = 0.0013). The mean number of arteries supplying the AVM was 1.44 and 1.41 in the unruptured and ruptured groups, respectively (p = 0.75). The mean number of arteries embolized was 2.51 in the unruptured group and 1.82 in the ruptured group (p = 0.003). n-Butyl cyanoacrylate and Onyx were the two most commonly used embolic agents. Four complications were seen in four patients (4/164 patients embolized): two peri-/postprocedural hemorrhage, one dissection, and one infarct. All patients undergoing surgery had a complete cure on postoperative angiography. Patients were followed up for a mean of 55 months. Good long-term outcomes (mRS score ≤ 2) were seen in 92.5% of patients with unruptured AVMs and 88.0% of those with ruptured AVMs. Permanent neurological morbidity occurred in 1.2%.ConclusionsCurative treatment of SM I-II AVMs can be performed using endovascular embolization with microsurgical resection or radiosurgery in selected cases, with very low morbidity and high cure rates. Compared with other published series, these outcomes suggest that preoperative embolization is a safe and effective adjunct to definitive surgical treatment. Long-term follow-up showed that patients with low-grade AVMs undergoing surgical resection or radiosurgery have good functional outcomes.

scholarly journals Efficacy and Safety of Drug-Eluting Beads Transarterial Chemoembolization by CalliSpheres® in 275 Hepatocellular Carcinoma Patients: Results From the Chinese CalliSpheres® Transarterial Chemoembolization in Liver Cancer (CTILC) Study

2020 ◽  
Vol 28 (1) ◽  
pp. 75-94 ◽  
Author(s):  
Junhui Sun ◽  
Guanhui Zhou ◽  
Xiaoxi Xie ◽  
Wenjiang Gu ◽  
Jing Huang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Portal Vein ◽  
Treatment Response ◽  
Transarterial Chemoembolization ◽  
Efficacy And Safety ◽  
Portal Vein Invasion ◽  
Drug Eluting Beads ◽  
Drug Eluting ◽  
The Mean

The purpose of this study was to investigate the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) treatment in Chinese hepatocellular carcinoma (HCC) patients and the prognostic factors for treatment response as well as survival. A total of 275 HCC patients were included in this prospective study. Treatment response was assessed by modified Response Evaluation Criteria in Solid Tumors (mRECIST), and progression-free survival (PFS) as well as overall survival (OS) were determined. Liver function and adverse events (AEs) were assessed before and after DEB-TACE operation. Complete response (CR), partial response (PR), and objective response rate (ORR) were 22.9%, 60.7%, and 83.6%, respectively. The mean PFS was 362 (95% CI: 34.9‐375) days, the 6-month PFS rate was 89.4 ± 2.1%, while the mean OS was 380 (95% CI: 370‐389) days, and the 6-month OS rate was 94.4 ± 1.7%. Multivariate logistic regression revealed that portal vein invasion (p = 0.011) was an independent predictor of worse clinical response. Portal vein invasion (p = 0.040), previous cTACE treatment (p = 0.030), as well as abnormal serum creatinine level (BCr) (p = 0.017) were independent factors that predicted worse ORR. In terms of survival, higher Barcelona Clinic Liver Cancer (BCLC) stage (p = 0.029) predicted for worse PFS, and abnormal albumin (ALB) (p = 0.011) and total serum bilirubin (TBIL) (p = 0.009) predicted for worse OS. The number of patients with abnormal albumin, total protein (TP), TBIL, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were augmented at 1 week posttreatment and were similar at 1‐3 months compared with baseline. The most common AEs were pain, fever, nausea, and vomiting, and no severe AEs were observed in this study. DEB-TACE was effective and tolerable in treating Chinese HCC patients, and portal vein invasion, previous cTACE treatment, abnormal BCr, ALB, and TBIL appear to be important factors that predict worse clinical outcome.

Ethiodized oil emulsion 13 in computed tomography of hepatoma.

1984 ◽  
Vol 2 (2) ◽  
pp. 118-123 ◽  
Author(s):  
J P Dutcher ◽  
P J Haney ◽  
N O Whitley ◽  
R Finley ◽  
P Pearl ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scanning ◽  
Tumor Location ◽  
Oil Emulsion ◽  
Accurate Definition ◽  
Enhanced Ct ◽  
Ethiodized Oil ◽  
Definition Of

Six patients with biopsy-proven hepatoma were prospectively evaluated both by conventional computed tomography (CT) and by scans using ethiodized oil emulsion 13 (EOE 13) as a contrast agent. EOE 13 infusion resulted in marked improvement in the demonstration of the neoplasm in all cases and allowed more accurate definition of tumor extent than was possible with standard scanning techniques. In two cases EOE 13 enhancement was essential for complete radiographic depiction of tumor location, size, and extent. EOE 13 also proved to be of considerable value in assessment of therapeutic response in three patients, permitting more objective determination of tumor growth or regression. EOE 13--enhanced CT scanning provides a valuable means of staging patients presenting with hepatoma and is a reliable, accurate means of radiographic follow-up.

scholarly journals Clinical Outcome of Carotid Body Paraganglioma Management: A Review of 10-Year Experience

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ahmed Elsayed Fathalla ◽  
Mohammad Ahmad Elalfy
Keyword(s):  
Adjuvant Chemotherapy ◽  
Carotid Artery ◽  
Carotid Body ◽  
Ct Scanning ◽  
Surgical Approaches ◽  
R0 Resection ◽  
Primary Malignancy ◽  
Nerve Paralysis ◽  
The Mean

Background. Carotid body paragangliomas are rare neoplasms usually benign, however sometimes presenting as highly aggressive tumors. Surgery is the main line of treatment. Purpose. To study and describe clinical presentations, surgical approaches, postoperative complications, and treatment outcomes. Materials and Methods. A single-institution retrospective analysis of 19 cases with carotid body paragangliomas who were candidates for surgery from January 2009 through January 2019 with a mean follow-up period of 58.8 months. Results. The mean age was 46 years with the female predominance of 63%. The mean size of the tumor was 4.3 cm. All cases were presented with a painless pulsating neck lump located anteriorly at the level of the hyoid bone. Neck US was done in all cases as a primary screening investigation. CT scanning was the second main investigation performed in 17 cases (89.5%) revealing tumors attached to the carotid artery at its bifurcation. Urinary catecholamine metabolites were measured in all cases to rule out familial functioning types. 5 cases (26.3%) were malignant. All cases were surgically approached through transcervical transverse incision. 11, 5, and 3 cases were classified as Shamblin’s type II, III, and I, respectively. All tumors were R0 resected with nodal neck dissection conducted in the malignant group. Major complications occurred in 4 cases (21%) during tumor dissection from the adventitia of carotid bifurcation. ECA ligation was performed in one case (5.3%). 2 patients (10.5%) suffered XII nerve paralysis. Carotid artery blowout occurred in one patient (5.3%) and was immediately controlled. No operative mortality occurred. All patients were free of disease during the follow-up period. 4 malignant cases (21%) suffered a systemic relapse to bone and lung metastasis justifying adjuvant chemotherapy, radiotherapy, or both. Conclusions. Surgery is the treatment of choice for carotid body paragangliomas. Complete R0 resection should be justified especially in case of malignancy. Adjuvant chemotherapy or radiotherapy is an option for patients with primary malignancy or relapse.

Three-dimensional measurement of growth of ossification of the posterior longitudinal ligament

2012 ◽  
Vol 16 (3) ◽  
pp. 289-295 ◽  
Author(s):  
Takahito Fujimori ◽  
Motoki Iwasaki ◽  
Yukitaka Nagamoto ◽  
Takahiro Ishii ◽  
Hironobu Sakaura ◽  
...  
Keyword(s):  
Multidetector Ct ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Ct Scanning ◽  
Posterior Longitudinal Ligament ◽  
Progression Rate ◽  
Volume Data ◽  
Volume Increase ◽  
True Value ◽  
The Mean

Object Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease that causes cervical myelopathy. Because 2D evaluation of ossification growth with plain lateral radiographs has limitations, the authors developed a unique technique to measure ossification progression and volume increase by using multidetector CT scanning. Methods The authors used serial thin-slice volume data obtained by multidetector CT scanning in 5 patients. The mean patient age was 63 years, and the mean follow-up duration was 3.1 years. First, a 3D model of OPLL was semiautomatically segmented at a specific threshold. Then, a preoperative model of OPLL was superimposed on a postoperative model using voxel-based registration of the vertebral bodies. Progression and volume increase were measured using a digital viewer that was developed by the authors. Progression was visualized using a color-coded contour on the surface of the OPLL model. Results All patients had progression of 0.5 mm or greater. The mean values concerning OPLL growth were as follows: maximum progression length, 4.7 mm; progression rate, 1.5 mm/year; volume increase, 1622 mm3; volume expansion rate, 37%; and volume increase rate, 484 mm3/year. The accuracy of superimposition by voxel-based registration, defined as closeness to the true value, was less than 0.31 mm. For intraobserver reproducibility of the volume measurement, the mean intraclass correlation coefficient, root mean square error, and coefficient of variation were 0.987, 16.0 mm3, and 1.7%, respectively. Conclusions Ossification of the posterior longitudinal ligament progresses even after surgery. Three-dimensional evaluation with the aid of CT scans is a useful and reliable method for assessing that growth.

scholarly journals Investigation on the relationship between CT numbers and marble failure under different confining pressures

2021 ◽  
Vol 60 (1) ◽  
pp. 846-852
Author(s):  
Yang Yan-Shuang ◽  
Li Kai-Yue ◽  
Zhou Hui ◽  
Tian Hao-Yuan ◽  
Cheng Wei ◽  
...  
Keyword(s):  
Damage Mechanics ◽  
Triaxial Compression ◽  
Ct Scanning ◽  
Confining Pressure ◽  
Triaxial Tests ◽  
Compression Tests ◽  
Ct Number ◽  
Confining Pressures ◽  
Loading Tests ◽  
Rock Specimens

Abstract Computed tomography (CT) scanning technology is helpful in investigating rock materials as it can demonstrate the micro structure of rock clearly. Conventional triaxial compression tests and the corresponding graded triaxial loading tests were carried out to investigate the complex failure mechanism of the marble at the Jinping Hydropower Station. After that CT-scanning tests were done on the loaded marble specimens. The test results show that (1) the CT numbers of the specimens have a certain statistical regularity, that is, the CT numbers of the specimens under different confining pressures satisfy the Weibull distribution, as the confining pressure increases, the mean values rise while variances decrease; (2) in the two groups of tests, the average CT numbers corresponding to the conventional triaxial tests are higher than those corresponding to the graded loading tests, but the CT number variances are lower than those of the graded loading tests; and (3) according to meso-damage mechanics, the damage variables of the rock specimens were established based on the definition of CT numbers. The calculation results show that the damage variables decrease with the increase in confining pressure, the damage variables of the rock specimens in the graded loading tests are higher than those in the conventional triaxial test, and the differences between the two loading tests have grown with the increase in confining pressure.

scholarly journals Controlling Shapes in a Coaxial Flow Focusing Microfluidic Device: Experiments and Theory

Micromachines ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 85
Author(s):  
Romen Rodriguez-Trujillo ◽  
Yu-Han Kim-Im ◽  
Aurora Hernandez-Machado
Keyword(s):  
Microfluidic Device ◽  
Soft Lithography ◽  
Flow Rate Ratio ◽  
Flow Focusing ◽  
Outer Flow ◽  
Flow Rates ◽  
Fluorescein Solution ◽  
Elliptical Section ◽  
Additional Water ◽  
And Control

A coaxial flow focusing PDMS (polydimethylsiloxane) microfluidic device has been designed and manufactured by soft lithography in order to experimentally study a miscible inner flow. We studied a coaxially focused inner flow (formed by an aqueous fluorescein solution) which was fully isolated from all microchannel surfaces by an additional water outer flow. Different flow rates were used to produce a variety of flow ratios and a 3D reconstruction of the cross-section was performed using confocal microscope images. The results showed an elliptical section of the coaxially focused inner flow that changes in shape depending on the flow rate ratio applied. We have also developed a mathematical model that allows us to predict and control the geometry of the coaxially focused inner flow.

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