The Impact of the use of C-Arm Cone-Beam CT during Chemoembolization for Hepatocellular Carcinoma

2021 ◽  
Vol 17 ◽  
Author(s):  
Mohamed E. Abdelsalam ◽  
Tomas M. Appleton Figueira ◽  
Joe Ensor ◽  
Alda L. Tam ◽  
Rony Avritscher ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Positive Impact ◽  
Average Duration ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Selection Order

Objective: The objective of the study was to investigate the consequences of using C-arm cone-beam computed tomography (CBCT) on super-selective catheterization of hepatic artery (HA) branches during chemoembolization of hepatocellular carcinoma. Methods: Two groups of patients were created according to the dates of their treatment sessions. Group A and Group B included patients who had their treatment sessions in 2004 - 2005 and 2008 - 2010, respectively. The sessions performed in 2006 and 2007 were excluded to allow for the adoption and incorporation of CBCT imaging into clinical practice. All chemoembolized HA branches were categorized according to selection order (0-1, 2, or ≥3). Other procedure variables were documented. Results: A total of 58 and 183 sessions were included in Groups A and B, respectively, for 144 patients. C-arm CBCT was used in 2 (3%) sessions and 142 (78%) sessions in groups A and B, respectively. The average number of vessels treated was significantly higher in group B (1.8) compared to group A (1.3) (P < .0001). A shift to an increased selection order in group B (0-1, 44 [24%]; 2, 85 [46%]; ≥3, 54 [30%]) was more significant (P = .0004) than that in group A (0-1, 32 [55%]; 2, 18 [31%]; ≥3, 8 [14%]). The average duration of the procedure was significantly longer in group B (P = .0002). Conclusions: Using C-arm CBCT during chemoembolization has a positive impact on increasing the number and order of HA selected and chemoembolized. This comes at the expense of an increase in the duration of the procedure.

scholarly journals Survival impact of C-Arm cone-beam computed tomography on hepatocellular carcinoma patients undergoing chemoembolization

2021 ◽  
Vol 5 ◽  
pp. 9
Author(s):  
Mohamed E. Abdelsalam ◽  
Tomas M. Appleton Figueira ◽  
Joe Ensor ◽  
Alda L. Tam ◽  
Rony Avritscher ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Cone Beam Computed Tomography ◽  
Multivariate Analyses ◽  
Cone Beam ◽  
Aggressive Approach ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Selection Order

Objectives: The objectives of the study were to evaluate the use of C-arm cone-beam computed tomography (CBCT) for tumor targeting for transarterial chemoembolization (TACE) and its impact on overall survival (OS) in hepatocellular carcinoma patients. Material and Methods: Two groups were retrospectively evaluated according to the date of the first TACE session before and after C-arm CBCT installation in late 2005 (group A [n = 34], 2004–2005; group B [n = 104], 2008+). The years 2006 and 2007 were excluded to allow for the incorporation of this new imaging technology into clinical practice. The vessel selection order was recorded for all TACE sessions. Univariate and multivariate analyses were performed to assess the impact on and predictors of survival. Results: The average TACE selection order for each patient was significantly higher in group B than in group A (P < 0.0001). The median OS was significantly longer in group B (29.34 months) than in group A (19.65 months; P = 0.0088), and the difference in duration was most pronounced in patients with tumor burdens < 25% (n = 93; P = 0.0075), in whom the 3-year survival rate was 56.1% in group B and 15.3% in group A. In these 93 patients, the OS was significant longer (P = 0.018) for high (41.07 months) versus low (19.65 months) vessel selection order across both groups. In multivariate analyses, both the period in which TACE was performed (P = 0.022) and the use of C-arm CBCT (P = 0.0075) were significant predictors of improved OS. Conclusion: Use of advanced C-arm CBCT during TACE enhances the operating physician’s ability to deliver targeted, effective therapy for hepatocellular carcinoma, an aggressive approach that favorably impacts survival.

scholarly journals Magnetic resonance imaging and computed tomography of equine cheek teeth and adjacent structures: comparative study of image quality in horses in vivo, post-mortem and frozen-thawed

2019 ◽  
Vol 61 (1) ◽  
Author(s):  
Christin Röttiger ◽  
Maren Hellige ◽  
Bernhard Ohnesorge ◽  
Astrid Bienert-Zeit
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Post Mortem ◽  
Mr Images ◽  
Adjacent Structures ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Ct And Mri

Abstract Background The use of cadavers for radiology research methodologies involving subjective image quality evaluation of anatomical criteria is well-documented. The purpose of this method comparison study was to evaluate the image quality of dental and adjacent structures in computed tomography (CT) and high-field (3 T) magnetic resonance (MR) images in cadaveric heads, based on an objective four-point rating scale. Whilst CT is a well-established technique, MR imaging (MRI) is rarely used for equine dental diagnostics. The use of a grading system in this study allowed an objective assessment of CT and MRI advantages in portraying equine cheek teeth. As imaging is commonly performed with cadaveric or frozen and thawed heads for dental research investigations, the second objective was to quantify the impact of the specimens’ conditions (in vivo, post-mortem, frozen-thawed) on the image quality in CT and MRI. Results The CT and MR images of nine horses, focused on the maxillary premolar 08s and molar 09s, were acquired post-mortem (Group A). Three observers scored the dental and adjacent tissues. Results showed that MR sequences gave an excellent depiction of endo- and periodontal structures, whereas CT produced high-quality images of the hard tooth and bony tissues. Additional CT and MRI was performed in vivo (Group B) and frozen-thawed (Group C) in three of these nine horses to specify the condition of the best specimens for further research. Assessing the impact of the specimens’ conditions on image quality, specific soft tissues of the maxillary 08s and 09s including adjacent structures (pulps, mucosa of the maxillary sinuses, periodontal ligament, soft tissue inside the infraorbital canal) were graded in group B and C and analysed for significant differences within CT and MR modalities in comparison to group A. Results showed that MRI scores in vivo were superior to the post-mortem and frozen-thawed condition. Conclusions On comparing the imaging performance of CT and MRI, both techniques show a huge potential for application in equine dentistry. Further studies are needed to assess the clinical suitability of MRI. For further research investigations it must be considered, that the best MR image quality is provided in live horses.

scholarly journals The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients

2020 ◽  
Vol 9 (9) ◽  
pp. 2943 ◽  
Author(s):  
Marco Vicenzi ◽  
Massimiliano Ruscica ◽  
Simona Iodice ◽  
Irene Rota ◽  
Angelo Ratti ◽  
...  
Keyword(s):  
Survival Rate ◽  
Receptor Antagonist ◽  
Positive Impact ◽  
Ventilatory Support ◽  
Continuous Administration ◽  
Pharmacological Management ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Free Rate

Background: In COVID-19 patients, aldosterone via angiotensin-converting enzyme-2 deregulation may be responsible for systemic and pulmonary vasoconstriction, inflammation, and oxidative organ damage. Aim: To verify retrospectively the impact of the mineralcorticoid receptor antagonist canrenone i.v. on the need of invasive ventilatory support and/or all-cause in-hospital mortality. Methods: Sixty-nine consecutive COVID-19 patients, hospitalized for moderate to severe respiratory failure at Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico of Milan, received two different therapeutic approaches in usual care according to the personal skills and pharmacological management experience of the referral medical team. Group A (n = 39) were given vasodilator agents or renin–angiotensin–aldosterone system (RAAS) inhibitors and group B (n = 30) were given canrenone i.v. Results: Among the 69 consecutive COVID-19 patients, those not receiving canrenone i.v. (group A) had an event-free rate of 51% and a survival rate of 64%. Group B (given a mean dose of 200 mg/q.d. of canrenone for at least two days of continuous administration) showed an event-free rate of 80% with a survival rate of 87%. Kaplan–Meier analysis for composite outcomes and mortality showed log rank statistics of 0.0004 and 0.0052, respectively. Conclusions: The novelty of our observation relies on the independent positive impact of canrenone on the all-cause mortality and clinical improvement of COVID-19 patients ranging from moderate to severe diseases.

Transcriptional characterization of microenvironment and their prediction role for the prognosis of hepatocellular carcinoma after surgery.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15650-e15650
Author(s):  
Kehe Chen ◽  
Haiming Wei ◽  
Tianqi Liu ◽  
Zhenxiang Chen ◽  
Deng Pan ◽  
...  
Keyword(s):  
Gene Expression ◽  
Hepatocellular Carcinoma ◽  
Antigen Processing ◽  
Tissue Samples ◽  
Ffpe Tumor ◽  
Group A ◽  
One Year ◽  
Group B ◽  
Immune Related Genes ◽  
The Impact

e15650 Background: Hepatocellular carcinoma (HCC) is one of the most common prevalent fatal cancers worldwide with poor prognosis due to high incidence of recurrence. For patients with HCC, surgical treatment is a potentially cutative therapy. However, the puzzle in the therapy was the rapid recurrence after surgery. The purpose of this study was to integrate the impact of different immune context present in HCC microenvironment on patients’ prognosis, provide the molecular prediction clue of HCC recurrence. Methods: RNA targeted sequencing was performed on 12 primary tumor specimens from HCC patients. Transcripts of 395 immune related genes expressed in FFPE tumor samples were analyzed. The lima package was used to analyze the different expressed genes (DEGs) between patients with different prognosis. The gene set variance analysis (GSVA) analysis was performed to explore gene sets enrichment related to the recurrence post-resection. Results: 15 DEGs were detected in tissue samples between the two groups (group A: patients who relapsed within one year after surgery; group B: patients who hadn't relapsed beyond two years after surgery). The Antigen processing pathway enrichment may associate with the favorable prognosis (p < 0.05). HLA-A gene expression in group A was lower than that in group B; The gene expression of IL23A, TP63, ALOX15B, BUB1, CXCR2, CCL20, CLEC4C, PTK7, MPO, IL1B, MMP9, GAGE2C, GAGE2A, GAGE2E, DMBT1, FOXM1 in group A was higher than that in group B. Additionally, the combination of 3 genes (TP63, IL23A and BUB1) can distinguish the patients recurrent within 1 year or beyond 2 years post-resection. The joint diagnostic equation is logit (Y = 1) = 0.073 +0.740 *(TP63) + 0.589 * (IL23A)+0.959(BUB1), (Optimal threshold: 0.667, specificity: 1, sensitivity: 0.833). Conclusions: Our results suggest that RNA-seq of immune related genes from FFPE sample can effectively profile the specific landscape of tumor immune microenvironment and predict the survival of HCC. 3 genes’ expression (TP63, IL23A and BUB1) might correlate with recurrence in HCC patients after surgery.

scholarly journals Prostatic Artery Embolization: Influence of Cone-Beam Computed Tomography on Radiation Exposure, Procedure Time, and Contrast Media Use

2021 ◽  
Author(s):  
F. Bürckenmeyer ◽  
I. Diamantis ◽  
T. Kriechenbauer ◽  
T. Lehmann ◽  
T. Franiel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Contrast Media ◽  
Radiation Exposure ◽  
Cone Beam ◽  
Procedure Time ◽  
Artery Embolization ◽  
Prostatic Artery Embolization ◽  
Group A ◽  
Group B ◽  
Prostatic Artery

Abstract Purpose To evaluate the effect of cone-beam computed tomography (CBCT) on radiation exposure, procedure time, and contrast media (CM) use in prostatic artery embolization (PAE). Materials and Methods Seventy-eight patients were enrolled in this retrospective, single-center study. All patients received PAE without (group A; n = 39) or with (group B; n = 39) CBCT. Total dose-area product (DAPtotal; Gycm2), total entrance skin dose (ESDtotal; mGy), and total effective dose (EDtotal; mSv) were primary outcomes. Number of digital subtraction angiography (DSA) series, CM use, fluoroscopy time, and procedure time were secondary outcomes. PAE in group A was performed by a single radiologist with 15 years experience, PAE in group B was conducted by four radiologists with 4 to 6 years experience. Results For groups A vs. B, respectively, median (IQR): DAPtotal 236.94 (186.7) vs. 281.20 (214.47) Gycm2(p = 0.345); EDtotal 25.82 (20.35) vs. 39.84 (23.75) mSv (p =  < 0.001); ESDtotal 2833 (2278) vs. 2563 (3040) mGy(p = 0.818); number of DSA series 25 (15) vs. 23 (10)(p = 0.164); CM use 65 (30) vs. 114 (40) mL(p =  < 0.001); fluoroscopy time 23 (20) vs. 28 (25) min(p = 0.265), and procedure time 70 (40) vs.120 (40) min(p =  < 0.001). Bilateral PAE was achieved in 33/39 (84.6%) group A and 32/39 (82.05%) group B(p = 0.761), all other patients received unilateral PAE. There were no significant differences between clinical parameters and origins of the prostatic arteries (PA) (p = 0.206–1.00). Conclusion Operators with extensive expertise on PAE may not benefit from addition of CBCT to DSA runs, whereas for operators with less expertise, CBCT when used alongside with DSA runs increased the overall radiation exposure.

scholarly journals The Effect of Watching English Movies with Subtitles on ESP Students’ Content and Vocabulary Comprehension. A Study Conducted at an Indonesia Polytechnic Engineering

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Eny Kusumawati
Keyword(s):  
Positive Impact ◽  
Class B ◽  
Vocabulary Comprehension ◽  
Quasi Experimental ◽  
Group A ◽  
The One ◽  
Group B ◽  
The Impact ◽  
Better Than ◽  
English Subject

<p>This research is focusing on the impact of English movies with subtitles on content comprehension of English movies and vocabulary comprehension. With fifty-six (56) students of <em>Politeknik Elektronika Negeri</em> <em>Surabaya</em> was selected randomly of English subject. Activate the quasi-experimental study, a movie with tittle <em>Transcendence </em>was selected based on the ESP content and language level difficulty.  With two intact groups, they were group A and group B. They watched the same movie, class A watched it with English subtitles and class B without subtitles. After watching the movie, the participants answered the relevant multiple-choice vocabulary, content comprehension questions, and questioners. The data gathered were subjected to the statistical procedure of paired sample t-test. The results showed that subtitles have a positive impact on content comprehension of English movies. It can be concluded that the participants comprehend the subtitled movie better than the one without it. Moreover, in this statistical study, it is found that the subtitles did not have an effect on participants’ vocabulary comprehension. The pedagogy of this study is to allow the lecturer use some film to enrich the teaching materials for reading class in ESP.</p><p>This research is focusing on the impact of English movies with subtitles on content comprehension of English movies and vocabulary comprehension. With fifty-six (56) students of <em>Politeknik Elektronika Negeri</em> <em>Surabaya</em> was selected randomly of English subject. Activate the quasi-experimental study, a movie with tittle <em>Transcendence </em>was selected based on the ESP content and language level difficulty.  With two intact groups, they were group A and group B. They watched the same movie, class A watched it with English subtitles and class B without subtitles. After watching the movie, the participants answered the relevant multiple-choice vocabulary, content comprehension questions, and questioners. The data gathered were subjected to the statistical procedure of paired sample t-test. The results showed that subtitles have a positive impact on content comprehension of English movies. It can be concluded that the participants comprehend the subtitled movie better than the one without it. Moreover, in this statistical study, it is found that the subtitles did not have an effect on participants’ vocabulary comprehension. The pedagogy of this study is to allow the lecturer use some film to enrich the teaching materials for reading class in ESP.</p>

scholarly journals Analysis by means of cone-beam computed tomography, bone density and X-ray beam attenuation of rabbit mandibles subjected to low-level laser therapy during distraction osteogenesis

2015 ◽  
Vol 14 (1) ◽  
pp. 30 ◽  
Author(s):  
Rodrigo Cenci ◽  
Vinicius Silveira ◽  
Luciano Mayer ◽  
Helena De Oliveira ◽  
João Moraes ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Bone Density ◽  
Low Level Laser Therapy ◽  
Cone Beam ◽  
X Ray ◽  
Beam Attenuation ◽  
Level Laser ◽  
Group A ◽  
Group B

<p><strong><em>Objectives: </em></strong><em>To assess by means of cone-beam computed tomography (CBCT) the relative bone density of newly formed bone in rabbit mandibles treated with low-level laser therapy (LLLT) during distraction osteogenesis (DO). </em><strong><em>Methods: </em></strong><em>Seven rabbits underwent surgical osteotomy and immediate installation of a distractor on the mandible (right side). DO was performed for 10 days, and LLLT (aluminum-gallium-arsenide [AlGaAs] infrared laser, λ 830 nm, 40 mW) was applied during distractor activation (days 4-10). Three rabbits were euthanized at the end of the activation period (day 10, group A), and four at the end of the maturation period (day 20, group B). Quality and quantity of newly formed bone in the distracted area were measured on grayscale images using adjacente untreated areas as controls. Two CBCT images were acquired for each animal (before and after removal of soft tissue) to evaluate the influence of the soft tissue on X-ray beam attenuation. </em><strong><em>Results: </em></strong><em>Mean grayscale values in the distracted area were higher in group B rabbits (140.47 vs. 102.55 in group A), indicating greater bone maturation in a short period. Absence of soft tissues during CBCT scanning was associated with higher grayscale values, indicative of less X-ray beam attenuation. </em><strong><em>Conclusions: </em></strong><em>It is possible to measure differences in bone density in areas subjected to DO on CBCT scans, providing an objective assessment useful for monitoring bone quality during the repair process.</em></p><p><em> </em></p>

scholarly journals Comparison between C-arm cone beam computed tomography and interventional angiography in transarterial chemoembolization of hepatocellular carcinoma

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Ibraheim Ahmed Diab ◽  
Shaimaa Abdel-hamid Hassanein ◽  
Hala Hafez Mohamed
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Cone Beam Computed Tomography ◽  
Vascular Anatomy ◽  
Cone Beam ◽  
Focal Lesion ◽  
Focal Lesions ◽  
Conventional Angiography ◽  
Interventional Angiography ◽  
Cross Sectional

Abstract Background Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy of adults. One of the established treatment procedures performed worldwide for HCC is transcatheter arterial chemoembolization (TACE). By using conventional angiography in TACE, we can detect and identify the vascular anatomy of the liver through obtaining 2D images. Recently C-arm cone beam computed tomography (CBCT) is introduced for obtaining cross-sectional and three-dimensional (3D) images for better visualization of small tumors and their feeding arteries. Results The number of detected focal lesions by angiography was 51 compared to 87 focal lesion detected by CBCT; of those, 45 and 77 were active lesions by both procedures respectively. For lesions, less than 1 cm CBCT detected 23 lesions while angiography detected only one lesion. Angiography detected 87 feeding arterial branch while cone beam CT-HA detected 130 branches to the same number of target lesion. Feeder tractability and confidence were better by CBCT. Conclusion CBCT is superior to angiography in tumor detectability, detection of lesions less than 1 cm, feeder detection, and feeder traction; however, conventional angiography and DSA are irreplaceable. Thus, combination of CBCT with angiography during TACE produces better results and less complication.

scholarly journals The Impact of Left Atrial Size in Catheter Ablation of Atrial Fibrillation Using Remote Magnetic Navigation

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Xiao-yu Liu ◽  
Hai-feng Shi ◽  
Jie Zheng ◽  
Ku-lin Li ◽  
Xiao-xi Zhao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrial ◽  
Magnetic Navigation ◽  
Remote Magnetic Navigation ◽  
X Ray ◽  
Group A ◽  
Group B ◽  
The Impact

Objective. The objective of this study was to investigate the impact of left atrial (LA) size for the ablation of atrial fibrillation (AF) using remote magnetic navigation (RMN). Methods. A total of 165 patients with AF who underwent catheter ablation using RMN were included. The patients were divided into two groups based on LA diameter. Eighty-three patients had small LA (diameter <40 mm; Group A), and 82 patients had a large LA (diameter ≥40 mm; Group B). Results. During mapping and ablation, X-ray time (37.0 (99.0) s vs. 12 (30.1) s, P<0.001) and X-ray dose (1.4 (2.7) gy·cm2 vs. 0.7 (2.1) gy·cm2, P=0.013) were significantly higher in Group A. No serious complications occurred in any of the patients. There was no statistical difference in the rate of first anatomical attempt of pulmonary vein isolation between the two groups (71.1% vs. 57.3%, P=0.065). However, compared with Group B, the rate of sinus rhythm was higher (77.1% vs. 58.5%, P<0.001) during the follow-up period. More patients in Group A required a sheath adjustment (47/83 vs. 21/82, P<0.001), presumably due to less magnets positioned outside of the sheath. In vitro experiments with the RMN catheter demonstrated that only one magnet exposed created the sheath affects which influenced the flexibility of the catheter. Conclusions. AF ablation using RMN is safe and effective in both small and large LA patients. Patients with small LA may pose a greater difficulty when using RMN which may be attributed to the fewer magnets beyond the sheath. As a result, the exposure of radiation was increased. This study found that having at least two magnets of the catheter positioned outside of the sheath can ensure an appropriate flexibility of the catheter.

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