Two-phase study of hepatic artery vascular occlusion with microencapsulated cisplatin in patients with liver metastases from neuroendocrine tumors.

Abstract Better understanding of the lead curvature, movement and their spatial distribution may be beneficial in developing lead testing methods, guiding implantations and improving life expectancy of implanted leads. Objective The aim of this two-phase study was to develop and test a novel biplane cine-fluoroscopy-based method to evaluate input parameters for bending stress in leads based on their in vivo 3D motion using precisely determined spatial distributions of lead curvatures. Potential tensile, compressive or torque forces were not subjects of this study. Methods A method to measure lead curvature and curvature evolution was initially tested in a phantom study. In the second phase using this model 51 patients with implanted ICD leads were included. A biplane cine-fluoroscopy recording of the intracardiac region of the lead was performed. The lead centerline and its motion were reconstructed in 3D and used to define lead curvature and curvature changes. The maximum absolute curvature Cmax during a cardiac cycle, the maximum curvature amplitude Camp and the maximum curvature Cmax@amp at the location of Camp were calculated. These parameters can be used to characterize fatigue stress in a lead under cyclical bending. Results The medians of Camp and Cmax@amp were 0.18 cm−1 and 0.42 cm−1, respectively. The median location of Cmax was in the atrium whereas the median location of Camp occurred close to where the transit through the tricuspid valve can be assumed. Increased curvatures were found for higher slack grades. Conclusion Our results suggest that reconstruction of 3D ICD lead motion is feasible using biplane cine-fluoroscopy. Lead curvatures can be computed with high accuracy and the results can be implemented to improve lead design and testing.

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Complications Following Irinotecan-Loaded Microsphere Chemoembolization of Colorectal Metastatic Liver Lesions Associated with Hepatic-Artery Branch Temporary Stasis

Current Oncology ◽

10.3390/curroncol28030211 ◽

2021 ◽

Vol 28 (3) ◽

pp. 2296-2307

Author(s):

Marcin Szemitko ◽

Elzbieta Golubinska-Szemitko ◽

Jerzy Sienko ◽

Aleksander Falkowski

Keyword(s):

Colorectal Cancer ◽

Adverse Events ◽

Liver Metastases ◽

Hepatic Artery ◽

Liver Lesions ◽

Apparent Lack ◽

Neoplastic Lesion ◽

Hepatic Artery Branch ◽

Artery Branch ◽

Metastatic Liver

Chemoembolization with irinotecan-loaded microspheres has proven effective in the treatment of unresectable liver metastases in the course of colorectal cancer (CRC). Most researchers recommend slowly administering the embolizate at the level of the lobar arteries, without obtaining visible stasis. However, there are reports of a relationship between postoperative embolizate retention in metastatic lesions and the response to treatment. To retain residual embolizate throughout the entire neoplastic lesion requires a temporary flow stop (stasis) within all supply vessels, which may cause temporary stasis in subsegmental or even segmental vessels. Objective: To assess the risk of complications and post-embolization syndrome severity following chemoembolization of CRC metastatic liver lesions with microspheres loaded with Irinotecan, with regard to hepatic-artery branch level of temporary stasis. Patients and methods: The study included 52 patients (29 female, 23 male) with liver metastases from CRC, who underwent 202 chemoembolization treatments (mean: 3.88 per patient) with microspheres loaded with 100 mg irinotecan. Postembolization syndrome (PES) severity and complication occurrence were assessed with regard to the hepatic-artery branch level of temporary stasis. Adverse events were assessed according to Cancer Therapy Evaluation Program Common Terminology Criteria for Adverse Events. Results: Median survival from the start of chemoembolization was 13 months. From 202 chemoembolization sessions, 15 (7.4%) significant complications were found. The study found a significant relationship between the branch level of temporary stasis and the presence of complications (p < 0.001), with the highest number of complications observed with temporary stasis in segmental vessels. PES was diagnosed after 103 (51%) chemoembolization treatments. A significant association was found between PES severity and the branch level of temporary stasis (p < 0.001). Conclusions: The branch level of temporary stasis affected the severity of post-embolization syndrome. A significant association was found between the branch level of temporary stasis obtained in chemoembolization procedures and the presence of complications. The apparent lack of change in numbers of complications when stasis was applied at tumor supply vessels or subsegmental arteries may indicate the safe use of temporary stasis in some cases where colorectal cancer metastases are treated. Further research is needed to determine the most effective chemoembolization technique.

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Multicenter Transversal Two-Phase Study to Determine a National Prevalence of Epilepsy in Algeria

Neuroepidemiology ◽

10.1159/000339637 ◽

2012 ◽

Vol 39 (2) ◽

pp. 131-134 ◽

Cited By ~ 8

Author(s):

Dalila Moualek ◽

Lamia Ali Pacha ◽

Samira Abrouk ◽

Mohamed Islam Kediha ◽

Sonia Nouioua ◽

...

Keyword(s):

Two Phase ◽

Phase Study ◽

National Prevalence

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A Comparison of Liver-Directed Therapy and Systemic Therapy for the Treatment of Liver Metastases in Patients with Gastrointestinal Neuroendocrine Tumors: Analysis of the California Cancer Registry

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2020.10.019 ◽

2021 ◽

Author(s):

Jonathan Kessler ◽

Gagandeep Singh ◽

Philip H.G. Ituarte ◽

Rebecca Allen ◽

Sue Chang ◽

...

Keyword(s):

Liver Metastases ◽

Neuroendocrine Tumors ◽

Cancer Registry ◽

Systemic Therapy ◽

California Cancer Registry

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Endometrial Adenocarcinoma in SurePath™ Cervical Samples: Cytological Features Revisited

Acta Cytologica ◽

10.1159/000444043 ◽

2016 ◽

Vol 60 (1) ◽

pp. 46-52 ◽

Cited By ~ 1

Author(s):

Nalini Gupta ◽

John Crossley ◽

Nick Dudding ◽

John H.F. Smith

Keyword(s):

Phase 1 ◽

Endometrial Adenocarcinoma ◽

Nuclear Chromatin ◽

Phase 2 ◽

Cervical Lesions ◽

Two Phase ◽

Endometrial Cells ◽

Phase Study ◽

Cytological Features ◽

Liquid Based Cytology

Objective: The cytomorphological criteria of malignant endometrial lesions in cervical samples are less well described than those of cervical lesions. We wished to investigate if there were features in SurePath™ liquid-based cytology samples that would facilitate more accurate differentiation between benign and malignant endometrial cells. Study Design: This was a two-phase study, with a review of all SurePath™ samples reported as endometrial adenocarcinoma (n = 42) evaluating 12 cytological features in the first phase. In phase 2 (test set), all initial cases plus an additional 83 cases were reviewed using these 12 cytological features to predict the outcome. Results: Out of 12 cytological features evaluated in phase 1 (training set), nuclear chromatin pattern, apoptotic bodies and tingible body macrophages were found to be the most significant features determining malignant histological outcome. These 12 cytological features were re-evaluated in phase 2 (n = 125). Of 125 cases, 54 had a benign and 71 had a malignant or premalignant histological outcome, with a positive predictive value of 56.8%. Conclusion: Granular nuclear chromatin, tingible body macrophages and apoptosis in the background are the most significant factors in determining whether endometrial cells present in cervical samples represent malignancy or are benign. Using these features, relatively accurate predictions of endometrial pathology can be made.

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