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.

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 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 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.

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.

C-Arm Cone Beam Computed Tomography Guidance for Radiofrequency Ablation in Hepatocellular Carcinoma

Oncology ◽  
2017 ◽  
Vol 92 (3) ◽  
pp. 142-152 ◽  
Author(s):  
Keizo Kato ◽  
Hiroshi Abe ◽  
Makiko Ika ◽  
Takeshi Yonezawa ◽  
Yoshiyuki Sato ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Computed Tomography Guidance
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