Deep segmentation of the liver and the hepatic tumors from abdomen tomography images

A pipelined framework is proposed for accurate, automated, simultaneous segmentation of the liver as well as the hepatic tumors from computed tomography (CT) images. The introduced framework composed of three pipelined levels. First, two different transfers deep convolutional neural networks (CNN) are applied to get high-level compact features of CT images. Second, a pixel-wise classifier is used to obtain two output-classified maps for each CNN model. Finally, a fusion neural network (FNN) is used to integrate the two maps. Experimentations performed on the MICCAI’2017 database of the liver tumor segmentation (LITS) challenge, result in a dice similarity coefficient (DSC) of 93.5% for the segmentation of the liver and of 74.40% for the segmentation of the lesion, using a 5-fold cross-validation scheme. Comparative results with the state-of-the-art techniques on the same data show the competing performance of the proposed framework for simultaneous liver and tumor segmentation.

Modeling of Interstitial Microwave Hyperthermia for Hepatic Tumors Using Floating Sleeve Antenna

PurposeMicrowave hyperthermia is a treatment modality that uses microwaves to destroy cancer cells by increasing their temperature to 41- 45°C. This study aims to design, modeling, and simulation of a microwave sleeve antenna for hepatic (liver) hyperthermia. MethodThe designed antenna resonated at 2.45 GHz. The antenna was tested in six different 3D liver models: Model A: without a tumor and blood vessels; Model B: with a realistic tumor (2x3 cm) and without blood vessels; Model C: created by adding blood vessels to model B; Model D: created by adding a small tumor (1.5x1.5 cm) to model C and changed its location; Model E: same as model C with a different tumor size; Model F: model with a simple spherical tumor (1.5x1.5 cm).ResultsThe return loss of the antenna varied from -45 dB to -25 dB for the 6 models. The Specific Absorption Rate (SAR) was between 29 W/kg to 30W/kg in the tumors and below 24 W/Kg in the surrounding tissues. The tumors’ temperature elevated to 43- 45°C, while the temperature of the surrounding tissues was below 41°C.ConclusionsThe results showed the capability of the designed antenna to raise the temperature of hepatic tumors to the therapeutic ranges of hyperthermia.

Baseline and contrast-enhanced ultrasound features of hepatic epithelioid angiomyolipoma

BACKGROUND: Recurrence or metastasis after surgery had been reported in hepatic epithelioid angiomylipoma (epi-AML). Most hepatic epi-AMLs were misdiagnosed with hepatocellular carcinoma or other hepatic tumors before surgery. OBJECTIVE: To describe the baseline and contrast-enhanced ultrasound (CEUS) features of hepatic epi-AMLs and to explore the potential ultrasonic features for prognosis. METHODS: The retrospective study enrolled 67 patients (56 females, 11 males) with 67 pathologically confirmed hepatic epi-AML lesions. All the lesions were examined by baseline ultrasound and 42 lesions were examined using CEUS with SonoVue (Bracco, Milan, Italy) before surgery. RESULTS: Baseline ultrasound features of hepatic epi-AMLs included heterogeneous echo (86.6%), well-defined border (68.7%), hypoecho (64.2%), regular morphology (62.7%), peripheral-tumor arc-shaped or ring-like vessels (53.7%), and low value of resistive index (0.51±0.08). CEUS features of hepatic epi-AMLs included arterial phase hyper-enhancement with smooth and well-defined margin (100%), peripheral-tumor ring-like vessels (57.1%), and intra-tumor vessels (52.4%). Some CEUS features, including arterial phase heterogeneously tortuous filling, intra-tumor vessels and peripheral-tumor ring-like vessels were more commonly found in hepatic epi-AMLs of uncertain malignant potential/malignant than in benign hepatic epi-AMLs (p < 0.05). CONCLUSIONS: Baseline ultrasound and CEUS features may be useful in diagnosis of hepatic epi-AML, and some CEUS features may be indicative of its malignant potential.

NIR-II emissive AIEgen photosensitizers enable ultrasensitive imaging-guided surgery and phototherapy to fully inhibit orthotopic hepatic tumors

Accurate diagnosis and effective treatment of primary liver tumors are of great significance, and optical imaging has been widely employed in clinical imaging-guided surgery for liver tumors. The second near-infrared window (NIR-II) emissive AIEgen photosensitizers have attracted a lot of attention with higher-resolution bioimaging and deeper penetration. NIR-II aggregation-induced emission-based luminogen (AIEgen) photosensitizers have better phototherapeutic effects and accuracy of the image-guided surgery/phototherapy. Herein, an NIR-II AIEgen phototheranostic dot was proposed for NIR-II imaging-guided resection surgery and phototherapy for orthotopic hepatic tumors. Compared with indocyanine green (ICG), the AIEgen dots showed bright and sharp NIR-II emission at 1250 nm, which extended to 1600 nm with high photostability. Moreover, the AIEgen dots efficiently generated reactive oxygen species (ROS) for photodynamic therapy. Investigations of orthotopic liver tumors in vitro and in vivo demonstrated that AIEgen dots could be employed both for imaging-guided tumor surgery of early-stage tumors and for ‘downstaging’ intention to reduce the size. Moreover, the therapeutic strategy induced complete inhibition of orthotopic tumors without recurrence and with few side effects. Graphical Abstract

Liver abscess after drug-eluting bead chemoembolization in patients with metastatic hepatic tumors

Objective: To investigate the incidence and risk factors for liver abscess formation after treatment with drug-eluting bead chemoembolization (DEB-TACE) in patients with metastatic hepatic tumors (MHT). Methods: The current study is a retrospective analysis of the clinical data of 137 patients with metastatic hepatic tumors who received DEB-TACE treatment in our institute between June 2015 and September 2020. Patients were evaluated for the presence or absence of post-DEB-TACE liver abscess. Univariate and multivariate analyses were used to identify risk factors for liver abscess formation. Results: The incidence of liver abscess formation after the DEB-TACE procedure was 8.76% per patient and 5.53% per procedure. Univariate analysis showed that larger maximum tumor diameter (p = 0.004), Grade one artery occlusion (p < 0.001) and systemic chemotherapy within 3 months before the DEB-TACE procedure (p < 0.001) were all associated with liver abscess formation. However, only systemic chemotherapy within 3 months before the DEB-TACE procedure (OR 5.49; 95% CI 0.34–13.54; p < 0.001) was identified by multivariate analysis to be an independent risk factor. Conclusions: Tumor size, Grade one artery occlusion and recent systemic chemotherapy may all be associated with increased risk of liver abscess formation following DEB-TACE treatment in patients with metastatic hepatic tumors. Advances in knowledge: Identification of risk factors for liver abscess formation following DEB-TACE in patients with MHT. These findings suggest the need for caution and consideration of the aforementioned risk factors on the part of interventional radiologists when designing DEB-TACE strategies and performing post-procedure patient management.