Safety and efficacy analysis of microwave ablation in small hepatocellular carcinomas sized below 3 cm

Purpose: The aim of this study was to investigate the efficacy and safety of microwave ablation (MWA) in small hepatocellular carcinomas sized ≤ 3 cm, determine long-term survival, and identify prognostic factors for survival rates. Material and methods: In this study, the radiological and laboratory findings obtained from 31 consecutive patients who underwent MWA were retrospectively evaluated. The survival periods and complication rates were analysed. Results: Microwave ablation was applied to 42 hepatocellular carcinoma nodules in 31 patients. The mean age of the patients was 61 ± 7.3 (median 62, range 46-78) years. The mean overall survival (OS) was 47.4 ± 3.3 months. The rates of cumulative OS in the first, second, and third years were 95.2%, 91.8%, and 79.2%, respectively. The mean disease-free survival (DFS) rate was 24.1 ± 2.5 months. The cumulative DFS rates in the first, second, and third years were 75.6%, 52.5%, and 28.2%, respectively. The number of tumours and tumour distribution were determined as prognostic factors. No major complication was detected, but six patients (13.9%) developed minor complications after MWA. Conclusions: Microwave ablation in patients with hepatocellular carcinoma is a safety treatment modality with very low rates of complications. It offers an effective treatment with a high rate of complete response and local disease control according to the short-term results. In the long term, it prolongs the survival time of the treated patients. The number of tumours and tumour distribution were determined as prognostic factors affecting survival rates

Super-selective transarterial chemoembolization of hepatocellular carcinoma with doxorubicin-eluting beads sized 40–75 microns: assessment of efficacy and safety

PURPOSEWe aimed to evaluate the effectiveness and safety of super-selective transarterial chemoembolization (TACE) with doxorubicin-loaded drug-eluting beads (DEB) sized 40–75 μm for hepatocellular carcinoma (HCC) in early and intermediate stages according to Barcelona Clinic Liver Cancer (BCLC) staging system.METHODSThis single-center retrospective study was conducted with 45 consecutive HCC patients treated by 72 sessions of DEB-TACE during the 2012–2017 period. Thirty-seven patients (82.2%) had single tumor staged BCLC A and B (53.3% and 46.7%, respectively). All procedures were performed by super-selective approach using 1.7–2.0 F microcatheters. Cone beam CT was performed to detect all tumor-feeding arteries and assess the treatment results immediately. Dynamic MRI and laboratory tests were obtained at 1-month follow-up and every 3 months thereafter. Response to treatment according to modified Response Evaluation Criteria in Solid Tumors, demographic and clinical status, laboratory tests, time-to-event durations and rates, complications according to the National Cancer Institute Criteria for Adverse Events were evaluated.RESULTSA total of 45 patients (median age, 65.6 years; range, 35–88 years; 33 men, 73.4%) were included. Eight patients (17.7%) underwent liver transplantation after DEB-TACE, and 20 (44.4%) died during the follow-up period. Median follow-up was 22 months (range, 13–31), and 42 (93.3%) patients were followed up for more than 1 year. Overall complete response, partial response, and progressive disease rates were 53.3%, 33.3%, and 13.4% at one year and 22.2%, 26.7%, and 13.3% at three years, respectively. For target lesions, these rates were 60.0%, 26.7%, and 13.3% at one year and 28.9%, 6.7%, and 4.4% at three years, respectively. Median overall survival (OS) duration was 24 months (95% CI, 20.9–31.9 months). At one year and three years, OS rates were 71.0% and 44.4%, respectively. The only statistically significant relationship with OS was presence of chronic liver disease, which worsened the OS rate (P = 0.031). Time-to-progression (TTP) was 23 months (95% CI, 15.1–40.0), and progression-free survival (PFS) was 28 months (95% CI, 6.2–39.8). Post-embolization syndrome occurred in 10 patients (22.2%). Transient grade I/II bilirubin and aminotransferase elevation was observed in 26 (57.7%) and 18 (40%) patients, respectively.CONCLUSIONSuper-selective DEB-TACE with doxorubicin-loaded beads sized 40–75 μm is an effective and safe treatment method with prolonged TTP and PFS in early and intermediate stages of HCC. Presence of chronic liver disease is the only significant factor that worsened OS ratios after DEB-TACE

Short-term changes of angiogenesis factors after transarterial radioembolization in hepatocellular carcinoma patients

PURPOSETo analyze changes in angiogenesis factors after transarterial radioembolization (TARE) with Yttrium- 90-loaded resin microspheres in hepatocellular carcinoma (HCC) patients.METHODSInterleukin-6, interleukin-8, hepatocyte growth factor, platelet-derived growth factor, fibroblast growth factor, vascular endothelial growth factor-A (VEGF-A), and angiopoietin-2 levels in 26 patients were measured before TARE and on day 1, 7, 14, and 30 after TARE and evaluated regarding radiological response.RESULTSIn the sixth month of follow-up, 11 (42.30%) patients had a complete or partial response to treatment, while progressive disease was found in 15 (57.69%) patients. The percentage changes in VEGF-A in the non-responders on day 30 (P = 0.034) after TARE were significantly more obvious. Peak formation rates of VEGF-A were higher in non-responders (P = 0.036).CONCLUSIONShort-term changes in angiogenesis factors in HCC patients after TARE with Yttrium-90-loaded resin microspheres fluctuate with different amplitudes at different times. The upregulation of growth factors has a prognostic capacity. Changes in VEGF-A after TARE may be helpful for the early recognition of non-responders

Seroprevalence of infectious diseases in saiga antelope (Saiga tataricatatarica) in Kazakhstan 2012–2014

286 serum samples were collected from three sub-populations of saiga in Kazakhstan (Betpakdala, Ustyurt and Volga-Ural) between 2012 and 2014, and were tested for the presence of antibodies to Brucella spp., bluetongue virus, peste des petits ruminants (PPR) virus, Akabane virus, Schmallenberg virus, Chlamydophila, Toxoplasma, Mycobacterium avium subspecies paratuberculosis and Coxiella burnetii (Q Fever). Seropositives to Coxiella burnetii of saiga were detected and the adjusted seroprevalence of Q Fever antibodies was 0.07 (95% confidence interval (CI): 0.03-0.10). Seropositives to Akabane virus were detected in all three populations and the adjusted seroprevalence values for this virus were very high (all were>0.13). Lower adjusted seroprevalence values were estimated for PPR Virus and Mycobacterium avium subsp. paratuberculosis (0.005 and 0.006). No seropositives for bluetongue, Toxoplasma, Brucella or Schmallenberg were detected

Treatment of pelvic venous insufficiency with amplatzer vascular plugs

PubMedID: 25523325[No abstract available

Efficacy of endovascular treatment in subclavian artery occlusive diseases

WOS: 000480626400007Purpose: The purpose of this retrospective study was to evaluate the technical success and clinical outcomes of endovascular procedures and to compare them with the surgical procedures of subclavian artery occlusive diseases. Materials and Methods: Between 1994 and 2009, 37 patients with clinical symptoms secondary to subclavian artery stenoses and/or occlusion were diagnosed by color Doppler ultrasound (CDUS) or Digital Subtraction Angiography (DSA). 14 (37.8%) of these patients were female and 23 (62.2%) were male; mean age was 56.4 (arange 22-82). 38 lesions were treated with balon anjioplasty and/or stent placement. After treatment, patients' follow-ups were performed by CDUS and clinically. Results: 32 (84.2%) of lesions were found on the left and 6 (15.8%) were on the right side. Technical success rate for stenotic lesions was 100%. We couldn't achieve to pass through 3 occlusions and so the technical success rate for occlusions was 57%. For early (0-3 months) and mid (3-6 months) terms primary and secondary patency rate was 100%. We found primary patency rate 95.5% and secondary patency rate 100% for late term (6-12 months). Conclusion: Endovascular treatment of subclavian artery occlusive diseases is technically and clinically effective and safe procedure and alternative to surgery

Mediastinal hemangioma (case report) [Mediastinal hemanjiyom.]

PubMedID: 15470623We present radiographic and computed tomographic findings of a mediastinal hemangioma, a very rare benign vascular tumor that comprises less than 0.5% of all mediastinal masses. Posteroanterior chest film showed a homogeneous opacity in the left upper zone that was contiguous with the mediastinum. Computed tomography demonstrated a mediastinal mass with inhomogeneous contrast enhancement and a small calcification

Unexpected hepatic uptake of Tc-99m-MAA in lung perfusion scintigraphy in a patient with end-stage renal disease [Son dönem böbrek hastaliği olan hastanin akciğer perfüzyon sintigrafisinde Tc-99m- MAA?in beklenmedik karaciğer tutulumu]

Extra-pulmonary accumulation of Tc-99m-macroaggregated albumin (MAA) is described as uptake areas out of the lung in perfusion scintigraphy. If the particles spread throughout the body before reaching the lung via venous collaterals or due to right-to-left shunt, or if the particles are too small to occlude the pulmonary capillaries, then the agent can be seen at different locations of the body. Extra-pulmonary accumulation of Tc-99m-MAA can be detected mostly in the liver as well as in the brain, kidney, thyroid, myocardium, spleen and vertebra. Herein, we present lung scanning images with unexpected hepatic accumulation of Tc-99m-MAA. This pulmonary perfusion scintigraphy was performed in a patient with end-stage renal disease due to dyspnea in the post-operative period of kidney transplantation. © 2019 by Turkish Society of Nuclear Medicine