A comparative study between two different 3D reconstruction methods by bi-planar radiographic in upright posture: Biomod 3sand sterEOS®

ObjectivesThis study aims to evaluate the repeatability and reproducibility of two different methods of 3D reconstruction of the spine sterEOS® and BIOMODTM3S.Materials and methodsRepeatability and reproducibility study. Three observers performed the reconstructions: a radiologist, a X-ray technologist and a rehabilitation specialist, inexperienced in X-ray reading. The observers made these reconstructions with each modality: sterEOS® and BIOMODTM3S. The parameters investigated were Cobb angle, sagittal parameters (cyphosis, lordosis), determination of apical and junctional vertebrae, axial rotation of the apical vertebra, pelvic parameters and time of reconstruction. Statistical analyses were done using Intraclass Correlation Coefficient (ICC) for reproducibility and Student's t test for time of reconstruction.ResultsWe analyzed X-rays of 44 women (71%) and 18 men (29%) with a mean age of 44±20.8. The repeatability was correct, good or excellent depending on observer. The reproducibility inter-observer was correct to excellent (ICC 0.73–0.96) for every parameter except the axial rotation of the apical vertebrae and the determination of levels of junctional and apical vertebrae. The reproducibility of the axial rotation of apical vertebrae was low to good with BIOMODTM3S (ICC 0.15–0.81; ESM=7.5°). The reproducibility of the determination of levels of junctional and apical vertebrae was low to excellent with sterEOS® (ICC 0.36–0.90). With sterEOS®, the reproducibility was impaired by the inexperienced observator for some parameters. The 3D reconstructions with sterEOS® was significantly faster than with BIOMODTM3S (10.8min vs 14.2min, p<0.05).DiscussionParameters’ reproducibility is different depending on the system. The 3D reconstruction with sterEOS® is faster than with BIOMODTM3S. The reproducibility of BIOMODTM3S is less influenced by observator's experienc

Laser-induced dealkylation of calix[4]arene-crown-6 ethers

International audienceSelective dealkylation of dialkyl calix(4)arene monocrown-6 and calix(4)arene biscrown-6 was achieved using laser irradiation. The resulting phenolic compounds structures,studied by NMR (1H and 13C) and ESI-MS (Cs+ spiking), probably originated from theirpartial photo-Claisen rearrangement

Point-shear wave elastography predicts liver hypertrophy after portal vein embolization and postoperative liver failure.

To correlate point-shear wave elastography (SWE) with liver hypertrophy after right portal vein embolization (RPVE) and to determine its usefulness in predicting postoperative liver failure in patients undergoing partial liver resection. Point-SWE was performed the day before RPVE in 56 patients (41 men) with a median age of 66 years. The percentage (%) of future remnant liver (FRL) volume increase was defined as: %FRL &lt;sub&gt;post&lt;/sub&gt; -%FRL &lt;sub&gt;pre&lt;/sub&gt; %FRL &lt;sub&gt;pre&lt;/sub&gt; ×100 and assessed on computed tomography performed 4 weeks after RPVE. Median (range) %FRL &lt;sub&gt;pre&lt;/sub&gt; and %FRL &lt;sub&gt;post&lt;/sub&gt; was respectively, 31.5% (12-48%) and 41% (23-61%) (P&lt;0.001), with a median %FRL volume increase of 25.6% (-8; 123%). SWE correlated with %FRL volume increase (P=-0.510; P&lt;0.001). SWV (P=0.003) and %FRL &lt;sub&gt;pre&lt;/sub&gt; (P&lt;0.001) were associated with %FRL volume increase at multivariate regression analysis. Forty-three patients (77%) were operated. Postoperative liver failure occurred in 14 patients (32.5%). Median SWE was different between the group with (1.68m/s) and without liver failure (1.07m/s) (P=0.018). The AUROC of SWE predicting liver failure was 0.724 with a best cut-off of 1.31m/s, corresponding to a sensitivity of 21%, specificity of 96%, positive predictive value 75% and negative predictive value of 72%. SWE was the single independent preoperative variable associated with liver failure. SWE assessed by point-SWE is a simple and useful tool to predict the FRL volume increase and postoperative liver failure in a population of patients with liver tumor

Radiofrequency Ablation of Liver Tumors: No Difference in the Ablation Zone Volume Between Cirrhotic and Healthy Liver.

The "oven effect" theory assumes that radiofrequency ablation (RFA) would be more efficient on tumors of cirrhotic livers. The aim of the study was to compare the size and volume of the ablation zone following RFA on tumors of cirrhotic versus healthy livers. One hundred and eleven patients who underwent RFA from 2011 to 2013 for the treatment of 140 liver tumors (83 hepatocellular carcinomas developed on a cirrhotic liver, i.e., "cirrhosis group," and 57 tumors developed on a healthy liver, mainly liver metastasis, i.e., "healthy liver group") using the same RFA device were retrospectively selected. The diameter and volume of the ablation zone were compared between groups at the end of the procedure (FU0), at first (FU1) and second follow-up (FU2) performed 1.6 months (± 19 days) and 4.7 months (± 40 days) post-RFA, respectively. No differences in the size or volume of the ablation zone were found between groups at FU0 (36.5 ± 12 mm vs. 34.3 ± 10 mm, p = 0.5; and 28 ± 16 mm &lt;sup&gt;3&lt;/sup&gt; vs. 26.5 ± 16 mm &lt;sup&gt;3&lt;/sup&gt; , p = 0.6, respectively), FU1, or FU2. Similarly, no differences were found at FU0, FU1, or FU2 in the subgroups of tumors treated using a single radiofrequency application. The mean volume of the ablation zone decreased over time, by 33.3% at FU1 and 48.5% at FU2, without any difference between groups. In contradiction to the "oven effect" theory, RFA achieves ablation zones of a comparable size and volume in cirrhotic and healthy livers

Magnetic resonance texture parameters are associated with ablation efficiency in MR-guided high-intensity focussed ultrasound treatment of uterine fibroids

OBJECTIVES: The objective of this study is to assess the association between texture parameter analysis derived from T2-weighted images and efficiency of magnetic resonance-guided focussed ultrasound (MRgFUS) ablation for the treatment of uterine fibroids. MATERIALS AND METHODS: Fifty-five women treated by MRgFUS were included in this retrospective analysis. Texture parameters were calculated using three 2D regions of interest placed on three consecutive slices on the same sagittal 3D T2-weighted images obtained at the beginning of MRgFUS ablation. Using uni- and multi-variate linear regression, texture parameters, fibroids/muscular T2W ratio (T2Wr), Funaki type, and fibroid depth were correlated with ablation efficiency, defined as the ratio of non-perfused volume (NPV) on post-treatment contrast-enhanced MRI by total volume of treatment-cell sizes used. Inter-rater reproducibility for texture analysis was assessed using variation coefficients. RESULTS: The mean total treatment cell volume was 49.5 (±30) ml, corresponding to a mean NPV of 57.2 (±57) ml (28%). The mean ablation efficiency was 1.14 (±0.7), with a range of 0.03-3.6. In addition to fibroid/muscular T2Wr, seven of the 14 texture parameters were significantly correlated with ablation efficiency: mean signal intensity (p = .047); Skewness (p = .03); Kurtosis (p = .015); mean uniformity (p = .052); mean sum of square (p = .045); mean sum entropy (p = .021) and mean entropy (p = .051). In multivariate linear regression, fibroid/muscular T2Wr and sum of entropy were associated with ablation efficiency. The inter-rater coefficient of variation for sum entropy was 2.6%. CONCLUSIONS: Uterine fibroid texture parameters provide complementary information to T2Wr, and are associated with MRgFUS efficiency. Key points Mean sum entropy is negatively correlated with MRgFUS efficiency (ρ = -0.307, p = .021). Fibroids/muscular T2-weighted ratio and entropy are associated with MRgFUS efficiency. Texture parameters are better predictors of MRgFUS efficiency than Funaki type. Fibroid MR texture analysis can improve patient selection for MRgFUS

Proximal embolization of splenic artery in acute trauma: Comparison between Penumbra occlusion device versus coils or Amplatzer vascular plug.

To compare intervention duration and fluoroscopy time for proximal embolization of splenic arteries in acute trauma using the Penumbra occlusion device (POD &lt;sup&gt;®&lt;/sup&gt; ), coils or Amplatzer™ vascular plug (AVP). A total of 29 patients with splenic injury without vascular injury who were treated by proximal splenic artery embolization using POD &lt;sup&gt;®&lt;/sup&gt; (n=12), coils (n=9) or AVP (n=8) were retrospectively included. There were 25 men and 4 women with a median age of 34 years (range: 10-69 years). To overcome bias in treatment choice, a propensity score was used using inverse probability weighting. Intervention duration and fluoroscopy time, treatment success and complications were compared. The median intervention duration was significantly shorter using POD &lt;sup&gt;®&lt;/sup&gt; (30min) or AVP (47min) than using coils (60min) (P=0.0001 and 0.004, respectively). The median fluoroscopy time was significantly lower using POD &lt;sup&gt;®&lt;/sup&gt; (11.5min) than using coils (23.6min) (P=0.0076) or AVP (16.5min) (P=0.049). The primary efficacy rate was 100% with POD &lt;sup&gt;®&lt;/sup&gt; and AVP and 89% with coils (P=0.586). Six complications occurred with a mean follow-up of 12 months for POD &lt;sup&gt;®&lt;/sup&gt; , 32 months for coils and 40 months for AVP, consisting in 2 abscesses treated by anti-biotherapy with POD &lt;sup&gt;®&lt;/sup&gt; , one abscess with AVP, 2 material migrations with coils and 1 coil dismantled without consequence. POD &lt;sup&gt;®&lt;/sup&gt; and AVP allow proximal embolization of splenic artery in acute trauma with shorter intervention duration by comparison with conventional metallic coils with similar technical success. POD &lt;sup&gt;®&lt;/sup&gt; allows a shorter fluoroscopy time than coils or AVP

First-Line Selective Internal Radiation Therapy in Patients with Uveal Melanoma Metastatic to the Liver.

Survival of patients with uveal melanoma metastatic to the liver correlates strongly with disease control in the liver. Unfortunately, there are no standardized treatments for this chemoresistant disease. Selective internal radiation therapy (SIRT) has been tested as salvage therapy, but no data exist about its use as first-line therapy. The purpose of this study was to investigate the safety and efficacy of SIRT as first-line therapy in patients with uveal melanoma metastatic to the liver. Methods: This retrospective analysis of a prospectively collected cohort included 22 patients treated with first-line SIRT. Biochemical and clinical toxicities were recorded. Tumor response was determined according to the European Association for the Study of Liver Disease (EASL) criteria. Predictive factors of survival were analyzed by univariate and multivariate analysis. Overall survival was calculated using the Kaplan-Meier method with the log-rank test. Results: Grade 3-4 biologic and clinical toxicities occurred in 24% of patients (for both). According to the EASL criteria, disease control at 6 mo after SIRT was achieved in 15 (52%) of the 29 SIRT patients and was predictive of survival. Median overall survival from the first SIRT was 18 mo (95% confidence interval [95%CI], 8-28 mo). At the time of the analysis, 5 patients (23%) were still alive. In multivariate analysis, largest lesion size (hazard ratio [HR], 1.22; 95%CI, 0.98-1.53], liver tumor volume (HR, 1.002; 95%CI, 1.0004-1.003), subsequent systemic therapy (HR, 0.04; 95%CI, 0.006-0.24), and liver-directed locoregional therapy (HR, 0.204; 95%CI, 0.04-0.94) were predictive of survival. Conclusion: First-line SIRT is safe and produced promising outcomes in patients with uveal melanoma metastatic to the liver. Subsequent systemic and liver-directed locoregional therapies ameliorated survival, highlighting the potential for improved outcomes with combination approaches. The results of this study suggest that prospective trials using first-line SIRT should be considered

Preoperative Portal Vein Embolization Alone with Biliary Drainage Compared to a Combination of Simultaneous Portal Vein, Right Hepatic Vein Embolization and Biliary Drainage in Klatskin Tumor.

To compare estimated future remnant liver (FRL) growth following portal vein embolization or liver venous deprivation (LVD) (combined PVE and right hepatic vein embolization), before surgery for a Klatskin tumor in patients who receive intraoperative biliary drainage or before venous interventional radiology. Six patients underwent LVD and six underwent PVE alone before hepatectomy for a Klatskin tumor. Before embolization, the FRL ratio, prothrombin time and bilirubin levels were similar in both groups. The FRL was determined before and 3 weeks after embolization by enhanced CT. PVE was performed with n-butyl-2-cyanoacrylate, and the right hepatic vein was embolized with vascular plugs during the same procedure. Biliary drainage was performed percutaneously or by endoscopy. Post-hepatectomy liver function and duration of hospital stay were assessed. There were no adverse events. The median FRL ratio was significantly higher following LVD than after PVE 58% (54-71) and 37% (30-44), respectively, p = 0.017. The FRL volume after embolization was 1.6 times higher after LVD than PVE (p = 0.016). Four and five patients were operated in the LVD and PVE groups, respectively. There was a trend toward a shorter median postoperative hospital stay and 90-day mortality in the LVD versus PVE group: 14 versus 44 days, (p = 0.114) and 0 versus two deaths (p = 0.429), respectively. LVD associated with biliary drainage is safe and results in a better FRL ratio than biliary drainage associated with PVE alone

Pre-treatment magnetic resonance-based texture features as potential imaging biomarkers for predicting event free survival in anal cancer treated by chemoradiotherapy.

To assess regular MRI findings and tumour texture features on pre-CRT imaging as potential predictive factors of event-free survival (disease progression or death) after chemoradiotherapy (CRT) for anal squamous cell carcinoma (ASCC) without metastasis. We retrospectively included 28 patients treated by CRT for pathologically proven ASCC with a pre-CRT MRI. Texture analysis was carried out with axial T2W images by delineating a 3D region of interest around the entire tumour volume. First-order analysis by quantification of the histogram was carried out. Second-order statistical texture features were derived from the calculation of the grey-level co-occurrence matrix using a distance of 1 (d1), 2 (d2) and 5 (d5) pixels. Prognostic factors were assessed by Cox regression and performance of the model by the Harrell C-index. Eight tumour progressions led to six tumour-specific deaths. After adjusting for age, gender and tumour grade, skewness (HR = 0.131, 95% CI = 0-0.447, p = 0.005) and cluster shade_d1 (HR = 0.601, 95% CI = 0-0.861, p = 0.027) were associated with event occurrence. The corresponding Harrell C-indices were 0.846, 95% CI = 0.697-0.993, and 0.851, 95% CI = 0.708-0.994. ASCC MR texture analysis provides prognostic factors of event occurrence and requires additional studies to assess its potential in an "individual dose" strategy for ASCC chemoradiation therapy. • MR texture features help to identify tumours with high progression risk. • Texture feature maps help to identify intra-tumoral heterogeneity. • Texture features are a better prognostic factor than regular MR findings

Case report: Acute pericarditis following hepatic microwave ablation for liver metastasis

Hepatic microwave ablation (MWA) is a growing treatment modality in the field of primary and secondary liver cancer. One potential side effect is thermal damage to adjacent structures, including the pericardium if the hepatic lesion is located near the diaphragm. Hemorrhagic cardiac tamponade is known to be a rare but potentially life-threatening complication. Here we present the first case of cardiac complication following MWA treatment in a 55-year-old man who presented with late cardiac tamponade. Adequate and timely management is essential, and clinicians should be fully aware of the need to perform early transthoracic echocardiography to detect signs of pericardial effusion when cardiac involvement is suspected