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

Investigating the Frequency of Stent Fracture and its Impact on in-Stent Restenosis in Patients Undergoing Carotid Artery Stenting

Objective: This single-center study aimed to assess the incidence and predictors of carotid artery Xact stent fractures (SF) and their impact on in-stent restenosis (ISR) during long-term follow-up. Methods: A cohort of 108 patients (97 males, median age 69.4±8 months) who underwent Xact stent placement for internal carotid artery stenosis between 2013 and 2021 and were diagnosed with SFs through fluoroscopy in 2022 were included. SFs were categorized as types I-V based on fracture characteristics. Follow-up included duplex ultrasound examinations to assess stent patency. Results: The average follow-up duration was 49.2±24.3 months, with ISR observed in 10 patients. Twenty-three SFs (21.3%) were identified: type I (5 patients), type II (7 patients), type III (3 patients), type IV (6 patients), and type V (2 patients). Calcification and stent length significantly predicted SFs (p<0.001; p<0.028). Conclusion: Calcification and stent length are associated with Xact SFs, but SFs do not impact ISR during long-term follow-up

The Efficacy and Safety of Microwave Ablation in Hepatocellular Carcinoma.

TEZ11762Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2019.Kaynakça (s. 67-74) var.viii, 76 s. : res. (bzs. rnk.), tablo ; 29 cm.Amaç: Bu çalışmanın amacı hepatosellüler karsinomlu hastalarda mikrodalga ablasyon tedavisinin etkinliği ve güvenirliliğini araştırmak idi. Gereç ve Yöntem: Bu tek merkezli retrospektiv çalışmaya Mart 2013 ile Kasım 2018 arasında tümör konseyi kararı ile cerrahi tedaviye uygun olmayan, mikrodalga ablasyon işlemi uygulanmış toplam 46 ardışık hasta dahil edilmiştir. Mikrodalga ablasyon sonrası hastalar 1. ay ve sonrasında 3 aylık aralıklar ile takip edildi. Tedaviye yanıt oranları (Modified Response Evaluation Criteria in Solid Tumors’a ?mRECIST?), genel sağ kalım süreleri, progresyonsuz sağ kalım süreleri ile komplikasyonlar değerlendirilmiştir. Bulgular: Bu çalışmada toplam 67 hepatosellüler karsinom nodülü bulunan 47 hasta (40’i ?%85? erkek) değerlendirilmiştir. Hastaların yaşları 44 ile 78 (medyan 64) arasında idi. Medyan genel sağ kalım süresi 38 ay (aralık 30-45 ay), medyan progresyonsuz sağ kalım süresi 26 ay (aralık 9-42 ay) idi. Alfa-fetoprotein değerlerine göre hastalar iki gruba ayrıldığında, alfa-fetoprotein değerlerinin genel sağ kalım süreleri üzerine etkileri istatistiksel olarak anlamlı bulunmuştur (P=0.015). Hastalar, tümör sayısına göre farklı gruplara ayrıldığında genel sağ kalım süreleri, progresyonsuz sağ kalım süreleri açısından tüm gruplar arasında anlamlı fark saptanmıştır (sırasıyla, P=0.01, P=0.005). Mikrodalga ablasyon tedavisi sonrası 1 hastada (%0,01) majör komplikasyon tespit edilmiştir. Sonuç: Mikrodalga ablasyon hepatosellüler karsinomlarda etkin ve güvenilir bir tedavi yöntemidir. Takiplerde alfa-fetoprotein değerlerinde değişim mikrodalga ablasyon tedavisi’nin etkinliğinin bir göstergesidir. Tümör sayısı hasta seçiminde önemli bir kriterdir.Aim: The aim of this study was to investigate the efficacy and safety of Microwave ablation in hepatocellular carcinoma. Material and Methods: This single-center retrospective study included consecutive patients not suitable for surgical treatment for whose microwave ablation was performed between March 2013 and November 2018. After microwave ablation, patients were followed up at 1st month and thereafter at 3 months intervals. Treatment response rates (Modified Response Evaluation Criteria in Solid Tumors ?mRECIST?), overall survival and progression-free survival were evaluated. Findings: In this study, 46 patients (40% ? 85% male?) with a total of 67 tumors were evaluated. The ages of the patients were between 44 and 78 years (median 64). Median overall survival duration was 38 months (range 30-45 months), median progression-free survival was 26 months (range 9-42 months). When the patients were divided into two groups according to their alpha fetoprotein values, the effects of alpha-fetoprotein on overall survival were statistically significant (P=0.015). When patients were divided into different groups according to the number of tumors, a significant difference was found between the groups in terms of overall survival and progression-free survival (P=0.01, P=0.005, respectively). Major complication after microwave ablation was detected in 1 patient (0.01%). Conclusion: Microwave ablation is an effective and safe treatment method for hepatocellular carcinoma. The change in alpha-fetoproteion values during follow-up is an strong indicator for the effectiveness of microwave ablation. The number of tumors is an important criterion in patient selection

Predictability of the radiological response to Yttrium-90 transarterial radioembolization by dynamic magnetic resonance imaging-based radiomics analysis in patients with intrahepatic cholangiocarcinoma

PURPOSE: The study aims to investigate the predictability of the radiological response in intrahepatic cholangiocarcinoma (iCC) patients undergoing Yttrium-90 transarterial radioembolization (TARE) with a combined model built on dynamic magnetic resonance imaging (MRI)-based radiomics and clinical features. METHODS: Thirty-six naive iCC patients who underwent TARE were included in this study. The tumor segmentation was performed on the axial T2-weighted (T2W) without fat suppression, axial T2W with fat suppression, and axial T1-weighted (T1W) contrast-enhanced (CE) sequence in equilibrium phase (Eq). At the sixth month MRI follow-up, all patients were divided into responders and non-responders according to the modified Response Evaluation Criteria in Solid Tumors. Subsequently, a radiomics score (rad-score) and a combined model of the rad-score and clinical features for each sequence were generated and compared between the groups. RESULTS: Thirteen (36.1%) patients were considered responders, and the remaining 23 (63.9%) were non-responders. Responders exhibited significantly lower rad-scores than non-responders (P < 0.050 for all sequences). The radiomics models showed good discriminatory ability with an area under the curve (AUC) of 0.696 [95% confidence interval (CI), 0.522–0.870] for the axial T1W-CE-Eq, AUC of 0.839 (95% CI, 0.709–0.970) for the axial T2W with fat suppression, and AUC of 0.836 (95% CI, 0.678–0.995) for the axial T2W without fat suppression. CONCLUSION: Radiomics models created by pre-treatment MRIs can predict the radiological response to Yttrium- 90 TARE in iCC patients with high accuracy. Combining radiomics with clinical features could increase the power of the test. Large-scale studies of multi-parametric MRIs with internal and external validations are needed to determine the clinical value of radiomics in iCC patients

Evaluation of abdominal computed tomography findings in patients with COVID-19: a multicenter study

PURPOSE To evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta. METHODS This study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded. RESULTS Ischemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P < 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P < 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations. CONCLUSION Abdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19

Evaluation of abdominal computed tomography findings in patients with COVID-19: a multicenter study

PURPOSE: To evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta. METHODS: This study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded. RESULTS: Ischemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations. CONCLUSION: Abdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19