Interventional Radiology Approaches for Liver Metastases from Thyroid Cancer: A Case Series and Overview of the Literature

BACKGROUND: Liver metastases (LMs) from thyroid cancer (TC) are relatively uncommon in clinical practice and their management is challenging. Interventional radiology loco-regional treatments (LRTs), including radiofrequency ablation (RFA) and trans-arterial chemoembolization (TACE), have been successfully employed to treat LMs from various types of cancer. METHODS: We analyzed the role of LRTs in the management of unresectable LMs from differentiated and medullary TCs performed at our institution from 2015 to 2020. A review of the available English literature regarding this topic was also performed. RESULTS: Six hepatic LRTs were performed in 4 TC patients with LMs, in 2 cases after the start of treatment with a tyrosine kinase inhibitor (TKI). A partial response was obtained in 2 patients; the diameter of the largest targeted lesion was 18 mm in both of them. The remaining procedures were performed on larger lesions and a stable disease was achieved in all but one case. Acute LRT-related complications were transient and mild. In literature, the largest studies were focused on TACE in LMs from MTC, showing good tolerance and remarkable disease control, especially in case of limited liver tumour involvement. CONCLUSION: LRTs for LMs represent a valuable option for the treatment of metastatic TC in case of isolated hepatic progression or for symptoms relief, also after the start of TKI treatment as part of a multimodal approach. The best disease control is obtained when hepatic metastatic burden is limited. These procedures are generally well tolerated; however, a cautious multidisciplinary selection of the candidates is mandatory

Fusion Imaging and Virtual Navigation to Guide Percutaneous Thermal Ablation of Hepatocellular Carcinoma : a Review of the Literature

As medical imaging advancements have improved the detectability of hepatocellular carcinoma (HCC) in early stages, the approach to percutaneous thermal ablation for curative treatment has concomitantly advanced. Although many centers are adopting cross-sectional imaging to guide percutaneous ablation, the majority of procedures are still performed under ultrasound (US) guidance worldwide. Challenges to ultrasound guidance may present due to relatively poor resolution particularly with small or isoechoic lesions, or due to intervening structures such as the bowel or diaphragm that obstruct lesional visualization. Fusion imaging (FI) systems have been employed to address these challenges. By merging or synchronizing the real-time images from US with a previously obtained cross-sectional study, FI mitigates the inherent limitations of each individual imaging modality and expands procedural feasibility and technical outcomes. This manuscript reviews the current literature on the use of FI during percutaneous thermal ablation of HCC

New amphiphilic copolymers for PDMS-based nanocomposite films with long-term marine antifouling performance

Amphiphilic methacrylate copolymers (Si-co-EF) containing polysiloxane (Si) and mixed poly(oxyethylene)-perfluorohexyl (EF) side chains were synthesized with different compositions and used together with polysiloxane-functionalized nanoparticles as additives of condensation cured nanocomposite poly(siloxane) films. The mechanical properties of the nanocomposite films were consistent with the elastomeric behavior of the poly(siloxane) matrix without significant detriment from either the copolymer or the nanoparticles. Films were found to be markedly hydrophobic and liphophobic, with both properties being maximized at an intermediate content of EF units. The high enrichment in fluorine at the film surface was proven by angle-resolved X-ray photoelectron spectroscopy (AR-XPS). Long-term marine antifouling performance was evaluated in field immersion trials of test panels for up to 10 months of immersion. Both nanoparticles and amphiphilic copolymer were found to be highly effective in reducing the colonization of foulants, especially hard macrofoulants, when compared with control panels. Lowest percentage of surface coverage was 20% after 10 months of immersion (films with 4 wt% copolymer and 0.5 wt% nanoparticles), which was further decreased to less than 10% after exposure to a water jet for 10 s. The enhanced antifouling properties of coatings containing both nanoparticles and copolymer were confirmed by laboratory assays against the polychaete Ficopomatus enigmaticus and the diatom Navicula salinicola