Advancements in minimally invasive image-guided liver therapies

This thesis is a contribution to the fight against cancer. It focuses on patients with hepatic malignancies. Interventional oncology (IO) is a rapidly evolving sub-speciality of interventional radiology with an increasing role in the management of cancer patients. Over the past two decades interventional radiologists together with scientists have ridding the tidal wave of technological innovation to introduce multiple novel cancer treatments. IO procedures are minimally invasive, targeted therapies that are associated with low complication rates and short hospital admissions. Such therapies offer clear advantages over surgical procedures and intense chemotherapeutic regimes that put a larger burden on both the health care budget and patients. In this thesis several novel minimally invasive therapies are investigated. PART I focuses on image-guided percutaneous RFA. PART II discusses transarterial liver therapies, such as transarterial chemoembolisation, radioembolisation and percutaneous hepatic perfusion. PART III investigates ways to improve the management of patients that undergo IO procedures.LUMC / Geneeskund

Misknown Interventional Radiology Indications and Techniques

Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas

Het krimpende brein: normale veroudering of een gevolg van selectiebias in het onderzoek?

Het volume van ons brein neemt af naarmate we ouder worden. Dat is door verschillende grootschalige studies naar normale veroudering aangetoond. Een recent onderzoek wijst er echter op dat de mate van deze krimp bij normale veroudering waarschijnlijk overschat wordt doordat deze studies proefpersonen met een preklinisch ziektebeeld hebben geïncludeerd. In dit artikel wordt vanuit een voorbeeld uit de wetenschap beschreven welk effect selectiebias kan hebben op ons model van het verouderende brein

In Vivo Proof of Superselective Transarterial Chemoembolization with 40-mu m Drug-Eluting Beads in a Patient with Hepatocellular Carcinoma

Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Athletes treated for inguinal-related groin pain by endoscopic totally extraperitoneal (TEP) repair:long-term benefits of a prospective cohort

Purpose: Inguinal-related groin pain (IRGP) in athletes is a multifactorial condition, posing a therapeutic challenge. If conservative treatment fails, totally extraperitoneal (TEP) repair is effective in pain relief. Because there are only few long-term follow-up results available, this study was designed to evaluate effectiveness of TEP repair in IRGP-patients years after the initial procedure. Methods: Patients enrolled in the original, prospective cohort study (TEP-ID-study) were subjected to two telephone questionnaires. The TEP-ID-study demonstrated favorable outcomes after TEP repair for IRGP-patients after a median follow-up of 19 months. The questionnaires in the current study assessed different aspects, including, but not limited to pain, recurrence, new groin-related symptoms and physical functioning measured by the Copenhagen Hip and Groin Outcome Score (HAGOS). The primary outcome was pain during exercise on the numeric rating scale (NRS) at very long-term follow-up.Results: Out of 32 male participants in the TEP-ID-study, 28 patients (88%) were available with a median follow-up of 83 months (range: 69–95). Seventy-five percent of athletes were pain free during exercise (p &lt; 0.001). At 83 months follow-up, a median NRS of 0 was observed during exercise (IQR 0–2), which was significantly lower compared to earlier scores (p &lt;0.01). Ten patients (36%) mentioned subjective recurrence of complaints, however, physical functioning improved on all HAGOS subscales (p &lt;0.05).Conclusion:This study demonstrates the safety and effectivity of TEP repair in a prospective cohort of IRGP-athletes, for whom conservative treatment had failed, with a follow-up period of over 80 months.</p

Gastric Variceal Hemorrhage in a Noncirrhotic Patient Treated with Balloon-Occluded Retrograde Transvenous Obliteration

Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Unilateral Ovarian Abscess Caused by Salmonella

Background: Patients with unilateral ovarian abscesses due to Salmonella are rare. Case report: A 48-year-old woman with a left ovarian abscess caused by Salmonella group O7 is reported. Conclusion: In our patient, the ovary may have been seeded hematogenously by salmonellae and may have evolved into a local infection

Pilot study evaluating catheter-directed contrast-enhanced ultrasound compared to catheter-directed computed tomography arteriography as adjuncts to digital subtraction angiography to guide transarterial chemoembolization

Cellular mechanisms in basic and clinical gastroenterology and hepatolog