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Long-term outcomes of hepatocellular carcinoma that underwent chemoembolization for bridging or downstaging

World Journal of Gastroenterology 2019年第37期25卷 5687-5701页

作者： Breno Boueri Affonso Francisco Leonardo Galastri Joaquim Mauricio da Motta Leal Filho Felipe Nasser Priscila Mina Falsarella Rafael Noronha Cavalcante Marcio Dias de Almeida Guilherme Eduardo Goncalves Felga Leonardo Guedes Moreira Valle nelson wolosker Department of Interventional Radiology Hospital Israelita Albert EinsteinSao Paulo 05651-901Sao PauloBrazil Department of Liver Transplant Hospital Israelita Albert EinsteinSao Paulo 05651-901Sao PauloBrazil Department of Vascular Surgery Hospital Israelita Albert EinsteinSao Paulo 05651-901Sao PauloBrazil

BACKGROUND Prospective study of 200 patients with hepatocellular carcinoma(HCC)that underwent liver transplant(LT)after drug-eluting beads transarterial chemoembolization(DEB-TACE)for downstaging versus *** survival and tumor recurrence rates were calculated,eligibility for LT,time on the waiting list and radiological response were *** TACE,only patients within Milan Criteria(MC)were *** patients underwent LT in bridging ***-year post-transplant overall survival,recurrence-free survival has no difference between the *** response was observed more frequently in bridging *** in DS group can achieve posttransplant survival and HCC recurrence-free probability,at five years,just like patients within MC in patients undergoing *** To determine long-term outcomes of patients with HCC that underwent LT after DEB-TACE for downstaging vs *** Prospective cohort study of 200 patients included from April 2011 through June *** group included patients within *** group(out of MC)was divided in 5 subgroups(G1 to G5).Total tumor diameter was≤8 cm for G1,2,3,4(n=42)and was>8 cm for G5(n=22).Downstaging(n=64)and bridging(n=136)populations were not significantly *** survival and tumor recurrence rates were calculated by the Kaplan-Meier ***,eligibility for LT,time on the waiting list until LT and radiological response were *** After TACE,only patients within MC were *** patients underwent LT in bridging group 65.9%(P=0.001).Downstaging population presented:higher number of nodules 2.81(P=0.001);larger total tumor diameter 8.09(P=0.001);multifocal HCC 78%(P=0.001);more post-transplantation recurrence 25%(P=0.02).Patients with maximal tumor diameter up to 7.05 cm were more likely to receive LT(P=0.005).Median time on the waiting list was significantly longer in downstaging group 10.6 mo(P=0.028).Five-year posttransplant over

关键词： Hepatocellular carcinoma Down-staging Liver transplantation Localregional therapy Bridging

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Imaging response predictors following drug eluting beads chemoembolization in the neoadjuvant liver transplant treatment of hepatocellular carcinoma

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World Journal of Hepatology 2020年第1期12卷 21-33页

作者： Francisco Leonardo Galastri Felipe Nasser Breno Boueri Affonso Leonardo Guedes Moreira Valle Bruno Calazans Odísio Joaquim Mauricio Motta-Leal Filho Paolo Rogério Salvalaggio Rodrigo Gobbo Garcia Márcio Dias de Almeida Ronaldo Hueb Baroni nelson wolosker Department of Interventional Radiology Hospital Israelita Albert EinsteinSão Paulo 05652-000Brazil Department of Diagnostic Radiology The University of Texas MD Anderson Cancer CenterHoustonTX 77230United States Radiology Department Radiology DepartmentHeart Institute(InCor)University of São PauloSão Paulo 05403-900Brazil Teaching and Research Institute São PauloBrazilHospital Israelita Albert EinsteinSão Paulo 05652-000Brazil Department of Liver Transplant Hospital Israelita Albert EinsteinSão Paulo 05652-900Brazil Department of Radiology Hospital Israelita Albert EinsteinSão Paulo 05652-000Brazil Department of Vascular Surgery Hospital Israelita Albert EinsteinSão Paulo 05652-000Brazil

BACKGROUND Drug-eluting bead transarterial chemoembolization(DEB-TACE)is an endovascular treatment to release chemotherapeutic agents within a target lesion,minimizing systemic exposure and adverse effects to ***,identifying which patient characteristics may predict imaging response to DEB-TACE can improve treatment results while selecting the best *** of the response after DEB-TACE still have not been fully *** is the first prospective study performed with standardized DEBTACE technique that aim to identify predictors of radiological response,assessing patients clinical and laboratory characteristics,diagnostic imaging and intraprocedure data of the hepatocellular carcinoma treated in the neoadjuvant context for liver *** To identify pre-and intraoperative clinical and imaging predictors of the radiological response of drug-eluting bead transarterial chemoembolization(DEB-TACE)for the neoadjuvant treatment of hepatocellular carcinoma(HCC).METHODS This is prospective,cohort study,performed in a single transplant center,from 2011 to *** patients with HCC considered for liver transplant who underwent DEB-TACE in the first session for downstaging or bridging purposes were *** and post-chemoembolization imaging studies were performed by computed tomography or magnetic *** radiological response of each individual HCC was evaluated by objective response using mRECIST and the percentage of *** Two hundred patients with 380 HCCs were *** of the objective response(nodule-based analysis)demonstrated that HCC with pseudocapsules had a 2.01 times greater chance of being responders than those without pseudocapsules(P=0.01),and the addition of every 1mg of chemoembolic agent increased the chance of therapeutic response in 4%(P<0.001).Analysis of the percentage of necrosis through multiple linear regression revealed that the addition of each 1mg of the

关键词： Hepatocellular carcinoma Liver transplantation Response evaluation criteria in solid tumors Neoadjuvant therapy Liver neoplasms

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Diagnosis and management of hepatic artery in-stent restenosis after liver transplantation by optical coherence tomography:A case report

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World Journal of Hepatology 2020年第7期12卷 399-405页

作者： Francisco Leonardo Galastri Guilherme Moratti Gilberto Breno Boueri Affonso Leonardo Guedes Moreira Valle Priscila Mina Falsarella Adriano Mendes Caixeta Camila Antunes Lima Marcela Juliano Silva Lucas Lembrança Pinheiro Conrado Dias Pacheco Annicchino Baptistella Márcio Dias de Almeida Rodrigo Gobbo Garcia nelson wolosker Felipe Nasser Hospital Israelita Albert Einstein Department of Interventional RadiologySão Paulo 05652900Brazil Hospital Israelita Albert Einstein Department of Interventional CardiologySão Paulo 0562900Brazil Hospital Israelita Albert Einstein Department of Liver TransplantSão Paulo 05652900Brazil Hospital Israelita Albert Einstein Department of Vascular SurgerySão Paulo 05652-000Brazil

BACKGROUNDPercutaneous transluminal angioplasty and stenting represent an effectivetreatment for hepatic artery stenosis after liver transplantation. In the first yearafter stenting, approximately 22% of patients experience in-stent restenosis,increasing the risk of artery thrombosis and related complications, and 50%experience liver failure. Although angiography is an important tool for diagnosisand the planning of therapeutic interventions, it may raise doubts, especially insmall-diameter arteries, and it provides low resolution rates compared withnewer intravascular imaging methods, such as optical coherence tomography(OCT).CASE SUMMARYA 64-year-old male developed hepatic artery stenosis one year after orthotropicliver transplantation and was successfully treated with percutaneous transluminalangioplasty with stenting. Five months later, the Doppler ultrasound resultsindicated restenosis. Visceral arteriography confirmed hepatic artery tortuositybut was doubtful for significant in-stent restenosis (ISR) and intrahepatic flowreduction. To confirm ISR, identify the etiology and guide treatment, OCT wasperformed. OCT showed severe stenosis due to four mechanisms: Focal andpartial stent fracture, late stent malapposition, in-stent neointimal hyperplasia,and *** diagnostic methods can be useful in evaluating cases in which initialangiography results are not sufficient to provide a proper diagnosis of significantstenosis, especially with regard to ISR. A wide range of diagnoses are provided byOCT, resulting in different treatment options. Interventional radiologists shouldconsider intravascular diagnostic methods as additional tools for evaluatingpatients when visceral angiography results are unclear.

关键词： Liver transplantation Hepatic artery restenosis Tomography Optical coherence Case report Endovascular procedures Angiography

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Decoding complexity: the need to enhance precision and streamline spatial understanding in neuroscience

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Neural Regeneration Research 2025年第3期20卷 801-802页

作者： Sameehan Mahajani Armita Salahi Brenda Gonzalez Charlotte nelson Frank Hsiung Biology&Applications Division NodexusSan JoseCAUSA

Neuroscience is the ultimate frontier in our quest for a comprehensive understanding of human behavior. Since its launch in 2009, the Human Connectome Project has emerged as a pioneering force, making heroic strides i... 详细信息

关键词： behavior frontier dating

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Experimental and numerical evaluation of multidirectional compressive and flexure behavior of three-dimensional printed concrete

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Frontiers of Structural and Civil Engineering 2023年第11期17卷 1643-1661页

作者： Lalit KUMAR Dhrutiman DEY Biranchi PANDA nelson MUTHU Department of Mechanical Engineering Indian Institute of Technology GuwahatiAssam 781039India

Three-dimensional concrete printing(3DCP)can proliferate the industrialization of the construction sector,which is notoriously conservative and indolent toward ***,the mechanical behavior of 3DCP should be characterized and modeled considering the interfaces when its performance is thoroughly compared to that of the existing concrete construction *** study presents an experimental and numerical investigation of uniaxial compression and three-point bending(TPB)tests on extruded 3DCP beams in different loading *** orientation of translational and depositional interfaces with respect to the direction of loading influenced the *** the elastic and post-damage behavior of the 3DCP specimens were compared with those of the conventionally cast specimen under quasi-static loading *** the higher compressive strength of the casted specimen,the flexural strength of the 3DCP specimens was *** study employed the finite element and cohesive zone models of the appropriate calibrated traction-separation law to model fracture in the notched TPB ***,the real-time acoustic emission test revealed the nature of failure phenomenon of three-dimensional-printed specimens under flexion,and accordingly,the cohesive law was *** predicted load-displacement responses are in good agreement with the experimental ***,the effects of cohesive thickness and notch shape on the performance under bending were explored through parametric studies.

关键词： three-dimensional printing anisotropy flexure compression cohesive zone model finite element model

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