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Novel imaging biomarkers of response to transcatheter arterial chemoembolization in hepatocellular carcinoma patients

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Chinese Journal of Cancer Research 2015年第6期27卷 611-616页

作者： Sylvain Favelier Louis Estivalet pierre pottecher Romaric Loffroy Department of Vascular Oncologic and Interventional Radiology University of Dijon School of Medicine Bocage Teaching Hospital

Hepatocellular carcinoma common cause of cancer death （HCC） is the third most worldwide （1）. Most patients present with intermediate or advanced disease that is not amenable to curative treatment, and the median survival in this group is 6-8 months （2）. Several studies and well- designed randomized trials have shown a positive effect of transcatheter arterial chemoembolization （TACE） on patient outcome and survival （3-8）. As nicely described in the present article from Wring et al., assessment of tumor response is of extreme importance in patients undergoing locoregional treatments of liver cancer （9）. Early assessment of the effectiveness of TACE and monitoring of tumor response are paramount to the identification of treatment failure, guidance of future therapy, and determination of the interval for repeat treatment.

关键词： TACE Novel imaging biomarkers of response to transcatheter arterial chemoembolization in hepatocellular carcinoma patients HCC CBCT

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Interventional radiology therapies for liver cancer

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Hepatoma Research 2016年第1期2卷 1-9页

作者： Romaric Loffroy Louis Estivalet Sylvain Favelier pierre pottecher pierre-Yves Genson Jean-pierre Cercueil Denis Krause Department of Vascular Oncologic and Interventional RadiologyLe2i UMR CNRS 6306University of Dijon School of MedicineBocage Teaching Hospital21079 Dijon CedexFrance

Hepatocellular carcinoma(HCC)is the fifth most frequently found primary malignant tumor in the *** surgery and liver transplantation are considered optimal for the curative treatment of ***,only 15-20%of HCCs may be surgically *** of the surgically-non-eligible patients have to receive locoregional image-guided interventional treatments including intra-arterial and percutaneous ablative *** goal of this paper is to review these interventional oncology *** therapeutic approaches include chemical therapies(such as ethanol or acetic acid injection),and thermal therapies(such as radiofrequency ablation,laser-induced thermotherapy,microwave ablation,cryoablation,and high-intensity focused ultrasound ablation).Catheter-based therapies include embolotherapy/chemotherapy-based treatments(such as transcatheter arterial chemoembolization,bland embolization,transcatheter arterial chemoinfusion,and chemoembolization with drug-eluting beads),and radiotherapy-based treatments(such as radioembolization with yttrium-90 and injection of iodine-131-labeled lipiodol).As a result of the technical development of locoregional approaches for HCC during the recent decades,the range of combined interventional therapies has been continuously *** this article,an evidence-based approach will be used to review the current role of interventional radiology therapies in the management of unresectable HCC.

关键词： Hepatocellular carcinoma local ablative therapy radioembolization transarterial chemoembolization

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Transjugular intrahepatic portosystemic shunt for the management of acute variceal hemorrhage

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World Journal of Gastroenterology 2013年第37期19卷 6131-6143页

作者： Romaric Loffroy Louis Estivalet Violaine Cherblanc Sylvain Favelier pierre pottecher Samia Hamza Anne Minello Patrick Hillon pierre Thouant pierre-Henri Lefevre Denis Krausé Jean-pierre Cercueil Department of Vascular Oncologic and Interventional RadiologyUniversity of Dijon School of MedicineBocage Teaching Hospital Department of Intensive Care Medicine Gastroenterology and HepatologyUniversity of Dijon School of MedicineBocage Teaching Hospital

Acute variceal hemorrhage,a life-threatening condition that requires a multidisciplinary approach for effective therapy,is defined as visible bleeding from an esophageal or gastric varix at the time of endoscopy,the presence of large esophageal varices with recent stigmata of bleeding,or fresh blood visible in the stomach with no other source of bleeding *** of blood products,pharmacological treatments and early endoscopic therapy are often effective;however,if primary hemostasis cannot be obtained or if uncontrollable early rebleeding occurs,transjugular intrahepatic portosystemic shunt(TIPS)is recommended as rescue *** TIPS represents a major advance in the treatment of complications of portal *** variceal hemorrhage that is poorly controlled with endoscopic therapy is generally well controlled with TIPS,which has a 90%to 100%success ***,TIPS is associated with a mortality of 30%to 50%in such a *** TIPS should be considered early in patients with refractory variceal bleeding once medical treatment and endoscopic sclerotherapy failure,before the clinical condition ***,admission to specialized centers is mandatory in such a setting and regional protocols are essential to be organized *** review article discusses initial management and then focuses on the specific role of TIPS as a primary therapy to control acute variceal hemorrhage,particularly as a rescue therapy following failure of endoscopic approaches.

关键词： Cirrhosis Portal hypertension Transjugular intrahepatic portosystemic shunt Variceal hemorrhage

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Endovascular management of visceral artery aneurysms: When to watch, when to intervene?

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World Journal of Radiology 2015年第7期7卷 143-148页

作者： Romaric Loffroy Sylvain Favelier pierre pottecher pierre-Yves Genson Louis Estivalet Sophie Gehin Jean-pierre Cercueil Denis Krausé Department of Vascular Oncologic and Interventional Radiology University of Dijon School of Medicine Bocage Teaching Hospital

Visceral artery aneurysms(VAA) include splanchnic and renal artery aneurysms. They represent a rare clinical entity, although their detection is rising due to an increased use of cross-sectional imaging. Rupture is the most devastating complication, and is associated with a high morbidity and mortality. In addition, increased percutaneous endovascular interventions have raised the incidence of iatrogenic visceral artery pseudoaneurysms(VAPAs). For this reason, elective repair is preferable in the appropriately chosen patient. Controversy still exists regarding their treatment. Over the past decade, there has been steady increase in the utilization of minimally invasive, non-operative interventions, for vascular aneurysmal disease. All VAAs and VAPAs can technically be fixed by endovascular techniques but that does not mean they should. These catheter-based techniques constitute an excellent approach in the elective setting. However, in the emergent setting it may carry a higher morbidity and mortality. The decision for intervention has to take into account the size and the natural history of the lesion, the risk of rupture, which is high during pregnancy, and the relative risk of surgical or radiological intervention. For splanchnic artery aneurysms, we should recognize that we are not, in reality, well informed about their natural history. For most asymptomatic aneurysms, expectant treatment is acceptable. For large, symptomatic or aneurysms with a high risk of rupture, endovascular treatment has become the firstline therapy. Treatment of VAPAs is always mandatory because of the high risk of rupture. We present our point of view on interventional radiology in the splanchnic arteries, focusing on what has been achieved and the remaining challenges.

关键词： Visceral artery Aneurysm False aneurysm Angiography Embolization Stent-graft

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