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World Journal of Gastroenterology 2022年第17期28卷 1768-1780页

作者： Neil Grey Michael Silosky Christopher H Lieu Bennett B Chin radiology-nuclear medicine University of Colorado School of MedicineAnschutz Medical CampusAuroraCO 80045United States department of radiology University of Colorado School of MedicineAnschutz Medical CampusAuroraCO 80045United States Medical Oncology University of Colorado School of MedicineAnschutz Medical CampusAuroraCO 80045United States

Theranostics is the highly targeted molecular imaging and therapy of tumors.Targeted peptide receptor radionuclide therapy has taken the lead in demonstrating the safety and effectiveness of this molecular approach to treating cancers.Metastatic,well-differentiated gastroenteropancreatic neuroendocrine tumors may be most effectively imaged and treated with DOTATATE ligands.We review the current practice,safety,advantages,and limitations of DOTATATE based theranostics.Finally,we briefly describe the exciting new areas of development and future directions of gastroenteropancreatic neuroendocrine tumor theranostics.

关键词： DOTATATE Theranostics Gastroenteropancreatic neuroendocrine tumors 68Ga DOTATATE 177Lu DOTATATE Review

Transjugular intrahepatic portosystemic shunt vs conservative treatment for recurrent ascites:A propensity score matched comparison

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World Journal of Gastroenterology 2022年第41期28卷 5944-5956页

作者： Martin Philipp Theresia Blattmann Jörn Bienert Kristian Fischer Luisa Hausberg Jens-Christian Kröger Thomas Heller Marc-AndréWeber Georg Lamprecht department of medicine Division of Gastroenterology and EndocrinologyRostock University Medical CenterRostock 18057Germany Institute of diagnostic and Interventional radiology Pediatric Radiology and NeuroradiologyRostock University Medical CentreRostock 18057Germany

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS) placement is an effective intervention for recurrent tense ascites. Some studies show an increased risk of acute on chronic liver failure(ACLF) associated with TIPS placement. It is not clear whether ACLF in this context is a consequence of TIPS or of the pre-existing liver disease.AIM To better understand the risks of TIPS in this challenging setting and to compare them with those of conservative therapy.METHODS Two hundred and fourteen patients undergoing their first TIPS placement for recurrent tense ascites at our tertiary-care center between 2007 and 2017 were identified(TIPS group). Three hundred and ninety-eight patients of the same time interval with liver cirrhosis and recurrent tense ascites not undergoing TIPS placement(No TIPS group) were analyzed as a control group. TIPS indication,diagnosis of recurrent ascites, further diagnoses and clinical findings were obtained from a database search and patient records. The in-hospital mortality and ACLF incidence of both groups were compared using 1:1 propensity score matching and multivariate logistic regressions.RESULTS After propensity score matching, the TIPS and No TIPS groups were comparable in terms of laboratory values and ACLF incidence at hospital admission. There was no detectable difference in mortality(TIPS: 11/214, No TIPS 13/214). During the hospital stay, ACLF occurred more frequently in the TIPS group than in the No TIPS group(TIPS: 70/214, No TIPS: 57/214, P = 0.04). This effect was confined to patients with severely impaired liver function at hospital admission as indicated by a significant interaction term of Child score and TIPS placement in multivariate logistic regression. The TIPS group had a lower ACLF incidence at Child scores < 8 points and a higher ACLF incidence at ≥ 11 points. No significant difference was found between groups in patients with Child scores of 8 to 10 points.CONCLUSION TIPS placement for recurrent tense ascites is associated with an increased rate of AC

关键词： Liver cirrhosis Ascites Transjugular intrahepatic portosystemic shunt Acute on chronic liver failure Mortality Propensity score

Biliary obstruction following transjugular intrahepatic portosystemic shunt placement in a patient after liver transplantation:A case report

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World Journal of Hepatology 2022年第5期14卷 1038-1046页

作者： Peter Macinga Darina Gogova Jan Raupach Jana Jarosova Libor Janousek Eva Honsova Pavel Taimr Julius Spicak Jiri Novotny Jan Peregrin Tomas Hucl department of Gastroenterology and Hepatology Institute for Clinical and Experimental MedicinePrague 14021Czech Republic department of radiology University HospitalHradec Kralove 50005Czech Republic department of Transplant Surgery Institute for Clinical and Experimental MedicinePrague 14021Czech Republic department of Pathology Institute for Clinical and Experimental MedicinePrague 14021Czech Republic department of diagnostic and Interventional radiology Institute for Clinical and Experimental MedicinePrague 14021Czech Republic

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a method used to decrease portal hypertension.Biliary stricture is the rarest of the complications associated with this procedure with only 12 cases previously reported in the literature.None of these cases have documented the resolution of biliary stenosis induced by a stent graft.The only curative solutions reported are liver transplantation or bypassing the stenosis with an artificial biliary tract using advanced endoscopic techniques.CASE SUMMARY This is the first reported case of biliary obstruction secondary to TIPS placement in a transplanted liver.In our patient,a portosystemic shunt was created to treat severe veno-occlusive liver graft disease manifesting itself primarily by fluid retention.A cholestatic liver lesion and cholangitis with abscesses developed due to a stent graft-induced stricture in the dorsal segment of the right hepatic duct and the stricture diminished following percutaneous drainage.Endoscopic drainage was performed after unsuccessful removal of the percutaneous catheter resulting in a bilio-cutaneous fistula.Although the liver graft now functions well,the stricture remains refractory even after 44 mo of treatment.CONCLUSION Biliary strictures caused by TIPS in both transplanted and native livers seem refractory to endoscopic treatment.

关键词： Biliary stricture Transjugular intrahepatic portosystemic shunt Liver trans-plantation Sinusoidal obstruction syndrome Literature review Case report

Gene signatures to therapeutics:Assessing the potential of ivermectin against t(4;14)multiple myeloma

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World Journal of Clinical Oncology 2024年第1期15卷 115-129页

作者： Yang Song Hao-Jun Zhang Xia Song Jie Geng Hong-Yi Li Li-Zhong Zhang Bo Yang Xue-Chun Lu School of Basic medicine Medical School of Chinese PLABeijing 100853China School of Basic medicine Shanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina department of Hematology The Second Medical CentreChinese PLA General HospitalBeijing 100853China

BACKGROUND Multiple myeloma(MM)is a terminal differentiated B-cell tumor disease characterized by clonal proliferation of malignant plasma cells and excessive levels of monoclonal immunoglobulins in the bone marrow.The translocation,(t)(4;14),results in high-risk MM with limited treatment alternatives.Thus,there is an urgent need for identification and validation of potential treatments for this MM subtype.Microarray data and sequencing information from public databases could offer opportunities for the discovery of new diagnostic or therapeutic targets.AIM To elucidate the molecular basis and search for potential effective drugs of t(4;14)MM subtype by employing a comprehensive approach.METHODS The transcriptional signature of t(4;14)MM was sourced from the Gene Expression Omnibus.Two datasets,GSE16558 and GSE116294,which included 17 and 15 t(4;14)MM bone marrow samples,and five and four normal bone marrow samples,respectively.After the differentially expressed genes were identified,the Cytohubba tool was used to screen for hub genes.Then,the hub genes were analyzed using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis.Using the STRING database and Cytoscape,protein–protein interaction networks and core targets were identified.Potential small-molecule drugs were identified and validated using the Connectivity Map database and molecular docking analysis,respectively.RESULTS In this study,a total of 258 differentially expressed genes with enriched functions in cancer pathways,namely cytokine receptor interactions,nuclear factor(NF)-κB signaling pathway,lipid metabolism,atherosclerosis,and Hippo signaling pathway,were identified.Ten hub genes(cd45,vcam1,ccl3,cd56,app,cd48,btk,ccr2,cybb,and cxcl12)were identified.Nine drugs,including ivermectin,deforolimus,and isoliquiritigenin,were predicted by the Connectivity Map database to have potential therapeutic effects on t(4;14)MM.In molecular docking,ivermectin showed strong binding affinity to all 10 identified targets,especially cd45 and cybb.Ivermec

关键词： Multiple myeloma Functional enrichment analysis Molecular docking simulation Gene expression profiling Therapeutic target Ivermectin

Radiological findings in non-surgical recurrent hepatocellular carcinoma:From locoregional treatments to immunotherapy

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World Journal of Gastroenterology 2023年第11期29卷 1669-1684页

作者： Davide Ippolito Cesare Maino Marco Gatti Paolo Marra Riccardo Faletti Francesco Cortese Riccardo Inchingolo Sandro Sironi department of radiology IRCCS San Gerardo dei TintoriMonza 20900Italy School of medicine and Surgery University of Milano-BicoccaMilano 20121Italy department of Surgical Sciences University of TurinTurin 10126Italy department of diagnostic and Interventional radiology Papa Giovanni ⅩⅩⅢ HospitalBergamo 24127Italy Interventional radiology Unit “F.Miulli”Regional General HospitalBari 70121Italy

Since hepatocellular carcinoma(HCC)represents an important cause of mortality and morbidity all over the world.Currently,it is fundamental not only to achieve a curative treatment but also to manage in the best way any possible recurrence.Even if the latest update of the Barcelona Clinic Liver Cancer guidelines for HCC treatment has introduced new locoregional techniques and confirmed others as well-established clinical practices,there is still no consensus about the treatment of recurrent HCC(RHCC).Locoregional treatments and medical therapy represent two of the most widely accepted approaches for disease control,especially in the advanced stage of liver disease.Different medical treatments are now approved,and others are under investigation.On this basis,radiology plays a central role in the diagnosis of RHCC and the assessment of response to locoregional treatments and medical therapy for RHCC.This review summarized the actual clinical practice by underlining the importance of the radiological approach both in the diagnosis and treatment of RHCC.

关键词： Carcinoma Hepatocellular Liver Ablation Catheter Radio frequency ablation Ablation techniques Medication therapy management RECIST

Quadricuspid aortic valve and right ventricular type of myocardial bridging in an asymptomatic middle-aged woman:A case report

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World Journal of Clinical Cases 2022年第25期10卷 8954-8961页

作者： Ivana Sopek Merkaš Nenad Lakušić Maja Hrabak Paar department of Cardiology Special Hospital for Medical Rehabilitation Krapinske TopliceKrapinske Toplice 49217Croatia department of Clinical medicine Faculty of Dental Medicine and Health OsijekOsijek 31000Croatia department of Internal medicine Family Medicine and History of MedicineFaculty of Medicine OsijekOsjiek 31000Croatia department of diagnostic and Interventional radiology University Hospital Centre ZagrebZagreb 10000Croatia School of medicine University of ZagrebZagreb 10000Croatia

BACKGROUND Quadricuspid aortic valve(QAV)is a very rare congenital cardiac defect with the incidence of 0.0125%-0.033%(<0.05%)predominantly causing aortic regurgitation.A certain number of patients(nearly one-half)hav... 详细信息

BACKGROUND Quadricuspid aortic valve(QAV)is a very rare congenital cardiac defect with the incidence of 0.0125%-0.033%(diagnostic method although more and more importance is given to computed tomography(CT)and magnetic resonance imaging(MRI)as complementary methods.CASE SUMMARY A 60-year-old female patient was referred for transthoracic ultrasound of the heart as part of a routine examination in the treatment of arterial hypertension.She did not have any significant symptoms.QAV was confirmed and there were no elements of valve stenosis with moderate aortic regurgitation.At first,it seemed that in the projection of the presumed left coronary cusp,there were two smaller and equally large cusps along with two larger and normally developed cusps.Cardiac CT imaging was performed to obtain an even more precise valve morphology and it showed that the location of the supernumerary cusp is between the right and left coronary cusp,with visible central malcoaptation of the cusps.Also,coronary computed angiography confirmed the right-type of myocardial bridging at the distal segment of the left anterior descending coronary artery.Significant valve dysfunction often occurs in middle-aged patients and results in surgical treatment,therefore,a 1-year transthoracic echocardiogram control examination and follow-up was recommended to our patient.CONCLUSION This case highlights the importance of diagnosing QAV since it leads to progressive valve dysfunction and can be associated with other congenital heart defects which is important to detect,emphasizing the role of cardiac CT and MRI.

关键词： Quadricuspid aortic valve Congenital cardiac defect Aortic insufficiency Multimodal imaging Myocardial bridging Case report

Ansa pancreatica as a predisposing factor for recurrent acute pancreatitis

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World Journal of Gastroenterology 2016年第40期22卷 8940-8948页

作者： Takana Yamakawa Hayashi Wataru Gonoi Takeharu Yoshikawa Naoto Hayashi Kuni Ohtomo department of radiology Graduate School of Medicine The University of Tokyo department of Computational diagnostic radiology and Preventive medicine The University of Tokyo

AIM To determine the non-biased prevalence and clinical significance of ansa pancreatica in patients with acute pancreatitis using magnetic resonance imaging(MRI).METHODS Our institutional review board approved this crosssectional study, which consisted of a community-based cohort of 587 consecutive participants in a whole-body health-check program, and 73 subjects with episode of acute pancreatitis(55 patients with a single episode of acute pancreatitis, and 18 patients with recurrent acute pancreatitis). All of the subjects underwent abdominal MRI including magnetic resonance cholangiopancreatography, medical examinations, and blood tests. Two board-certified, diagnostic, abdominal radiologists evaluated the images, and ansa pancreatica was diagnosed based on its characteristic anatomy on MRI.RESULTS Compared with the community group [5/587(0.85%)], patients with recurrent acute pancreatitis had a significantly higher frequency of ansa pancreatica [2/18(11.1%)](P = 0.016; OR = 14.3; 95%CI: 1.27-96.1), but not compared with patients with single-episode acute pancreatitis [1/55(1.8%)](P = 0.42; OR = 2.1; 95%CI: 0.44-19.7). Multiple logistic regression analysis using age, alcohol intake, presence of ansa pancreatica, and presence of autoimmune disease as independent covariates, revealed a significant relationship between the presence of ansa pancreatica and recurrent acute pancreatitis. The presence of autoimmune disease was also significantly associated with the onset of recurrent acute pancreatitis. On the other hand, neither age nor alcohol intake were significantly related to the onset of recurrent acute pancreatitis.CONCLUSION The present study is the first to provide robust evidence that the presence of ansa pancreatica is significantly associated with recurrent acute pancreatitis.

关键词：解剖 Cholangiopancreatography 胰腺炎磁性的回声成像胰腺的管

Low-dose computed tomography with 4th-generation iterative reconstruction algorithm in assessment of oncologic patients

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World Journal of Gastrointestinal Oncology 2017年第10期9卷 423-430页

作者： Davide Ippolito Alessandra Silvia Casiraghi Cammillo Talei Franzesi Davide Fior Franca Meloni Sandro Sironi department of diagnostic radiology 'San Gerardo' Hospital School of medicine University of Milano-Bicocca department of diagnostic radiology 'Papa Giovanni XXIII' Hospital

AIM To compare radiation dose and image quality of lowdose computed tomography(CT) protocol combined with hybrid-iterative reconstruction algorithm with standarddose CT examinations for follow-up of oncologic patients. METHODS Fifty-one patients with known malignant diseases which underwent, during clinical follow-up, both standarddose and low-dose whole-body CT scans were enrolled. Low-dose CT was performed on 256-row scanner, with 120 kV and automated m A modulation, and iterative reconstruction algorithm. Standard-dose CT was performed on 16-rows scanner, with 120 kV, 200-400 m As(depending on patient weight). We evaluated density values and signal-to-noise ratio, along with image noise(SD), sharpness and diagnostic quality with 4-point scale.RESULTS Density values in liver, spleen and aorta were higher in lowdose images(liver 112.55 HU vs 103.90 HU, P diagnostic quality.CONCLUSION Automatic tube-current modulation combined with hybriditerative algorithm allows radiation dose reduction of 28.9% without loss of diagnostic quality, being useful in reducing dose exposure in oncologic patients.

关键词： Computed tomography Low-dose computed tomography Tube current modulation Oncologic imaging Radiation dose

Transarterial chemoembolization using degradable starch microspheres and iodized oil in the treatment of advanced hepatocellular carcinoma: evaluation of tumor response, toxicity, and survival

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Hepatobiliary & Pancreatic Diseases International 2007年第3期6卷 259-266页

作者： Timm D Kirchhoff Joerg S Bleck Arne Dettmer Ajay Chavan Herbert Rosenthal Sonja Merkesdal Bernd Frericks Lars Zender Nisar P Malek Tim F Greten Stefan Kubicka Michael P Manns Michael Galanski department of diagnostic radiology Hannover Medical School Germany department of Gastroenterology Hepatology and Endocrinology Hannover Medical School Germany department of diagnostic and Interventional radiology Klinikum Oldenburg Germany Division of Rheumatology Hannover Medical School Germany department of radiology and nuclear medicine Campus B.F-Charité-University Medicine Berlin Germany

BACKGROUND: In a multidisciplinary conference patients with advanced non-resectable hepatocellular carcinoma (HCC) were stratified according to their clinical status and tumor extent to different regional modalities or to best supportive care. The present study evaluated all patients who were stratified to repeated transarterial chemoembolization (TACE) from 1999 until 2003 in terms of tumor response, toxicity, and survival. A moderate embolizing approach was chosen using a combination of degradable starch microspheres (DSM) and iodized oil (Lipiodol) in order to combine anti-tumoral efficiency and low toxicity. METHODS: Fourty-seven patients were followed up prospectively. TACE treatment consisted of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), 450-900 mg DSM, and 5-30 ml Lipiodol. DSM and Lipiodol were administered according to tumor vascularization. Patient characteristics,toxicity, and complications were outlined. In multivariate regression analyses of pre-treatment variables from a prospective database, predictors for tumor response and survival after TACE were determined. RESULTS: 112 TACE courses were performed (2.4±1.5 courses per patient). Mean maximum tumor size was 75 (± 43) mm, in 68% there was bilobar disease. Best response to TACE treatment was: progressive disease (PD) 9%, stable disease (SD) 55%, partial remission (PR) 36%, and complete remission (CR) 0%. Multivariate regression analyses identified tumor size ≤75 mm, tumor number ≤5, and tumor hypervascularization as predictors for PR. The overall 1-, 2-, and 3-year-survival rates were 75%, 59%, and 41%, respectively, and the median survival was 26 months. Low α-fetoprotein levels (30 months, R2=36%). Grade 3 toxicity occurred in 7.1% (n=8), and grade 4 toxicity in 3.6% (n=4) of all courses in terms of reversible leukopenia and thrombocytopenia. The incidence of major complications was 5.4% (n=6). All complications

关键词： carcinoma, hepatocellular transarterial chemoembolization degradable starch microspheres Lipiodol tumor response survival

Sodium-glucose cotransporter 2 inhibitors in Asian patients with heart failure

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Chinese Medical Journal 2023年第8期136卷 1004-1005页

作者： Shingo Kato Nobuyuki Horita Daisuke Utsunomiya department of diagnostic radiology Yokohama City University Graduate School of MedicineKanagawaJapan department of Cardiology Kanagawa Cardiovascular and Respiratory CenterKanagawaJapan Chemotherapy Center Yokohama City University HospitalKanagawaJapan

To the Editor:Sodium-glucose cotransporter 2(SGLT-2)inhibitors are recognized as one of the essential drugs for the treatment of heart failure(HF).Recent randomized controlled trials(RCTs)have shown that the SGLT-2 in... 详细信息

关键词： patients drugs mortality