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Computed tomography radiomic features and clinical factors predicting the response to first transarterial chemoembolization in intermediate-stage hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 361-369页

作者： Zhong-Xing Shi Chang-Fu Li Li-Feng Zhao Zhong-Qi Sun Li-Ming Cui Yan-Jie Xin Dong-Qing Wang Tan-Rong Kang Hui-Jie Jiang department of Interventional radiology the Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086China department of Digestive Medicine Daqing Longnan HospitalDaqing 163453China department of radiology Daqing Longnan HospitalDaqing 163453China department of radiology the Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086China

Background:According to clinical practice guidelines,transarterial chemoembolization(TACE)is the standard treatment modality for patients with intermediate-stage hepatocellular carcinoma(HCC).Early prediction of treatment response can help patients choose a reasonable treatment *** study aimed to investigate the value of the radiomic-clinical model in predicting the efficacy of the first TACE treatment for HCC to prolong patient ***:A total of 164 patients with HCC who underwent the first TACE from January 2017 to September 2021 were *** tumor response was assessed by modified response evaluation criteria in solid tumors(mRECIST),and the response of the first TACE to each session and its correlation with overall survival were *** radiomic signatures associated with the treatment response were identified by the least absolute shrinkage and selection operator(LASSO),and four machine learning models were built with different types of regions of interest(ROIs)(tumor and corresponding tissues)and the model with the best performance was *** predictive performance was assessed with receiver operating characteristic(ROC)curves and calibration ***:Of all the models,the random forest(RF)model with peritumor(+10 mm)radiomic signatures had the best performance[area under ROC curve(AUC)=0.964 in the training cohort,AUC=0.949 in the validation cohort].The RF model was used to calculate the radiomic score(Rad-score),and the optimal cutoff value(0.34)was calculated according to the Youden’s *** were then divided into a high-risk group(Rad-score>0.34)and a low-risk group(Rad-score≤0.34),and a nomogram model was successfully established to predict treatment *** predicted treatment response also allowed for significant discrimination of Kaplan-Meier *** Cox regression identified six independent prognostic factors for overall survival,including male[hazard ratio(HR)=0.500,95%confidence interva

关键词： Hepatocellular carcinoma Transarterial chemoembolization Radiomics Treatment response Prediction

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Individualised evaluation based on pathophysiology for moyamoya vasculopathy:application in surgical revascularisation

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Stroke & Vascular Neurology 2024年第3期9卷 268-278,I0241-I0246页

作者： Xin Zhang Yu Lei Jiabin Su Chao Gao Yanjiang Li Rui Feng Ding Xia Peng Gao Yuxiang Gu Ying Mao department of Neurosurgery Huashan Hospital Fudan UniversityShanghaiChina department of radiology Huashan Hospital Fudan UniversityShanghaiChina

Background Although bypass surgery is an effective treatment for moyamoya vasculopathy(MMV),the incidence of postoperative complications is still *** study aims to introduce a novel evaluating system based on individualised pathophysiology of MMV,and to assess its clinical *** This multicentre,prospective study enrolled adult patients with MMV from Huashan hospital,Fudan university and National Center for Neurological Disorders,China between March 2021 and February *** neuroimages containing structural and functional information were used to evaluate personalised disease severity and fused to localise the surgical field,avoid invalid regions and propose alternative recipient *** recipient artery was further selected intraoperatively by assessing regional haemodynamic and electrophysiological *** preanastomosis and postanastomosis data were compared with assist with the postoperative *** who received such tailored revascularisations were included in the novel group and the others were included in the traditional *** 30-day surgical outcomes and intermediate long-term follow-up were *** Totally 375 patients(145 patients in the novel group and 230 patients in the traditional group)were *** overall complication rate was significantly lower in the novel group(p˂0.001).In detail,both the rates of postoperative infarction(p=0.009)and hyperperfusion syndrome(p=0.010)were significantly *** functional outcomes trended to be more favourable in the novel group,though not significantly(p=0.260).Notably,the proportion of good functional status was higher in the novel group(p=0.009).Interestingly,the preoperative statuses of perfusion and metabolism around the bypass area were significantly correlated with the occurrence of postoperative complications(P˂0.0001).Conclusions This novel evaluating system helps to identify appropriate surgical field and recipient arteries during b

关键词： surgical bypass metabolism

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Alterations in the gut microbiome after transjugular intrahepatic portosystemic shunt in patients with hepatitis B virus-related portal hypertension

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World Journal of Gastroenterology 2024年第31期30卷 3668-3679页

作者： Hong-Wei Zhao Jin-Long Zhang Fu-Quan Liu Zhen-Dong Yue Lei Wang Yu Zhang Cheng-Bin Dong Zhen-Chang Wang department of radiology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China department of radiology Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China department of Interventional radiology Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China

BACKGROUND Gut microbiota(GM)affects the progression and response to treatment in liver *** GM composition is diverse and associated with different etiologies of liver ***,alterations in GM alterations are observed in patients with portal hypertension(PH)secondary to cirrhosis,with hepatitis B virus(HBV)infection being a major cause of cirrhosis in ***,understanding the role of GM alterations in patients with HBV infection-related PH is *** To evaluate GM alterations in patients with HBV-related PH after transjugular intrahepatic portosystemic shunt(TIPS)*** This was a prospective,observational clinical *** were 30 patients(with a 100%technical success rate)recruited in the present *** with esophagogastric variceal bleeding due to HBV infection-associated PH who underwent TIPS were *** samples were obtained before and one month after TIPS treatment,and GM was analyzed using 16S ribosomal RNA amplicon *** One month after TIPS placement,8 patients developed hepatic encephalopathy(HE)and were assigned to the HE group;the other 22 patients were assigned to the non-HE *** was no substantial disparity in the abundance of GM at the phylum level between the two groups,regardless of TIPS treatment(all,P>0.05).However,following TIPS placement,the following results were observed:(1)The abundance of Haemophilus and Eggerthella increased,whereas that of Anaerostipes,Dialister,Butyricicoccus,and Oscillospira declined in the HE group;(2)The richness of Eggerthella,Streptococcus,and Bilophila increased,whereas that of Roseburia and Ruminococcus decreased in the non-HE group;and(3)Members from the pathogenic genus Morganella appeared in the HE group but not in the non-HE *** Intestinal microbiota-related synergism may predict the risk of HE following TIPS placement in patients with HBVrelated *** microbiome therapies may be useful for preventing and trea

关键词： Transjugular intrahepatic portosystemic shunt Hepatic encephalopathy Gut microbiota Hepatitis B virus Portal hypertension

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Self-fueling ferroptosis-inducing microreactors based on p H-responsive Lipiodol Pickering emulsions enable transarterial ferro-embolization therapy

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National Science Review 2024年第1期11卷 74-85页

作者： Chunjie Wang Lei Zhang Zhijuan Yang Dongxu Zhao Zheng Deng Jialu Xu Yumin Wu Yu Hao Ziliang Dong Liangzhu Feng Zhuang Liu Institute of Functional Nano & Soft Materials (FUNSOM) Jiangsu Key Laboratory for Carbon-Based Functional Materials & Devices Soochow University Center of Interventional radiology & Vascular Surgery Department of Radiology Zhongda Hospital Medical School Southeast University department of Interventional radiology The First Afflliated Hospital of Soochow University

Lipiodol chemotherapeutic emulsions remain one of the main choices for the treatment of unresectable hepatocellular carcinoma(HCC) via transarterial chemoembolization(TACE). However, the limited stability of Lipiodol chemotherapeutic emulsions would lead to rapid drug diffusion, which would reduce the therapeutic benefit and cause systemic toxicity of administrated chemotherapeutics. Therefore, the development of enhanced Lipiodol-based formulations is of great significance to enable effective and safe TACE treatment. Herein, a stable water-in-oil Lipiodol Pickering emulsion(LPE) stabilized by pH-dissociable calcium carbonate nanoparticles and hemin is prepared and utilized for efficient encapsulation of lipoxygenase(LOX). The obtained LOX-loaded CaCO3&hemin-stabilized LPE(LHCa-LPE) showing greatly improved emulsion stability could work as a pH-responsive and self-fueling microreactor to convert polyunsaturated fatty acids(PUFAs), a main component of Lipiodol, to cytotoxic lipid radicals through the cascading catalytic reaction driven by LOX and hemin, thus inducing ferroptosis of cancer cells. As a result, such LHCa-LPE upon transcatheter embolization can effectively suppress the progression of orthotopic N1S1 HCC in rats. This study highlights a concise strategy to prepare pH-responsive and stable LPE-based self-fueling microreactors, which could serve as bifunctional embolic and ferroptosis-inducing agents to enable proof-of-concept transarterial ferro-embolization therapy of HCC.

关键词： CaCO3 nanoparticles Pickering emulsion ferroptosis lipid peroxidation transarterial ferro-embolization

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Comparative study between Embosphere®and Marine gel®as embolic agents for chemoembolization of hepatocellular carcinoma

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 102-109页

作者： Hyo-Cheol Kim Jin Woo Choi department of radiology Seoul National University HospitalSeoul 03080South Korea

BACKGROUND While gelatin sponge particles and calibrated microspheres are commonly used as embolic materials in conventional transarterial chemoembolization(cTACE),direct comparisons between these embolic agents are *** To compare the efficacy and safety of superselective cTACE using Embosphere®or Marine gel®in patients with early-stage hepatocellular carcinoma(HCC).METHODS This retrospective study included 70 patients with small(<4 cm)HCC who underwent cTACE with Embosphere®(n=33)or Marine gel®(n=37)as the embolic agent at a single center between March 2021 and July *** radiologic images and clinical data were retrospectively reviewed,with an emphasis on tumor response,procedure-related complications,and local tumor *** primary index tumor was assessed on a 1-mo follow-up image,and local progression-free survival was obtained using the Kaplan-Meier method and was compared by the log-rank *** The median tumor size of both groups was 1.5 cm,and 69 patients achieved a complete response one month after *** cumulative local recurrence rate at 12 mo was 15.5%in the Embosphere®group and 14.4%in the Marine gel®*** local progression-free survival was not significantly different between the two groups(P=0.83).In the multivariate analysis,high serum alphafetoprotein was the only significant poor prognostic factor for local tumor progression(P=0.01).Postembolization syndrome occurred in 36.4%of the Embosphere®group and 35.1%of the Marine gel®group,and there were no cases of biloma,biliary duct dilation,or liver abscess in either *** Calibrated gelatin sponge particles(Marine gel®)and calibrated microspheres(Embosphere®)have similar outcomes in terms of tumor response for superselective cTACE of small HCC.

关键词： Hepatocellular carcinoma Chemoembolization Temporary embolic material Permanent embolic material Tumor response

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Cross-continental insights into liver cancer: an East vs. West epidemiology

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 739-741页

作者： Mohamad Azhar Meerun Boris Guiu department of radiology St-Eloi University HospitalMontpellierFrance

Liver cancer,encompassing both primary and secondary forms,presents a formidable global health *** to the GLOBOCAN 2020 database,liver cancer ranks as the sixth most common cancer globally in terms of incidence,yet it stands as the third leading cause of cancer-related mortality worldwide(1).By 2040,liver cancer cases and deaths are expected to rise by 55.0%and 56.4%,respectively(2).The geographical distribution of incidence and mortality rates for these cancers varies,with the highest occurrence noted in Eastern Asia,Northern Africa,and South-Eastern Asia(2).This variation arises from a complex interplay of factors,encompassing sociodemographic aspects like age and gender,environmental exposures to viruses such as hepatitis B virus(HBV)and hepatitis C virus(HCV),and cultural habits including alcohol consumption(3,4).

关键词： Hepatocellular carcinoma(HCC) intrahepatic cholangiocarcinoma(ICC) epidemiology

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New First-line Immunotherapy-based Therapies for Unresectable Hepatocellular Carcinoma: A Living Network Meta-analysis

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Journal of Clinical and Translational Hepatology 2024年第1期12卷 15-24页

作者： Jian-Jian Chen Zhi-Cheng Jin Biao Luo Yu-Qing Wang Rui Li Hai-Dong Zhu Gao-Jun Teng Center of Interventional radiology&Vascular Surgery Department of RadiologyZhongda HospitalMedical SchoolSoutheast UniversityNanjingJiangsuChina

Background and Aims:Several first-line immune checkpoint inhibitor(ICI)-based combination therapies have been identified for unresectable hepatocellular carcinoma(uHCC).This network meta-analysis(NMA)aimed to provide the most updated evidence about the preferred first-line ICI-based regimens for ***:A comprehensive literature search was performed in various databases from database inception to May *** phase 3 trials evaluating first-line single-agent ICIs,molecular-target agents(MTAs),or their combinations in uHCC were *** main endpoints were overall survival(OS)and progression-free survival(PFS).Pooled effect estimates were calculated using a random effects model within the frequentist *** analyses based on etiology were also ***:Twelve trials at low risk of bias with 8,275 patients comparing 13 treatments were *** with atezolizumab plus bevacizumab was comparable to sintilimab plus IBI305[hazard ratio(HR):1.16;95%confidence interval(CI):0.80–1.68]and camrelizumab plus apatinib(HR:1.06;95%CI:0.75–1.51).The combination therapies,apart from atezolizumab plus cabozantinib in OS and durvalumab plus tremelimumab in PFS,had higher P-score than single-agent MTAs or *** survival benefits were associated with a high risk of adverse events leading to treatment *** proportion of patients with hepatitis B virus-related HCC receiving ICIs combinations might positively correlate with survival advantages(R2=0.8039,p=0.0155).Conclusion:This NMA demonstrated that atezolizumab plus bevacizumab remains the stand of care and confers comparable survival benefits to sintilimab plus IBI305 and camrelizumab plus apatinib in first-line therapy for *** optimal treatment algorithms should consider efficacy,safety,and etiology.

关键词： Hepatocellular carcinoma Systemic therapy Immunotherapy Molecular targeted therapy Tyrosine protein kinase inhibitors Overall survival

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Preoperatively predicting vessels encapsulating tumor clusters in hepatocellular carcinoma:Machine learning model based on contrast-enhanced computed tomography

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 857-874页

作者： Chao Zhang Hai Zhong Fang Zhao Zhen-Yu Ma Zheng-Jun Dai Guo-Dong Pang department of radiology The Second Hospital of Shandong UniversityJinan 250033Shandong ProvinceChina department of radiology Qilu Hospital of Shandong UniversityJinan 250014Shandong ProvinceChina department of radiology Linglong Yingcheng HospitalYantai 265499Shandong ProvinceChina department of Scientific Research Huiying Medical Technology Co.LtdBeijing 100192China

BACKGROUND Recently,vessels encapsulating tumor clusters(VETC)was considered as a distinct pattern of tumor vascularization which can primarily facilitate the entry of the whole tumor cluster into the bloodstream in an invasion independent manner,and was regarded as an independent risk factor for poor prognosis in hepatocellular carcinoma(HCC).AIM To develop and validate a preoperative nomogram using contrast-enhanced computed tomography(CECT)to predict the presence of VETC+in *** We retrospectively evaluated 190 patients with pathologically confirmed HCC who underwent CECT scanning and immunochemical staining for cluster of differentiation 34 at two medical *** analysis was conducted on intratumoral and peritumoral regions in the portal vein *** features,essential for identifying VETC+HCC,were extracted and utilized to develop a radiomics model using machine learning algorithms in the training *** model’s performance was validated on two separate test *** operating characteristic(ROC)analysis was employed to compare the identified performance of three models in predicting the VETC status of HCC on both training and test *** most predictive model was then used to constructed a radiomics nomogram that integrated the independent clinical-radiological *** and decision curve analysis were used to assess the performance characteristics of the clinical-radiological features,the radiomics features and the radiomics *** The study included 190 individuals from two independent centers,with the majority being male(81%)and a median age of 57 years(interquartile range:51-66).The area under the curve(AUC)for the combined radiomics features selected from the intratumoral and peritumoral areas were 0.825,0.788,and 0.680 in the training set and the two test sets.A total of 13 features were selected to construct the *** nomogram,combining clinicalradiological and combined radiomics features could acc

关键词： Hepatocellular carcinoma Vessels encapsulating tumor clusters Intratumoral and peritumoral regions Radiomics features Nomog

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Predicting Acute Mountain Sickness Using Regional Sea-Level Cerebral Blood Flow

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Biomedical and Environmental Sciences 2024年第8期37卷 887-896页

作者： Hao Zhang Jie Feng Shiyu Zhang Wenjia Liu Lin Ma Chinese PLA Medical School Beijing 100853China department of radiology First Medical CenterChinese PLA General HospitalBeijing 100853China department of radiology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

Objective To investigate the role of sea-level cerebral blood flow(CBF)in predicting acute mountain sickness(AMS)using three-dimensional pseudo-continuous arterial spin labeling(3D-pCASL).Methods Forty-eight healthy volunteers reached an altitude of 3,650 m by air after undergoing a head magnetic resonance imaging(MRI)including 3D-pCASL at sea *** CBF values of the bilateral anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),and posterior inferior cerebellar artery(PICA)territories and the laterality index(LI)of CBF were compared between the AMS and non-AMS *** analyses were performed to determine the relationship between CBF and AMS,and the predictive performance was assessed using receiver operating characteristic(ROC)*** The mean cortical CBF in women(81.65±2.69 mL/100 g/min)was higher than that in men(74.35±2.12 mL/100 g/min)(P<0.05).In men,the cortical CBF values in the bilateral ACA,PCA,PICA,and right MCA were higher in patients with AMS than in those *** CBF in the right PCA best predicted AMS(AUC=0.818).In women,the LI of CBF in the ACA was different between the AMS and non-AMS groups and predicted AMS with an AUC of *** Although the mechanism and prediction of AMS are quite complicated,higher cortical CBF at sea level,especially the CBF of the posterior circulatory system,may be used for prediction in male volunteers using non-invasive 3D-pCASL.

关键词： Acute mountain sickness High-altitude headache Cerebral blood flow Arterial spin labeling Magnetic resonance imaging

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Surgical timing and long-term outcomes in patients with severe haemorrhagic spinal cord cavernous malformations

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Stroke & Vascular Neurology 2024年第4期9卷 439-445页

作者： An Tian Ziwei Cui Jian Ren Yeqing Ren Ming Ye Guilin Li Chuan He Xiaoyu Li Gao Zeng Peng Hu Yongjie Ma Jiaxing Yu Jingwei Li Lisong Bian Fan Yang Qianwen Li Feng Ling Tao Hong Liyong Sun Hongqi Zhang department of Neurosurgery Xuanwu Hospital Capital Medical UniversityBeijingChina department of Neurosurgery Beijing Haidian HospitalBeijingChina department of Neurosurgery United Family HealthcareBeijingChina department of radiology Xuanwu Hospital Capital Medical UniversityBeijingChina

Background Surgical resection of the lesions remains the main treatment method for most symptomatic spinal cord cavernous malformations(SCCMs)to eliminate the occupation and associated subsequent lifelong haemorrhagic ***,the timing of surgical intervention remains controversial,especially for patients in the acute stage after severe *** Patients diagnosed with SCCMs who were surgically treated between January 2002 and December 2021 were selected and retrospectively *** Modified McCormick Scale(MMS)was used to evaluate neurological and disability *** medical information was reviewed,and all patients were followed up for at least 6 *** A total of 279 patients were ultimately *** regard to long-term outcomes,110(39.4%)patients improved,159(57.0%)remained unchanged and 10(3.6%)*** patients with an MMS score of 2–5 on admission,in univariate and multivariate analyses,a≤6 weeks period between onset and surgery(adjusted OR 3.211,95%CI 1.504 to 6.856,p=0.003)was a significant predictor of improved *** 69 patients who first presented with severe haemorrhage,undergoing surgery within 6 weeks of the onset of severe haemorrhage(adjusted OR 4.901,95%CI 1.126 to 21.325,p=0.034)was significantly associated with improvement of MMS *** Surgical timing can influence the long-term outcome of *** patients with symptomatic SCCMs,especially those with severe haemorrhage,early surgical intervention within 6 weeks can provide more benefit.

关键词： patients Surgical haemorrhagic

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