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Hepatobiliary & Pancreatic Diseases International 2018年第2期17卷 176-179页

作者： Ravi N Srinivasa Rajiv N Srinivasa Joseph J Gemmete Jeffrey Forris Beecham Chick Department of radiology Division of Vascular and Interventional radiology University of Michigan Health System 1500 East Medical Center Drive Ann Arbor MI 48109 USA

To the Editor:Intraductal papillary neoplasm of the bile duct(IPNB)may occur in the setting of primary sclerosing cholangitis,choledochal cysts or hepatolithiasis[1].The entity may be a precursor of cancer or intrahepatic *** carcinoma,tubular or mucinous adenocarcinoma is present in approximately 40%-80%of IPNBs[1–3].IPNB is frequently found in the resection margins of patients undergoing hepatectomy for cholangiocarcinoma[4].

关键词： fulguration and debulking of a high grade intraductal papillary neoplasm of the bile duct Bugbee flexible electrocautery facilitates choledochoscopic biopsy flexible

Radiological response and inflammation scores predict tumour recurrence in patients treated with transarterial chemoembolization before liver transplantation

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World Journal of Gastroenterology 2017年第20期23卷 3690-3701页

作者： Daniele Nicolini Andrea Agostini Roberto Montalti Federico Mocchegiani Cinzia Mincarelli Alessandra Mandolesi Nicola L Robertson Roberto Candelari Andrea Giovagnoni Marco Vivarelli division of Hepatobiliary and Transplant Surgery Department of Experimental and Clinical MedicinePolytechnic University of Marche division of General and Pediatric radiology Department of Radiological SciencesPolytechnic University of Marche division of interventional radiology Department of Radiological SciencesPolytechnic University of Marche division of Pathology Department of PathologyPolytechnic University of Marche division of radiology Department of RadiologyMemorial Sloan Kettering Cancer Center

To investigate the prognostic value of the radiological response after transarterial chemoembolization (TACE) and inflammatory markers in patients affected by hepatocellular carcinoma (HCC) awaiting liver transplantation (LT).METHODSWe retrospectively evaluated the preoperative predictors of HCC recurrence in 70 patients treated with conventional (n = 16) or doxorubicin-eluting bead TACE (n = 54) before LT. The patient and tumour characteristics, including the static and dynamic alpha-fetoprotein, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR) measurements, were recorded. Treatment response was classified according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST) and the European Association for the Study of the Liver (EASL) criteria as complete response (CR), partial response (PR), stable disease or progressive disease. After examination of the explanted livers, histological necrosis was classified as complete (100% of the cumulative tumour area), partial (50%-99%) or minimal (< 50%) and was correlated with the preoperative radiological *** to the pre-TACE radiological evaluation, 22/70 (31.4%) and 12/70 (17.1%) patients were beyond Milan and University of San Francisco (UCSF) criteria, respectively. After TACE procedures, the objective response (CR + PR) rates were 71.4% and 70.0% according to mRECIST and EASL criteria, respectively. The agreement between the two guidelines in defining the radiological response was rated as very good both for the overall and target lesion response (weighted k-value: 0.98 and 0.93, respectively). Complete and partial histological necrosis were achieved in 14/70 (20.0%) and 28/70 (40.0%) patients, respectively. Using histopathology as the reference standard, mRECIST criteria correctly classified necrosis in 72.9% (51/70) of patients and EASL criteria in 68.6% (48/70) of cases. The mRECIST non-response to TACE [Exp(b) = 9.2, p = 0.012], exceeding UCSF criteria before

关键词： Liver transplantation Recurrence-free survival Hepatocellular carcinoma Radiological response Locoregional therapies Inflammatory markers Selection criteria

Role of transcatheter arterial embolization for massive bleeding from gastroduodenal ulcers

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World Journal of Gastroenterology 2009年第47期15卷 5889-5897页

作者： Romaric Loffroy Boris Guiu The Russell H Morgan Department of radiology and Radiological Science Division of Cardiovascular and Interventional Radiology The Johns Hopkins Hospital 600 North Wolfe Street Blalock 545 BaltimoreMD 21287 United States division of Vascular and interventional radiology University of Dijon School of Medicine Bocage Teaching Hospital 2 bd du Maréchal de Lattre de Tassigny BP 77908 21079 Dijon Cedex France

Intractable bleeding from gastric and duodenal ulcers is associated with significant morbidity and mortality. Aggressive treatment with early endoscopic hemostasis is essential for a favourable outcome. In as many as 12%-17% of patients,endoscopy is either not available or unsuccessful. Endovascular therapy with selective catheterization of the culprit vessel and injection of embolic material has emerged as an alternative to emergent operative intervention in high-risk patients. There has not been a systematic literature review to assess the role for embolotherapy in the treatment of acute upper gastrointestinal bleeding from gastroduo-denal ulcers after failed endoscopic hemostasis. Here,we present an overview of indications,techniques,and clinical outcomes after endovascular embolization of acute peptic-ulcer bleeding. Topics of particular relevance to technical and clinical success are also discussed. Our review shows that transcatheter arterial embolization is a safe alternative to surgery for massive gastroduodenal bleeding that is refractory to endoscopic treatment,can be performed with high technical and clinical success rates,and should be considered the salvage treatment of choice in patients at high surgical risk.

关键词： Peptic ulcer Massive bleeding Endoscopy Angiography Embolization

Efficacy and safety of combined endoscopic cyanoacrylate injection and balloon-occluded retrograde transvenous occlusion(BRTOcc)of gastrorenal shunts in patients with bleeding gastric fundal varices

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Gastroenterology Report 2021年第3期9卷 212-218,I0001,I0002页

作者： Fateh Bazerbachi Akira Dobashi Swarup Kumar Sanjay Misra Navtej S.Buttar Louis M.Wong Kee Song division of Gastroenterology Interventional Endoscopy ProgramMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Vascular and interventional radiology Mayo ClinicRochesterMNUSA

Background:Endoscopic cyanoacrylate(glue)injection of fundal varices may result in life-threatening embolic adverse events through spontaneous gastrorenal shunts(GRSs).Balloon-occluded retrograde transvenous occlusion(BRTOcc)of GRSs during cyanoacrylate injection may prevent serious systemic glue embolization through the *** study aimed to evaluate the efficacy and safety of a combined endoscopic–interventional radiologic(BRTOcc)approach for the treatment of bleeding fundal ***:We retrospectively analysed the data of patients who underwent the combined procedure for acutely bleeding fundal varices between January 2010 and April *** were extracted for patient demographics,clinical and endoscopic findings,technical details,and adverse events of the endoscopic–BRTOcc approach and patient ***:We identified 30 patients(13[43.3%]women;median age 58[range,25–92]years)with gastroesophageal varices type 2(53.3%,16/30)and isolated gastric varices type 1(46.7%,14/30)per Sarin classification,and median clinical and endoscopic follow-up of 151(range,4–2,513)days and 98(range,3–2,373)days,*** median volume of octylcyanoacrylate:Lipiodol injected was 7(range,4–22)***-related adverse events occurred in three(10.0%)patients,including transient fever,non-life-threatening pulmonary glue embolism,and an injection-site ulcer *** gastric variceal obturation was achieved in 18 of 21 patients(85.7%)at endoscopic *** variceal rebleeding was confirmed in one patient(3.3%)and suspected in two patients(6.7%).Although no procedure-related deaths occurred,the overall mortality rate was 46.7%,primarily from liver-disease progression and ***:The combined endoscopic–BRTOcc procedure is a relatively safe and effective technique for bleeding fundal varices,with a high rate of variceal obturation and a low rate of serious adverse events.

关键词： balloon-occluded retrograde transvenous occlusion cyanoacrylate injection gastric varices gastric variceal bleeding gastrorenal shunt

Application of ozonated water for treatment of gastro-thoracic fistula after comprehensive esophageal squamous cell carcinoma therapy: A case report

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World Journal of Clinical Cases 2020年第19期8卷 4550-4557页

作者： De-Di Wu Ke-Nan Hao Xiao-Jing Chen Xin-Min Li Xiao-Feng He division of Vascular and interventional radiology Department of General SurgeryNanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina

BACKGROUND Gastro-thoracic fistula is a serious complication after radical surgery for esophageal cancer,and a conservative approach or endoscopic intervention is commonly applied to treat most *** SUMMARY Here we describe the case of a patient with a gastro-thoracic fistula which could not be closed during gastroscopy after receiving postoperative radiotherapy,together with severe multiple drug-resistant bacterial infection and chest wall *** abscess was drained and local irrigation applied with ozonated water,together with oral ozonated water,which achieved a good effect and highlighted a new way to cure fistula in such *** Patients with gastro-thoracic fistula that cannot be closed and severe infection can be treated by drainage and flushing with ozonated water.

关键词： Esophageal squamous cell carcinoma Ozonated water Radiotherapy Gastrothoracic fistula Drug-resistant bacterial infection Case report

Recent advances in non-invasive magnetic resonance imaging assessment of hepatocellular carcinoma

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World Journal of Gastroenterology 2018年第23期24卷 2413-2426页

作者： Davide Ippolito Riccardo Inchingolo Luigi Grazioli Silvia Girolama Drago Michele Nardella Marco Gatti Riccardo Faletti School of Medicine University of Milano-Bicocca Department of Diagnostic radiology HS Gerardo Monza division of interventional radiology Department of RadiologyMadonna delle Grazie Hospital Department of radiology University of Brescia "Spedali Civili" Department of Surgical Sciences Radiology UnitUniversity of Turin

Magnetic resonance(MR) imaging of the liver is an important tool for the detection and characterization of focal liver lesions and for assessment of diffuse liver disease,having several intrinsic characteristics,represented by high soft tissue contrast,avoidance of ionizing radiation or iodinated contrast media,and more recently,by application of several functional imaging techniques(i.e.,diffusion-weighted sequences,hepatobiliary contrast agents,perfusion imaging,magnetic resonance(MR)-elastography,and radiomics analysis). MR functional imaging techniques are extensively used both in routine practice and in the field of clinical and pre-clinical research because,through a qualitative rather than quantitative approach,they can offer valuable information about tumor tissue and tissue architecture,cellular biomarkers related to the hepatocellular functions,or tissue vascularization profiles related to tumor and tissue biology. This kind of approach offers in vivo physiological parameters,capable of evaluating physiological and pathological modifications of tissues,by the analysis of quantitative data that could be used in tumor detection,characterization,treatmentselection,and follow-up,in addition to those obtained from standard morphological imaging. In this review we provide an overview of recent advanced techniques in MR for the diagnosis and staging of hepatocellular carcinoma,and their role in the assessment of response treatment evaluation.

关键词： Liver Cirrhosis Hepatocellular carcinoma Magnetic resonance Transarterial chemoembolization Contrast media

Prognostic Performance of the China Liver Cancer Staging System in Hepatocellular Carcinoma Following Transarterial Chemoembolization

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Journal of Clinical and Translational Hepatology 2023年第6期11卷 1321-1328页

作者： Bin-Yan Zhong Jian-Qiang Jiang Jun-Hui Sun Jin-Tao Huang Wei-Dong Wang Qi Wang Wen-Bin Ding Xiao-Li Zhu Cai-Fang Ni Department of interventional radiology The First Affiliated Hospital of Soochow UniversitySuzhouJiangsuChina Department of interventional Therapy Nantong Tumor HospitalNantongJiangsuChina Hepatobiliary and Pancreatic interventional Treatment Center Division of Hepatobiliary and Pancreatic SurgeryThe First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina Department of interventional radiology The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityWuxiJiangsuChina Department of interventional radiology Third Affiliated Hospital of Soochow UniversityChangzhou First HospitalChangzhouJiangsuChina Department of interventional radiology Nantong First People’s HospitalNantongJiangsuChina

Background and Aims:To validate prognostic performance of the China liver cancer(CNLC)staging system as well as to compare these parameters with those of the Barcelona Clinic Liver Cancer(BCLC)staging system for Chinese hepatocellular carcinoma(HCC)treated with transarterial chemoembolization(TACE).Methods:This multicenter retrospective study included 1,124 patients with HCC between January 2012 and December 2020 from six Chinese *** on overall survival(OS),the prognostic performance outcomes for the CNLC and BCLC staging systems were compared by model discrimination[C statistic and Akaike information criterion(AIC)],monotonicity of the gradient(linear trend chi-square test),homogeneity(likelihood ratio chisquare test),and calibration(calibration plots).A prospective cohort of 44 patients receiving TACE-based therapy included between January 2021 and December 2022 was used to prospectively validate the ***:Median OS was 19.1(18.2–20.0)months,with significant differences in OS between stages defined by the CNLC and BCLC observed(p<0.001).The CNLC performed better than the BCLC regarding model discrimination(C-index:0.661 vs.0.644;AIC:10,583.28 vs.10,583.72),model monotonicity of the gradient(linear trend chi-square test:66.107 vs.57.418;p<0.001),model homogeneity(159.2 vs.158.7;p<0.001).Both staging systems had good model *** results were observed in the prospective ***:Combining model discrimination,gradient monotonicity,homogeneity,and calibration,the CNLC performed better than the BCLC for Chinese HCC patients receiving TACE.

关键词： Hepatocellular carcinoma CNLC BCLC TACE

Special considerations in the management of lower GI bleed by interventional radiology

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Journal of interventional Medicine 2019年第3期2卷 101-105页

作者： Shihong Li Brendan Oshea Shiliang Sun University of Iowa Health Care Department of RadiologyDivision of Interventional Radiology.Iowa CityIowa52242USA

Despite the rapid development of diagnostic and therapeutic modalities and techniques to manage LGIB patients from interventional radiology’s standpoint,a successful localization of the bleeding site that leads to an effective embolotherapy remains a significant technical *** interventional radiologist’s decisions when managing patients with LGIB may significantly impact the clinical outcomes;therefore,management should be made based on careful and thorough considerations of factors such as etiology,locations,patient’s comorbidities,and potential post-procedure complications,among *** purpose of this paper is to review the management of LGIB by interventional radiology,focusing on a few challenging and common clinical situations that require special consideration by interventional radiologists.

关键词： Lower gastrointestinal bleeding Angiography Embolization Anticoagulation related lower gastrointestinal bleeding

Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma(CHANCE001)

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Signal Transduction and Targeted Therapy 2023年第3期8卷 1198-1207页

作者： Hai-Dong Zhu Hai-Liang Li Ming-Sheng Huang Wei-Zhu Yang Guo-Wen Yin Bin-Yan Zhong Jun-Hui Sun Zhi-Cheng Jin Jian-Jian Chen Nai-Jian Ge Wen-Bin Ding Wen-Hui Li Jin-Hua Huang Wei Mu Shan-Zhi Gu Jia-Ping Li Hui Zhao Shu-Wei Wen Yan-Ming Lei Yu-Sheng Song Chun-Wang Yuan Wei-Dong Wang Ming Huang Wei Zhao Jian-Bing Wu Song Wang Xu Zhu Jian-Jun Han Wei-Xin Ren Zai-Ming Lu Wen-Ge Xing Yong Fan Hai-Lan Lin Zi-Shu Zhang Guo-Hui Xu Wen-Hao Hu Qiang Tu Hong-Ying Su Chuan-Sheng Zheng Yong Chen Xu-Ya Zhao Zhu-Ting Fang Qi Wang Jin-Wei Zhao Ai-Bing Xu Jian Xu Qing-Hua Wu Huan-Zhang Niu Jian Wang Feng Dai Dui-Ping Feng Qing-Dong Li Rong-Shu Shi Jia-Rui Li Guang Yang Hai-Bin Shi Jian-Song Ji Yu-E Liu Zheng Cai Po Yang Yang Zhao Xiao-Li Zhu Li-Gong Lu Gao-Jun Teng Center of interventional radiology&Vascular Surgery Department of RadiologyZhongda HospitalMedical SchoolSoutheast UniversityNanjing 210009China Department of Minimally invasive Intervention The Affiliated Cancer Hospital of Zhengzhou UniversityZhengzhou 450008China Department of interventional radiology the Third Affiliated HospitalSun Yat-Sen UniversityGuangzhou 510630China Department of interventional radiology Union Hospital of Fujian Medical UniversityFuzhou 350001China Department of interventional radiology Jiangsu Cancer Hospital&Jiangsu Institute of Cancer Research&The Affiliated Cancer Hospital of Nanjing Medical UniversityNanjing 210009China Department of interventional radiology The First Affiliated Hospital of Soochow UniversitySoochow UniversitySuzhou 215006China Hepatobiliary and Pancreatic interventional Treatment Center Division of Hepatobiliary and Pancreatic SurgeryThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of interventional radiology Eastern Hospital of Hepatobiliary SurgeryNavy Medical University(Second Military Medical University)Shanghai 200438China Department of interventional radiology Nantong First People’s HospitalNantong 226001China Department of interventional radiology Yancheng Third People’s HospitalYancheng 224008China Department of Minimally Invasive interventional Therapy Sun YatSen University Cancer CenterGuangzhou 510060China Department of Vascular Surgery Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China. Department of interventional radiology Hunan Cancer HospitalChangsha 410031China Department of interventional Oncology The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080China Department of interventional radiology The Hospital of Nantong UniversityNantong 226001China Department of interventional Therapy Shanxi Tumor HospitalTaiyuan 030001China Department of interventional radiology Tibet Autonomous Region People’s

There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world *** this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May *** primary endpoint was progression-free survival(PFS)according to modified *** secondary outcomes included overall survival(OS),objective response rate(ORR),and *** performed propensity score matching approaches to reduce bias between two *** matching,228 pairs were included with a predominantly advanced disease *** PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,*** results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.

关键词： hepatocellular targeted matching

Same day yttrium-90 radioembolization with single photon emission computed tomography/computed tomography: An opportunity to improve care during the COVID-19 pandemic and beyond

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World Journal of Gastrointestinal Oncology 2021年第5期13卷 440-452页

作者： Mohammad Elsayed Mohammad Loya James Galt David M Schuster Zachary L Bercu Janice Newsome David Brandon Sonia Benenati Keywan Behbahani Richard Duszak Ila Sethi Nima Kokabi division of interventional radiology and Image-Guided Medicine Department of Radiology and Imaging SciencesEmory University School of MedicineAtlantaGA 30322United States division of Nuclear Medicine and Molecular Imaging Department of Radiology and Imaging SciencesEmory University School of MedicineAtlantaGA 30322United States

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has made it more challenging for patients to undergo yttrium-90(Y-90)radioembolization(RE).Same day Y-90 RE provides an opportunity to minimize logistical challenges and infection risk associated with COVID-19,thus improving patient *** To describe the use of same day Y-90 RE with routine single photon emission computed tomography/computed tomography(SPECT/CT)in order to optimize *** All patients were selected for Y-90 RE through a multidisciplinary tumor board,and were screened and tested for COVID-19 infection per institutional protocol.A same day procedure was developed,consisting of angiography,imaging,and Y-90 resin particle *** SPECT/CT after technetium-99m macroaggregated albumin(Tc-99m MAA)administration was performed for assessment of arterial supply,personalized dosimetry,and extrahepatic ***-treatment Y-90 bremsstrahlung SPECT/CT was performed for confirmation of particle delivery,by utilization of energy windowing to limit signal from previously administered Tc-99m MAA *** A total of 14 patients underwent same day Y-90 RE between March and June *** lung shunt fraction was 6.13%(range 3.5%-13.1%).Y-90 RE was performed for a single lesion in 7 patients,while the remaining 7 patients had treatment of multifocal *** largest lesion measured 8.3 *** patients tolerated the procedure well and were discharged the same *** Same day Y-90 RE with resin-based microspheres is feasible,and provides an opportunity to mitigate infection risk and logistical challenges associated with the COVID-19 pandemic and *** recommend consideration of SPECT/CT,especially among patients with complex malignancies,for the potential to improve outcomes and eligibility of patients to undergo same day Y-90 RE.

关键词： Yttrium-90 radioembolization Same day Selective internal radiotherapy Transarterial radioembolization Single photon emission computed tomography/computed tomography Dosimetry COVID-19