Diagnostic and interventional radiology最新文献

{"title":"Flow-diverting stents in the management of extracranial carotid artery aneurysms.","authors":"Celal Cinar, Erol Akgul, Alperen Elek, Mahmut Kusbeci, Egemen Ozturk, Hasan Bilen Onan, Irem Islek, Mohammad Naim Forogh, Mohammad Nawas Nasiri, Ismail Oran","doi":"10.4274/dir.2024.242946","DOIUrl":"https://doi.org/10.4274/dir.2024.242946","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the indications and therapeutic efficacy of flow-diverting stents (FDSs) in the management of extracranial carotid artery aneurysms (ECAAs) and dissections.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 18 patients treated for ECAAs with an FDS between 2010 and 2024. Patient demographics, aneurysm characteristics, procedural details, and clinical and radiologic follow-up outcomes were extracted from medical records. Procedures were performed under general anesthesia using standard endovascular techniques. Patients received preoperative and postoperative antiplatelet therapy and were fully anticoagulated during the procedure. Follow- up assessments included digital subtraction angiography or computed tomography angiography at 6-12 months and clinical evaluations to monitor symptom resolution and complications.</p><p><strong>Results: </strong>Eighteen patients, with an average age of 46.44 ± 17.54 years, underwent 19 endovascular interventions. Technical success was achieved in all cases. Single stent deployment was used in 15 aneurysms, and telescopic stent deployment in 7. Total occlusion of the aneurysm was achieved in 94.4% of cases. One patient required retreatment due to the separation of two overlapped telescopic stents. All patients were discharged within 2 days post-procedure, with symptomatic patients experiencing the complete resolution of symptoms. No complications or adverse events were reported during the follow-up period.</p><p><strong>Conclusion: </strong>The endovascular treatment of ECAAs with FDSs appears to be a safe and effective alternative, achieving high technical success and positive clinical outcomes.</p><p><strong>Clinical significance: </strong>The use of FDSs for treating ECAAs significantly improves patient outcomes with minimal complications.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of dual-energy computed tomography angiography-based virtual monoenergetic imaging for evaluations after cerebral aneurysm clipping.","authors":"Zhihua Lu, Suying Wu, Feijian Wu, Qingdong Jin, Qingjing Huang, Baoteng Zhang","doi":"10.4274/dir.2024.242975","DOIUrl":"https://doi.org/10.4274/dir.2024.242975","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to research the optimal energy range of dual-energy computed tomography angiography (DECTA)-based virtual monoenergetic imaging (VMI) for evaluations after cerebral aneurysm clipping.</p><p><strong>Methods: </strong>Sixty patients who underwent DECTA after cerebral aneurysm clipping were analyzed retrospectively. Conventional computed tomography angiography (CTA) was compared with VMIs at 60, 70, 80, 90, and 100 keV. The mean attenuation and standard deviation values within the regions of interest placed in the brain parenchyma and arteries with the worst artifact were measured, respectively. The ΔCT and artifact index (AI) values were calculated to assess the artifact severity. The contrast-to-noise ratio (CNR) was calculated to assess vascular contrast. Two radiologists assessed brain parenchyma and cerebrovascular scores qualitatively using a five-point Likert scale.</p><p><strong>Results: </strong>Quantitative analysis showed that the artifacts of VMIs were significantly reduced compared with conventional CTA (<i>P</i> ≤ 0.014), except for the ΔCT and AI of 60 keV and the ΔCT of 70 keV. However, there was no significant difference in the vascular contrast on VMIs compared with conventional CTA, except for the CNR of 60 keV (<i>P</i> = 0.008). In qualitative analysis, the proportions of brain parenchyma scores and cerebrovascular scores ≥4 on the VMIs of 70 and 80 keV were higher than those of conventional CTA and other VMIs.</p><p><strong>Conclusion: </strong>For the patients who underwent DECTA after cerebral aneurysm clipping, the 70-80 keV VMIs are expected to be the optimal energy range for balancing clip artifacts and visibility of adjacent vessels.</p><p><strong>Clinical significance: </strong>Studying the optimal energy range of DECTA-based VMI for post-operative assessment of aneurysm clipping can reduce metal artifacts in images and increase vascular contrast. This facilitates the follow-up of patients after aneurysm clipping, offers timely and accurate detection of postoperative complications, provides assistance to clinicians in diagnosis and treatment, and improves patient prognosis.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer detection and classification with digital breast tomosynthesis: a two-stage deep learning approach.","authors":"Yazeed Alashban","doi":"10.4274/dir.2024.242923","DOIUrl":"https://doi.org/10.4274/dir.2024.242923","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to propose a new computer-assisted two-staged diagnosis system that combines a modified deep learning (DL) architecture (VGG19) for the classification of digital breast tomosynthesis (DBT) images with the detection of tumors as benign or cancerous using the You Only Look Once version 5 (YOLOv5) model combined with the convolutional block attention module (CBAM) (known as YOLOv5-CBAM).</p><p><strong>Methods: </strong>In the modified version of VGG19, eight additional layers were integrated, comprising four batch normalization layers and four additional pooling layers (two max pooling and two average pooling). The CBAM was incorporated into the YOLOv5 model structure after each feature fusion. The experiment was carried out using a sizable benchmark dataset of breast tomography images. A total of 22,032 DBT examinations from 5,060 patients were included in the data.</p><p><strong>Results: </strong>Test accuracy, training loss, and training accuracy showed better performance with our proposed architecture than with previous models. Hence, the modified VGG19 classified DBT images more accurately than previously possible using pre-trained model-based architectures. Furthermore, a YOLOv5-based CBAM precisely discriminated between benign lesions and those that were malignant.</p><p><strong>Conclusion: </strong>DBT images can be classified using modified VGG19 with accuracy greater than the previously available pre-trained models-based architectures. Furthermore, a YOLOv5-based CBAM can precisely distinguish between benign and cancerous lesions.</p><p><strong>Clinical significance: </strong>The proposed two-tier DL algorithm, combining a modified VGG19 model for image classification and YOLOv5-CBAM for lesion detection, can improve the accuracy, efficiency, and reliability of breast cancer screening and diagnosis through innovative artificial intelligence-driven methodologies.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open- and closed-type congenital cholesteatomas of the middle ear: computed tomography differentiation and correlation with surgical staging.","authors":"Minjung Seong, Hyung-Jin Kim, Yikyung Kim, Sung Tae Kim","doi":"10.4274/dir.2024.242913","DOIUrl":"https://doi.org/10.4274/dir.2024.242913","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the differences in computed tomography (CT) features between closed-type congenital cholesteatoma (CCC) and open-type congenital cholesteatoma (OCC) of the middle ear and to evaluate the usefulness of preoperative CT examination for staging workup of congenital cholesteatoma (CC) in correlation with the surgical findings.</p><p><strong>Methods: </strong>We retrospectively reviewed the preoperative CT scans of the temporal bone obtained from 80 patients with surgically confirmed CC of the middle ear. All patients had a solitary lesion, except for one patient with two lesions, resulting in 81 CCs, which formed the basis of this study. We compared the CT features between CCCs and OCCs, focusing on their morphological characteristics, such as size, shape, location, and bone change. Based on the Potsic classification, the stage of CCs was determined at CT and surgery, and the results were compared between CCCs and OCCs.</p><p><strong>Results: </strong>Of the 81 CCs, surgery revealed 43 CCCs and 38 OCCs. On CT scans, CCC was frequently seen as a small (median: 3.15 mm), round to oval (65.1%) mass, most commonly located in the anterosuperior quadrant (74.4%) of the middle ear with less frequent ossicular erosion (14.0%). In contrast, OCC was frequently seen as a large (median: 6.70 mm), irregular (94.7%) mass, most commonly located in the posterosuperior quadrant (68.4%) of the middle ear with frequent ossicular erosion (55.3%). The size, shape, location, and presence of ossicular erosion were significantly different between the two types. Overall, the CT and surgical stages of CCs demonstrated good agreement (kappa value: 0.77) and the CT and surgical stages of OCCs were statistically significantly higher than those of CCCs (<i>P</i> < 0.001 in both).</p><p><strong>Conclusion: </strong>CT is useful for preoperative determination of the types and staging of CC of the middle ear.</p><p><strong>Clinical significance: </strong>Preoperative differentiation between CCC and OCC is important to avoid reoperation and prevent an extensive surgery. By providing valuable information on the morphology and extent of the lesions, CT is useful for not only the accurate preoperative determination of the type of CCs but also the accurate prediction of staging of the lesion, which should be important to preparing optimal treatment plans.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposal for training: the educational value of a musculoskeletal embolization patellar tendinopathy model.","authors":"Emeric Gremen, Julien Ghelfi, Marylène Bacle, Julien Frandon","doi":"10.4274/dir.2024.243005","DOIUrl":"https://doi.org/10.4274/dir.2024.243005","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of balloon angioplasty under intravascular ultrasound guidance in calcified below-the-knee tibial arteries.","authors":"Muhammed Said Beşler, Asiye Sözeri, Murat Canyiğit","doi":"10.4274/dir.2024.243022","DOIUrl":"https://doi.org/10.4274/dir.2024.243022","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the optimal balloon diameter for intravascular ultrasound (IVUS)-guided balloon angioplasty in calcified below-the-knee (BTK) tibial artery lesions.</p><p><strong>Methods: </strong>Between February 2024 and April 2024, a retrospective review was conducted on 17 patients with Rutherford category 4-6 severely calcified tibial arteries with >70% stenosis, treated with IVUS-guided balloon angioplasty. Sequentially, 3 mm and then 3.5 mm diameter balloons were inflated. The minimum lumen diameter and area were measured before and after the procedure in the proximal, mid, and distal segments of the tibial arteries. One- and three-month follow-ups were conducted using Doppler ultrasound.</p><p><strong>Results: </strong>Significant increases in lumen diameter (<i>P</i> < 0.001 for all) and lumen area (<i>P</i> < 0.001, <i>P</i> = 0.003, <i>P</i> = 0.002, respectively) were observed in the proximal, mid, and distal segments of the BTK arteries following IVUS-guided 3.5 mm balloon angioplasty. Ultra-low iodinated contrast media was used [median 2 mL (range, 1-4 mL)]. Lumen area increase ratios were similar among the proximal, mid, and distal segments (<i>P</i> = 0.905). No target vessel revascularization, major amputation, or mortality was observed during follow-up. Wound healing was seen in 62.5% of the cases with foot ulcers.</p><p><strong>Conclusion: </strong>In the treatment of calcified BTK tibial arteries, a gradual balloon diameter increase up to 3.5 mm in IVUS-guided balloon angioplasty is safe and effective.</p><p><strong>Clinical significance: </strong>Gradual balloon diameter increase up to 3.5 mm under IVUS guidance in calcified BTK lesions demonstrates significant potential. It enables ultra-low contrast usage, provides low complication rates, and achieves high patency and limb salvage, along with satisfactory wound healing in the short term.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing ultrasound-guided intra-articular injection and medial branch block for lumbar facet joint pain: a clinical study.","authors":"Hui Zhao, Yun-Long Hou, Le-Hang Guo, Qiao Wang, Tian He, Guang-Fei Gu, Li-Ping Sun, Feng-Shan Jin","doi":"10.4274/dir.2024.242765","DOIUrl":"https://doi.org/10.4274/dir.2024.242765","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare the effectiveness of ultrasound-guided intra-articular (IA) injections with medial branch nerve blocks in treating lumbar facet joint pain.</p><p><strong>Methods: </strong>This retrospective study enrolled 94 patients clinically diagnosed with lumbar facet joint pain. Diagnostic blocks confirmed the diagnosis in 82 patients, evidenced by a pain visual analog score (VAS) reduction of at least 50% immediately following the injection. Of these, 42 were treated with ultrasound-guided IA injections (group 1), and 40 received ultrasound-guided medial branch blocks (group 2). Effective pain relief was defined as a VAS reduction of at least 50%.</p><p><strong>Results: </strong>Group 1 showed significantly higher pain relief rates compared with group 2 at both 1-month (54.76% versus 2.5%, <i>P</i> < 0.001) and 3-month (26.19% versus 5%, <i>P</i> = 0.014) follow-ups. Within group 1, patients aged 21-50 years experienced higher relief rates (81.25% at 1-month and 56.25% at 3-month follow-ups) compared with those over 50 (38.46% at 1-month and 7.69% at 3-month follow-ups), which was statistically significant (<i>P</i> = 0.007 at 1-month and <i>P</i> = 0.001 at 3-month follow-ups). Furthermore, in group 1, patients with sedentary jobs reported significantly greater pain relief (90.91% at 1-month and 81.82% at 3-month follow-ups) compared with those with non-sedentary jobs (41.94% at 1-month and 6.45% at 3-month follow-ups) (<i>P</i> = 0.005 at 1-month and <i>P</i> < 0.001 at 3-month follow-ups).</p><p><strong>Conclusion: </strong>Ultrasound-guided IA injection provides better pain relief compared with medial branch nerve blocks. This method serves as a viable alternative for patients, especially younger and middle-aged patients with lumbar facet pain due to sedentary lifestyles.</p><p><strong>Clinical significance: </strong>This study compared and analyzed the therapeutic effects of two different ultrasound intervention blockade methods on patients with lumbar facet joint pain, demonstrating that IA injection has a better pain relief effect and can be used as a pain relief method for patients who refuse radiofrequency therapy.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining transarterial chemoembolization, radiofrequency ablation, and iodine-125 seed implantation for recurrent hepatocellular carcinoma post-hepatectomy.","authors":"Yong Zhong, Li Wang, Weibin Dan, Dan Liang","doi":"10.4274/dir.2024.242814","DOIUrl":"https://doi.org/10.4274/dir.2024.242814","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and iodine-125 (125I) seed implantation (TACE-RFA-125I) for recurrent hepatocellular carcinoma (HCC) after hepatectomy.</p><p><strong>Methods: </strong>The study retrospectively analyzed patients with recurrent HCC who received TACE-RFA-125I or TACE-RFA treatment in our institution between January 2013 and January 2023. Overall survival (OS), progression-free survival (PFS), and recurrence were compared between the two groups.</p><p><strong>Results: </strong>A total of 187 patients were enrolled in this study, with 105 in the TACE-RFA-125I group and 82 in the TACE-RFA group. There were 67 men and 15 women in the TACE-RFA group, with an average age of 55.4 ± 10.9 years, and 93 men and 12 women in the TACE-RFA-125I group, with an average age of 55.5 ± 10.7 years. The TACE-RFA-125I group exhibited a significantly improved survival benefit compared with the TACE-RFA group (median OS: 49 months vs. 32 months, <i>P</i> < 0.001; median PFS: 24 months vs. 16 months, <i>P</i> < 0.001). The univariate and multivariate analyses revealed that TACE-RFA-125I was a protective factor for OS and PFS. A total of 32 patients in the TACE-RFA group experienced recurrence during follow-up, with local recurrence in 12 cases, intrahepatic recurrence in 10 cases, and extrahepatic metastases in 10 cases. A total of 28 patients in the TACE-RFA-125I group experienced recurrence, 6 with local recurrence, 12 with intrahepatic recurrence, and 10 with extrahepatic metastases. No procedure-related deaths occurred in this study.</p><p><strong>Conclusion: </strong>In patients with recurrent HCC, TACE-RFA-125I demonstrates promising tumor control and acceptable safety.</p><p><strong>Clinical significance: </strong>This study provides promising clinical guidance for patients with recurrent HCC after hepatectomy and is expected to provide beneficial strategies for the treatment of this disease.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of multiparametric magnetic resonance imaging in the differentiation of low- and high-grade non-muscle invasive bladder cancer.","authors":"Merve Nur Taşdemir, Uluhan Eryürük, Ural Oğuz, Birgül Tok, Serdar Aslan","doi":"10.4274/dir.2024.243004","DOIUrl":"https://doi.org/10.4274/dir.2024.243004","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic efficacy of apparent diffusion coefficient (ADC) measurements and semi-quantitative dynamic contrast enhancement (DCE) parameters in predicting the differentiation between low- and high-grade tumors in non-muscle invasive bladder cancers (NMIBC).</p><p><strong>Methods: </strong>Patients with NMIBC, who were histopathologically confirmed between August 2020 and July 2023, were analyzed by 2 radiologists with different levels of experience. DCE semi-quantitative parameters such as wash-in rate (WiR), wash-out ratio (WoR), time to peak (TTP), and peak enhancement (PE) were calculated. ADC measurements were performed using the three-region-of-interest (ADCt) and whole volume (ADCw) methods; ADCt ratio (ADCtR) and ADCw ratio (ADCwR) were also calculated. Receiver operating characteristic curve analysis was performed to demonstrate the cut-off values of ADCt, ADCw, ADCtR, and ADCwR to differentiate low- and high-grade tumors. The intraclass correlation coefficient was used to evaluate inter-reader agreement.</p><p><strong>Results: </strong>A total of 89 patients were included in this study. Of these patients, 48 had low-grade NMIBC, and 41 had high-grade NMIBC. There was no significant difference in mean WoR, WiR, TTP, and PE values between low- and high-grade NMIBC (<i>P</i> > 0.05). The ADCt, ADCw, ADCtR, and ADCwR values of high-grade NMIBC were significantly lower than those of low-grade NMIBC (<i>P</i> < 0.001). With cut-off values of 0.449 and 0.435, ADCtR had the best diagnostic value for both readers, showing better accuracy, sensitivity, specificity, and area under the curve (85.4%-83.1%, 87.5%-85.4%, 82.9%-80.4%, and 0.879-0.857, respectively, with confidence intervals). Additionally, ADCtR and ADCt showed acceptable diagnostic performance for both readers, with cut-off values of 0.439 and 0.431, respectively, for differentiating Ta- and T1-stages. The inter-reader agreement was almost perfect for ADC measurements.</p><p><strong>Conclusion: </strong>While DCE semiquantative parameters did not yield significant outcomes in distinguishing between low and high grades, ADCtR holds promise for enhancing patient management in NMIBC cases and stands as a potential preoperative radiological asset.</p><p><strong>Clinical significance: </strong>Individuals diagnosed with NMIBC may require different treatment approaches; therefore, it is very important to distinguish between low- and high-grade cases preoperatively. The differentiation between the Ta- and T1-stages is recognized as crucial in patient treatment strategies. Furthermore, ADCtR shows promise for improving patient management in NMIBC cases.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the prognostic impact of inflammatory markers on treatment outcomes in patients with intrahepatic cholangiocarcinoma undergoing radioembolization.","authors":"Sinan Sözütok, Ferhat Can Pişkin, Hüseyin Tuğsan Ballı, Berkay Dik","doi":"10.4274/dir.2024.242929","DOIUrl":"https://doi.org/10.4274/dir.2024.242929","url":null,"abstract":"<p><strong>Purpose: </strong>Intrahepatic cholangiocarcinoma (iCCA) is a rare and aggressive malignancy with limited treatment options, often diagnosed at advanced stages. Radioembolization has emerged as a promising therapy, but its efficacy varies among patients, necessitating reliable biomarkers to predict treatment response. This study evaluates the prognostic impact of systemic inflammatory response markers on treatment outcomes in patients with iCCA undergoing radioembolization.</p><p><strong>Methods: </strong>This retrospective study included 70 patients with iCCA treated with radioembolization between January 2016 and December 2023. Inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were measured from peripheral blood samples. Treatment response was assessed using the modified RECIST criteria, and survival analyses were performed using the Kaplan-Meier method and Cox proportional hazards regression.</p><p><strong>Results: </strong>Patients with lower NLR, PLR, and SII values exhibited significantly higher objective response rates (<i>P</i> = 0.032, <i>P</i> = 0.016, and <i>P</i> = 0.001, respectively). High levels of NLR, PLR, and SII were associated with shorter overall survival (12 vs. 16 months, <i>P</i> = 0.007; 12 vs. 16 months, <i>P</i> = 0.004; and 10 vs. 22 months, <i>P</i> < 0.001, respectively) and progression-free survival (3 vs. 7 months, <i>P</i> = 0.046 for SII). Multivariate analysis identified high SII (<i>P</i> = 0.040), lymph node metastasis (<i>P</i> = 0.042), and high serum total bilirubin (<i>P</i> = 0.013) as significant independent prognostic factors.</p><p><strong>Conclusion: </strong>Systemic inflammatory markers such as NLR, PLR, and SII are valuable prognostic indicators for patients with iCCA undergoing radioembolization. These markers can aid in identifying patients likely to benefit from personalized treatment strategies, potentially improving clinical outcomes.</p><p><strong>Clinical significance: </strong>The clinical significance of this study lies in its demonstration that systemic inflammatory markers (NLR, PLR, and SII) serve as valuable prognostic indicators for predicting treatment outcomes in patients with iCCA undergoing radioembolization, thus aiding in the identification of patients who may benefit from personalized treatment strategies and potentially improving clinical outcomes.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}