CVIR oncology最新文献

{"title":"The effects of measurement errors on minimum ablative margins after thermal ablation of liver tumors: a simulation study.","authors":"Iwan Paolucci, Jessica Albuquerque, Noreen S Siddiqi, A Kyle Jones, Kristy K Brock, Bruno C Odisio","doi":"10.1007/s44343-025-00029-9","DOIUrl":"10.1007/s44343-025-00029-9","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a mathematical framework to estimate the in silico A0 threshold based on the technical specifications of a specific ablation confirmation software package for thermal ablation of liver tumors that can then be used to identify the impact of different sources of error.</p><p><strong>Methods: </strong>To estimate in silico A0 thresholds, we developed a simulation framework incorporating technical parameters and biological effects. Technical parameters were segmentation error, registration error, and slice thickness, and biological effects were tissue shrinkage and microscopic satellite lesions; these parameters and effects were all modeled using statistical distributions. For each permutation of parameters, a logistic regression was fitted to determine the observed MAM required to achieve ≥ 99% probability of true complete tumor coverage (i.e., the A0 threshold). The mathematical framework was integrated into a web application to estimate the A0 threshold and the reliability of the commonly used 5-mm A0 threshold based on several software performance characteristics.</p><p><strong>Results: </strong>A total of 15,000,000 simulations (10,000 simulations × 1500 parameter permutations) were run and summarized. Tumor and ablation zone segmentation most greatly influenced the A0 threshold, with thresholds of 3.4 and 8.4 mm for 1- and 5-mm errors, whereas slice thickness had a relatively small effect, with A0 thresholds of 2.9 and 3.4 mm for thicknesses of 1 and 5 mm, respectively.</p><p><strong>Conclusion: </strong>This framework provides a method to determine software-specific in silico A0 thresholds and evaluate the reliability of existing 5-mm criteria based on software performance metrics. The results further show that ablation confirmation software should have registration and segmentation errors of ≤ 3 mm to reliably use a 5-mm A0 threshold.</p>","PeriodicalId":521157,"journal":{"name":"CVIR oncology","volume":"2 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12804325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding histotripsy ablation safety: a systematic review of pre-clinical and clinical adverse events.","authors":"Madeline I Foo, Cynthia Uzoukwu, Robert Morhard, Katrina L Falk, Bradford J Wood, Gregory Frey, Timothy J Ziemlewicz, Eli Vlaisavljevich, Beau B Toskich, Alissa Hendricks-Wenger","doi":"10.1007/s44343-026-00062-2","DOIUrl":"10.1007/s44343-026-00062-2","url":null,"abstract":"<p><p>Histotripsy is the first cavitation-based ablation modality. Given limited clinical experience, synthesis of pre-clinical and early clinical data is essential to guide safe adoption. A PubMed and SCOPUS search was performed focused on pre-clinical and clinical adverse events (AEs) from Histotripsy ablation of parenchymal tissues in vivo (<i>n</i> = 141 total studies, <i>n</i> = 27 clinical reports). Early data suggest an acceptable acute safety profile in select settings; however, reports of serious AEs including pre-clinical bowel perforations, clinical acute kidney injuries, clinical vascular injuries and thromboses, and a clinical case report of hyperprogression raise caution. These highlight the need for proper technique, understanding of mechanism nuances, and longer-term follow-up to assess effects. Recognition of mechanism-specific AEs provides a framework to guide future assessments and safer adoption of Histotripsy. <b>Level of Evidence</b> No level of evidence (review).</p>","PeriodicalId":521157,"journal":{"name":"CVIR oncology","volume":"2 1","pages":"33"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical and Clinical Outcomes of Embolization of Hypervascular Renal Tumors Using Tantalum-Loaded Obsidio Conformable Embolic (Ta-OCE): a single-center experience.","authors":"Sandra Gad, Michael Mohnasky, Zachary Schrank, Bryan Harris, Priya Mody, Alexander Villalobos, Andrew Caddell, Arianna Dezfulian, Nima Kokabi","doi":"10.1007/s44343-025-00025-z","DOIUrl":"10.1007/s44343-025-00025-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of renal artery embolization (RAE) in hypervascular renal tumors using Tantalum-Loaded Obsidio^™ Conformable Embolic (Ta-OCE).</p><p><strong>Methods: </strong>A single-center institutional review board (IRB) approved retrospective analysis of consecutive patients with benign and malignant hypervascular renal tumors treated with Ta-OCE between May 2023 and June 2024 was performed. Specific clinical data on tumor size reduction, renal function preservation, bleeding, and complications were collected. Follow-up imaging was conducted using MRI or CT scans. Adverse events were evaluated according to the Common Toxicity Criteria for Adverse Events (v.5). Student's t-test was used to compare continuous variables.</p><p><strong>Results: </strong>Overall, <i>N</i> = 10 patients (mean age 64.1 + 14.9 (SD) years, 46% female) were included; 5 patients with renal cell carcinoma (RCC) and 5 patients with angiomyolipoma (AML). Technical success was achieved in all 10 patients. There was a significant reduction in tumor diameter of 1.03 cm following embolization (<i>p</i> = 0.0009). There was no significant change in renal function post-RAE at 1 month, GFR pre-(72.8 ± 23.5 mL/min/1.73 m², GFR post 63 ± 24.7 mL/min/1.73 m², with a mean change in GFR (%) of - 13.5 ± 11.2%. (<i>p</i> = 0.116). Additionally, no significant bleeding requiring further intervention was experienced. One patient experienced a Grade 1 adverse effect due to an underlying heart condition.</p><p><strong>Conclusion: </strong>Embolization of hypervascular renal tumors with Ta-OCE appears to be safe and effective. Prospective, ideally multicenter studies are needed to further clarify the ideal scenarios for the use of Ta-OCE in hypervascular renal tumors.</p>","PeriodicalId":521157,"journal":{"name":"CVIR oncology","volume":"1 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping drug distribution using CT imaging following direct tissue injection in ex vivo liver: informing clinical implementation.","authors":"Robert Morhard, Michal Mauda-Havakuk, Jose F Delgado, Michael T Kassin, Azam Ghafoor, Ira Pastan, Raffit Hassan, John W Karanian, William F Pritchard, Bradford J Wood, Andrew S Mikhail","doi":"10.1007/s44343-025-00027-x","DOIUrl":"10.1007/s44343-025-00027-x","url":null,"abstract":"<p><strong>Purpose: </strong>Direct intratumoral injection of therapeutic drugs can minimize total dose and adverse effects compared to systemic administration. Leakage from the injection site may cause variable drug distribution and efficacy, and off-target toxicity. This study aimed to evaluate the co-injection of an iodinated contrast agent with an imageable surrogate drug (fluorescent albumin) to estimate spatial drug distribution.</p><p><strong>Methods: </strong>Fluorescent albumin and iodixanol were injected (1, 2, or 4 mL at 1 mL/min) into ex vivo bovine liver. Distribution of iodine on CT was compared to fluorescent albumin on fluorescence microscopy, including comparison of distribution volume in liver as a function of injected volume. Physical properties (hydrodynamic diameter, zeta potential) of both iodixanol and fluorescent albumin were measured.</p><p><strong>Results: </strong>In comparison to fluorescent albumin, iodixanol is smaller (2.7 ± 0.4 nm vs. 17.0 ± 1.7 nm) and more neutrally charged (2.3 ± 0.5 mV vs. - 17.7 ± 1.4 mV). The distribution volume of iodixanol in tissue is approximately 7 times greater than that of fluorescent albumin. However, the correlation of distribution volumes of both agents is <i>R</i> ² = 0.89. The variance in distribution volume in tissue of iodixanol and fluorescent albumin increased with injection volume.</p><p><strong>Conclusion: </strong>The distributions of contrast and surrogate drug were correlated; however, differing physicochemical properties caused differences in their distribution. Although drug and contrast may not colocalize, contrast may serve as an imageable surrogate to inform preclinical development and clinical applications. This study suggests that dividing an interstitial injection into multifocal small-volume injections results in better localization of the injected drug at the target.</p><p><strong>Trial registration: </strong>NCT04840615.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s44343-025-00027-x.</p>","PeriodicalId":521157,"journal":{"name":"CVIR oncology","volume":"1 1","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}