CardioVascular and Interventional Radiology最新文献

{"title":"Predicting Survival and Recurrence of Lung Ablation Patients Using Deep Learning-Based Automatic Segmentation and Radiomics Analysis.","authors":"Hossam A Zaki, Karim Oueidat, Celina Hsieh, Helen Zhang, Scott Collins, Zhicheng Jiao, Aaron W P Maxwell","doi":"10.1007/s00270-024-03912-9","DOIUrl":"10.1007/s00270-024-03912-9","url":null,"abstract":"<p><strong>Purpose: </strong>To predict survival and tumor recurrence following image-guided thermal ablation (IGTA) of lung tumors segmented using a deep learning approach.</p><p><strong>Methods and materials: </strong>A total of 113 patients who underwent IGTA for primary and metastatic lung tumors at a single institution between January 1, 2004 and July 14, 2022 were retrospectively identified. A pretrained U-Net model was applied to the dataset of pre- and post-procedure CT scans to segment lung zones. Following lung segmentation, a U-shaped encoder-decoder transformer architecture (UNETR) was trained to segment lung tumors from pre- and post-procedure CT scans, and radiomic features were automatically extracted. These features were input into a support vector machine (SVM)-based survival prediction model trained to assign rank scores to samples based on binary survival or recurrence label and follow-up time. C-index and time-dependent AUC were subsequently calculated to evaluate model performance.</p><p><strong>Results: </strong>Initial tumor segmentation using UNETR achieved a Dice score of 0.75. Applying a radiomics-based survivability prediction model to the post-procedure scans resulted in a c-index of 0.71 and a time-dependent AUC of 0.75. In contrast, when this model was applied to pre-procedure scans, it achieved a 0.56 for both metrics. For predicting time to recurrence, the radiomics-based model achieved a c-index of 0.65 and a time-dependent AUC of 0.72 on post-procedure imaging. In contrast, when this model was applied to pre-procedure scans, it achieved a 0.54 for both metrics.</p><p><strong>Conclusion: </strong>Radiomic feature analysis of lung tumors following automatic segmentation by a state-of-the-art transformer-based U-NET may predict survival and recurrence following image-guided thermal ablation of pulmonary malignancies.</p><p><strong>Level of evidence: </strong>Level 3, Retrospective cohort study.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"16-25"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"In-Stent Restenosis in Peripheral Arterial Disease: Ultra-High-Resolution Photon-Counting Versus Third-Generation Dual-Source Energy-Integrating Detector CT Phantom Study in Seven Different Stent Types\" Dachs TM, et al. CVIR 2024.","authors":"Josua A Decker, Thomas Kroencke","doi":"10.1007/s00270-024-03929-0","DOIUrl":"10.1007/s00270-024-03929-0","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"75-76"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Suppressor miR-34a: Potential Biomarker of TACE Response in HCC.","authors":"Jan Zavadil, Jaroslav Juracek, Barbora Cechova, Tomas Rohan, Jakub Husty, Ondrej Slaby, Martina Litschmannova, Michal Uher, S Nahum Goldberg, Tomas Andrasina","doi":"10.1007/s00270-024-03908-5","DOIUrl":"10.1007/s00270-024-03908-5","url":null,"abstract":"<p><strong>Purpose: </strong>TACE induces variable systemic effects by producing factors that promote inflammation, oncogenesis, and angiogenesis. Here we compare concentrations of microRNAs (miR-21, miR-210 and miR-34a) and vascular endothelial growth factor (VEGF) in hepatocellular carcinoma (HCC) patients undergoing TACE with degradable (DSM) and nondegradable (DEB) particles and potential use of these biomarker changes for prediction of patient outcomes.</p><p><strong>Materials and methods: </strong>Overall, 52 patients with HCC treated with DSM TACE (24 patients) and DEB TACE (28 patients) were included in this prospective study. Concentrations of studied biomarkers were measured from blood plasma preprocedurally, immediately (< 90 min) postprocedurally, and 24-h after TACE. Levels were compared between DSM and DEB TACE and correlated with treatment response six and 12 months after the first TACE.</p><p><strong>Results: </strong>Both DSM and DEB TACE elevated plasma levels of miR-21, miR-34a, and miR-210 at 24 h post-procedure compared to baseline levels (FC 1.25-4.0). MiR-34a elevation immediately after TACE was significantly associated with nonprogressive disease compared to those with progressive disease at both six months (FC_a: p = 0.014) and 12 months (FC_a: p = 0.029) post-TACE. No significant biomarker changes were found between the embolization particle groups. However, VEGF levels showed a decrease only in the DSM TACE group (FC₂₄: p =  < 0.001).</p><p><strong>Conclusion: </strong>Embolization particle type did not significantly impact miRNA or VEGF changes post-TACE. However, miR-34a elevation immediately after the procedure predicts better patient outcome and may prove useful as a biomarkers for the monitoring of clinical outcomes.</p><p><strong>Level of evidence: </strong>Level 3 Prospective cohort study.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"26-37"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of Elastic Nail(s) and Cementoplasty to Treat Pathological Fractures in Long Bones of the Upper Limb.","authors":"Julien Garnon, Pierre-Alexis Autrusseau, Jean Caudrelier, Julia Weiss, Gregory Bertucci, Guillaume Koch, Afshin Gangi, Roberto Luigi Cazzato","doi":"10.1007/s00270-024-03844-4","DOIUrl":"10.1007/s00270-024-03844-4","url":null,"abstract":"<p><strong>Objective: </strong>To describe and study retrospectively the combination of elastic nails and cementoplasty to stabilize pathological fractures in the upper limb and present the results on pain and mobility.</p><p><strong>Materials and methods: </strong>Between January 2022 and April 2024, six patients with a median age of 65 were treated with elastic nailing and cement injection. Pathological fractures were located in the clavicle (n = 3), humerus (n = 1) and radius (n = 2). Displacement at the fracture site was noted in two cases.</p><p><strong>Results: </strong>All nails were inserted successfully. Two nails were used for the humerus (n = 1) and the radius (n = 2), and a single nail was used for the clavicle (n = 3). A median volume of 6.5 cc of PMMA was injected. Median duration of the procedure was 155 min. Median pain score dropped from 8/10 the day before intervention to 3.5/10 at 10 days of follow-up and 3/10 at one-month follow-up. Three patients could move their upper limb without limitation. For the five patients for whom imaging was available, no fracture displacement was recorded at a median last follow-up of 3 months. There was no delayed complication.</p><p><strong>Conclusion: </strong>The combination of elastic nail and cementoplasty is feasible and allows to reduce pain and restore limb function. It may offer an alternative to patients suffering from pathological fractures in the upper limb and who are not candidates for surgery.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"84-93"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microvascular Plug Embolization of Anterior Spinal Artery Bearing Segmental Arteries Prior Aortic Stenting: Technique and Safety.","authors":"Sinan Deniz, Osman Öcal, Matthias Fabritius, Daniel Puhr-Westerheide, Gizem Abaci, Moritz Wildgruber, Muzaffer Reha Ümütlü, Mustafa Gök, Jan Stana, Barbara Rantner, Nikolaos Tsilimparis, Jens Ricke, Max Seidensticker","doi":"10.1007/s00270-024-03909-4","DOIUrl":"10.1007/s00270-024-03909-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to present our experience with superselective embolization of the anterior spinal artery-bearing segmental artery (ASAbSA) using a microvascular plug (MVP) during the minimally invasive segmental artery coil embolization (MISACE) procedure prior endovascular repair of the thoracoabdominal aortic aneurysms.</p><p><strong>Methods: </strong>We retrospectively evaluated all MISACE procedures performed between May 2018 and July 2023, where MVP was deployed into an angiographically confirmed ASAbSA. Data were analyzed regarding interventional details, technical aspects, and safety protocols. The standard procedure for MVP embolization involves detaching the plug after 10 min, provided no neurological symptoms occur.</p><p><strong>Results: </strong>A total of 22 patients underwent MVP deployment into the proximal segmental artery supplying the ASAbSA. There were no instances of non-target embolization or segmental artery dissection. Furthermore, none of the patients experienced temporary or permanent spinal cord ischemia.</p><p><strong>Conclusion: </strong>MVP deployment into the ASAbSA is a safe strategy for protecting the spinal cord during preemptive embolization of segmental arteries prior to endovascular aortic repair.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"95-101"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethanol Chemical Gallbladder Ablation for Cholecystitis in Inoperable Elderly Patients.","authors":"Thomas Le Tat, Raphaël Jost, Clément Hanotin, Alexandre Lucas, Abdellahi Abed, Antoine Hakime, Jan Martin Proske, Viseth Kuoch","doi":"10.1007/s00270-024-03921-8","DOIUrl":"10.1007/s00270-024-03921-8","url":null,"abstract":"<p><strong>Purpose: </strong>Cholecystitis presents significant treatment challenges, especially in elderly patients with high surgical or anesthetic risks. While cholecystectomy remains the standard intervention, its feasibility is sometimes limited, leading to reliance on cholecystostomy, which has a high recurrence rate and does not address the underlying cause. The aim was to evaluate the efficacy and safety of chemical gallbladder ablation as a minimally invasive treatment option for acute cholecystitis in elderly and comorbid patients.</p><p><strong>Materials and methods: </strong>This retrospective study included patients admitted for chemical gallbladder ablation from 2014 to 2024, contraindicated for cholecystectomy/anesthesia. Procedures involved ultrasound-guided drainage, cholangiography, potential cystic duct embolization, and ethanol ablation. Outcomes measured included complications, recurrence rates, gallbladder atrophy rates, and hospital stay duration.</p><p><strong>Results: </strong>Of 24 patients considered, 20 underwent chemical ablation with no reported complications or ethanol intoxication, with one recurrence of cholecystitis. 9 patients underwent cystic duct embolization prior to chemical ablation. The median hospital stay duration and post-procedure overall survival was 20 and 603 days, respectively. Among the 13 patients who received follow-up imaging, gallbladder atrophy was achieved in 5 of the 6 patients who had cystic duct embolization prior to chemical ablation, and 2 of the 7 patients who had not cystic duct embolization.</p><p><strong>Conclusion: </strong>This series suggests that chemical gallbladder ablation with cystic duct embolization could be a viable, safe and minimally invasive option for managing acute cholecystitis in elderly, multimorbid patients. Further research is necessary to validate these findings.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"38-44"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Intranodal and Modified Intranodal Lymphangiography for Treatment of Traumatic Chylous Leaks in the Thorax and Neck.","authors":"Rupal Parikh, Elisabeth R Seyferth, Sanjay Palat, Maxim Itkin, Gregory J Nadolski","doi":"10.1007/s00270-024-03900-z","DOIUrl":"10.1007/s00270-024-03900-z","url":null,"abstract":"<p><strong>Purpose: </strong>To report outcomes, procedure and fluoroscopy times, and adverse event rates after intranodal lymphangiography (IL) and modified IL (mIL) for treatment of traumatic chylous leaks in the thorax and neck.</p><p><strong>Methods: </strong>Under an IRB-approved protocol, retrospective review of a quality assurance database identified all lymphangiograms for post-surgical refractory chylous leaks in the thorax and neck at a tertiary center from 2002-2022. Records were reviewed for technical and clinical outcomes, procedure and fluoroscopy times, and adverse events. Pedal lymphangiograms were excluded. Patients were categorized into IL (pre-2016) and mIL (post-2016) cohorts. mIL incorporated pneumatic calf compression throughout the procedure. Technical success was defined as successful thoracic duct cannulation. Clinical success was defined as leak resolution and eventual chest or other drain removal within 2 weeks post-procedure. A two-tailed Fischer's exact test was used to compare categorical outcomes. A two-tailed t test was used to compare means.</p><p><strong>Results: </strong>Two hundred and thirty-nine patients underwent 263 thoracic duct embolizations of traumatic chylous leaks in the thorax/neck. Intranodal lymphangiography was used in 167 cases in 150 patients. Overall clinical success was 94.6% [n = 142/150]. Technical success was higher in mIL (94.2% [81/86]) than IL (76.5% [62/81]) (p = 0.002). Clinical success per patient and procedure were similar between cohorts (92.3% [72/78] mIL versus 97.2% [70/72] IL, p = 0.27, and 83.7% [72/86] mIL versus 85.1% [69/81] IL, p = 0.83, respectively). Mean procedure time in mIL (83.4 ± 31.9 min) was shorter than in IL (119.2 ± 45.9 min) (p < 0.0001). Mean fluoroscopy time in mIL (33.8 ± 17.3 min) was shorter than in IL (41.7 ± 23.2 min) (p = 0.02). Adverse event rate was not significantly different between groups.</p><p><strong>Conclusion: </strong>Overall, thoracic duct embolization for traumatic chylothorax has high clinical success, approaching 95%. While clinical success of mIL was similar to IL, technical success and mean procedure and fluoroscopic times were significantly improved. Findings suggest modified intranodal lymphangiography should be utilized to treat traumatic chylothorax.</p><p><strong>Level of evidence: </strong>Level 4, Case Series.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"59-64"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Insertion of Peritoneal Dialysis Catheters.","authors":"Ahmed Kamel Abdel-Aal, Reema F AlRasheed, Mohamed Shahin, Shahroz Aziz, Juri Bassuner, Husameddin El-Khudari","doi":"10.1007/s00270-024-03873-z","DOIUrl":"10.1007/s00270-024-03873-z","url":null,"abstract":"<p><p>Patients with end-stage renal disease undergoing hemodialysis encounter significant challenges in care coordination and experience higher complication rates. Peritoneal dialysis (PD) is an evidence-based alternative that significantly improves patients' quality of life.Peritoneal dialysis catheter insertion methods include open surgical, laparoscopic, peritoneoscopic, and percutaneous image-guided approaches. Despite comparable success rates and cost-effectiveness, the US healthcare system underutilizes the percutaneous method.This article aims to provide an overview of the essential components of the technique of percutaneous peritoneal dialysis catheter insertion, as well as address patient selection nuances and considerations for urgent-start dialysis. Additionally, it reviews the outcomes and complications associated with image-guided percutaneous PD catheter placement, advocating for its wider adoption.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"6-15"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical Note on Modified Direct Intrahepatic Portocaval Shunt Targeting Different Vessels for Portal Vein Obstruction in Cirrhosis.","authors":"Tangnuer Maimaitiaishan, Xiaobing Wang, Xiaojia Chen, Feng Zhou, Feng Ding, Jie Cheng, Jun Lin, Liping Chen","doi":"10.1007/s00270-024-03932-5","DOIUrl":"10.1007/s00270-024-03932-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore a modified direct intrahepatic portocaval shunt (DIPS) technique as an alternative approach for patients with portal vein occlusion (PVO) and cirrhosis who were not candidates for traditional transjugular intrahepatic portosystemic shunt (TIPS) due to anatomical challenges.</p><p><strong>Technique: </strong>Three patients with esophageal or gastric fundus variceal hemorrhage complicated by severe PVO were treated using innovative DIPS approaches. Preoperative contrast-enhanced computed tomography was employed to assess anatomical feasibility. The modified DIPS techniques involved targeting dilated varicose veins or the confluence of the superior mesenteric and splenic veins to access the inferior vena cava. For broader clinical applications, we outlined the anatomical conditions necessary for adopting the method proposed in this study. Following the puncture, portal hypertension was effectively alleviated, and bleeding was controlled. There were no obvious complications during the follow-up period.</p><p><strong>Conclusion: </strong>Modified DIPS targeting different vessels appears to be a feasible alternative for the treatment of severe PVO when conventional TIPS by ultrasound-guided percutaneous transhepatic or transsplenic pathway and DIPS are unsuccessful. Future validation in a larger patient population is needed.</p><p><strong>Level of evidence: </strong>Level 4, Case Series.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"102-107"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IROS 2025 Book of Abstracts.","authors":"","doi":"10.1007/s00270-024-03937-0","DOIUrl":"https://doi.org/10.1007/s00270-024-03937-0","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}