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Xie Q, Qiu G, Liao M, Hou Z, Jin Z, Mi S, Huang J, Liu C. Transhepatic arterial approaches for ICG injection to guide laparoscopic anatomical hepatectomy: A case series study. Asian J Surg 2024; 47:916-922. [PMID: 38110326 DOI: 10.1016/j.asjsur.2023.10.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/20/2023] [Accepted: 10/27/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Laparoscopic anatomical hepatectomy guided by near-infrared fluorescence imaging (NIR-FI) has been utilized extensively. However, it is difficult to resect "cone units" above the third branch of the Glissonean pedicle in the right posterior lobe using the laparoscopic positive or negative staining techniques. Therefore, we undertook a new laparoscopic segmentectomy based on the concept of "cone unit" assisted by interventional radiology combined with NIR-FI. METHODS Laparoscopic segmentectomy guided by NIR-FI via super-selective hepatic arteriography and trans-arterial injection of ICG was carried out on 13 patients with early-stage HCC between September 2020 and January 2022.11 of cases were successful, and relevant pathological characteristics and perioperative outcomes were retrospectively analyzed. RESULTS Two cases failed NIR-FI out of which one case involved over-staining to the non-target segment, and in the other case, which was to undergo laparoscopic segment V resection, only the ventral segment was stained while the imaging of the dorsal segment failed. In the intraoperative conditions, the tumor safe margin was 1.1 (0.7-1.55) cm, the interventional operation time was 50 (45.5-60.5) minutes, the operation time was 280 (242.5-307.5) minutes, the blood loss was 100 (50-200) ml, the postoperative hospital stay was 5 (4.5-5.5) days. No cases converted to laparotomy, and no serious postoperative complications developed. CONCLUSIONS NIR-FI through super-selective hepatic arteriography and trans-arterial injection of ICG can provide a clear and lasting navigation aid for laparoscopic segmentectomy, which may have positive implication for early-stage HCC with poor preoperative liver reserves.
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Affiliation(s)
- Qingyun Xie
- Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, And State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Guoteng Qiu
- Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, And State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Mingheng Liao
- Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, And State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Ziqi Hou
- Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, And State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaoxing Jin
- Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, And State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Shizheng Mi
- Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, And State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jiwei Huang
- Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, And State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
| | - Chang Liu
- Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, And State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
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Kacała A, Dorochowicz M, Korbecki A, Sobański M, Puła M, Patrzałek D, Janczak D, Guziński M. Transarterial Bleomycin-Lipiodol Chemoembolization for the Treatment of Giant Hepatic Hemangiomas: An Assessment of Effectiveness. Cancers (Basel) 2024; 16:380. [PMID: 38254869 PMCID: PMC10814004 DOI: 10.3390/cancers16020380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 12/28/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
This study evaluates the effectiveness of superselective transcatheter arterial chemoembolization (TACE) using a bleomycin-lipiodol emulsion in treating giant hepatic hemangiomas. A retrospective review included 31 patients with a mean age of 53 ± 10.42 years who underwent TACE from December 2014 to October 2022, with follow-up imaging examinations to assess outcomes. Technical success was defined as successful embolization of all feeding arteries, and clinical success was defined as a reduction in hemangioma volume by 50% or more on follow-up imaging. This study observed a 100% technical success rate. Post-embolization syndrome was common, and two cases of asymptomatic hepatic artery dissection were noted. Clinical success was achieved in 80.6% of patients, with significant volume reduction observed in the majority. Conclusively, superselective transcatheter arterial chemoembolization with bleomycin-lipiodol emulsions is presented as a viable and effective treatment option for giant hepatic hemangiomas. With no procedure-related mortality and significant volume reduction in most cases, this method offers a promising alternative to surgical intervention. This study's findings suggest a need for further exploration and validation in larger-scale prospective studies.
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Affiliation(s)
- Arkadiusz Kacała
- Department of General, Interventional and Neuroradiology, Wroclaw Medical University, 50-367 Wrocław, Poland
| | | | - Adrian Korbecki
- Department of General, Interventional and Neuroradiology, Wroclaw University Hospital, 50-556 Wrocław, Poland; (A.K.); (M.P.)
| | - Michał Sobański
- Department of General, Interventional and Neuroradiology, Wroclaw University Hospital, 50-556 Wrocław, Poland; (A.K.); (M.P.)
| | - Michał Puła
- Department of General, Interventional and Neuroradiology, Wroclaw University Hospital, 50-556 Wrocław, Poland; (A.K.); (M.P.)
| | - Dariusz Patrzałek
- Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (D.P.); (D.J.)
| | - Dariusz Janczak
- Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (D.P.); (D.J.)
| | - Maciej Guziński
- Department of General, Interventional and Neuroradiology, Wroclaw Medical University, 50-367 Wrocław, Poland
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3
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Hadi M, Qutaiba B Allela O, Jabari M, Jasoor AM, Naderloo O, Yasamineh S, Gholizadeh O, Kalantari L. Recent advances in various adeno-associated viruses (AAVs) as gene therapy agents in hepatocellular carcinoma. Virol J 2024; 21:17. [PMID: 38216938 PMCID: PMC10785434 DOI: 10.1186/s12985-024-02286-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/02/2024] [Indexed: 01/14/2024] Open
Abstract
Primary liver cancer, which is scientifically referred to as hepatocellular carcinoma (HCC), is a significant concern in the field of global health. It has been demonstrated that conventional chemotherapy, chemo-hormonal therapy, and conformal radiotherapy are ineffective against HCC. New therapeutic approaches are thus urgently required. Identifying single or multiple mutations in genes associated with invasion, metastasis, apoptosis, and growth regulation has resulted in a more comprehensive comprehension of the molecular genetic underpinnings of malignant transformation, tumor advancement, and host interaction. This enhanced comprehension has notably propelled the development of novel therapeutic agents. Therefore, gene therapy (GT) holds great promise for addressing the urgent need for innovative treatments in HCC. However, the complexity of HCC demands precise and effective therapeutic approaches. The adeno-associated virus (AAV) distinctive life cycle and ability to persistently infect dividing and nondividing cells have rendered it an alluring vector. Another appealing characteristic of the wild-type virus is its evident absence of pathogenicity. As a result, AAV, a vector that lacks an envelope and can be modified to transport DNA to specific cells, has garnered considerable interest in the scientific community, particularly in experimental therapeutic strategies that are still in the clinical stage. AAV vectors emerge as promising tools for HCC therapy due to their non-immunogenic nature, efficient cell entry, and prolonged gene expression. While AAV-mediated GT demonstrates promise across diverse diseases, the current absence of ongoing clinical trials targeting HCC underscores untapped potential in this context. Furthermore, gene transfer through hepatic AAV vectors is frequently facilitated by GT research, which has been propelled by several congenital anomalies affecting the liver. Notwithstanding the enthusiasm associated with this notion, recent discoveries that expose the integration of the AAV vector genome at double-strand breaks give rise to apprehensions regarding their enduring safety and effectiveness. This review explores the potential of AAV vectors as versatile tools for targeted GT in HCC. In summation, we encapsulate the multifaceted exploration of AAV vectors in HCC GT, underlining their transformative potential within the landscape of oncology and human health.
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Affiliation(s)
- Meead Hadi
- Department of Microbiology, Faculty of Basic Science, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | | | - Mansoureh Jabari
- Medical Campus, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Asna Mahyazadeh Jasoor
- Department of Microbiology, School of Biology, College of Science, University of Tehran, Tehran, Iran
| | - Omid Naderloo
- Department of Laboratory Sciences, Faculty of Medicine, Islamic Azad University of Gorgan Breanch, Gorgan, Iran
| | | | | | - Leila Kalantari
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
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Kliem P, Ebel S, Werdehausen R, Girrbach F, Bösemann D, van Bömmel F, Denecke T, Stehr S, Struck MF. [Anesthesiological and postinterventional management in percutaneous hepatic melphalan perfusion (chemosaturation)]. DIE ANAESTHESIOLOGIE 2023; 72:113-120. [PMID: 36477906 PMCID: PMC9892165 DOI: 10.1007/s00101-022-01235-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 12/13/2022]
Abstract
Percutaneous hepatic melphalan perfusion (PHMP) is a last-line treatment of inoperable primary or secondary liver tumors. Selective perfusion and saturation (chemosaturation) of the liver with the chemotherapeutic agent melphalan is performed via catheterization of the hepatic artery without affecting the rest of the body with its cytotoxic properties. Using an extracorporeal circulation and balloon occlusion of the inferior vena cava, the venous hepatic blood is filtered and returned using a bypass procedure. During the procedure, considerable circulatory depression and coagulopathy are frequent. The purpose of this article is to review the anesthesiological and postprocedural management of patients undergoing PHMP with consideration of the pitfalls and special circumstances.
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Affiliation(s)
- Peter Kliem
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland
| | - Sebastian Ebel
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Robert Werdehausen
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland
| | - Felix Girrbach
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland
| | - Denis Bösemann
- Klinik für Herz- und Thoraxchirurgie, Kardiotechnik, Universitätsklinikum Jena, Jena, Deutschland
| | - Florian van Bömmel
- Klinik und Poliklinik für Onkologie, Gastroenterologie, Hepatologie, Pneumologie und Infektiologie, Bereich Hepatologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Timm Denecke
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Sebastian Stehr
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland
| | - Manuel F Struck
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
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Bowman KER, Ahne L, O'Brien L, Vander Mause ER, Lu P, Wallis B, Evason KJ, Lim CS. p53-Bad* Fusion Gene Therapy Induces Apoptosis In Vitro and Reduces Zebrafish Tumor Burden in Hepatocellular Carcinoma. Mol Pharm 2023; 20:331-340. [PMID: 36490361 PMCID: PMC10760808 DOI: 10.1021/acs.molpharmaceut.2c00665] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
With few curative treatments and a global yearly death rate of over 800,000, hepatocellular carcinoma (HCC) desperately needs new therapies. Although wild-type p53 gene therapy has been shown to be safe in HCC patients, it has not shown enough efficacy to merit approval. This work aims to show how p53 can be re-engineered through fusion to the pro-apoptotic BH3 protein Bcl-2 antagonist of cell death (Bad) to improve anti-HCC activity and potentially lead to a novel HCC therapeutic, p53-Bad*. p53-Bad* is a fusion of p53 and Bad, with two mutations, S112A and S136A. We determined mitochondrial localization of p53-Bad* in liver cancer cell lines with varying p53 mutation statuses via fluorescence microscopy. We defined the apoptotic activity of p53-Bad* in four liver cancer cell lines using flow cytometry. To determine the effects of p53-Bad* in vivo, we generated and analyzed transgenic zebrafish expressing hepatocyte-specific p53-Bad*. p53-Bad* localized to the mitochondria regardless of the p53 mutation status and demonstrated superior apoptotic activity over WT p53 in early, middle, and late apoptosis assays. Tumor burden in zebrafish HCC was reduced by p53-Bad* as measured by the liver-to-body mass ratio and histopathology. p53-Bad* induced significant apoptosis in zebrafish HCC as measured by TUNEL staining but did not induce apoptosis in non-HCC fish. p53-Bad* can induce apoptosis in a panel of liver cancer cell lines with varying p53 mutation statuses and induce apoptosis/reduce HCC tumor burden in vivo in zebrafish. p53-Bad* warrants further investigation as a potential new HCC therapeutic.
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Affiliation(s)
- Katherine E Redd Bowman
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, Utah 84112, United States
| | - Lisa Ahne
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, Utah 84112, United States
- Institute of Pharmacy, Experimental Pharmacology for Natural Sciences, Martin Luther University, Halle-Wittenberg, Halle (Saale) 06120, Germany
| | - Liam O'Brien
- Department of Pathology and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, United States
| | - Erica R Vander Mause
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, Utah 84112, United States
| | - Phong Lu
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, Utah 84112, United States
| | - Bryce Wallis
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, Utah 84112, United States
| | - Kimberley J Evason
- Department of Pathology and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, United States
| | - Carol S Lim
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, Utah 84112, United States
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Zulaziz N, Chai SJ, Lim KP. The origins, roles and therapies of cancer associated fibroblast in liver cancer. Front Oncol 2023; 13:1151373. [PMID: 37035187 PMCID: PMC10076538 DOI: 10.3389/fonc.2023.1151373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/03/2023] [Indexed: 04/11/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common form of liver cancer. It is often preceded by chronic inflammation such as liver fibrosis and cirrhosis. Different cell types are believed to give rise to liver-specific cancer associated fibroblast (CAF), these include resident fibroblast, hepatic stellate cell, liver cancer cell, hepatic sinusoidal endothelial cell and mesenchymal stromal cell. The abundance of fibroblasts has contributed to the cancer progression, immune modulation and treatment resistance in HCC. In this review, we discussed the origins, subtypes and roles of cancer associated fibroblasts in HCC. Their specific roles in shaping the tumor microenvironment, facilitating cancer growth, and modulating different immune cell types to confer a permissive environment for cancer growth. CAF is now an attractive therapeutic target for cancer treatment, however specific therapeutic development in HCC is still lacking. Hence, we have included preclinical and clinical development of CAF-specific interventions for other cancer types in this review. However, most CAF-specific therapies have resulted in disappointing clinical outcomes, likely due to the difficulties in differentiating CAF from normal fibroblast. A thorough understanding of the characteristics and functionalities of CAF is warranted to further improve the therapeutic efficacy of anti-CAF therapies.
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7
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Sartorius K, Antwi SO, Chuturgoon A, Roberts LR, Kramvis A. RNA Therapeutic Options to Manage Aberrant Signaling Pathways in Hepatocellular Carcinoma: Dream or Reality? Front Oncol 2022; 12:891812. [PMID: 35600358 PMCID: PMC9115561 DOI: 10.3389/fonc.2022.891812] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/04/2022] [Indexed: 11/24/2022] Open
Abstract
Despite the early promise of RNA therapeutics as a magic bullet to modulate aberrant signaling in cancer, this field remains a work-in-progress. Nevertheless, RNA therapeutics is now a reality for the treatment of viral diseases (COVID-19) and offers great promise for cancer. This review paper specifically investigates RNAi as a therapeutic option for HCC and discusses a range of RNAi technology including anti-sense oligonucleotides (ASOs), Aptamers, small interfering RNA (siRNA), ribozymes, riboswitches and CRISPR/Cas9 technology. The use of these RNAi based interventions is specifically outlined in three primary strategies, namely, repressing angiogenesis, the suppression of cell proliferation and the promotion of apoptosis. We also discuss some of the inherent chemical and delivery problems, as well as targeting issues and immunogenic reaction to RNAi interventions.
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Affiliation(s)
- Kurt Sartorius
- Hepatitis Virus Diversity Research Unit, School of Internal Medicine, University of the Witwatersrand, Johannesburg, South Africa.,The Africa Hepatopancreatobiliary Cancer Consortium (AHPBCC), Mayo Clinic, Jacksonville, FL, United States.,Department of Surgery, KZN Kwazulu-Natal (UKZN) Gastrointestinal Cancer Research Centre, Durban, South Africa
| | - Samuel O Antwi
- The Africa Hepatopancreatobiliary Cancer Consortium (AHPBCC), Mayo Clinic, Jacksonville, FL, United States.,Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, United States
| | - Anil Chuturgoon
- Discipline of Medical Biochemistry, School of Laboratory Medicine and Medical Sciences, College of Health Science, University of KwaZulu-Natal, Durban, South Africa
| | - Lewis R Roberts
- The Africa Hepatopancreatobiliary Cancer Consortium (AHPBCC), Mayo Clinic, Jacksonville, FL, United States.,Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit, School of Internal Medicine, University of the Witwatersrand, Johannesburg, South Africa
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Takeuchi S, Ambo Y, Kodama Y, Takada M, Kato K, Nakamura F, Hirano S. Preoperative embolization strategy for the combined resection of replaced right hepatic artery in pancreaticoduodenectomy: a small case series. Surg Case Rep 2022; 8:49. [PMID: 35316851 PMCID: PMC8941043 DOI: 10.1186/s40792-022-01403-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 03/17/2022] [Indexed: 11/22/2022] Open
Abstract
Background Replaced right hepatic artery (rRHA) is a common vascular variation, and combined resection of this vessel is sometimes needed for the curative resection of pancreatic head malignancy. Safe surgical management has not been established, and there is a small number of reported cases. Here, we reported five cases, wherein preoperative embolization of rRHA was performed for combined resection. Case presentation All patients had pancreatic head malignancies that were in contact with rRHA. We performed a preoperative embolization of the rRHA before the scheduled pancreaticoduodenectomy for the combined resection. Arterial embolization was safely accomplished, and the communicating arcade from the left hepatic artery via the hilar plate was clearly revealed in all cases. Four patients underwent the operative procedure, except for one patient who had liver metastasis at laparotomy. No patient suffered from a severe abnormal liver function during the management; however, one patient had multiple liver infarctions during the postoperative course. Conclusions Preoperative embolization for the combined resection of rRHA in pancreaticoduodenectomy can be a management option for the precise evaluation of hemodynamics after sacrificing rRHA. In our cases, arterial flow to the right liver lobe was supplied by the left hepatic artery via the bypass route, including the communicating arcade of the hilar plate.
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Affiliation(s)
- Shintaro Takeuchi
- Department of Surgery, Teine Keijinkai Hospital, 1-12-1-40, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan.
| | - Yoshiyasu Ambo
- Department of Surgery, Teine Keijinkai Hospital, 1-12-1-40, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan
| | - Yoshihisa Kodama
- Department of Radiology, Teine Keijinkai Hospital, 1-12-1-40, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan
| | - Minoru Takada
- Department of Surgery, Teine Keijinkai Hospital, 1-12-1-40, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan
| | - Kentaro Kato
- Department of Surgery, Teine Keijinkai Hospital, 1-12-1-40, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan
| | - Fumitaka Nakamura
- Department of Surgery, Teine Keijinkai Hospital, 1-12-1-40, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, West-7, North-15, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
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Zherebtsov EA, Potapova EV, Mamoshin AV, Shupletsov VV, Kandurova KY, Dremin VV, Abramov AY, Dunaev AV. Fluorescence lifetime needle optical biopsy discriminates hepatocellular carcinoma. BIOMEDICAL OPTICS EXPRESS 2022; 13:633-646. [PMID: 35284175 PMCID: PMC8884204 DOI: 10.1364/boe.447687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/30/2021] [Accepted: 11/30/2021] [Indexed: 05/06/2023]
Abstract
This work presents results of in vivo and in situ measurements of hepatocellular carcinoma by a developed optical biopsy system. Here, we describe the technical details of the implementation of fluorescence lifetime and diffuse reflectance measurements by the system, equipped with an original needle optical probe, compatible with the 17.5G biopsy needle standard. The fluorescence lifetime measurements observed by the setup were verified in fresh solutions of NADH and FAD++, and then applied in a murine model for the characterisation of inoculated hepatocellular carcinoma (HCC) and adjacent liver tissue. The technique, applied in vivo and in situ and supplemented by measurements of blood oxygen saturation, made it possible to reveal statistically significant transformation in the set of measured parameters linked with the cellular pools of NADH and NADPH. In the animal model, we demonstrate that the characteristic changes in registered fluorescent parameters can be used to reliably distinguish the HCC tissue, liver tissue in the control, and the metabolically changed liver tissues of animals with the developed HCC tumour. For further transition to clinical applications, the optical biopsy system was tested during the routing procedure of the PNB in humans with suspected HCC. The comparison of the data from murine and human HCC tissues suggests that the tested animal model is generally representative in the sense of the registered fluorescence lifetime parameters, while statistically significant differences between their absolute values can still be observed.
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Affiliation(s)
- Evgenii A Zherebtsov
- Research & Development Center of Biomedical Photonics, Orel State University, Orel, Russia
- Optoelectronics and Measurement Techniques unit, University of Oulu, Oulu, Finland
- Co-first authors with equal contribution
| | - Elena V Potapova
- Research & Development Center of Biomedical Photonics, Orel State University, Orel, Russia
- Co-first authors with equal contribution
| | - Andrian V Mamoshin
- Research & Development Center of Biomedical Photonics, Orel State University, Orel, Russia
- Orel Regional Clinical Hospital, Orel, Russia
| | - Valery V Shupletsov
- Research & Development Center of Biomedical Photonics, Orel State University, Orel, Russia
| | - Ksenia Y Kandurova
- Research & Development Center of Biomedical Photonics, Orel State University, Orel, Russia
| | - Viktor V Dremin
- Research & Development Center of Biomedical Photonics, Orel State University, Orel, Russia
- College of Engineering and Physical Sciences, Aston University, Birmingham, UK
| | - Andrey Y Abramov
- Research & Development Center of Biomedical Photonics, Orel State University, Orel, Russia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Andrey V Dunaev
- Research & Development Center of Biomedical Photonics, Orel State University, Orel, Russia
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Filippi L, Braat AJ. Theragnostics in primary and secondary liver tumors: the need for a personalized approach. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF... 2021; 65:353-370. [PMID: 34881847 DOI: 10.23736/s1824-4785.21.03407-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Primary and secondary hepatic tumors have a dramatic impact in oncology. Despite many advances in diagnosis and therapy, the management of hepatic malignancies is still challenging, ranging from various loco-regional approaches to system therapies. In this scenario, theragnostic approaches, based on the administration of a radiopharmaceuticals' pair, the first labeled with a radionuclide suitable for the diagnostic phase and the second one bound to radionuclide emitting particles for therapy, is gaining more and more importance. Selective internal radiation therapy (SIRT) with microspheres labeled with 90Y or 166Ho is widely used as a loco-regional treatment for primary and secondary hepatic tumors. While 166Ho presents both gamma and beta emission and can be therefore considered a real "theragnostic" agent, for 90Y-microspheres theragnostic approach is realized at the diagnostic phase through the utilization of macroaggregates of human albumin, labeled with 99mTc as "biosimilar" agent respect to microspheres. The aim of the present review was to cover theragnostic applications of 90Y/166Ho-labeled microspheres in clinical practice. Furthermore, we report the preliminary data concerning the potential role of some emerging theragnostic biomarkers for hepatocellular carcinoma, such as glypican-3 (GPC3) and prostate specific membrane antigen (PSMA).
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Affiliation(s)
- Luca Filippi
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy -
| | - Arthur J Braat
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
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11
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Tonon F, Farra R, Zennaro C, Pozzato G, Truong N, Parisi S, Rizzolio F, Grassi M, Scaggiante B, Zanconati F, Bonazza D, Grassi G, Dapas B. Xenograft Zebrafish Models for the Development of Novel Anti-Hepatocellular Carcinoma Molecules. Pharmaceuticals (Basel) 2021; 14:ph14080803. [PMID: 34451900 PMCID: PMC8400454 DOI: 10.3390/ph14080803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 02/07/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the sixth most common type of tumor and the second leading cause of tumor-related death worldwide. Liver cirrhosis is the most important predisposing factor for HCC. Available therapeutic approaches are not very effective, especially for advanced HCC, which is the most common form of the disease at diagnosis. New therapeutic strategies are therefore urgently needed. The use of animal models represents a relevant tool for preclinical screening of new molecules/strategies against HCC. However, several issues, including animal husbandry, limit the use of current models (rodent/pig). One animal model that has attracted the attention of the scientific community in the last 15 years is the zebrafish. This freshwater fish has several attractive features, such as short reproductive time, limited space and cost requirements for husbandry, body transparency and the fact that embryos do not show immune response to transplanted cells. To date, two different types of zebrafish models for HCC have been developed: the transgenic zebrafish and the zebrafish xenograft models. Since transgenic zebrafish models for HCC have been described elsewhere, in this review, we focus on the description of zebrafish xenograft models that have been used in the last five years to test new molecules/strategies against HCC.
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Affiliation(s)
- Federica Tonon
- Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Hospital, Strada di Fiume, 447, I 34149 Trieste, Italy; (F.T.); (R.F.); (C.Z.); (G.P.); (F.Z.); (D.B.)
| | - Rossella Farra
- Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Hospital, Strada di Fiume, 447, I 34149 Trieste, Italy; (F.T.); (R.F.); (C.Z.); (G.P.); (F.Z.); (D.B.)
| | - Cristina Zennaro
- Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Hospital, Strada di Fiume, 447, I 34149 Trieste, Italy; (F.T.); (R.F.); (C.Z.); (G.P.); (F.Z.); (D.B.)
| | - Gabriele Pozzato
- Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Hospital, Strada di Fiume, 447, I 34149 Trieste, Italy; (F.T.); (R.F.); (C.Z.); (G.P.); (F.Z.); (D.B.)
| | - Nhung Truong
- Stem Cell Research and Application Laboratory, VNUHCM, University of Science, Ho Chi Minh City 72711, Vietnam;
| | - Salvatore Parisi
- Pathology Unit, CRO Aviano, National Cancer Institute, IRCCS, I 33081 Aviano, Italy; (S.P.); (F.R.)
- Doctoral School in Molecular Biomedicine, University of Trieste, I 34127 Trieste, Italy
| | - Flavio Rizzolio
- Pathology Unit, CRO Aviano, National Cancer Institute, IRCCS, I 33081 Aviano, Italy; (S.P.); (F.R.)
- Department of Molecular Sciences and Nanosystems, Ca’ Foscari University of Venice, I 30170 Mestre, Italy
| | - Mario Grassi
- Department of Engineering and Architecture, University of Trieste, Via Valerio 6/A, I 34127 Trieste, Italy;
| | - Bruna Scaggiante
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, I 34149 Trieste, Italy; (B.S.); (B.D.)
| | - Fabrizio Zanconati
- Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Hospital, Strada di Fiume, 447, I 34149 Trieste, Italy; (F.T.); (R.F.); (C.Z.); (G.P.); (F.Z.); (D.B.)
| | - Deborah Bonazza
- Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Hospital, Strada di Fiume, 447, I 34149 Trieste, Italy; (F.T.); (R.F.); (C.Z.); (G.P.); (F.Z.); (D.B.)
| | - Gabriele Grassi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Hospital, Strada di Fiume, 447, I 34149 Trieste, Italy; (F.T.); (R.F.); (C.Z.); (G.P.); (F.Z.); (D.B.)
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, I 34149 Trieste, Italy; (B.S.); (B.D.)
- Correspondence:
| | - Barbara Dapas
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, I 34149 Trieste, Italy; (B.S.); (B.D.)
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Nebelung H, Wolf T, Bund S, Radosa CG, Plodeck V, Grosche-Schlee S, Riediger C, Hoffmann RT, Kühn JP. Radioembolization versus portal vein embolization for contralateral liver lobe hypertrophy: effect of cirrhosis. Abdom Radiol (NY) 2021; 46:4046-4055. [PMID: 33779787 PMCID: PMC8286933 DOI: 10.1007/s00261-021-03048-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 10/24/2022]
Abstract
PURPOSE Preoperative hypertrophy induction of future liver remnant (FLR) reduces the risk of postoperative liver insufficiency after partial hepatectomy. One of the most commonly used methods to induce hypertrophy of FLR is portal vein embolization (PVE). Recent studies have shown that transarterial radioembolization (TARE) also induces hypertrophy of the contralateral liver lobe. The aim of our study was to evaluate contralateral hypertrophy after TARE versus after PVE taking into account the effect of cirrhosis. METHODS Forty-nine patients undergoing PVE before hemihepatectomy and 24 patients with TARE as palliative treatment for liver malignancy were retrospectively included. Semi-automated volumetry of the FLR/contralateral liver lobe before and after intervention (20 to 65 days) was performed on CT or MRI, and the relative increase in volume was calculated. Cirrhosis was evaluated independently by two radiologists on CT/MRI, and interrater reliability was calculated. RESULTS Hypertrophy after PVE was significantly more pronounced than after TARE (25.3% vs. 7.4%; p < 0.001). In the subgroup of patients without cirrhosis, the difference was also statistically significant (25.9% vs. 8.6%; p = 0.002), whereas in patients with cirrhosis, the difference was not statistically significant (18.2% vs. 7.4%; p = 0.212). After PVE, hypertrophy in patients without cirrhosis was more pronounced than in patients with cirrhosis (25.9% vs. 18.2%; p = 0.203), while after TARE, hypertrophy was comparable in patients with and without cirrhosis (7.4% vs. 8.6%; p = 0.928). CONCLUSION TARE induces less pronounced hypertrophy of the FLR compared to PVE. Cirrhosis seems to be less of a limiting factor for hypertrophy after TARE, compared to PVE.
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13
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Li WF, Al-Taher M, Yu CY, Liu YW, Liu YY, Marescaux J, Cheng YF, Diana M, Wang CC. Super-Selective Intra-Arterial Indocyanine Green Administration for Near-Infrared Fluorescence-Based Positive Staining of Hepatic Segmentation: A Feasibility Study. Surg Innov 2021; 28:669-678. [PMID: 33787401 DOI: 10.1177/1553350621996972] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Despite the increasing number of laparoscopic hepatic procedures for the resection of hepatocellular carcinoma (HCC), intraoperative tumor localization and demarcation remains challenging in comparison to open surgery. In this study, we evaluated the feasibility of positive liver segment staining through the super-selective intra-arterial indocyanine green (ICG) administration. METHODS Eight patients presenting with a single HCC underwent an interventional vascular procedure followed by laparoscopic surgery. A microcatheter was advanced into the hepatic artery branches perfusing the HCC followed by digital subtraction angiography and angiography computed tomography (angio-CT). Patients were then transferred to the operating room, and a laparoscopic hepatectomy was performed under ultrasound guidance. A 5 mL bolus of ICG with a concentration of .125 mg/mL was injected through the microcatheter, and a near-infrared laparoscope was used to detect the fluorescence signal to assess the correspondence between the fluorescence-based demarcation and the intraoperative ultrasound-based demarcation. RESULTS The duration for the angiography procedure was 32.7 +/- 5.3 min, and it took 242 +/- 118 min from the end of angiography procedure until the start of the surgical procedure. In all cases, the fluorescent liver segment was corresponding to the angio-CT findings. In 6/8 cases, fluorescence imaging was considered helpful in the identification of the resection line. In 3 patients, the resection line was changed according to the positively stained liver segment. CONCLUSION We successfully demonstrated the feasibility of the super-selective intra-arterial ICG administration for fluorescence-based positive staining of hepatic segmentation during laparoscopic surgery for HCC (NCT04266548).
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Affiliation(s)
- Wei-Feng Li
- Department of General Surgery, 63328Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Mahdi Al-Taher
- IHU-Strasbourg, 560036Institute of Image-Guided Surgery, Strasbourg, France
| | - Chun-Yen Yu
- Department of Diagnostic Radiology, 63328Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yueh-Wei Liu
- Department of General Surgery, 63328Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Yin Liu
- Department of General Surgery, 63328Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jacques Marescaux
- IHU-Strasbourg, 560036Institute of Image-Guided Surgery, Strasbourg, France.,IRCAD, 560036Research Institute Against Digestive Cancer, Strasbourg, France
| | - Yu-Fan Cheng
- Department of Diagnostic Radiology, 63328Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Michele Diana
- IHU-Strasbourg, 560036Institute of Image-Guided Surgery, Strasbourg, France.,IRCAD, 560036Research Institute Against Digestive Cancer, Strasbourg, France.,ICube Laboratory, Photonics Instrumentation for Health, Strasbourg, France
| | - Chih-Chi Wang
- Department of General Surgery, 63328Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Shiozawa K, Matsui T, Murakami T, Watanabe M, Maetani I. Predicting Therapeutic Efficacy of Transarterial Chemoembolization with Drug-Eluting Beads for Hepatocellular Carcinoma Using Contrast-Enhanced Ultrasound. Diagnostics (Basel) 2021; 11:diagnostics11020291. [PMID: 33673221 PMCID: PMC7917690 DOI: 10.3390/diagnostics11020291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to assess the usefulness of contrast-enhanced ultrasound (CEUS) for predicting the therapeutic efficacy of transarterial chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma (HCC). Thirty-two patients with HCC who underwent DEB-TACE were enrolled in this study. Enhancement patterns of vascular phase images on CEUS were compared before and within 3 days after DEB-TACE, and the patterns after DEB-TACE were classified as follows: Pattern A, no enhancement; Pattern B, peripheral ring enhancement; Pattern C, partial enhancement within or peripheral to tumors, and Pattern D, reduced or unchanged enhancement in the whole tumor. Enhancement patterns in all lesions and contrast-enhanced computed tomography (CECT) findings after DEB-TACE were compared statistically. The treatment response of DEB-TACE was evaluated using the Modified Response Evaluation Criteria in Solid Tumors (mRECIST) by CECT. The enhancement patterns on CEUS performed within 3 days after DEB-TACE were defined as Pattern A in 17 cases, B in 7, C in 13, and D in 2. The complete response rates at one month after treatment were 94.1% (16/17 lesions) for Pattern A, 85.7% (6/7) for B, 15.4% (2/13) for C, and 50% (1/2) for D. The response rates were significantly higher for lesions with Pattern A compared to those with Pattern C at one month (p = 0.009) and 12 months (p < 0.001) after treatment, and significantly higher for lesions with Pattern B compared to those with Pattern C at 12 months after treatment (p = 0.031). Comparisons between other patterns showed no significant differences. CEUS immediately after DEB-TACE may allow early assessment of therapeutic efficacy, with findings of no enhancement or peripheral ring enhancement suggesting a positive outcome.
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15
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Lin YJ, Ho CM. Is the Rationale of Anatomical Liver Resection for Hepatocellular Carcinoma Universally Adoptable? A Hypothesis-Driven Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:131. [PMID: 33540784 PMCID: PMC7913024 DOI: 10.3390/medicina57020131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 02/08/2023]
Abstract
Surgical resection is the first-line curative treatment modality for resectable hepatocellular carcinoma (HCC). Anatomical resection (AR), described as systematic removal of a liver segment confined by tumor-bearing portal tributaries, may improve survival by reducing the risk of tumor recurrence compared with non-AR. In this article, we propose the rationale for AR and its universal adoption by providing supporting evidence from the advanced understanding of a tumor microenvironment and accumulating clinical experiences of locoregional tumor ablation therapeutics. AR may be advantageous because it completely removes the en-bloc by interrupting tumor vascular supply and thus extirpates the spreading of tumor microthrombi, if they ever exist, within the supplying portal vein. However, HCC is a hypervascular tumor that can promote neoangiogenesis in the local tumor microenvironment, which in itself can break through the anatomical boundary within the liver and even retrieve nourishment from extrahepatic vessels, such as inferior phrenic or omental arteries. Additionally, increasing clinical evidence for locoregional tumor ablation therapies, such as radiofrequency ablation, predominantly performed as a non-anatomical approach, suggests comparable outcomes for surgical resection, particularly in small HCC and colorectal, hepatic metastases. Moreover, liver transplantation for HCC, which can be considered as AR of the whole liver followed by implantation of a new graft, is not universally free from post-transplant tumor recurrence. Overall, AR should not be considered the gold standard among all surgical resection methods. Surgical resection is fundamentally reliant on choosing the optimal margin width to achieve en-bloc tumor niche removal while balancing between oncological radicality and the preservation of postoperative liver function. The importance of this is to liberate surgical resilience in hepatocellular carcinoma. The overall success of HCC treatment is determined by the clearance of the theoretical niche. Developing biomolecular-guided navigation device/technologies may provide surgical guidance toward the total removal of microscopic tumor niche to achieve superior oncological outcomes.
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Affiliation(s)
| | - Cheng-Maw Ho
- Department of Surgery, National Taiwan University Hospital and College of Medicine, 7 Chung-Shan South Road, Taipei 100, Taiwan;
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Whitley A, Křeček J, Kachlík D. The inferior phrenic arteries: A systematic review and meta-analysis. Ann Anat 2021; 235:151679. [PMID: 33516785 DOI: 10.1016/j.aanat.2021.151679] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The inferior phrenic artery is a paired artery that supplies the diaphragm from its inferior aspect. It may arise as a common trunk, the common inferior phrenic artery (CIPA), or as two individual arteries, the right and left inferior phrenic arteries (RIPA and LIPA, respectively). The aim of this study was to perform a systematic review and meta-analysis to create pooled prevalence data on the various origins of the inferior phrenic arteries and to discuss their clinical importance. METHODS Major electronic medical databases were reviewed to identify articles with anatomical prevalence data on the origin of the inferior phrenic arteries. Data on the origin of the left, right and common inferior phrenic arteries were extracted and quantitatively synthesized. RESULTS The CIPA was present in 24.2% of cases and most commonly originated from the aorta, with a pooled prevalence 57.2% (95% CI 52.4-62.0%), and the coeliac trunk, with a pooled prevalence of 41.3% (95% CI 36.8-45.9%). Other origins were much less common (1.00% (95% CI 0.28-1.71%)). Independent origin of the RIPA and LIPA were present in 75.8%. The RIPA arose from the aorta (49.6%, 95% CI 43.2%-55.9%), coeliac trunk (35.7%, 95% CI 28.7-42.6%), right renal artery (10.3%, 95% CI 7.27-13.3%) and left gastric artery (2.07%, 95% CI 0.97-3.16%). Other less common origins had a pooled prevalence of 2.07% (95% CI 0.97-3.16%). The LIPA arose from the aorta (46.8%, 95% CI 39.1-54.6%), coeliac trunk (46.1%, 95 CI 38.6-53.5%), left renal artery (1.47%, 95% CI 0.78-2.15%) and left gastric artery (1.07%, 95% CI 0.25-1.89%). Other less common origins had a pooled prevalence of 1.29% (95% CI 0.44-2.14%). CONCLUSION The inferior phrenic arteries express a wide range of variations in origin. Knowledge of their origins are important in interventional radiology, gastroenterology, surgery and traumatology.
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Affiliation(s)
- Adam Whitley
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Surgery, University Hospital Královské Vinohrady, Prague, Czech Republic.
| | - Jan Křeček
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Kachlík
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic
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Abdelgawad MS, Aly RA. Right inferior phrenic artery; Don't miss on MDCT before chemoembolization of hepatic dome HCC. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00167-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Transarterial chemoembolization (TACE) is considered a standard local-regional treatment for intermediate-stage hepatocellular carcinoma (HCC) and the most common bridging therapy. HCC typically receives its blood supply from the hepatic artery; however, it can recruit a parasitic supply from extrahepatic collateral arteries. The right inferior phrenic artery (RIPA) is considered the most common extrahepatic collateral pathway supplying HCC and so interfere with the therapeutic efficacy of TACE resulting in treatment failure and poor outcome. Imaging by MDCT with angiography has an essential role in depicting the presence or absence of an EHC arterial supply during the pre-TACE evaluation. We analyzed MDCT studies with CT angiography of patients with hepatic dome HCC retrospectively to confirm the diagnosis of HCC and to assess its blood supply. All patients were subjected to a proper assessment by history, clinical examination, as well as routine laboratory investigations
Results
Our study includes 58 cases with hepatic dome HCC. On CT angiography, the extrahepatic collateral from the RIPA supplying hepatic dome HCC was detected in about 33 out of 58 cases (56.9%). The RIPA arose directly from the aorta in 30 cases (90.9%) with only three cases (9.1%) from the celiac trunk. All cases were managed with TACE with about 25 out of 33 cases (75.8%) with extrahepatic RIPA were undergone concomitant embolisation of both RIPA and hepatic artery during TACE procedure.
Conclusion
MDCT assesses well the HCC arterial supply which is fundamental for planning subsequent cannulation and embolization of extrahepatic RIPA supply to hepatic dome HCC.
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Optical percutaneous needle biopsy of the liver: a pilot animal and clinical study. Sci Rep 2020; 10:14200. [PMID: 32848190 PMCID: PMC7449966 DOI: 10.1038/s41598-020-71089-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022] Open
Abstract
This paper presents the results of the experiments which were performed using the optical biopsy system specially developed for in vivo tissue classification during the percutaneous needle biopsy (PNB) of the liver. The proposed system includes an optical probe of small diameter acceptable for use in the PNB of the liver. The results of the feasibility studies and actual tests on laboratory mice with inoculated hepatocellular carcinoma and in clinical conditions on patients with liver tumors are presented and discussed. Monte Carlo simulations were carried out to assess the diagnostic volume and to trace the sensing depth. Fluorescence and diffuse reflectance spectroscopy measurements were used to monitor metabolic and morphological changes in tissues. The tissue oxygen saturation was evaluated using a recently developed approach to neural network fitting of diffuse reflectance spectra. The Support Vector Machine Classification was applied to identify intact liver and tumor tissues. Analysis of the obtained results shows the high sensitivity and specificity of the proposed multimodal method. This approach allows to obtain information before the tissue sample is taken, which makes it possible to significantly reduce the number of false-negative biopsies.
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Abstract
Hepatocellular carcinoma (HCC) is the third most common cause of cancer death globally, mainly due to lack of effective treatments – a problem that gene therapy is poised to solve. Successful gene therapy requires safe and efficient delivery vectors, and recent advances in both viral and nonviral vectors have made an important impact on HCC gene therapy delivery. This review explores how adenoviral, retroviral and adeno-associated viral vectors have been modified to increase safety and delivery capacity, highlighting studies and clinical trials using these vectors for HCC gene therapy. Nanoparticles, liposomes, exosomes and virosomes are also featured in their roles as HCC gene delivery vectors. Finally, new discoveries in gene editing technology and their impacts on HCC gene therapy are discussed.
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Kouri BE. Interventional Oncology: Optimizing Transarterial Therapies for the Treatment of Hepatic Malignancy. Tech Vasc Interv Radiol 2018; 21:205-222. [DOI: 10.1053/j.tvir.2018.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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21
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Dubbelboer IR, Sjögren E, Lennernäs H. Porcine and Human In Vivo Simulations for Doxorubicin-Containing Formulations Used in Locoregional Hepatocellular Carcinoma Treatment. AAPS JOURNAL 2018; 20:96. [PMID: 30167825 DOI: 10.1208/s12248-018-0251-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/31/2018] [Indexed: 12/21/2022]
Abstract
It is important to be able to simulate and predict formulation effects on the pharmacokinetics of a drug in order to optimize effectivity in clinical practice and drug development. Two formulations containing doxorubicin are used in the treatment of hepatocellular carcinoma (HCC): a Lipiodol-based emulsion (LIPDOX) and a loadable microbead system (DEBDOX). Although equally effective, the formulations are vastly different, and little is known about the parameters affecting doxorubicin release in vivo. However, mathematical modeling can be used to predict doxorubicin release properties from these formulations and its in vivo pharmacokinetic (PK) profiles. A porcine semi-physiologically based pharmacokinetic (PBPK) model was scaled to a human physiologically based biopharmaceutical (PBBP) model that was altered to include HCC. DOX in vitro and in vivo release data from LIPDOX or DEBDOX were collected from the literature and combined with these in silico models. The simulated pharmacokinetic profiles were then compared with observed porcine and human HCC patient data. DOX pharmacokinetic profiles of LIPDOX-treated HCC patients were best predicted from release data sets acquired by in vitro methods that did not use a diffusion barrier. For the DEBDOX group, the best predictions were from the in vitro release method with a low ion concentration and a reduced loading dose. The in silico modeling combined with historical release data was effective in predicting in vivo plasma exposure. This can give useful insights into the release method properties necessary for correct in vivo predictions of pharmacokinetic profiles of HCC patients dosed with LIPDOX or DEBDOX.
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Affiliation(s)
- Ilse R Dubbelboer
- Department of Pharmacy, Uppsala University, Box 580, 751 23, Uppsala, Sweden
| | - Erik Sjögren
- Department of Pharmacy, Uppsala University, Box 580, 751 23, Uppsala, Sweden
| | - Hans Lennernäs
- Department of Pharmacy, Uppsala University, Box 580, 751 23, Uppsala, Sweden.
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Farra R, Musiani F, Perrone F, Čemažar M, Kamenšek U, Tonon F, Abrami M, Ručigaj A, Grassi M, Pozzato G, Bonazza D, Zanconati F, Forte G, El Boustani M, Scarabel L, Garziera M, Russo Spena C, De Stefano L, Salis B, Toffoli G, Rizzolio F, Grassi G, Dapas B. Polymer-Mediated Delivery of siRNAs to Hepatocellular Carcinoma: Variables Affecting Specificity and Effectiveness. Molecules 2018; 23:E777. [PMID: 29597300 PMCID: PMC6017305 DOI: 10.3390/molecules23040777] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 02/06/2023] Open
Abstract
Despite the advances in anticancer therapies, their effectiveness for many human tumors is still far from being optimal. Significant improvements in treatment efficacy can come from the enhancement of drug specificity. This goal may be achieved by combining the use of therapeutic molecules with tumor specific effects and delivery carriers with tumor targeting ability. In this regard, nucleic acid-based drug (NABD) and particularly small interfering RNAs (siRNAs), are attractive molecules due to the possibility to be engineered to target specific tumor genes. On the other hand, polymeric-based delivery systems are emerging as versatile carriers to generate tumor-targeted delivery systems. Here we will focus on the most recent findings in the selection of siRNA/polymeric targeted delivery systems for hepatocellular carcinoma (HCC), a human tumor for which currently available therapeutic approaches are poorly effective. In addition, we will discuss the most attracting and, in our opinion, promising siRNA-polymer combinations for HCC in relation to the biological features of HCC tissue. Attention will be also put on the mathematical description of the mechanisms ruling siRNA-carrier delivery, this being an important aspect to improve effectiveness reducing the experimental work.
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Affiliation(s)
- Rossella Farra
- Department of Engineering and Architecture, University of Trieste, Via Alfonso Valerio, 6/A, I-34127 Trieste, Italy.
| | - Francesco Musiani
- Laboratory of Bioinorganic Chemistry, Department of Pharmacy and Biotechnology, University of Bologna, I-40127 Bologna, Italy.
| | - Francesca Perrone
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, I-34149 Trieste, Italy.
| | - Maja Čemažar
- Department of Experimental Oncology, Institute of Oncology, Ljubljana, Zaloska 2, SI-1000 Ljubljana, Slovenia.
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia.
| | - Urška Kamenšek
- Department of Experimental Oncology, Institute of Oncology, Ljubljana, Zaloska 2, SI-1000 Ljubljana, Slovenia.
| | - Federica Tonon
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, I-34149 Trieste, Italy.
| | - Michela Abrami
- Department of Engineering and Architecture, University of Trieste, Via Alfonso Valerio, 6/A, I-34127 Trieste, Italy.
| | - Aleš Ručigaj
- Faculty of Chemistry and Chemical Technology, University of Ljubljana, Večna pot 113, SI-1000 Ljubljana, Slovenia.
| | - Mario Grassi
- Department of Engineering and Architecture, University of Trieste, Via Alfonso Valerio, 6/A, I-34127 Trieste, Italy.
| | - Gabriele Pozzato
- Department of "Scienze Mediche, Chirurgiche e della Salute", University of Trieste, Cattinara Hospital, Strada di Fiume 447, I-34149 Trieste, Italy.
| | - Deborah Bonazza
- Department of "Scienze Mediche, Chirurgiche e della Salute", University of Trieste, Cattinara Hospital, Strada di Fiume 447, I-34149 Trieste, Italy.
| | - Fabrizio Zanconati
- Department of "Scienze Mediche, Chirurgiche e della Salute", University of Trieste, Cattinara Hospital, Strada di Fiume 447, I-34149 Trieste, Italy.
| | - Giancarlo Forte
- Center for Translational Medicine (CTM), International Clinical Research Center (ICRC), St. Anne's University Hospital, Studenstka 6, 656 91 Brno, Czech Republic.
| | - Maguie El Boustani
- Experimental and Clinical Pharmacology Unit, C.R.O.-National Cancer Institute, via Franco Gallini 2, I-33081 Aviano (PN), Italy.
- Doctoral School in Molecular Biomedicine, University of Trieste, 34100 Trieste, Italy.
| | - Lucia Scarabel
- C.R.O.-National Cancer Institute, via Franco Gallini 2, I-33081 Aviano (PN), Italy.
| | - Marica Garziera
- Experimental and Clinical Pharmacology Unit, C.R.O.-National Cancer Institute, via Franco Gallini 2, I-33081 Aviano (PN), Italy.
| | - Concetta Russo Spena
- Experimental and Clinical Pharmacology Unit, C.R.O.-National Cancer Institute, via Franco Gallini 2, I-33081 Aviano (PN), Italy.
- Doctoral School in Chemistry, University of Trieste, 34100 Trieste, Italy.
| | - Lucia De Stefano
- Experimental and Clinical Pharmacology Unit, C.R.O.-National Cancer Institute, via Franco Gallini 2, I-33081 Aviano (PN), Italy.
- Doctoral School in Chemistry, University of Trieste, 34100 Trieste, Italy.
| | - Barbara Salis
- Experimental and Clinical Pharmacology Unit, C.R.O.-National Cancer Institute, via Franco Gallini 2, I-33081 Aviano (PN), Italy.
- Doctoral School in Molecular Biomedicine, University of Trieste, 34100 Trieste, Italy.
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology Unit, C.R.O.-National Cancer Institute, via Franco Gallini 2, I-33081 Aviano (PN), Italy.
| | - Flavio Rizzolio
- Experimental and Clinical Pharmacology Unit, C.R.O.-National Cancer Institute, via Franco Gallini 2, I-33081 Aviano (PN), Italy.
- Department of Molecular Sciences and Nanosystems, Ca' Foscari University, via Torino 155, I-30172 Mestre (Venezia), Italy.
| | - Gabriele Grassi
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, I-34149 Trieste, Italy.
- Faculty of Chemistry and Chemical Technology, University of Ljubljana, Večna pot 113, SI-1000 Ljubljana, Slovenia.
| | - Barbara Dapas
- Department of Life Sciences, Cattinara University Hospital, Trieste University, Strada di Fiume 447, I-34149 Trieste, Italy.
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Shiozawa K, Watanabe M, Ikehara T, Yamamoto S, Matsui T, Saigusa Y, Igarashi Y, Maetani I. Efficacy of intra-arterial contrast-enhanced ultrasonography during transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma. World J Hepatol 2018; 10:95-104. [PMID: 29399283 PMCID: PMC5787690 DOI: 10.4254/wjh.v10.i1.95] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/07/2017] [Accepted: 12/29/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the usefulness of intra-arterial contrast-enhanced ultrasonography (IAUS) during transarterial chemoembolization (TACE) with drug-eluting beads (DEB) for hepatocellular carcinoma (HCC).
METHODS Thirty two patients with 39 HCC underwent DEB-TACE guided with IAUS, and examined by contrast-enhanced ultrasonography (CEUS) or dynamic CT after DEB-TACE were enrolled in this study. CEUS findings before DEB-TACE and IAUS findings were compared. Treatments judged to be complete and incomplete for lesions were appropriate and insufficient, respectively. Findings on CEUS and/or dynamic CT performed 1, 3 and 6 mo after DEB-TACE were evaluated using mRECIST (CR/PR/SD/PD).
RESULTS The treatments were complete and incomplete in 26 and 13 lesions, respectively. On imaging evaluation using CEUS and/or dynamic CT one month after treatment, 25 and 1 lesions were judged to be CR and PR, respectively, and at 6 mo after treatment, the results were CR, PR, SD and PD for 24, 1, 0 and 1 of these lesions, respectively, in the 26 completely treated lesions. Of the 13 lesions in which treatment was incomplete, the results on imaging at one month after treatment were CR, PR, SD and PD for 0, 6, 4 and 3 lesions, respectively. The overall CR rate at 6 mo after treatment was 61.5% (24/39).
CONCLUSION A combination of DEB-TACE with IAUS can improve the therapeutic effects in patients with HCC.
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Affiliation(s)
- Kazue Shiozawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Ohashi Hospital, Tokyo 153-8515, Japan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital, Tokyo 143-8541, Japan
| | - Manabu Watanabe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Ohashi Hospital, Tokyo 153-8515, Japan
| | - Takashi Ikehara
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital, Tokyo 143-8541, Japan
| | - Shuhei Yamamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Ohashi Hospital, Tokyo 153-8515, Japan
| | - Takashi Matsui
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Ohashi Hospital, Tokyo 153-8515, Japan
| | - Yoshinori Saigusa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Ohashi Hospital, Tokyo 153-8515, Japan
| | - Yoshinori Igarashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital, Tokyo 143-8541, Japan
| | - Iruru Maetani
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Ohashi Hospital, Tokyo 153-8515, Japan
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24
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Porcu EP, Salis A, Rassu G, Maestri M, Galafassi J, Bruni G, Giunchedi P, Gavini E. Engineered polymeric microspheres obtained by multi-step method as potential systems for transarterial embolization and intraoperative imaging of HCC: Preliminary evaluation. Eur J Pharm Biopharm 2017; 117:160-167. [DOI: 10.1016/j.ejpb.2017.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 04/06/2017] [Accepted: 04/11/2017] [Indexed: 12/11/2022]
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25
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Lekht I, Nayyar M, Luu B, Guichet PL, Ho J, Ter-Oganesyan R, Katz M, Gulati M. Intra-arterial contrast-enhanced ultrasound (IA CEUS) for localization of hepatocellular carcinoma (HCC) supply during transarterial chemoembolization (TACE): a case series. Abdom Radiol (NY) 2017; 42:1400-1407. [PMID: 28008454 DOI: 10.1007/s00261-016-1016-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Transarterial chemoembolization (TACE) is a proven catheter-based locoregional therapy for treatment of hepatocellular carcinoma (HCC). Drug-eluting bead TACE involves delivering micrometer-sized particles preloaded with doxorubicin directly to the tumor via its arterial blood supply and results in vascular embolization with intra-tumoral drug release. Effective therapy requires mapping of the tumor arterial supply, which in some cases cannot be accomplished with conventional angiographic techniques alone. Contrast-enhanced ultrasound (CEUS) is an imaging technique which utilizes microbubble contrast agents to demonstrate blood flow and tissue perfusion, enabling tumor visualization in real time. CEUS with intravenous contrast administration is well established for evaluation of HCC. Intra-arterial (IA) CEUS, on the other hand, is an emerging technique that allows more selective evaluation of the arterial supply to the tumor. The three cases in this report illustrate the utility of intra-procedural IA CEUS during TACE. Specifically, IA CEUS aided TACE in cases where the HCC showed poor arterial enhancement, an extrahepatic arterial supply, and a portal venous supply, respectively.
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26
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Scarabel L, Perrone F, Garziera M, Farra R, Grassi M, Musiani F, Russo Spena C, Salis B, De Stefano L, Toffoli G, Rizzolio F, Tonon F, Abrami M, Chiarappa G, Pozzato G, Forte G, Grassi G, Dapas B. Strategies to optimize siRNA delivery to hepatocellular carcinoma cells. Expert Opin Drug Deliv 2017; 14:797-810. [DOI: 10.1080/17425247.2017.1292247] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Lucia Scarabel
- Experimental and Clinical Pharmacology Unit, C.R.O. National Cancer Institute, Aviano, Italy
| | - Francesca Perrone
- Department of Life Sciences, Cattinara University Hospital, University of Trieste, Trieste, Italy
| | - Marica Garziera
- Experimental and Clinical Pharmacology Unit, C.R.O. National Cancer Institute, Aviano, Italy
| | - Rossella Farra
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Mario Grassi
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Francesco Musiani
- Laboratory of Bioinorganic Chemistry, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Concetta Russo Spena
- Experimental and Clinical Pharmacology Unit, C.R.O. National Cancer Institute, Aviano, Italy
| | - Barbara Salis
- Experimental and Clinical Pharmacology Unit, C.R.O. National Cancer Institute, Aviano, Italy
| | - Lucia De Stefano
- Experimental and Clinical Pharmacology Unit, C.R.O. National Cancer Institute, Aviano, Italy
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology Unit, C.R.O. National Cancer Institute, Aviano, Italy
| | - Flavio Rizzolio
- Experimental and Clinical Pharmacology Unit, C.R.O. National Cancer Institute, Aviano, Italy
| | - Federica Tonon
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Michela Abrami
- Department of Life Sciences, Cattinara University Hospital, University of Trieste, Trieste, Italy
| | - Gianluca Chiarappa
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Gabriele Pozzato
- Department of ‘Scienze Mediche, Chirurgiche e della Salute’, Cattinara University Hospital, University of Trieste, Trieste, Italy
| | - Giancarlo Forte
- Center for Translational Medicine, International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic
| | - Gabriele Grassi
- Department of Life Sciences, Cattinara University Hospital, University of Trieste, Trieste, Italy
- Department of ‘Scienze Mediche, Chirurgiche e della Salute’, Cattinara University Hospital, University of Trieste, Trieste, Italy
| | - Barbara Dapas
- Department of Life Sciences, Cattinara University Hospital, University of Trieste, Trieste, Italy
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27
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El Bacha H, Salihoun M, Kabbaj N, Benkabbou A. Complete necrosis of hepatocellular carcinoma after preoperative portal vein embolization: a case report. J Med Case Rep 2017; 11:7. [PMID: 28049508 PMCID: PMC5210282 DOI: 10.1186/s13256-016-1160-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 11/24/2016] [Indexed: 12/21/2022] Open
Abstract
Background Hepatocellular carcinoma has a poor prognosis; few patients can undergo surgical curative treatment according to Barcelona Clinic Liver Cancer guidelines. Progress in surgical techniques has led to operations for more patients outside these guidelines. Our case shows a patient with intermediate stage hepatocellular carcinoma presenting a good outcome after curative treatment. Case presentation We report the case of an 80-year-old Moroccan man, who was positive for hepatitis c virus, presenting an intermediate stage hepatocellular carcinoma (three lesions between 20 and 60 mm). He presented a complete tumor necrosis after portal vein embolization and achieved 24-month disease-free survival after surgery. Conclusions Perioperative care in liver surgery and multidisciplinary discussion can help to extend indications for liver resection for hepatocellular carcinoma outside European Association for the Study of the Liver/American Association for the Study of Liver Diseases recommendations and offer a curative approach to selected patients with intermediate and advanced stage hepatocellular carcinoma.
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Affiliation(s)
- H El Bacha
- Faculté de médecine et de pharmacie de Rabat, Mohammed V University, Rabat, Morocco. .,Explorations Fonctionnelles Digestives, Ibn Sina Hospital, Rabat, Morocco.
| | - M Salihoun
- Faculté de médecine et de pharmacie de Rabat, Mohammed V University, Rabat, Morocco.,Explorations Fonctionnelles Digestives, Ibn Sina Hospital, Rabat, Morocco
| | - N Kabbaj
- Faculté de médecine et de pharmacie de Rabat, Mohammed V University, Rabat, Morocco.,Explorations Fonctionnelles Digestives, Ibn Sina Hospital, Rabat, Morocco
| | - A Benkabbou
- Faculté de médecine et de pharmacie de Rabat, Mohammed V University, Rabat, Morocco.,Surgical Department A, Ibn Sina Hospital, Rabat, Morocco
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28
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Tonon F, Zennaro C, Dapas B, Carraro M, Mariotti M, Grassi G. Rapid and cost-effective xenograft hepatocellular carcinoma model in Zebrafish for drug testing. Int J Pharm 2016; 515:583-591. [PMID: 27989824 DOI: 10.1016/j.ijpharm.2016.10.070] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 10/28/2016] [Indexed: 02/07/2023]
Abstract
We developed a novel, rapid and cost-effective Zebrafish xenograft model of hepatocellular carcinoma (HCC) for drug screening in the disease. Following injection into the yolk sack of Zebrafish larvae of the human HCC cell line JHH6 stained by a vital dye, tumor mass growth was followed by fluorescence microscopy and by human Ki67 quantification. Tumor induced neo-angiogenesis was evaluated by alkaline phosphatase staining of the vessels, by using the Tg(fli1:EGFP)y1 strain of Zebrafish and by the quantification of the zebrafish vascular endothelial growth factor and of its receptor. We show that it is feasible to micro-inject JHH6 in Zebrafish larvae, that injected cells can grow for different days and that this induces a marked neo-angiogenesis. Finally, we show that our model allows testing the effects of anti-HCC drugs such as Bortezomib. Compared to more complex HCC mouse models, our model is far less expensive, faster to set up and does not need immunosuppressant treatment. Finally, the model makes use of JHH6, an aggressive form of HCC cell line never tested before in Zebrafish. In conclusion, the possibility to test anti HCC/neo-angiogenesis drugs makes our JHH6 model useful to select therapeutic molecules for a highly vascularized tumor such as HCC.
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Affiliation(s)
- Federica Tonon
- Department of Medical, Surgery and Health Sciences, University of Trieste, Cattinara Hospital, Italy
| | - Cristina Zennaro
- Department of Medical, Surgery and Health Sciences, University of Trieste, Cattinara Hospital, Italy
| | - Barbara Dapas
- Department of Life Sciences, University of Trieste, Italy
| | - Michele Carraro
- Department of Medical, Surgery and Health Sciences, University of Trieste, Cattinara Hospital, Italy
| | - Massimo Mariotti
- IRCCS Galeazzi Orthopedic Institute Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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29
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Biliary complications of arterial chemoembolization of hepatocellular carcinoma. Diagn Interv Imaging 2015; 96:1169-75. [DOI: 10.1016/j.diii.2015.06.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/26/2015] [Accepted: 06/30/2015] [Indexed: 02/08/2023]
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30
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Iguchi T, Inoue D, Tatsukawa M, Yabushita K, Sakaguchi K, Kanazawa S. Transpulmonary radiofrequency ablation of hepatocellular carcinoma contiguous to the heart. Diagn Interv Imaging 2015; 96:1207-9. [PMID: 26277644 DOI: 10.1016/j.diii.2015.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 06/13/2015] [Accepted: 06/15/2015] [Indexed: 11/16/2022]
Affiliation(s)
- T Iguchi
- Department of Diagnostic and Interventional Radiology, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama 721-8511, Japan; Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
| | - D Inoue
- Department of Diagnostic and Interventional Radiology, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama 721-8511, Japan.
| | - M Tatsukawa
- Department of Internal Medicine, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama 721-8511, Japan.
| | - K Yabushita
- Department of Internal Medicine, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama 721-8511, Japan.
| | - K Sakaguchi
- Department of Internal Medicine, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama 721-8511, Japan.
| | - S Kanazawa
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
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31
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Farra R, Grassi M, Grassi G, Dapas B. Therapeutic potential of small interfering RNAs/micro interfering RNA in hepatocellular carcinoma. World J Gastroenterol 2015; 21:8994-9001. [PMID: 26290628 PMCID: PMC4533033 DOI: 10.3748/wjg.v21.i30.8994] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 04/28/2015] [Accepted: 07/03/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the predominant form of primary liver cancer and represents the third leading cause of cancer-related death worldwide. Current available therapeutic approaches are poorly effective, especially for the advanced forms of the disease. In the last year, short double stranded RNA molecules termed small interfering RNAs (siRNAs) and micro interfering RNAs (miRNA), emerged as interesting molecules with potential therapeutic value for HCC. The practical use of these molecules is however limited by the identification of optimal molecular targets and especially by the lack of effective and targeted HCC delivery systems. Here we focus our discussion on the most recent advances in the identification of siRNAs/miRNAs molecular targets and on the development of suitable siRNA/miRNAs delivery systems.
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32
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Dohan A, Dautry R, Guerrache Y, Fargeaudou Y, Boudiaf M, Le Dref O, Sirol M, Soyer P. Three-dimensional MDCT angiography of splanchnic arteries: Pearls and pitfalls. Diagn Interv Imaging 2015; 96:187-200. [DOI: 10.1016/j.diii.2014.06.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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33
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Chen J, Zhang J, Dowell JD, Xi W, Zhang X, Chen S. A spindle cell sarcoma of liver supplied by internal mammary artery. Diagn Interv Imaging 2014; 96:103-5. [PMID: 25533497 DOI: 10.1016/j.diii.2014.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- J Chen
- Department of Radiology, Jiangsu Cancer Hospital & Cancer Hospital of Nanjing Medical University (NMU), 42, Baiziting, Nanjing 210009, China
| | - J Zhang
- Department of Pathology, Jiangsu Cancer Hospital & Cancer Hospital of Nanjing Medical University (NMU), Nanjing 210009, China
| | - J D Dowell
- Division of Interventional Radiology, Department of Radiology, Wexner Medical Center, The Ohio State University, Columbus, Ohio 43210, USA
| | - W Xi
- Department of Radiology, Jiangsu Cancer Hospital & Cancer Hospital of Nanjing Medical University (NMU), 42, Baiziting, Nanjing 210009, China
| | - X Zhang
- Department of Radiology, Jiangsu Cancer Hospital & Cancer Hospital of Nanjing Medical University (NMU), 42, Baiziting, Nanjing 210009, China
| | - S Chen
- Department of Radiology, Jiangsu Cancer Hospital & Cancer Hospital of Nanjing Medical University (NMU), 42, Baiziting, Nanjing 210009, China.
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34
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Vesselle G, Petit I, Boucebci S, Rocher T, Velasco S, Tasu JP. Radioembolization with yttrium-90 microspheres work up: Practical approach and literature review. Diagn Interv Imaging 2014; 96:547-62. [PMID: 24776810 DOI: 10.1016/j.diii.2014.03.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Radioembolization (RE) is a selective internal radiotherapy technique in which yttrium-90 blended microspheres are infused through the hepatic arteries. It is based on the fact that primary and secondary hepatic tumors are vascularized mostly by arterial blood flow whereas healthy hepatocytes obtain their blood supply mostly from the portal network. This enables high radiation doses to be delivered, sparing the surrounding non-malignant liver parenchyma. Most of the complications are caused by unexpected particles passing into the gastrointestinal tract through branches originating from the main hepatic arterial supply. Knowledge of this hepatic arterial network and of its variations and the technical considerations this raises are required in preparation for treatment. This work describes the specific anatomical features and techniques for this anatomy through recent literature illustrated by cases from our own experience.
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Affiliation(s)
- G Vesselle
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France.
| | - I Petit
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France
| | - S Boucebci
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France
| | - T Rocher
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France
| | - S Velasco
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France
| | - J-P Tasu
- Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France
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