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Habibi HA, Cevener M, Yilmaz S. Image-guided percutaneous cutting needle biopsy in difficult locations. Jpn J Radiol 2022; 40:560-567. [DOI: 10.1007/s11604-021-01238-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/09/2021] [Indexed: 12/01/2022]
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Reitano E, de'Angelis N, Bianchi G, Laera L, Spiliopoulos S, Calbi R, Memeo R, Inchingolo R. Current trends and perspectives in interventional radiology for gastrointestinal cancers. World J Radiol 2021; 13:314-326. [PMID: 34786187 PMCID: PMC8567440 DOI: 10.4329/wjr.v13.i10.314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/12/2021] [Accepted: 10/15/2021] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal (GI) cancers often require a multidisciplinary approach involving surgeons, endoscopists, oncologists, and interventional radiologists to diagnose and treat primitive cancers, metastases, and related complications. In this context, interventional radiology (IR) represents a useful minimally-invasive tool allowing to reach lesions that are not easily approachable with other techniques. In the last years, through the development of new devices, IR has become increasingly relevant in the context of a more comprehensive management of the oncologic patient. Arterial embolization, ablative techniques, and gene therapy represent useful and innovative IR tools in GI cancer treatment. Moreover, IR can be useful for the management of GI cancer-related complications, such as bleeding, abscesses, GI obstructions, and neurological pain. The aim of this study is to show the principal IR techniques for the diagnosis and treatment of GI cancers and related complications, as well as to describe the future perspectives of IR in this oncologic field.
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Affiliation(s)
- Elisa Reitano
- Division of General Surgery, Department of Translational Medicine, University of Eastern Piedmont, Novara 28100, Italy
| | - Nicola de'Angelis
- Unit of Minimally Invasive and Robotic Digestive Surgery, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti 70021, Italy
| | - Giorgio Bianchi
- Unit of Minimally Invasive and Robotic Digestive Surgery, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti 70021, Italy
| | - Letizia Laera
- Department of Oncology, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti 70021, Italy
| | - Stavros Spiliopoulos
- 2nd Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Athens 12461, Greece
| | - Roberto Calbi
- Department of Radiology, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti 70124, Italy
| | - Riccardo Memeo
- Unit of Hepato-Pancreatic-Biliary Surgery, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti 70021, Italy
| | - Riccardo Inchingolo
- Interventional Radiology Unit, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti 70021, Italy
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Türk Y, Devecioğlu İ. A Retrospective Analysis of the Effectiveness of Extrapleural Autologous Blood Patch Injection on Pneumothorax and Intervention Need in CT-guided Lung Biopsy. Cardiovasc Intervent Radiol 2021; 44:1223-1230. [PMID: 34021378 DOI: 10.1007/s00270-021-02866-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To assess the effect of extrapleural autologous blood injection (EPABI) technique on pneumothorax development before and after coaxial needle withdrawal (CNW) and intervention rate for pneumothorax. To analyze the risk factors of pneumothorax and parenchymal hemorrhage. MATERIALS AND METHODS The records of 288 patients who had lung biopsies were analyzed. Of these patients, 188 received EPABI (group-A) before penetrating the parietal pleura, and the remaining did not (group-B). Intraparenchymal autologous blood patch injection was applied at the end of the procedure. The pneumothorax rates before/after CNW and intervention requirement for pneumothorax were compared between groups. The risk factors of pneumothorax before/after CNW and parenchymal hemorrhage were assessed with stepwise logistic regression. RESULTS The pneumothorax rate before CNW was significantly lower in group-A (5.92%) than in group-B (19.10%) (p = 0.029). Pneumothorax risk before CNW was reduced if EPABI was applied and skin-to-pleura distance increased. The pneumothorax rate after CNW was similar between two groups (group-A: 6.94%, group-B: 8%), while emphysema grade along the needle path and procedure duration was the significant risk factor. The intervention requirement for pneumothorax was significantly lower in group-A (6.38%) than in group-B (16%) (p = 0.012). Needle aspiration requirement was significantly reduced in group-A. The rate of external drainage catheter and chest tube placement was similar in both groups. The risk factors of parenchymal hemorrhage were overall emphysema grade of the lung, target-to-pleura distance, and target size. CONCLUSION Use of EPABI along with IAPBI significantly decreased the pneumothorax rate during biopsy procedure and the intervention rate compared to IAPBI-alone.
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Affiliation(s)
- Yaşar Türk
- Radiology Department, Medical Faculty, Tekirdağ Namık Kemal University, Namik Kemal Mh., Kampus CdSuleymanpasa, 59100, Tekirdag, Turkey. .,Radiology Department, Medical Faculty, Zonguldak Bülent Ecevit University, Esenköy, 67000, Kozlu/Zonguldak, Turkey.
| | - İsmail Devecioğlu
- Biomedical Engineering Department, Çorlu Engineering Faculty, NKU Corlu Muhendislik Fakultesi, Tekirdağ Namık Kemal University, Silahtaraga Mh, Çorlu, Tekirdağ, Turkey
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D'Amore B, Smolinski-Zhao S, Daye D, Uppot RN. Role of Machine Learning and Artificial Intelligence in Interventional Oncology. Curr Oncol Rep 2021; 23:70. [PMID: 33880651 DOI: 10.1007/s11912-021-01054-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight the current role of machine learning and artificial intelligence and in the field of interventional oncology. RECENT FINDINGS With advancements in technology, there is a significant amount of research regarding the application of artificial intelligence and machine learning in medicine. Interventional oncology is a field that can benefit greatly from this research through enhanced image analysis and intraprocedural guidance. These software developments can increase detection of cancers through routine screening and improve diagnostic accuracy in classifying tumors. They may also aid in selecting the most effective treatment for the patient by predicting outcomes based on a combination of both clinical and radiologic factors. Furthermore, machine learning and artificial intelligence can advance intraprocedural guidance for the interventional oncologist through more accurate needle tracking and image fusion technology. This minimizes damage to nearby healthy tissue and maximizes treatment of the tumor. While there are several exciting developments, this review also discusses limitations before incorporating machine learning and artificial intelligence in the field of interventional oncology. These include data capture and processing, lack of transparency among developers, validating models, integrating workflow, and ethical challenged. In summary, machine learning and artificial intelligence have the potential to positively impact interventional oncologists and how they provide cancer care treatments.
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Affiliation(s)
- Brian D'Amore
- Drexel University College of Medicine, 2900 W Queen Lane, Philadelphia, PA, 19129, USA
| | - Sara Smolinski-Zhao
- Division of Interventional Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street; Gray #290, Boston, MA, 02114, USA
| | - Dania Daye
- Division of Interventional Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street; Gray #290, Boston, MA, 02114, USA
| | - Raul N Uppot
- Division of Interventional Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street; Gray #290, Boston, MA, 02114, USA.
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Kovács A, Bischoff P, Haddad H, Kovács G, Schaefer A, Zhou W, Pinkawa M. Personalized Image-Guided Therapies for Local Malignencies: Interdisciplinary Options for Interventional Radiology and Interventional Radiotherapy. Front Oncol 2021; 11:616058. [PMID: 33869002 PMCID: PMC8047426 DOI: 10.3389/fonc.2021.616058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 03/09/2021] [Indexed: 12/19/2022] Open
Abstract
Minimal-invasive interventions considerably extend the therapeutic spectrum in oncology and open new dimensions in terms of survival, tolerability and patient-friendliness. Through the influence of image-guided interventions, many interdisciplinary therapy concepts have significantly evolved, and this process is by far not yet over. The rapid progression of minimal-invasive technologies offers hope for new therapeutic concepts in the short, medium and long term. Image-guided hybrid-technologies complement and even replace in selected cases classic surgery. In this newly begun era of immune-oncology, interdisciplinary collaboration and the focus on individualized and patient-friendly therapies are crucial.
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Affiliation(s)
- Attila Kovács
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, MediClin Robert Janker Klinik, Bonn, Germany
| | - Peter Bischoff
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, MediClin Robert Janker Klinik, Bonn, Germany
| | - Hathal Haddad
- Clinic for Radiotherapy and Radiooncology, MediClin Robert Janker Klinik, Bonn, Germany
| | - György Kovács
- Gemelli-INTERACTS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andreas Schaefer
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, MediClin Robert Janker Klinik, Bonn, Germany
| | - Willi Zhou
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, MediClin Robert Janker Klinik, Bonn, Germany
| | - Michael Pinkawa
- Clinic for Radiotherapy and Radiooncology, MediClin Robert Janker Klinik, Bonn, Germany
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Alessandrino F, Williams K, Nassar AH, Gujrathi R, Silverman SG, Sonpavde G, Shinagare AB. Muscle-invasive Urothelial Cancer: Association of Mutational Status with Metastatic Pattern and Survival. Radiology 2020; 295:572-580. [PMID: 32228295 DOI: 10.1148/radiol.2020191770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Muscle-invasive urothelial cancer (MIUC) is characterized by substantial genetic heterogeneity and high mutational frequency. Correlation between frequently mutated genes with clinical behavior has been recently demonstrated. Nonetheless, correlation between mutational status of MIUC and metastatic pattern is unknown. Purpose To investigate the association of mutational status of MIUC with metastatic pattern, metastasis-free survival (MFS), and overall survival (OS). Materials and Methods This single-center retrospective study evaluated consecutive patients with biopsy-proven MIUC who underwent serial cross-sectional imaging (CT, MRI, or fluorine 18 fluorodeoxyglucose PET/CT) between April 2010 and December 2018. Mutational status was correlated with location of metastases using the χ2 or Fisher exact test. Mutational status and metastatic pattern were correlated with MFS and OS using univariable Cox proportional hazard models. High-risk (presence of TP53, RB1, or KDM6A mutation) and low-risk (presence of ARID1A, FGFR3, PIK3CA, STAG2, and/or TSC1 mutation and absence of TP53, RB1, or KDM6A mutation) groups were determined according to existing literature and were correlated with MFS and OS by using multivariable Cox proportional hazard models. Results One hundred three patients (mean age, 72 years ± 11 [standard deviation]; 81 men) were evaluated. Seventeen of 103 (16%) patients had metastatic disease at diagnosis; 38 of 103 (37%) developed metastatic disease at a median of 5.9 months (interquartile range, 0.8-28 months). TP53 mutation (seen in 58 of 103 patients, 56%) was associated with lymphadenopathy (relative risk [RR]: 1.7; 95% confidence interval [CI]: 1.2, 2.4; P = .002) and osseous metastases (RR: 1.9; 95% CI: 1.6, 2.3; P = .02); RB1 mutation (seen in 19 of 103 patients, 18.4%) was associated with peritoneal carcinomatosis (RR: 5.9; 95% CI: 3.8, 9.2; P = .03). ARID1A mutation was associated with greater OS (hazard ratio [HR]: 3.1; 95% CI: 1.2, 10; P = .01). At multivariable Cox analysis, the high-risk group (TP53, RB1, and/or KDM6A mutations) was independently associated with shorter MFS (HR: 3.5, 95% CI: 1.3, 12; P = .009) and shorter OS (HR: 3.1; 95% CI: 1.2, 10; P = .02). Conclusion Mutational status of muscle-invasive urothelial cancer has implications on metastatic pattern, metastasis-free survival, and overall survival. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Choyke in this issue.
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Affiliation(s)
- Francesco Alessandrino
- From the Department of Imaging (F.A., K.W., R.G., A.B.S.) and Lank Center for Genitourinary Oncology (A.H.N., G.S.), Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215; and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (F.A., K.W., R.G., S.G.S., A.B.S.)
| | - Kristin Williams
- From the Department of Imaging (F.A., K.W., R.G., A.B.S.) and Lank Center for Genitourinary Oncology (A.H.N., G.S.), Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215; and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (F.A., K.W., R.G., S.G.S., A.B.S.)
| | - Amin H Nassar
- From the Department of Imaging (F.A., K.W., R.G., A.B.S.) and Lank Center for Genitourinary Oncology (A.H.N., G.S.), Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215; and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (F.A., K.W., R.G., S.G.S., A.B.S.)
| | - Rahul Gujrathi
- From the Department of Imaging (F.A., K.W., R.G., A.B.S.) and Lank Center for Genitourinary Oncology (A.H.N., G.S.), Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215; and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (F.A., K.W., R.G., S.G.S., A.B.S.)
| | - Stuart G Silverman
- From the Department of Imaging (F.A., K.W., R.G., A.B.S.) and Lank Center for Genitourinary Oncology (A.H.N., G.S.), Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215; and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (F.A., K.W., R.G., S.G.S., A.B.S.)
| | - Guru Sonpavde
- From the Department of Imaging (F.A., K.W., R.G., A.B.S.) and Lank Center for Genitourinary Oncology (A.H.N., G.S.), Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215; and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (F.A., K.W., R.G., S.G.S., A.B.S.)
| | - Atul B Shinagare
- From the Department of Imaging (F.A., K.W., R.G., A.B.S.) and Lank Center for Genitourinary Oncology (A.H.N., G.S.), Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215; and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (F.A., K.W., R.G., S.G.S., A.B.S.)
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Sone M, Arai Y, Sugawara S, Kubo T, Itou C, Hasegawa T, Umakoshi N, Yamamoto N, Sunami K, Hiraoka N, Kubo T. Feasibility of genomic profiling with next-generation sequencing using specimens obtained by image-guided percutaneous needle biopsy. Ups J Med Sci 2019; 124:119-124. [PMID: 31179853 PMCID: PMC6567228 DOI: 10.1080/03009734.2019.1607635] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aims: The demand for specimen collection for genomic profiling is rapidly increasing in the era of personalized medicine. Percutaneous needle biopsy is recognized as minimally invasive, but the feasibility of comprehensive genomic analysis using next-generation sequencing (NGS) is not yet clear. The purpose of this study was to evaluate the feasibility of genomic analysis using NGS with specimens obtained by image-guided percutaneous needle biopsy with 18-G needles. Patients and methods: Forty-eight patients who participated in a clinical study of genomic profiling with NGS with the specimen obtained by image-guided needle biopsy were included. All biopsies were performed under local anesthesia, with imaging guidance, using an 18-G cutting needle. A retrospective chart review was performed to determine the rate of successful genomic analysis, technical success rate of biopsy procedure, adverse events, rate of success in pathological diagnosis, and cause of failed genomic analysis. Results: The success rate of genomic analysis was 79.2% (38/48). The causes of failure were unprocessed for DNA extraction due to insufficient specimen volume (6/10), insufficient DNA volume (2/10), and deteriorated DNA quality (2/10). The rate of successful genomic analysis excluding NGS analysis that failed for reasons unrelated to the biopsy procedures was 95.2% (40/42). Technical success of biopsy was achieved in all patients without severe adverse events. The rate of success in the pathological diagnosis was 97.9% (47/48). Conclusions: Image-guided needle biopsy specimens using an 18-G cutting needle yielded a successful NGS genomic analysis rate with no severe adverse events and could be an adoptable method for tissue sampling for NGS.
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Affiliation(s)
- Miyuki Sone
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
- CONTACT Miyuki Sone Department of Diagnostic Radiology, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo1040045, Japan
| | - Yasuaki Arai
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Shunsuke Sugawara
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Takatoshi Kubo
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Chihiro Itou
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Hasegawa
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Noriyuki Umakoshi
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Kumiko Sunami
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Nobuyoshi Hiraoka
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Takashi Kubo
- Division of Translational Genomics, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Tokyo, Japan
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Raja J, Ludwig JM, Gettinger SN, Schalper KA, Kim HS. Oncolytic virus immunotherapy: future prospects for oncology. J Immunother Cancer 2018; 6:140. [PMID: 30514385 PMCID: PMC6280382 DOI: 10.1186/s40425-018-0458-z] [Citation(s) in RCA: 188] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 11/20/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Immunotherapy is at the forefront of modern oncologic care. Various novel therapies have targeted all three layers of tumor biology: tumor, niche, and immune system with a range of promising results. One emerging class in both primary and salvage therapy is oncolytic viruses. This therapy offers a multimodal approach to specifically and effectively target and destroy malignant cells, though a barrier oncoviral therapies have faced is a limited therapeutic response to currently delivery techniques. MAIN BODY The ability to deliver therapy tailored to specific cellular targets at the precise locus in which it would have its greatest impact is a profound development in anti-cancer treatment. Although immune checkpoint inhibitors have an improved tolerability profile relative to cytotoxic chemotherapy and whole beam radiation, severe immune-related adverse events have emerged as a potential limitation. These include pneumonitis, pancreatitis, and colitis, which are relatively infrequent but can limit therapeutic options for some patients. Intratumor injection of oncolytic viruses, in contrast, has a markedly lower rate of serious adverse effects and perhaps greater specificity to target tumor cells. Early stage clinical trials using oncolytic viruses show induction of effector anti-tumor immune responses and suggest that such therapies could also morph and redefine both the local target cells' niche as well as impart distant effects on remote cells with a similar molecular profile. CONCLUSION It is imperative for the modern immuno-oncologist to understand the biological processes underlying the immune dysregulation in cancer as well as the effects, uses, and limitations of oncolytic viruses. It will be with this foundational understanding that the future of oncolytic viral therapies and their delivery can be refined to forge future horizons in the direct modulation of the tumor bed.
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Affiliation(s)
- Junaid Raja
- Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510, USA
| | - Johannes M Ludwig
- Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510, USA
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Scott N Gettinger
- Division of Medical Oncology, Department of Medicine, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510, USA
- Yale Cancer Center, Yale University School of Medicine, 330 Cedar Street, New Haven, CT 06510, USA
| | - Kurt A Schalper
- Department of Pathology, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510, USA
| | - Hyun S Kim
- Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510, USA.
- Division of Medical Oncology, Department of Medicine, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510, USA.
- Yale Cancer Center, Yale University School of Medicine, 330 Cedar Street, New Haven, CT 06510, USA.
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Prud'homme C, Deschamps F, Allorant A, Massard C, Hollebecque A, Yevich S, Ngo-Camus M, Gravel G, Nicotra C, Michiels S, Scoazec JY, Lacroix L, Solary E, Soria JC, De Baere T, Tselikas L. Image-guided tumour biopsies in a prospective molecular triage study (MOSCATO-01): What are the real risks? Eur J Cancer 2018; 103:108-119. [PMID: 30223224 DOI: 10.1016/j.ejca.2018.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/29/2018] [Accepted: 08/02/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate efficacy, complications and preprocedural risk factors for percutaneous image-guided core needle biopsy of malignant tumours for genomic tumour analysis. MATERIALS AND METHODS Procedural data for core biopsies performed at a single centre for the MOSCATO-01 clinical trial were prospectively recorded between December 2011 and March 2016. Data assessed included patient demographics, tumour characteristics, procedural outcomes and complications. RESULTS A total of 877 biopsies were performed under computed tomography (38.4%) or ultrasound guidance (61.6%) for tumours in the liver (n = 363), lungs (n = 229), lymph nodes (n = 138), bones (n = 15) and other miscellaneous sites (n = 124). Each biopsy harvested a mean 4.4 samples [1-15], with adequate tumour yield for genomic analysis in 95.3% of cases. Procedural complications occurred in 89 cases (10.1%), with minor grade I complications in 59 (66.3%); grade II in 16 (18%) and grade III in 14 (15.7%). No grade IV complications and no procedure-related death occurred. The most common complications were pneumothorax (51/89, 57.3%), haemorrhage (24/89, 27%) and pain (8/89, 8.9%). Predictive factors for complications by univariate analysis included biopsied organ (lung vs other), sample number, prone position, lesion size, lesion depth and biopsy approach. By multivariate analysis, only pulmonary biopsy was a significant risk factor (odds ratio = 27.23 [4.93-242.76], p < 0.01). CONCLUSION Percutaneous image-guided core needle biopsy in cancer patients provides an effective method to obtain molecular screening samples, with an overall low complication rate. Lung mass biopsies present a higher risk of complication, although complications are manageable by minimally invasive techniques without prolonged sequelae.
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Affiliation(s)
- Clara Prud'homme
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France.
| | - Fréderic Deschamps
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France.
| | - Adrien Allorant
- Biostatistics and Epidemiology Unit, Gustave Roussy, Université Paris-Saclay University, CESP, INSERM, Villejuif, F-94805, France.
| | | | | | - Steve Yevich
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France.
| | - Maud Ngo-Camus
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France.
| | - Guillaume Gravel
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France.
| | - Claudio Nicotra
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France.
| | - Stefan Michiels
- Biostatistics and Epidemiology Unit, Gustave Roussy, Université Paris-Saclay University, CESP, INSERM, Villejuif, F-94805, France.
| | - Jean-Yves Scoazec
- Department of Pathology and Laboratory Medicine, Gustave Roussy, Villejuif, France; Faculté de Médecine, Kremlin-Bicêtre, Université Paris Sud, France; Laboratory of Translational Research and Biological Resource Center - AMMICA, INSERM US23/CNRS UMS3655, France.
| | - Ludovic Lacroix
- Department of Pathology and Laboratory Medicine, Gustave Roussy, Villejuif, France; Laboratory of Translational Research and Biological Resource Center - AMMICA, INSERM US23/CNRS UMS3655, France.
| | - Eric Solary
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France; Faculté de Médecine, Kremlin-Bicêtre, Université Paris Sud, France.
| | - Jean-Charles Soria
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France; Faculté de Médecine, Kremlin-Bicêtre, Université Paris Sud, France.
| | - Thierry De Baere
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France; Faculté de Médecine, Kremlin-Bicêtre, Université Paris Sud, France.
| | - Lambros Tselikas
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France; Faculté de Médecine, Kremlin-Bicêtre, Université Paris Sud, France; Laboratory of Translational Research in Immunology - LRTI, INSERM U1015, Gustave Roussy, France.
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10
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Schachtschneider KM, Gaba RC. Utilization of Genomics and Functional Genomics to Inform Clinical Decisions in IR. J Vasc Interv Radiol 2018; 29:1117-1121. [PMID: 30055782 DOI: 10.1016/j.jvir.2018.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/16/2018] [Accepted: 03/16/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Kyle M Schachtschneider
- Department of Radiology, University of Illinois Health, 1740 West Taylor Street MC 931, Chicago, IL 60612.
| | - Ron C Gaba
- Department of Radiology, University of Illinois Health, 1740 West Taylor Street MC 931, Chicago, IL 60612
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Mohammadi MR, Nojoomi A, Mozafari M, Dubnika A, Inayathullah M, Rajadas J. Nanomaterials engineering for drug delivery: a hybridization approach. J Mater Chem B 2017; 5:3995-4018. [PMID: 32264132 DOI: 10.1039/c6tb03247h] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The last twenty years have witnessed great advances in biology, medicine, and materials science, leading to the development of various nanoparticle (NP)-mediated drug delivery systems. Innovation in materials science has led the generation of biodegradable, biocompatible, stimuli-responsive, and targeted delivery systems. However, currently available nanotherapeutic technologies are not efficient, which has culminated in the failure of their clinical trials. Despite huge efforts devoted to drug delivery nanotherapeutics, only a small amount of the injected material could reach the desired target. One promising strategy to enhance the efficiency of NP drug delivery is to hybridize multiple materials, where each component could play a critical role in an efficient multipurpose delivery system. This review aims to comprehensively cover different techniques, materials, advantages, and drawbacks of various systems to develop hybrid nano-vesicles for drug delivery. Attention is finally given to the hybridization benefits in overcoming the biological barriers for drug delivery. It is believed that the advent of modern nano-formulations for multifunctional hybrid carriers paves the way for future advances to achieve more efficient drug delivery systems.
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Affiliation(s)
- M Rezaa Mohammadi
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, 1050 Arastradero Road, Palo Alto, CA 94304, USA
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12
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The Role of Interventional Oncology in the Management of Lung Cancer. Cardiovasc Intervent Radiol 2016; 40:153-165. [PMID: 27815575 DOI: 10.1007/s00270-016-1495-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 10/26/2016] [Indexed: 12/11/2022]
Abstract
Interventional radiological procedures for diagnosis and treatment of lung cancer have become increasingly important. Imaging-guided percutaneous biopsy has become the modality of choice for diagnosing lung cancer, and in the era of target therapies, it is an useful tool to define earlier patient-specific tumor phenotypes. In functionally inoperable patients, especially the ablative procedures are potentially curative alternatives to surgery. In addition to thermally ablative treatment, selective chemoembolization by a vascular access allows localized therapy. These treatments are considered for patients in a reduced general condition which does not allow systemic chemotherapy. The present article reviews the role of interventional oncology in the management of primary lung cancer, focusing on the state of the art for each procedure.
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Daldrup-Link HE, Sammet C, Hernanz-Schulman M, Barsness KA, Cahill AM, Chung E, Doria AS, Darge K, Krishnamurthy R, Lungren MP, Moore S, Olivieri L, Panigrahy A, Towbin AJ, Trout A, Voss S. White Paper on P4 Concepts for Pediatric Imaging. J Am Coll Radiol 2016; 13:590-597.e2. [PMID: 26850380 PMCID: PMC4860067 DOI: 10.1016/j.jacr.2015.10.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 10/20/2015] [Accepted: 10/21/2015] [Indexed: 12/21/2022]
Abstract
Over the past decade, innovations in the field of pediatric imaging have been based largely on single-center and retrospective studies, which provided limited advances for the benefit of pediatric patients. To identify opportunities for potential "quantum-leap" progress in the field of pediatric imaging, the ACR-Pediatric Imaging Research (PIR) Committee has identified high-impact research directions related to the P4 concept of predictive, preventive, personalized, and participatory diagnosis and intervention. Input from 237 members of the Society for Pediatric Radiology was clustered around 10 priority areas, which are discussed in this article. Needs within each priority area have been analyzed in detail by ACR-PIR experts on these topics. By facilitating work in these priority areas, we hope to revolutionize the care of children by shifting our efforts from unilateral reaction to clinical symptoms, to interactive maintenance of child health.
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Affiliation(s)
- Heike E Daldrup-Link
- Lucile Packard Children's Hospital, Stanford School of Medicine, Palo Alto, California.
| | - Christina Sammet
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | | | | | | | - Ellen Chung
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Kassa Darge
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Matthew P Lungren
- Lucile Packard Children's Hospital, Stanford School of Medicine, Palo Alto, California
| | - Sheila Moore
- Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | | | - Andrew Trout
- Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Stephan Voss
- Children's Hospital of Boston, Boston, Massachusetts
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Zhou Y, Sun J, Yang X. Molecular Imaging-Guided Interventional Hyperthermia in Treatment of Breast Cancer. BIOMED RESEARCH INTERNATIONAL 2015; 2015:505269. [PMID: 26491673 PMCID: PMC4605349 DOI: 10.1155/2015/505269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 08/11/2015] [Accepted: 09/02/2015] [Indexed: 12/29/2022]
Abstract
Breast cancer is the most frequent malignancy in women worldwide. Although it is commonly treated via chemotherapy, responses vary among its subtypes, some of which are relatively insensitive to chemotherapeutic drugs. Recent studies have shown that hyperthermia can enhance the effects of chemotherapy in patients with refractory breast cancer or without surgical indications. Recent advances in molecular imaging may not only improve early diagnosis but may also facilitate the development and response assessment of targeted therapies. Combining advanced techniques such as molecular imaging and hyperthermia-integrated chemotherapy should open new avenues for effective management of breast cancer.
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Affiliation(s)
- Yurong Zhou
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, Zhejiang 310016, China
| | - Jihong Sun
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, Zhejiang 310016, China
| | - Xiaoming Yang
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, Zhejiang 310016, China
- Image-Guided Bio-Molecular Interventions Research, Department of Radiology, University of Washington School of Medicine, 815 Mercer Street, Room S470, Seattle, WA 98109, USA
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15
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Image-guided interventional therapy for cancer with radiotherapeutic nanoparticles. Adv Drug Deliv Rev 2014; 76:39-59. [PMID: 25016083 DOI: 10.1016/j.addr.2014.07.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 06/09/2014] [Accepted: 07/01/2014] [Indexed: 12/18/2022]
Abstract
One of the major limitations of current cancer therapy is the inability to deliver tumoricidal agents throughout the entire tumor mass using traditional intravenous administration. Nanoparticles carrying beta-emitting therapeutic radionuclides that are delivered using advanced image-guidance have significant potential to improve solid tumor therapy. The use of image-guidance in combination with nanoparticle carriers can improve the delivery of localized radiation to tumors. Nanoparticles labeled with certain beta-emitting radionuclides are intrinsically theranostic agents that can provide information regarding distribution and regional dosimetry within the tumor and the body. Image-guided thermal therapy results in increased uptake of intravenous nanoparticles within tumors, improving therapy. In addition, nanoparticles are ideal carriers for direct intratumoral infusion of beta-emitting radionuclides by convection enhanced delivery, permitting the delivery of localized therapeutic radiation without the requirement of the radionuclide exiting from the nanoparticle. With this approach, very high doses of radiation can be delivered to solid tumors while sparing normal organs. Recent technological developments in image-guidance, convection enhanced delivery and newly developed nanoparticles carrying beta-emitting radionuclides will be reviewed. Examples will be shown describing how this new approach has promise for the treatment of brain, head and neck, and other types of solid tumors.
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The future of molecular imaging in paradigm shift from reactive to proactive (P4) medicine: predictive, preventive, personalized and participatory. Nucl Med Commun 2014; 35:1193-6. [PMID: 25211627 DOI: 10.1097/mnm.0000000000000205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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17
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Floridi C, Radaelli A, Abi-Jaoudeh N, Grass M, Lin M, Chiaradia M, Geschwind JF, Kobeiter H, Squillaci E, Maleux G, Giovagnoni A, Brunese L, Wood B, Carrafiello G, Rotondo A. C-arm cone-beam computed tomography in interventional oncology: technical aspects and clinical applications. Radiol Med 2014; 119:521-32. [PMID: 25012472 DOI: 10.1007/s11547-014-0429-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 06/16/2014] [Indexed: 12/12/2022]
Abstract
C-arm cone-beam computed tomography (CBCT) is a new imaging technology integrated in modern angiographic systems. Due to its ability to obtain cross-sectional imaging and the possibility to use dedicated planning and navigation software, it provides an informed platform for interventional oncology procedures. In this paper, we highlight the technical aspects and clinical applications of CBCT imaging and navigation in the most common loco-regional oncological treatments.
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Affiliation(s)
- Chiara Floridi
- Radiology Department, Insubria University, Viale Borri 57, 21100, Varese, Italy,
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Cornalba G, Melchiorre F. Interventional oncology: state of the art. Radiol Med 2014; 119:449-50. [PMID: 25001586 DOI: 10.1007/s11547-014-0428-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 06/11/2014] [Indexed: 01/27/2023]
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