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Taketomi T, Sanui T, Fukuda T, Takeshita G, Nojiri J. Preoperative endovascular arterial embolization to avoid maxillary artery injury in maxillary gingival cancer surgery. Radiol Case Rep 2024; 19:3561-3568. [PMID: 38933655 PMCID: PMC11200169 DOI: 10.1016/j.radcr.2024.05.052] [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: 05/09/2024] [Accepted: 05/19/2024] [Indexed: 06/28/2024] Open
Abstract
For maxillary gingival carcinomas, especially those in the molar region, surgical resection is often performed beyond the maxillary tuberosity. Bleeding from the posterior superior alveolar or maxillary artery into the pterygoid process is difficult to stop during partial maxillary resection. Advances in catheterization and materials have enabled the embolization of various vessels. In this report, we describe two cases of maxillary gingival cancer in which preoperative endovascular arterial embolization prevented bleeding due to unexpected vascular injury, allowing for a safe surgery with minimal blood loss. This technique effectively avoids emergency hemostasis for unexpected bleeding when resecting gingival cancers in the maxillary molar region.
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Affiliation(s)
- Takaharu Taketomi
- Department of Dental and Oral Surgery, St. Mary's Hospital, 422 Tsubukuhonmachi, Kurume, Fukuoka, 830-8543, Japan
- Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Terukazu Sanui
- Department of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takao Fukuda
- Department of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Go Takeshita
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga City, Saga 849-8501, Japan
| | - Junichi Nojiri
- Department of Radiology, Takagi Hospital, Sakemi 141-11, Okawa, Fukuoka, 831-0016, Japan
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Erinjeri JP, Doustaly R, Avignon G, Bendet A, Petre EN, Ziv E, Yarmohammadi H, Solomon SB. Utilization of integrated angiography-CT interventional radiology suites at a tertiary cancer center. BMC Med Imaging 2020; 20:114. [PMID: 33059619 PMCID: PMC7559017 DOI: 10.1186/s12880-020-00515-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/01/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Integrated Angiography-Computed Tomography (ACT) suites were initially designed in the 1990's to perform complex procedures requiring high-resolution cross-sectional imaging and fluoroscopy. Since then, there have been technology developments and changes in patient management. The purpose of this study was to review the current usage patterns of a single center's integrated ACT suites. METHODS All procedures performed in 2017 in 3 ACT suites (InterACT Discovery RT, GE Healthcare) at a tertiary cancer center were reviewed retrospectively. Usage was classified as: Standard, in which the patient underwent a single procedure using either fluoroscopy, CT, or ultrasound (US); Combined, in which the patient underwent a single procedure utilizing both fluoroscopy and CT; or Staged, in which the patient underwent 2 separate but successive procedures using fluoroscopy and CT individually. The most frequently performed Combined and Staged procedures were further reviewed to determine how the different modalities were used. The duration of the most common Staged procedures was compared to analogous procedures' durations in single modality rooms over the period Jan 2016 to Sep 2019. RESULTS A total of 3591 procedures were performed on 2678 patients in the 3 ACT Suites. 80% of patients underwent a Standard procedure using fluoroscopy (38%), CT (32%) or US (10%) and accounted for 70% of the room occupation time. Fourteen and three percent of the patients underwent Combined or Staged procedures, occupying 19 and 5% of the room time, respectively. The remaining procedures were classified as both Combined and Staged, representing 3% of the patients and 6% of the room occupation time. The most common Combined procedures were drainages, hepatic arterial embolizations or radioembolizations, arterial, and biliary interventions. The most common Staged procedures were multiple drainages and hepatic arterial embolizations followed by biopsies or ablations. The room occupation time for liver tumor embolization and ablation was significantly shorter (p < 0.01) when performed in a Staged fashion versus the analogous procedures in single modality room. CONCLUSION An integrated ACT system provides the capability to perform complex Combined or Staged procedures as well as scheduling flexibility by allowing any type of case to be performed in the IR suite.
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Affiliation(s)
- Joseph P Erinjeri
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1250 York Ave, Suite H112, New York, NY, 10021, USA.
| | | | | | | | - Elena N Petre
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1250 York Ave, Suite H112, New York, NY, 10021, USA
| | - Etay Ziv
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1250 York Ave, Suite H112, New York, NY, 10021, USA
| | - Hooman Yarmohammadi
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1250 York Ave, Suite H112, New York, NY, 10021, USA
| | - Stephen B Solomon
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1250 York Ave, Suite H112, New York, NY, 10021, USA
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Yuan H, Li X, Tian X, Ji K, Liu F. Comparison of Angio-CT and cone-beam CT-guided immediate radiofrequency ablation after transcatheter arterial chemoembolization for large hepatocellular carcinoma. Abdom Radiol (NY) 2020; 45:2585-2592. [PMID: 32107583 DOI: 10.1007/s00261-020-02462-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate the rapeutic effectiveness of Angio-CT or cone-beam CT (CBCT)-guided immediate radiofrequency ablation (RFA) after transcatheter arterial chemoembolization (TACE) for large hepatocellular carcinoma (HCC). METHODS 117 large HCC patients (mean maximum diameter: 9.3 cm; range 5.3-17.7 cm) were retrospective studied and divided into Angio-CT group (n = 66 cases), CBCT group (n = 21 cases), and single TACE group (n = 30 cases) according to treatment (Angio-CT/CBCT-guided immediate RFA after TACE, single TACE, respectively). The operative time, effective radiation dose, local-regional tumor responses, overall survival (OS), and progression‑free survival (PFS) time and complications were recorded. RESULTS The operative time and effective radiation dose of Angio-CT group and CBCT group were higher than those of TACE group (P < 0.01). The local-regional tumor responses on 1-month follow-up MRI (complete response + partial response) of Angio-CT group and CBCT group were 100%, which were significantly higher than that of single TACE group (76.7%, P < 0.05). There was no significant difference in local-regional tumor responses of 1-month follow-up between Angio-CT group and CBCT group (P = 0.831). The median PFS and OS time of Angio-CT group were 14.7 ± 1.43 months and 18.21 ± 0.88 months, CBCT group were 13.9 ± 1.53 months and 17.87 ± 1.78 months, TACE group were 10.4 ± 1.21 months and 12.87 ± 0.91 months, respectively. No procedure-related major complications occurred. CONCLUSIONS MIYABI Angio-CT or CBCT-guided immediate RFA after TACE for large HCC both have more effective than single TACE. The former is worth popularizing, due to its advantages of convenience, shorter operative time, and less radiation dose for doctors.
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Abstract
Recent advances in targeted therapy and immunotherapy have once again raised the hope that a cure might be within reach for many cancer types. Yet, most late-stage cancers are either insensitive to the therapies to begin with or develop resistance later. Therapy with live tumour-targeting bacteria provides a unique option to meet these challenges. Compared with most other therapeutics, the effectiveness of tumour-targeting bacteria is not directly affected by the 'genetic makeup' of a tumour. Bacteria initiate their direct antitumour effects from deep within the tumour, followed by innate and adaptive antitumour immune responses. As microscopic 'robotic factories', bacterial vectors can be reprogrammed following simple genetic rules or sophisticated synthetic bioengineering principles to produce and deliver anticancer agents on the basis of clinical needs. Therapeutic approaches using live tumour-targeting bacteria can either be applied as a monotherapy or complement other anticancer therapies to achieve better clinical outcomes. In this Review, we summarize the potential benefits and challenges of this approach. We discuss how live bacteria selectively induce tumour regression and provide examples to illustrate different ways to engineer bacteria for improved safety and efficacy. Finally, we share our experience and insights on oncology clinical trials with tumour-targeting bacteria, including a discussion of the regulatory issues.
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Affiliation(s)
- Shibin Zhou
- Ludwig Center for Cancer Genetics and Therapeutics, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Claudia Gravekamp
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David Bermudes
- Department of Biology, California State University, Northridge, CA, USA
| | - Ke Liu
- Oncology Branch, Division of Clinical Evaluation, Pharmacology and Toxicology; Office of Tissues and Advanced Therapies, CBER, FDA, Silver Spring, MD, USA
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Quantification of Cisplatin Using a Modified 3-Material Decomposition Algorithm at Third-Generation Dual-Source Dual-Energy Computed Tomography. Invest Radiol 2018; 53:673-680. [DOI: 10.1097/rli.0000000000000491] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Forbes NS, Coffin RS, Deng L, Evgin L, Fiering S, Giacalone M, Gravekamp C, Gulley JL, Gunn H, Hoffman RM, Kaur B, Liu K, Lyerly HK, Marciscano AE, Moradian E, Ruppel S, Saltzman DA, Tattersall PJ, Thorne S, Vile RG, Zhang HH, Zhou S, McFadden G. White paper on microbial anti-cancer therapy and prevention. J Immunother Cancer 2018; 6:78. [PMID: 30081947 PMCID: PMC6091193 DOI: 10.1186/s40425-018-0381-3] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/27/2018] [Indexed: 12/13/2022] Open
Abstract
In this White Paper, we discuss the current state of microbial cancer therapy. This paper resulted from a meeting ('Microbial Based Cancer Therapy') at the US National Cancer Institute in the summer of 2017. Here, we define 'Microbial Therapy' to include both oncolytic viral therapy and bacterial anticancer therapy. Both of these fields exploit tumor-specific infectious microbes to treat cancer, have similar mechanisms of action, and are facing similar challenges to commercialization. We designed this paper to nucleate this growing field of microbial therapeutics and increase interactions between researchers in it and related fields. The authors of this paper include many primary researchers in this field. In this paper, we discuss the potential, status and opportunities for microbial therapy as well as strategies attempted to date and important questions that need to be addressed. The main areas that we think will have the greatest impact are immune stimulation, control of efficacy, control of delivery, and safety. There is much excitement about the potential of this field to treat currently intractable cancer. Much of the potential exists because these therapies utilize unique mechanisms of action, difficult to achieve with other biological or small molecule drugs. By better understanding and controlling these mechanisms, we will create new therapies that will become integral components of cancer care.
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Affiliation(s)
- Neil S Forbes
- grid.266683.f0000 0001 2184 9220Department of Chemical EngineeringUniversity of Massachusetts 159 Goessmann Hall 01003 Amherst MA USA
| | | | - Liang Deng
- 0000 0001 2171 9952grid.51462.34Department of Medicine, Memorial Sloan Kettering Cancer Center 10065 New York NY USA
| | - Laura Evgin
- 0000 0004 0459 167Xgrid.66875.3aMayo Clinic Rochester USA
| | - Steve Fiering
- 0000 0001 2179 2404grid.254880.3Geisel School of Medicine at Dartmouth Hanover USA
| | | | - Claudia Gravekamp
- 0000000121791997grid.251993.5Albert Einstein College of Medicine Bronx USA
| | - James L Gulley
- 0000 0004 1936 8075grid.48336.3aNational Cancer Institute, National Institutes of Health Bethesda USA
| | | | - Robert M Hoffman
- 0000 0001 2107 4242grid.266100.3UC, San Diego San Diego USA
- 0000 0004 0461 1271grid.417448.aAntiCancer Inc. San Diego USA
| | - Balveen Kaur
- 0000000121548364grid.55460.32University of Texas Austin USA
| | - Ke Liu
- 0000 0001 2243 3366grid.417587.8Center for Biologics Evaluation and ResearchUS Food and Drug Administration Silver Spring USA
| | | | - Ariel E Marciscano
- 0000 0004 1936 8075grid.48336.3aNational Cancer Institute, National Institutes of Health Bethesda USA
| | | | - Sheryl Ruppel
- 0000 0004 4665 8158grid.419407.fLeidos Biomedical Research, Inc. Frederick USA
| | - Daniel A Saltzman
- 0000000419368657grid.17635.36University of Minnesota Minneapolis USA
| | | | - Steve Thorne
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh Pittsburgh USA
| | - Richard G Vile
- 0000 0004 0459 167Xgrid.66875.3aMayo Clinic Rochester USA
| | | | - Shibin Zhou
- 0000 0001 2171 9311grid.21107.35Johns Hopkins University Baltimore USA
| | - Grant McFadden
- 0000 0001 2151 2636grid.215654.1Center for Immunotherapy, Vaccines and Virotherapy , Biodesign InstituteArizona State University 727 E Tyler Street, Room A330E 85281 Tempe AZ USA
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Facial nerve paralysis after super-selective intra-arterial chemotherapy for oral cancer. Int J Oral Maxillofac Surg 2017; 46:682-686. [DOI: 10.1016/j.ijom.2017.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 01/16/2017] [Indexed: 11/18/2022]
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Sakai M, Illies T, Jerusel N, Tateishi S, Uchikoshi M, Fiehler J, Watanabe Y, Nakanishi K, Tomiyama N. Feasibility of non-contrast-enhanced four dimensional (4D) MRA in head and neck tumors, comparison with contrast-enhanced 4D MRA. SPRINGERPLUS 2016; 5:1282. [PMID: 27547657 PMCID: PMC4977233 DOI: 10.1186/s40064-016-2953-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 07/29/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Information of tumor vascular architecture and hemodynamics is important in treating patients with head and neck tumors (HNTs). The purpose of this study is to investigate the feasibility of non-contrast-enhanced four-dimensional magnetic resonance angiography (non-CE 4DMRA) using arterial spin labeling for anatomical and hemodynamic evaluation of vascularity of head and neck tumors. RESULTS Non-CE 4DMRA images of 15 patients with HNTs were compared with those of contrast-enhanced 4DMRA (CE 4DMRA) by two independent observers. For qualitative evaluation, overall image quality, visualization of arterial branches and main arterial tumor feeders were assessed. For hemodynamic evaluation, signal-intensity-over-time curves within the tumors were compared. The sensitivity of non-CE 4DMRA for the identification of arterial branches and the main arterial tumor feeders was 75 and 20 %, respectively (interobserver agreement, κ = 0.56 and 0.54, respectively), while that of CE 4DMRA was 99 and 95 %, respectively (interobserver agreement, κ = 0.62 and 0.70, respectively). All three arterial/hypervascularized tumors determined on CE 4DMRA showed distinct signal-intensity-over-time curve pattern on non-CE 4DMRA, with distinct peak and wash out phases. Other tumors showed no wash out on non-CE 4DMRA. CONCLUSIONS Use of non-CE 4DMRA for the anatomical and hemodynamic evaluation of vascularity of head and neck tumors is feasible, although the technique needs to be improved.
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Affiliation(s)
- Mio Sakai
- Department of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511 Japan
| | - Till Illies
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nadine Jerusel
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Souichirou Tateishi
- Department of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511 Japan ; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Yoshiyuki Watanabe
- Department of Diagnostis and Interventional Radiology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Katsuyuki Nakanishi
- Department of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511 Japan
| | - Noriyuki Tomiyama
- Department of Diagnostis and Interventional Radiology, Graduate School of Medicine, Osaka University, Osaka, Japan
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Tanaka T, Arai Y, Inaba Y, Inoue M, Nishiofuku H, Anai H, Hori S, Sakaguchi H, Kichikawa K. Current role of hybrid CT/angiography system compared with C-arm cone beam CT for interventional oncology. Br J Radiol 2014; 87:20140126. [PMID: 24968749 DOI: 10.1259/bjr.20140126] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Hybrid CT/angiography (angiography) system and C-arm cone beam CT provide cross-sectional imaging as an adjunct to angiography. Current interventional oncological procedures can be conducted precisely using these two technologies. In this article, several cases using a hybrid CT/angiography system are shown first, and then the advantages and disadvantages of the hybrid CT/angiography and C-arm cone beam CT are discussed with literature reviews.
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Affiliation(s)
- T Tanaka
- 1 Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
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Araki T, Okada H, Araki T. Enhancement of ascites during abdominal oncological endovascular intervention without iatrogenic extravasation in patients with chronic liver disease. Clin Radiol 2013; 68:e460-6. [PMID: 23623579 DOI: 10.1016/j.crad.2013.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Revised: 03/06/2013] [Accepted: 03/14/2013] [Indexed: 11/17/2022]
Abstract
AIM To evaluate ascites enhancement during abdominal oncological endovascular intervention (IVR) without iatrogenic extravasation and the factors associated with enhancement of ascites. METHODS AND MATERIALS CT images were obtained using an IVR-CT system for 73 patients with chronic liver disease and ascites. The CT images were obtained at least twice during each IVR. Radiodensity values of ascites at CT were measured for the first and last CT images in each procedure. The factors evaluated for their association with elevated ascitic fluid density were age, interval from the first to the last CT scan, Child-Pugh score, albumin level, total bilirubin level, prothrombin activity, the need for transcatheter arterial chemoembolization (TACE), estimated glomerular filtration rate, total amount of contrast material (CM) per square metre of body surface area (/m(2)), amount of ascitic fluid, and the amount of CM entering the superior mesenteric artery (SMA) or coeliac artery/m(2). RESULTS The average ascitic radiodensity values for the first and last CT images were 18 and 51 HU, respectively. The percentage of patients with "significantly elevated" ascitic fluid density (≥10 HU) was 92%. Multivariate analysis showed that the total amount of CM/m(2) and the amount of ascitic fluid were significantly correlated and inversely correlated, respectively, with elevated ascitic fluid density. CONCLUSIONS Ascites enhancement without extravasation frequently occurs during abdominal oncological endovascular intervention in patients with chronic liver disease.
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Affiliation(s)
- Takuji Araki
- Department of Radiology, University of Yamanashi, University Hospital, Yamanashi, Japan.
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