A new promising oncogenic target (p.C382R) for treatment with pemigatinib in patients with cholangiocarcinoma

Point mutations of the fibroblast growth factor receptor (FGFR)2 receptor in intrahepatic cholangiocarcinoma (iCC) are mainly of unknown functional significance compared to FGFR2 fusions. Pemigatinib, a tyrosine kinase inhibitor, is approved for the treatment of cholangiocarcinoma with FGFR2 fusion/rearrangement. Although it is hypothesized that FGFR2 mutations may cause uncontrolled activation of the signaling pathway, the data for targeted therapies for FGFR2 mutations remain unclear. In vitro analyses demonstrated the importance of the p.C382R mutation for ligand-independent constitutive activation of FGFR2 with transforming potential. The following report describes the clinical case of a patient diagnosed with an iCC carrying a FGFR2 p.C382R point mutation which was detected in liquid, as well as in tissue-based biopsies. The patient was treated with pemigatinib, resulting in a sustained complete functional remission in fluorodeoxyglucose-positron emission tomography/computed tomography over 10 months to date. The reported case is the first description of a complete functional remission under the treatment with pemigatinib in a patient with p.C383R mutation.

Graph matching survey for medical imaging: On the way to deep learning

The interest on graph matching has not stopped growing since the late seventies. The basic idea of graph matching consists of generating graph representations of different data or structures and compare those representations by searching correspondences between them. There are manifold techniques that have been developed to find those correspondences and the choice of one or another depends on the characteristics of the application of interest. These applications range from pattern recognition (e.g. biometric identification) to signal processing or artificial intelligence. One of the aspects that make graph matching so attractive is its ability to facilitate data analysis, and medical imaging is one of the fields that can benefit from this in a greater extent. The potential of graph matching to find similarities and differences between data acquired at different points in time shows its potential to improve diagnosis, follow-up of human diseases or any other of the clinical scenarios that require comparison between different datasets. In spite of the large amount of papers that were published in this field to the date there is no survey paper of graph matching for clinical applications. This survey aims to fill this gap.

Accurate Physics-Based Registration for the Outcome Validation of Minimal Invasive Interventions and Open Liver Surgeries

OBJECTIVE

The purpose of this paper is to present an outcome validation tool for tumor radiofrequency (RF) ablation and resection.

METHODS

Intervention assessment tools require an accurate registration of both pre- and postoperative computed tomographies able to handle big deformations. Therefore, a physics-based method is proposed with that purpose. To increase the accuracy both automatically detected internal and surface physical landmarks are incorporated in the registration process.

RESULTS

The algorithm has been evaluated in 25 clinical datasets containing RF ablations, resections, and patients with recurrent tumors. The achieved accuracy is 1.2 mm measured as mean internal distance between vessel landmarks and a positive predictive value of 0.95. The quantitative and qualitative results of the outcome validation tool show that in 50% of the cases tumors were only partially covered by the treatment.

CONCLUSION

The use of internal and surface landmarks combined with a physics-based registration method increases the accuracy of the results compared to the accuracy of state of the art methods. An accurate outcome validation tool is important in order to certify that the tumor and its safety margin were fully covered by the treatment.

SIGNIFICANCE

An accurate outcome validation tool can result in a decrease of the tumor recurrence rate.

Interventional planning of liver resections: an overview

Liver cancer is the third most common type of cancer. Among available treatment options, a surgical resection offers the best prognosis for long-term survival. It is important that such a surgical procedure is carefully prepared. Modern computer technology offers convenient ways to simulate different resection scenarios and help to determine the best treatment for a given case. This paper provides a non-exhaustive overview of existing computer-based systems for interventional planning of liver resections. They are reviewed according to their medical use case, e.g. if they support typical or atypical resections.