Sample records for hepatic tumour ablation

  1. Computer-aided hepatic tumour ablation

    CERN Document Server

    Voirin, D; Amavizca, M; Leroy, A; Letoublon, C; Troccaz, J; Voirin, David; Payan, Yohan; Amavizca, Miriam; Leroy, Antoine; Letoublon, Christian; Troccaz, Jocelyne


    Surgical resection of hepatic tumours is not always possible. Alternative techniques consist in locally using chemical or physical agents to destroy the tumour and this may be performed percutaneously. It requires a precise localisation of the tumour placement during ablation. Computer-assisted surgery tools may be used in conjunction to these new ablation techniques to improve the therapeutic efficiency whilst benefiting from minimal invasiveness. This communication introduces the principles of a system for computer-assisted hepatic tumour ablation.

  2. Computer-aided hepatic tumour ablation requirements and preliminary results

    CERN Document Server

    Voirin, D; Amavizca, M; Letoublon, C; Troccaz, J; Voirin, David; Payan, Yohan; Amavizca, Miriam; Letoublon, Christian; Troccaz, Jocelyne


    Surgical resection of hepatic tumours is not always possible, since it depends on different factors, among which their location inside the liver functional segments. Alternative techniques consist in local use of chemical or physical agents to destroy the tumour. Radio frequency and cryosurgical ablations are examples of such alternative techniques that may be performed percutaneously. This requires a precise localisation of the tumour placement during ablation. Computer-assisted surgery tools may be used in conjunction with these new ablation techniques to improve the therapeutic efficiency, whilst they benefit from minimal invasiveness. This paper introduces the principles of a system for computer-assisted hepatic tumour ablation and describes preliminary experiments focusing on data registration evaluation. To keep close to conventional protocols, we consider registration of pre-operative CT or MRI data to intra-operative echographic data.

  3. MR-guided microwave ablation in hepatic tumours: initial results in clinical routine

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    Hoffmann, Ruediger; Rempp, Hansjoerg; Kessler, David-Emanuel; Weiss, Jakob; Nikolaou, Konstantin; Clasen, Stephan [Eberhard-Karls-University, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Pereira, Philippe L. [SLK-Kliniken Heilbronn GmbH, Department of Radiology, Minimally Invasive Therapies and Nuclear Medicine, Heilbronn (Germany)


    Evaluation of the technical success, patient safety and technical effectiveness of magnetic resonance (MR)-guided microwave ablation of hepatic malignancies. Institutional review board approval and informed patient consent were obtained. Fifteen patients (59.8 years ± 9.5) with 18 hepatic malignancies (7 hepatocellular carcinomas, 11 metastases) underwent MR-guided microwave ablation using a 1.5-T MR system. Mean tumour size was 15.4 mm ± 7.7 (7-37 mm). Technical success and ablation zone diameters were assessed by post-ablative MR imaging. Technique effectiveness was assessed after 1 month. Complications were classified according to the Common Terminology Criteria for Adverse Events (CTCAE). Mean follow-up was 5.8 months ± 2.6 (1-10 months). Technical success and technique effectiveness were achieved in all lesions. Lesions were treated using 2.5 ± 1.2 applicator positions. Mean energy and ablation duration per tumour were 37.6 kJ ± 21.7 (9-87 kJ) and 24.7 min ± 11.1 (7-49 min), respectively. Coagulation zone short- and long-axis diameters were 31.5 mm ± 10.5 (16-65 mm) and 52.7 mm ± 15.4 (27-94 mm), respectively. Two CTCAE-2-complications occurred (pneumothorax, pleural effusion). Seven patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed. Microwave ablation is feasible under near real-time MR guidance and provides effective treatment of hepatic malignancies in one session. (orig.)

  4. Should fat in the radiofrequency ablation zone of hepatocellular adenomas raise suspicion for residual tumour?

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    Costa, Andreu F. [University Health Network and Mount Sinai Hospital, University of Toronto, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Dalhousie University, Department of Diagnostic Radiology, QE II Health Sciences Centre - VG Site, Halifax, Nova Scotia (Canada); Kajal, Dilkash; Pereira, Andre; Atri, Mostafa [University Health Network and Mount Sinai Hospital, University of Toronto, Joint Department of Medical Imaging, Toronto, Ontario (Canada)


    To assess the significance of fat in the radiofrequency ablation (RFA) zone of hepatocellular adenomas (HCA), and its association with tumoral fat and hepatic steatosis. The radiological archive was searched for patients with ablated HCAs and follow-up magnetic resonance imaging between January 2008 and June 2014. Age, sex, risk factors and duration of clinical and imaging follow-up were recorded. Pre-RFA imaging was assessed for tumour size, intra-tumoral fat and steatosis. Post-RFA imaging was reviewed for size, enhancement and intra-ablational fat. Intra-ablational fat was classified as peripheral, central or mixed; the association of these distributions with steatosis and tumoral fat was assessed using Fisher's exact test. Sixteen patients with 26 ablated HCAs were included. Fat was present in 23/26 (88 %) ablation zones. Only 1/26 (4 %) showed serial enlargement and enhancement suggestive of residual disease; the enhancing area did not contain fat. All remaining ablations showed involution and/or diminishing fat content without suspicious enhancement (mean follow-up, 27 months; range, 2-84 months). The peripheral and mixed/central patterns of intra-ablational fat were associated with steatosis (P = 0.0005) and tumoral fat (P = 0.0003), respectively. Fat in the ablation zone of HCAs is a common finding which, in isolation, does not indicate residual tumour. (orig.)

  5. Unusual tumour ablations: report of difficult and interesting cases (United States)

    Mauri, Giovanni; Nicosia, Luca; Varano, Gianluca Maria; Shyn, Paul; Sartori, Sergio; Tombesi, Paola; Di Vece, Francesca; Orsi, Franco; Solbiati, Luigi


    Image-guided ablations are nowadays applied in the treatment of a wide group of diseases and in different organs and regions, and every day interventional radiologists have to face more difficult and unusual cases of tumour ablation. In the present case review, we report four difficult and unusual cases, reporting some tips and tricks for a successful image-guided treatment. PMID:28487751

  6. Hepatic mitochondrial function and brain tumours. (United States)

    Pouliquen, Daniel L


    Therapeutic advances remain modest for patients with malignant brain tumours, due in part to inadequate ability of in-vitro models to mimic the consequences of tumour progression in vivo, which include profound immunosuppression, cytokine dysregulation and microvascular proliferation. This review summarizes recent findings on the wasting consequences of glioma growth, including changes in hepatic metabolism caused by the tumour. Release of proinflammatory cytokines by gliomas leads to anorexia, a sensation of tiredness and fatigue associated with sleep deprivation. The cachexia and associated decrease in relative liver mass that are observed in rats with the most aggressive gliomas may be accounted for by increased activity of the Cori cycle, with the intermediary metabolism of the glioma-influenced liver being directed toward energy utilization rather than energy storage. In these conditions, liver mitochondria exhibit abnormal biogenesis, together with modifications to water dynamics and ion content. Improved patient care will result from better understanding of the interactions between brain tumour cells and the immune system, and use of nutritional metabolic therapy to protect tumour-influenced hepatocytes and their mitochondria may improve outcomes.

  7. Image-guided multipolar radiofrequency ablation of liver tumours: initial clinical results

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    Terraz, Sylvain; Constantin, Christophe; Becker, Christoph D. [Geneva University Hospital, Department of Radiology, Geneva 14 (Switzerland); Majno, Pietro Edoardo; Mentha, Gilles [Geneva University Hospital, Department of Surgery, Geneva 14 (Switzerland); Spahr, Laurent [Geneva University Hospital, Department of Gastroenterology, Geneva 14 (Switzerland)


    The local effectiveness and clinical usefulness of multipolar radiofrequency (RF) ablation of liver tumours was evaluated. Sixty-eight image-guided RF sessions were performed using a multipolar device with bipolar electrodes in 53 patients. There were 45 hepatocellular carcinomas (HCC) and 42 metastases with a diameter {<=}3 cm (n = 55), 3.1-5 cm (n = 29) and >5 cm (n = 3); 26 nodules were within 5 mm from large vessels. Local effectiveness and complications were evaluated after RF procedures. Mean follow-up was 17 {+-} 10 months. Recurrence and survival rates were analysed by the Kaplan-Meier method. The primary and secondary technical effectiveness rate was 82% and 95%, respectively. The major and minor complication rate was 2.9%, respectively. The local tumour progression at 1- and 2-years was 5% and 9% for HCC nodules and 17% and 31% for metastases, respectively; four of 26 nodules (15%) close to vessels showed local progression. The survival at 1 year and 2 years was 97% and 90% for HCC and 84% and 68% for metastases, respectively. Multipolar RF technique creates ablation zones of adequate size and tailored shape and is effective to treat most liver tumours, including those close to major hepatic vessels. (orig.)

  8. Endoscopic removal or ablation of oesophageal and gastric superficial tumours. (United States)

    Deprez, P H; Aouattah, T; Piessevaux, H


    Endoscopic mucosal resection was developed in Eastern countries as a curative treatment for superficial carcinomas in the stomach and oesophagus. Experience in Western countries is more recent and limited due to less frequent diagnosis of early gastric cancers compared to the Japanese and Korean populations and to more frequent use of ablation techniques such as argon plasma coagulation and photodynamic therapy in pre-neoplastic lesions and superficial tumours. This review summarizes the respective indications, advantages, disadvantages, limitations and complications of the different ablative and resection techniques in the upper gastrointestinal tract. Several methods are described such as electrocoagulation, argon plasma coagulation, photodynamic therapy, lift and cut resection, cap assisted aspiration and band ligation mucosectomy, and endoscopic submucosal dissection. Local results in more than 170 patients managed with endoscopic resection of oesophageal high grade dysplasia or squamous cell carcinoma and gastric or Barrett's epithelium high grade dysplasia or adenocarcinoma furthermore demonstrate the safety and effectiveness of endoscopic resection practiced in experienced centres.

  9. Robotic-assisted thermal ablation of liver tumours

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    Abdullah, Basri Johan Jeet; Yeong, Chai Hong [University of Malaya, Department of Biomedical Imaging and University of Malaya Research Imaging Centre, Faculty of Medicine, Kuala Lumpur (Malaysia); University of Malaya, Department of Internal Medicine, Faculty of Medicine, Kuala Lumpur (Malaysia); Goh, Khean Lee [University of Malaya, Department of Internal Medicine, Faculty of Medicine, Kuala Lumpur (Malaysia); Yoong, Boon Koon [University of Malaya, Department of Surgery, Faculty of Medicine, Kuala Lumpur (Malaysia); Ho, Gwo Fuang [University of Malaya, Department of Oncology, Faculty of Medicine, Kuala Lumpur (Malaysia); Yim, Carolyn Chue Wai [University of Malaya, Department of Anesthesia, Faculty of Medicine, Kuala Lumpur (Malaysia); Kulkarni, Anjali [Perfint Healthcare Corporation, Florence, OR (United States)


    This study aimed to assess the technical success, radiation dose, safety and performance level of liver thermal ablation using a computed tomography (CT)-guided robotic positioning system. Radiofrequency and microwave ablation of liver tumours were performed on 20 patients (40 lesions) with the assistance of a CT-guided robotic positioning system. The accuracy of probe placement, number of readjustments and total radiation dose to each patient were recorded. The performance level was evaluated on a five-point scale (5-1: excellent-poor). The radiation doses were compared against 30 patients with 48 lesions (control) treated without robotic assistance. Thermal ablation was successfully completed in 20 patients with 40 lesions and confirmed on multiphasic contrast-enhanced CT. No procedure related complications were noted in this study. The average number of needle readjustment was 0.8 ± 0.8. The total CT dose (DLP) for the entire robotic assisted thermal ablation was 1382 ± 536, while the CT fluoroscopic dose (DLP) per lesion was 352 ± 228 There was no statistically significant (p > 0.05) dose reduction found between the robotic-assisted versus the conventional method. This study revealed that robotic-assisted planning and needle placement appears to be safe, with high accuracy and a comparable radiation dose to patients. (orig.)

  10. Investigation on nanoparticle distribution for thermal ablation of a tumour subjected to nanoparticle assisted thermal therapy. (United States)

    Soni, Sanjeev; Tyagi, Himanshu; Taylor, Robert A; Kumar, Amod


    This study investigates the effect of the distribution of nanoparticles delivered to a skin tumour for the thermal ablation conditions attained during thermal therapy. Ultimate aim is to define a distribution of nanoparticles as well as a combination of other therapeutic parameters to attain thermal ablation temperatures (50-60 °C) within whole of the tumour region. Three different cases of nanoparticle distributions are analysed under controlled conditions for all other parameters viz. irradiation intensity and duration, and volume fraction of nanoparticles. Results show that distribution of nanoparticles into only the periphery of tumour resulted in desired thermal ablation temperature in whole of tumour. For the tumour size considered in this study, an irradiation intensity of 1.25 W/cm(2) for duration of 300 s and a nanoparticle volume fraction of 0.001% was optimal to attain a temperature of ≥53 °C within the whole tumour region. It is concluded that distribution of nanoparticles in peripheral region of tumour, along with a controlled combination of other parameters, seems favourable and provides a promising pathway for thermal ablation of a tumour subjected to nanoparticle assisted thermal therapy.

  11. Radiofrequency ablation of renal tumours: diagnostic accuracy of contrast-enhanced ultrasound for early detection of residual tumour

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    Hoeffel, Christine [Service de Radiologie, CHU de Reims, Hopital Robert Debre, Pole d' imagerie, Reims Cedex (France); Pousset, Maud; Elie, Caroline [Universite Paris-Descartes, AP-HP, Departement de Biostatistiques, Hopital Necker, Paris Cedex 15 (France); Timsit, Marc-Olivier; Mejean, Arnaud [Universite Paris-Descartes, AP-HP, Service d' urologie, Hopital Necker, Paris Cedex 15 (France); Merran, Samuel [Federation mutualiste parisienne, Service d' imagerie medicale, Paris (France); Tranquart, Francois [Bracco Research, Plan les Ouates (Switzerland); Khairoune, Ahmed; Helenon, Olivier; Correas, Jean-Michel [Universite Paris-Descartes, AP-HP, Service de Radiologie Adultes, Hopital Necker, Paris Cedex 15 (France); Joly, Dominique [Universite Paris-Descartes, AP-HP, Service de Nephrologie, Hopital Necker, Paris Cedex 15 (France); Richard, Stephane [Service d' urologie, Hopital de Bicetre, Centre Pilote Tumeurs rares INCa, AP-HP, Le Kremlin-Bicetre (France); Hopital Necker, Service de Nephrologie, Paris Cedex 15 (France); Le Kremlin-Bicetre et Institut de Cancerologie Gustave Roussy, Genetique oncologique, CNRS FRE 2939, Faculte de medecine Paris-Sud, Villejuif (France)


    To evaluate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in the early detection of residual tumour after radiofrequency ablation (RFA) of renal tumours. Patients referred to our institution for RFA of renal tumours prospectively underwent CEUS and computed tomography (CT) or magnetic resonance imaging (MRI) before, within 1 day and 6 weeks after treatment. Identification of residual tumour was assessed by three blinded radiologists. Reference standard was CT/MRI performed at least 1 year after RFA. A total of 66 renal tumours in 43 patients (median age 62 years; range 44-71.5) were studied. Inter-reader agreement ({kappa} value) was 0.84 for CEUS. Prevalence of residual disease was 19%. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), respectively, were as follows: 64% [confidence interval (CI) 39-84], 98% [CI 91-100], 82% [CI 52-95] and 92% [CI 83-97] on 24-h CEUS; 79% [CI 52-92], 100% [CI 94-100], 100% [CI 74-100] and 95% [CI 87-100] on 6-week CEUS; 79% [CI 52-92], 95% [CI 86-98], 79% [CI 52-92] and 95% [CI 86-98] on 24-h CT/MRI; and 100% [CI 72-100], 98% [CI 90-100], 91% [CI 62-98] and 100% [CI 93-100] on 6-week CT/MRI. CEUS has high specificity for the early diagnosis of residual tumour after renal RFA. (orig.)

  12. Radiofrequency Ablation of Hepatic Paragonimiasis:a Case Report

    Institute of Scientific and Technical Information of China (English)

    Wei-gang Cao; Bao-an Qiu


    HEPATIC paragonimiasis is a rare disease with non-specific manifestation,which is often misdiagnosed in clinical practice.Long-time drug therapy treating this disease would be accompanied by the possible development of side effects.Given the fact that this disease has seldom been reported in the literature,we provide in this article a detailed report of one case with hepatic paragonimiases treated by radiofrequency ablation,which brought favorable outcome,aiming to shed some light on the understanding of this rare condition.

  13. Ultrasonography guided percutaneous radiofrequency ablation for hepatic cavernous hemangioma

    Institute of Scientific and Technical Information of China (English)

    Yan Cui; Hong-Wen Zhang; Li-Yan Zhou; Man-Ku Dong; Ping Wang; Min Ji; Xiao-Ou Li; Chang-Wei Chen; Zi-Pei Liu; Yong-Jie Xu


    AIM: Hepatic cavernous hemangioma (HCH) is the mostcommon benign tumor of the liver and its management isstill controversial. Recent successin situ radiofrequencyablation of hepatic malignancies has led us to consider usingthis technique in patients with HCH. This study was to assessthe efficacy, safety, and complications of percutaneousradiofrequency ablation (PRFA) under ultrasonographyguidance in patients with HCH.METHODS: Twelve patients (four men and eight women,age ranged 33-56 years, mean age was 41.7 years) with 15hepatic cavernous hemangiomas (2.5 cm to 9.5 cm) weretreated using the RF-2000 generator and 10-needle LeVeenelectrode percutaneously guided by B-ultrasound. Lesionslarger than 3 cm were treated by multiple overlappingablations that encompass the entire lesion as well as a rimof normal liver tissue (approximately 0.5 cm).RESULTS: All the patients who received PRFA therapy hadno severe pain, bleeding or bile leakage during and afterthe procedures. Nine to 34 months′ follow-up (mean, 21months) by ultrasound and/or spiral CT scan demonstratedthat the ablated lesions in this group were shrunk remarkably,and the shrunken range was 38-79 % (mean, 67 % per 21months). The contrast enhancement was disappeared withinthe tumor or at its periphery in all cases on spiral CT scansobtained 3 to 6 months after treatment.CONCLUSION: The results of this study suggest that PRFAtherapy is a mini-invasive, simple, safe, and effective methodfor the treatment of selected patients with HCH.

  14. Efficient loading of dendritic cells following cryo and radiofrequency ablation in combination with immune modulation induces anti-tumour immunity (United States)

    den Brok, M H M G M; Sutmuller, R P M; Nierkens, S; Bennink, E J; Frielink, C; Toonen, L W J; Boerman, O C; Figdor, C G; Ruers, T J M; Adema, G J


    Dendritic cells (DC) are professional antigen-presenting cells that play a pivotal role in the induction of immunity. Ex vivo-generated, tumour antigen-loaded mature DC are currently exploited as cancer vaccines in clinical studies. However, antigen loading and maturation of DC directly in vivo would greatly facilitate the application of DC-based vaccines. We formerly showed in murine models that radiofrequency-mediated tumour destruction can provide an antigen source for the in vivo induction of anti-tumour immunity, and we explored the role of DC herein. In this paper we evaluate radiofrequency and cryo ablation for their ability to provide an antigen source for DC and compare this with an ex vivo-loaded DC vaccine. The data obtained with model antigens demonstrate that upon tumour destruction by radiofrequency ablation, up to 7% of the total draining lymph node (LN) DC contained antigen, whereas only few DC from the conventional vaccine reached the LN. Interestingly, following cryo ablation the amount of antigen-loaded DC is almost doubled. Analysis of surface markers revealed that both destruction methods were able to induce DC maturation. Finally, we show that in situ tumour ablation can be efficiently combined with immune modulation by anti-CTLA-4 antibodies or regulatory T-cell depletion. These combination treatments protected mice from the outgrowth of tumour challenges, and led to in vivo enhancement of tumour-specific T-cell numbers, which produced more IFN-γ upon activation. Therefore, in situ tumour destruction in combination with immune modulation creates a unique, ‘in situ DC-vaccine' that is readily applicable in the clinic without prior knowledge of tumour antigens. PMID:16953240

  15. PEGylated polydopamine-coated magnetic nanoparticles for combined targeted chemotherapy and photothermal ablation of tumour cells. (United States)

    Xue, Peng; Sun, Lihong; Li, Qian; Zhang, Lei; Guo, Jinhong; Xu, Zhigang; Kang, Yuejun


    The integration of multifunctional therapeutic capabilities into a single nanosystem has attracted much attention for use as an efficient cancer therapy. However, developing biocompatible therapeutic nano-agents with desirable safety, efficiency, targeting, and synergistic effects remains challenging. Herein, we designed a class of multifunctional PEGylated magnetic nanoparticles (NPs) with a core-shell structure and polydopamine (PDA) coating, which were loaded with the anticancer drug doxorubicin (DOX) for simultaneous targeted chemotherapy and photothermal ablation of tumour cells. This nanosystem showed strong near-infrared absorption due to the polydopamine layer and was capable of magnetic field-guided drug delivery due to the superparamagnetism of the carrier. The resultant product exhibited excellent stability and biocompatibility in vitro due to the PEGylation of dopamine. Notably, the combination of chemotherapy and photothermal therapy had an evident synergistic effect on the ablation of tumour cells. This multifunctional nanoplatform has promising potential as an efficient therapeutic agent for multimodal cancer treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Treatment of hepatic cysts by B-ultrasound-guided radiofrequency ablation

    Institute of Scientific and Technical Information of China (English)

    Xi-Lin Du; Qing-Jiu Ma; Tao Wu; Jian-Guo Lu; Guo-Qiang Bao; Yan-Kui Chu


    BACKGROUND:The traditional therapy for hepatic cysts has limited success because of recrudescence. Radiofrequency ablation (RFA) has become popular because of its advantages including little damage, therapeutic effect and reduced suffering. This report describes the effects and reliability of RFA in the treatment of 29 patients with hepatic cysts. METHODS:B-ultrasound-guided RFA was used to treat hepatic mono-cyst or multi-cysts of 29 patients (63 tumors). Ablative efifciency and complications were assessed by imaging and clinical symptoms. RESULTS:The tumors were abated completely in 34 cysts with a diameter CONCLUSION:RFA for the treatment of hepatic cysts is safe, and free from complications.

  17. CT-based temperature monitoring during hepatic RF ablation : Feasibility in an animal model

    NARCIS (Netherlands)

    Bruners, Philipp; Pandeya, Ganga D.; Levit, Elena; Roesch, Eva; Penzkofer, Tobias; Isfort, Peter; Schmidt, Bernhardt; Greuter, Marcel J. W.; Oudkerk, Matthijs; Schmitz-Rode, Thomas; Kuhl, Christiane K.; Mahnken, Andreas H.


    Purpose: The aim of this paper was to establish non-invasive CT-based temperature monitoring during hepatic radiofrequency (RF) ablation in an ex vivo porcine model followed by transfer of the technique into a feasibility in vivo experiment. Materials and methods: Bipolar RF ablations were performed

  18. The challenge of extraabdominal desmoid tumour management in patients with Gardner's syndrome: radiofrequency ablation, a promising option. (United States)

    Cobianchi, Lorenzo; Ravetta, Valentina; Viera, Francesca Torello; Filisetti, Claudia; Siri, Barbara; Segalini, Edoardo; Maestri, Marcello; Dominioni, Tommaso; Alessiani, Mario; Rossi, Sandro; Dionigi, Paolo


    Desmoid tumours are benign, myofibroblastic stromal neoplasms common in Gardner's syndrome, which is a subtype of familial adenomatous polyposis characterized by colonic polyps, osteomas, thyroid cancer, epidermoid cysts, fibromas and sebaceous cysts. The primary treatment is surgery, followed by adjuvant radiotherapy, but the local recurrence rate is high, and wide resection can result in debilitating loss of function. We report the case of a 39-year-old man with Gardner's syndrome who had already undergone a total prophylactic colectomy. He developed desmoid tumours localized in the mesenteric root, abdominal wall and dorsal region, which were treated from 2003 through 2013 with several surgical procedures and percutaneous radiofrequency ablation. In 2008 and 2013, RFA was applied under ultrasonographic guidance to two desmoid tumours localized in the dorsal thoracic wall. The outcomes were low-grade pain and one case of superficial skin necrosis, but so far there has been no recurrence of desmoid tumours in these locations. Surgical resection remains the first-line therapy for patients with desmoid tumours, but wide resection may lead to a poor quality of life. Radiofrequency ablation is less invasive and expensive and is a possible therapeutic option for desmoid tumours in patients with Gardner's syndrome.

  19. Tumour Cell Membrane Poration and Ablation by Pulsed Low-Intensity Electric Field with Carbon Nanotubes

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    Lijun Wang


    Full Text Available Electroporation is a physical method to increase permeabilization of cell membrane by electrical pulses. Carbon nanotubes (CNTs can potentially act like “lighting rods” or exhibit direct physical force on cell membrane under alternating electromagnetic fields thus reducing the required field strength. A cell poration/ablation system was built for exploring these effects of CNTs in which two-electrode sets were constructed and two perpendicular electric fields could be generated sequentially. By applying this system to breast cancer cells in the presence of multi-walled CNTs (MWCNTs, the effective pulse amplitude was reduced to 50 V/cm (main field/15 V/cm (alignment field at the optimized pulse frequency (5 Hz of 500 pulses. Under these conditions instant cell membrane permeabilization was increased to 38.62%, 2.77-fold higher than that without CNTs. Moreover, we also observed irreversible electroporation occurred under these conditions, such that only 39.23% of the cells were viable 24 h post treatment, in contrast to 87.01% cell viability without presence of CNTs. These results indicate that CNT-enhanced electroporation has the potential for tumour cell ablation by significantly lower electric fields than that in conventional electroporation therapy thus avoiding potential risks associated with the use of high intensity electric pulses.

  20. Combining partial liver resection and local ablation of liver tumours: a preliminary Dutch experience

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    van Gulik Thomas M


    Full Text Available Abstract Background The combination of partial liver resection and radiofrequency ablation (RFA is a novel concept in the treatment of unresectable liver malignancies. The aim of this study is to evaluate the results of this combined strategy in the Netherlands. Methods Thirty-five patients treated with a combination of partial liver resection and RFA were identified from a prospectively registered pooled multicentre database. All patients were operated between June 1999 and November 2003 in 8 medical centres in the Netherlands. Main outcome parameters were morbidity, mortality, local success rate, and survival. Results Thirty-seven operations were performed in 35 patients. The group consisted of 20 male and 15 female patients with a median age of 59 years (range 41–76. Seventy-six lesions were resected and RFA was performed to ablate 82 unresectable liver tumours. Twelve patients developed a total of 24 complications, resulting in an overall perioperative morbidity rate of 32%. In two patients major complications resulted in postoperative death (postoperative mortality rate 5.4%. Local success rate after RFA was 88% and the estimated 1-, 2- and 3-year overall survival rates were 84%, 70% and 43%, respectively. Conclusion This strategy should only be performed following strict patient selection and within the context of prospective clinical trials.

  1. Successful treatment of hepatic oligometastases with stereotactic ablative radiotherapy and radiofrequency ablation in an anaplastic lymphoma kinase fusion-positive lung cancer patient

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    Weber, Britta; Liu, Mitchell; Sobkin, Paul


    Local ablative therapy with stereotactic ablative radiotherapy may improve survival in oncogene‐addicted lung cancer patients with extracranial oligometastatic disease treated with targeted therapies. There is limited data on the use of radiofrequency ablation (RFA) in this same setting. We present...... a case of an anaplastic lymphoma kinase (ALK)‐positive lung cancer patient with hepatic oligometastatic progression who was successfully treated with both stereotactic ablative radiation and RFA while continuing with an ALK inhibitor....

  2. Radiofrequency ablation of hepatic metastasis: Results of treatment in forty patients

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    Rath G


    Full Text Available Aim: To evaluate the local control of hepatic metastasis with radiofrequency ablation treatment. Materials and Methods: We did a retrospective analysis in 40 patients treated with radiofrequency ablation for hepatic metastasis. The tumors ablated included up to two metastatic liver lesions, with primaries in breast, gastrointestinal tract, cervix, etc. Radiofrequency ablation was performed under general anesthesia in all cases, using ultrasound guidance. Radionics Cool-Tip RF System was used to deliver the treatment. Results: The median age of patients treated was 49 years. There were 13 female and 27 male patients. The median tumor size ablated was 1.5 cm (0.75-4.0 cm. A total of 52 radiofrequency ablation cycles were delivered. Successful ablation was achieved in all patients with hepatic metastasis less than 3 cm in size. Pain was the most common complication seen (75%. One patients developed skin burns. At 2-year follow-up 7.5% of patients had locally recurrent disease. Conclusions: Radiofrequency ablation is a minimally invasive treatment modality. It can be useful in a select group of patients with solitary liver metastasis of less than 3 cm size.

  3. Impact of sex steroid ablation on viral, tumour and vaccine responses in aged mice.

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    Tracy S P Heng

    Full Text Available Recent evidence suggests that the decline in resistance to viral infections with age occurs predominantly as a result of a gradual loss of naïve antigen-specific T cells. As such, restoration of the naïve T cell repertoire to levels seen in young healthy adults may improve defence against infection in the aged. We have previously shown that sex steroid ablation (SSA rejuvenates the ageing thymus and increases thymic export of naïve T cells, but it remains unclear whether T cell responses are improved. Using mouse models of clinically relevant diseases, we now demonstrate that SSA increases the number of naïve T cells able to respond to antigen, thereby enhancing effector responses in aged mice. Specifically, aged mice exhibit a delay in clearing influenza A virus, which correlates with diminished specific cytotoxic activity. This is due to a decreased magnitude of response and not an intrinsic defect in effector T cell function. Upon SSA, aged mice exhibit increased T cell responsiveness that restores efficient viral clearance. We further demonstrate that SSA decreases the incidence of an inducible tumour in aged mice and can potentially increase their responsiveness to a low-dose human papillomavirus vaccine in clearing pre-formed tumours. As thymectomy abrogates the increase in T cell numbers and responsiveness following SSA, we propose that the T cell effects of SSA are dependent on thymic reactivation and subsequent replenishment of the peripheral T cell pool with newly emigrated naïve T cells. These findings have important implications for strategies to improve protection from infection and responsiveness to vaccination in the aged.

  4. Influence of electrical and thermal properties on RF ablation of breast cancer: is the tumour preferentially heated?

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    Sandstedt Bengt


    Full Text Available Abstract Background Techniques based on radio frequency (RF energy have many applications in medicine, in particular tumour ablation. Today, mammography screening detects many breast cancers at an early stage, facilitating treatment by minimally invasive techniques such as radio frequency ablation (RFA. The breast cancer is mostly surrounded by fat, which during RFA-treatment could result in preferential heating of the tumour due to the substantial differences in electrical parameters. The object of this study was to investigate if this preferential heating existed during experimental in vitro protocols and during computer simulations. Methods Excised breast material from four patients with morphologically diagnosed breast cancers were treated with our newly developed RFA equipment. Subsequently, two finite element method (FEM models were developed; one with only fat and one with fat and an incorporated breast cancer of varying size. The FEM models were solved using temperature dependent electrical conductivity versus constant conductivity, and transient versus steady-state analyses. Results Our experimental study performed on excised breast tissue showed a preferential heating of the tumour, even if associated with long tumour strands. The fat between these tumour strands was surprisingly unaffected. Furthermore, the computer simulations demonstrated that the difference in electrical and thermal parameters between fat and tumour tissue can cause preferential heating of the tumour. The specific absorption rate (SAR distribution changed significantly when a tumour was present in fatty tissue. The degree of preferential heating depended on tissue properties, tumour shape, and placement relative to the electrode. Temperature dependent electrical conductivity increased the thermal lesion volume, but did not change the preferential heating. Transient solutions decreased the thermal lesion volume but increased the preferential heating of the tumour

  5. Antenna design for microwave hepatic ablation using an axisymmetric electromagnetic model

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    Converse Mark C


    Full Text Available Abstract Background An axisymmetric finite element method (FEM model was employed to demonstrate important techniques used in the design of antennas for hepatic microwave ablation (MWA. To effectively treat deep-seated hepatic tumors, these antennas should produce a highly localized specific absorption rate (SAR pattern and be efficient radiators at approved generator frequencies. Methods and results As an example, a double slot choked antenna for hepatic MWA was designed and implemented using FEMLAB™ 3.0. Discussion This paper emphasizes the importance of factors that can affect simulation accuracy, which include boundary conditions, the dielectric properties of liver tissue, and mesh resolution.

  6. Magnetic resonance imaging with gadoxetic acid for local tumour progression after radiofrequency ablation in patients with hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Tae Wook; Rhim, Hyunchul; Lee, Jisun; Song, Kyoung Doo; Lee, Min Woo; Kim, Young-sun; Lim, Hyo Keun; Jang, Kyung Mi; Kim, Seong Hyun [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Gwak, Geum-Youn [Sungkyunkwan University School of Medicine, Division of Hepatology, Department of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Jung, Sin-Ho [Sungkyunkwan University School of Medicine, Biostatics and Clinical Epidemiology Center, Samsung Medical Center, Seoul (Korea, Republic of)


    To develop and validate a prediction model using magnetic resonance imaging (MRI) for local tumour progression (LTP) after radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients. Two hundred and eleven patients who had received RFA as first-line treatment for HCC were retrospectively analyzed. They had undergone gadoxetic acid-enhanced MRI before treatment, and parameters including tumour size; margins; signal intensities on T1-, T2-, and diffusion-weighted images, and hepatobiliary phase images (HBPI); intratumoral fat or tumoral capsules; and peritumoural hypointensity in the HBPI were used to develop a prediction model for LTP after treatment. This model to discriminate low-risk from high-risk LTP groups was constructed based on Cox regression analysis. Our analyses produced the following model: 'risk score = 0.617 x tumour size + 0.965 x tumour margin + 0.867 x peritumoural hypointensity on HBPI'. This was able to predict which patients were at high risk for LTP after RFA (p < 0.001). Patients in the low-risk group had a significantly better 5-year LTP-free survival rate compared to the high-risk group (89.6 % vs. 65.1 %; hazard ratio, 3.60; p < 0.001). A predictive model based on MRI before RFA could robustly identify HCC patients at high risk for LTP after treatment. (orig.)

  7. Radiofrequency Ablation of Hepatic Metastases from Thyroid Carcinoma

    NARCIS (Netherlands)

    Wertenbroek, Marieke W. J. L. A. E.; Links, Thera P.; Prins, Ted R.; Plukker, John T. M.; van der Jagt, Erik J.; de Jong, Koert P.


    Background: Radiofrequency ablation (RFA) is performed for various types of liver tumors. It might also have a role in the palliative treatment of liver metastases from thyroid carcinoma. Summary: Three patients with liver metastases of thyroid carcinoma were retrieved from our database of 125 patie

  8. Reconfigurable tapered coaxial slot antenna for hepatic microwave ablation. (United States)

    Malhotra, Neeru; Marwaha, Anupma; Kumar, Ajay


    Microwave ablation is rapidly being rediscovered and developed for treating many cancers of liver, lung, kidney and bone, as well as arrhythmias and other medical conditions. The microwaves ablate tissue by heating it to cytotoxic temperatures. The microwave antenna design suffers the challenges of effective coupling and penetration into body tissues, uncontrolled power deposition due to applicator construction limitations affecting uniform heating of target region, and narrowband operation leading to mismatch for many patients and detrimental heating. To meet out the requirements of wideband operation and localized lesion reconfigurable linearly tapered slot interstitial wideband antenna has been proposed for working in the 1.38 GHz to 4.31 GHz frequency band. The performance of the antenna is evaluated by using FEM-based HFSS software. The slot height and taper height are reconfigured for parametric analysis achieving maximum impedance matching and spherical ablation zone without requiring any additional adjustable structures. The tapering of the slot in coaxial antenna generates current distribution at the edges of the slot for maximizing specific absorption rate.

  9. Percutaneous ablation of pulmonary tumours: state-of-the-art 2004; Perkutane Ablation von Lungentumoren: Standortbestimmung 2004

    Energy Technology Data Exchange (ETDEWEB)

    Diederich, S. (Institut fuer Diagnostische und Interventionelle Radiologie/Nuklearmedizin, Marienhospital Duesseldorf; Institut fuer Diagnostische und Interventionelle Radiologie/Nuklearmedizin, Marienhospital, Rochusstr. 2, 40479, Duesseldorf); Hosten, N. (Institut fuer Diagnostische Radiologie und Neuroradiologie, Ernst-Moritz-Arndt-Universitaet Greifswald)


    Percutaneous radiofrequency ablation (RFA) and laser-induced interstitial thermotherapy (LITT) are well established since many years in liver and other soft tissue tumors. During the past 2 years there are increasing reports on applications in pulmonary tumors. There are, however, numerous differences to ablations in other organs: indications in pulmonary metastases and lung cancer have to be balanced against the specific possibilities of well-established surgical resections. Tissue specific features require different concepts of energy deployment and complications and methods for assessment of therapeutic effectiveness vary from other applications. Other aspects, however, are quite clear, yet. There are specific established indications particularly for thermoablation of pulmonary metastases. Tumor ablation is easily performed by experienced interventional radiologists and serious complications are rare. Patient acceptance is good. Further studies are required on indications, technical requirements, therapy control and particularly long-term results. (orig.) [German] Nachdem perkutane Radiofrequenzablation (RFA) und Lasertherapie (LITT) an der Leber und anderen Weichteilstrukturen seit Jahren regelmaessig durchgefuehrt werden, werden in den letzten 2 Jahren zunehmend auch Anwendungen bei Lungentumoren mitgeteilt. Allerdings bestehen zahlreiche Unterschiede zu Ablationen an anderen Organen: Indikationen bei Lungenmetastasen und Bronchialkarzinom muessen sich an den spezifischen Moeglichkeiten der etablierten operativen Verfahren der Lungenresektion messen, gewebespezifische Unterschiede erfordern andere Konzepte der Energieuebertragung. Unterschiede bestehen auch bei Komplikationen und Methoden der Therapiekontrolle. Andere Aspekte sind dagegen relativ klar: Es existieren bereits heute einzelne eindeutige Indikationen insbesondere fuer die Therapie von Lungenmetastasen. Die Technik der Tumorablation ist fuer den erfahrenen interventionellen Radiologen gut

  10. Imaging Features of Radiofrequency Ablation with Heat-Deployed Liposomal Doxorubicin in Hepatic Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Cheng William, E-mail:; Chow, Lucy, E-mail: [National Institutes of Health, Center for Interventional Oncology, Clinical Center (United States); Turkbey, Evrim B., E-mail: [National Institutes of Health, Radiology and Imaging Sciences, Clinical Center (United States); Lencioni, Riccardo, E-mail: [Pisa University Hospital, Division of Diagnostic Imaging and Intervention, Department of Hepatology and Liver Transplantation (Italy); Libutti, Steven K., E-mail: [Albert Einstein College of Medicine, Montefiore-Einstein Center for Cancer Care, Department of Surgery (United States); Wood, Bradford J., E-mail: [National Institutes of Health, Center for Interventional Oncology, Clinical Center (United States)


    IntroductionThe imaging features of unresectable hepatic malignancies in patients who underwent radiofrequency ablation (RFA) in combination with lyso-thermosensitive liposomal doxorubicin (LTLD) were determined.Materials and MethodsA phase I dose escalation study combining RFA with LTLD was performed with peri- and post- procedural CT and MRI. Imaging features were analyzed and measured in terms of ablative zone size and surrounding penumbra size. The dynamic imaging appearance was described qualitatively immediately following the procedure and at 1-month follow-up. The control group receiving liver RFA without LTLD was compared to the study group in terms of imaging features and post-ablative zone size dynamics at follow-up.ResultsPost-treatment scans of hepatic lesions treated with RFA and LTLD have distinctive imaging characteristics when compared to those treated with RFA alone. The addition of LTLD resulted in a regular or smooth enhancing rim on T1W MRI which often correlated with increased attenuation on CT. The LTLD-treated ablation zones were stable or enlarged at follow-up four weeks later in 69 % of study subjects as opposed to conventional RFA where the ablation zone underwent involution compared to imaging acquired immediately after the procedure.ConclusionThe imaging features following RFA with LTLD were different from those after standard RFA and can mimic residual or recurrent tumor. Knowledge of the subtle findings between the two groups can help avoid misinterpretation and proper identification of treatment failure in this setting. Increased size of the LTLD-treated ablation zone after RFA suggests the ongoing drug-induced biological effects.

  11. Should hepatic metastatic colorectal cancer patients with extrahepatic disease undergo liver resection/ablation? (United States)

    Byam, Jerome; Reuter, Nathaniel P; Woodall, Charles E; Scoggins, Charles R; McMasters, Kelly M; Martin, Robert C G


    Surgical therapy has been proven to be the mainstay of treatment for hepatic metastases from colorectal cancer (CRM) in the appropriate patient. Previous contraindications were patients with extrahepatic disease (EHD) do not benefit from liver resection or ablation. We hypothesized that the survival of patients with EHD who receive aggressive multimodality care would be the same as those without EHD. A review of our 1305 patient prospective hepato-pancreatico-biliary database from August 1995 to April 2008 identified 383 patients with surgical management of metastatic CRM to the liver. A total of 39 patients with limited EHD underwent liver resection/ablation vs 344 patients without EHD. There were no significant differences in hepatic disease burden (mean clinical risk score of 2.3 and 2.1 in patients with and without EHD, P=.19, and median number of hepatic metastases of 2 in each group, P=.88) or size of the largest lesion (mean 4.6 vs 4.5 cm with and without EHD, P=.84). EHD consisted of lung metastases in 33%, nodal metastases in 21%, peritoneal in 15%, unknown in 15%, and other in 15%. There was no difference in patients with and without EHD undergoing surgical with resection only in 41% vs 48%, ablation only in 31% vs 30%, and combined resection and ablation in 28% vs 22% (P=.61). Overall survival in patients with EHD was not significantly different (median survival 24 vs 33 months, P=.06). A thorough understanding of the biology of disease and appropriate multimodality care can lead to improved survival in patients with EHD, when compared with chemotherapy alone.

  12. Radiofrequency Ablation for 110 Malignant Liver Tumours: Preliminary Results on Percutaneous and Surgical Approaches

    Directory of Open Access Journals (Sweden)

    J. Wong


    Conclusion: RFA is a safe and effective procedure for treating patients with malignant liver tumours. No difference in short term outcomes was observed between percutaneous and surgical approaches. A more prolonged follow-up study is required to assess longer-term outcomes.

  13. In vitro artefact assessment of a new MR-compatible microwave antenna and a standard MR-compatible radiofrequency ablation electrode for tumour ablation

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Ruediger; Rempp, Hansjoerg; Eibofner, Frank; Kessler, David-Emanuel; Weiss, Jakob; Nikolaou, Konstantin; Clasen, Stephan [Eberhard Karls University, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Blumenstock, Gunnar [Eberhard Karls University, Department of Clinical Epidemiology and Applied Biometry, Tuebingen (Germany); Pereira, Philippe L. [SLK-Kliniken Heilbronn GmbH, Department of Radiology, Minimally Invasive Therapies, and Nuclear Medicine, Heilbronn (Germany)


    To evaluate and compare artefact configuration and diameters in a magnetic resonance (MR)-compatible prototype microwave (MW) applicator and a standard MR-compatible radiofrequency (RF) applicator for MR-guided tumour ablation. Both applicators were tested in a phantom study at 1.5T with three sequences: T1-weighted three-dimensional volume interpolated breath-hold examination (VIBE), T1-weighted fast low angle shot (FLASH), T2-weighted turbo spin echo (TSE). Applicator orientation to main magnetic field (B{sub 0}) and slice orientation were varied. Needle tip location error (TLE) was assessed, and artefact diameters were calculated. Influence of imaging parameters on artefacts was assessed with analysis of variance (ANOVA) and post hoc testing. MW applicator: the shaft artefact diameter measured 2.3 +/- 0.8 mm. Tip artefact diameter and length measured 2.2 ± 0.8 mm and 2.4 ± 1.3 mm, respectively. A prominent oval artefact (diameter: 16.5 +/- 1.8 mm, length: 19.1 +/- 2.5 mm) appeared close to the tip. TLE: -.3 +/- 0.6 mm. RF applicator: shaft and tip diameter measured 8.9 +/- 4.7 mm and 9.0 +/-.0 mm, respectively. TLE: -0.1 +/- 0.8 mm. Minimal artefacts were measured with RF applicator orientation parallel to B{sub 0} (P < 0.0001), whereas no such influence was found for MW applicator. For both applicators, significantly large artefacts were measured with T1 FLASH (P = 0.03). The MW applicator's artefact is satisfactory and seems useable for MR-guided ablation procedures. (orig.)

  14. Treatment efficacy of radiofrequency ablation of 338 patients with hepatic malignant tumor and the relevant complications

    Institute of Scientific and Technical Information of China (English)

    Min-Hua Chen; Wei Yang; Kun Yan; Wen Gao; Ying Dai; Yan-Bin Wang; Xiao-Peng Zhang; Shan-Shan Yin


    AIM: To investigate the treatment efficacy of radiofrequency ablation (RFA) of hepatic malignant tumor and the relevant complications.METHODS: A total of 338 patients with 763 hepatic tumors underwent ultrasound-guided RFA (565 procedures).There were 204 cases of hepatic cellular carcinoma (HCC)with 430 tumors, the mean largest diameter was 4.0 cm.Of them, 48 patients (23.5%) were in stages Ⅰ-Ⅱ (UICC Systems) and 156 (76.5%) in stages Ⅲ-Ⅳ There were 134 cases of metastatic liver carcinoma (MLC), with 333metastases in the liver, the mean diameter was 4.1 cm,the liver metastases of 96 patients (71.6%) came from gastrointestinal tract. Ninety-three percent of the 338patients were treated using the relatively standard protocol. Crucial attention must be paid to monitor the abnormal changes in ultrasound images as well as the vital signs of the patients to find the possible hemorrhage and peripheral structures injury in time. The tumors were considered as ablated completely, if no viability was found on enhanced CT within 24 h or at 1 mo after RFA. These patients were followed up for 3-57 mo.RESULTS: The ablation success rate was 93.3% (401/430tumors) for HCC and was 96.7% (322/333 tumors) for MLC. The local recurrence rate for HCC and MLC was 7.9% (34/430 tumors) and 10.5% (35/333 tumors),respectively. A total of 137 patients (40.5%) underwent 2-11times of repeated ablations because of tumor recurrence or metastasis. The 1st, 2nd, and 3rd year survival rate was84.6%, 66.6%, and 63.1%, respectively;the survival rate from 48 patients of Ⅰ-Ⅱ stage HCC was 93.7%, 80.4%,and 80.4%, respectively. The major complication rate in this study was 2.5% (14 of 565 procedures), which consisted of 5 hemorrhages, 1 colon perforation, 5 injuries of adjacent structures, 2 bile leakages, and 1 skin burn.CONCLUSION: RFA, as a minimally invasive local treatment,has become an effective and relatively safe alternative for the patients of hepatic

  15. Navigated Percutaneous Lung Ablation under High-Frequency Jet Ventilation of a Metastasis from a Wilms’ Tumour: A Paediatric Case Report

    Directory of Open Access Journals (Sweden)

    Jacob Freedman


    Full Text Available This is a case report of microwave energy being used to ablate an inoperable metastasis of a Wilms’ tumour in a 6-year-old boy using state-of-the-art navigated computed tomography targeting and high-frequency jet ventilation to reduce organ displacement and the potential risk of procedure-related pneumothorax. After the ablation, the young boy had high-dose chemotherapy followed by an autologous stem cell transplantation with rapid reduction of three recurrent right-sided lung metastases.

  16. Isolated hepatic perfusion with extracorporeal oxygenation using hyperthermia, tumour necrosis factor alpha and melphalan. (United States)

    Lindnér, P; Fjälling, M; Hafström, L; Kierulff-Nielsen, H; Mattsson, J; Scherstén, T; Rizell, M; Naredi, P


    To determine the toxicity and efficacy of isolated hepatic perfusion with tumour necrosis factor alpha (TNF-alpha) and melphalan (Alkeran) under mild hyperthermic conditions. A phase I trial was performed. Eleven patients with unresectable metastatic malignancies in the liver were pre-treated with 3 x 10(6) U leukocyte IFN daily 2 days before the perfusion. The liver was isolated and inflow catheters inserted in the hepatic artery and the portal vein. The hepatic veins were drained via a catheter in the retrohepatic caval vein. The venous blood flow from the lower extremities and the splanchnic circulation was bypassed to the axillar vein. The liver circuit was perfused with oxygenated blood and 30-200 microg TNF-alpha was added. At 39 degrees C in the liver circuit 0.5 mg/kg melphalan was added and the perfusion was continued for 1 h. Six patients underwent re-operation due to post-operative bleeding. Two patients died of coagulopathy or multiple organ failure within the first post-operative month. Three of six patients with liver metastases from malignant melanoma or leiomyosarcoma showed a partial response while no patients with liver metastases from colorectal cancer showed any response. The mean survival time was 20 months, which is within the same range as seen in previous isolated hepatic perfusion (IHP) studies. IHP with this drug regimen is a method with a considerable toxicity, though it is hard to distinguish between toxicity from TNF-alpha and that from the perfusion procedure itself. The method was not effective in patients with colorectal liver metastasis, but the results in melanoma and leiomyosarcoma patients warrant further studies.

  17. Secondary prevention of recurrence by interferon therapy after ablation therapy for hepatocellular carcinoma in chronic hepatitis C patients

    Institute of Scientific and Technical Information of China (English)

    Toru Ishikawa


    Chronic hepatitis C is a leading cause of hepatocellular carcinoma (HCC) worldwide. Interferon (IFN) ther-apy decreases the incidence of HCC in patients with chronic hepatitis C. Prevention of chronic-hepatitis-C-related HCC is one of the most important issues in current hepatology. We have previously reported that male gender and high titer of hepatitis C virus (HCV) RNA are predictive factors for the development of HCC in HCV-related cirrhosis. Clinical efforts at eradicat-ing or reducing the viral load may reduce the risk for HCC. Furthermore, because HCC often recurs after ablation therapy, we performed a trial of IFN in pa-tients with chronic liver disease caused by HCV to see whether IFN therapy decreases recurrence after abla-tion therapy of HCV-related HCC. By using IFN therapy as a secondary prevention, patients with HCC who had received complete tumor ablation showed better sur-vival, primarily as a result of the preservation of liver function and also probably prevention of recurrence. Postoperative IFN therapy appears to decrease recur-fence after ablation therapy such as radiofrequency ablation (RFA) therapy of HCV-related HCC. We believe that there is a survival benefit in secondary prevention using IFN therapy. However, a controlled study is es-sential to obtain conclusive evidence of the efficacy of this strategy.

  18. β2-Adrenergic receptor ablation modulates hepatic lipid accumulation and glucose tolerance in aging mice. (United States)

    Shi, Yun; Shu, Zhen-Ju; Xue, Xiaoling; Yeh, Chih-Ko; Katz, Michael S; Kamat, Amrita


    Catecholamines acting through β-adrenergic receptors (β(1)-, β(2)-, β(3)-AR subtypes) modulate important biological responses in various tissues. Our previous studies suggest a role for increased hepatic β-AR-mediated signaling during aging as a mediator of hepatic steatosis, liver glucose output, and insulin resistance in rodents. In the current study, we have utilized β(2)-AR knockout (KO) and wildtype (WT) control mice to define further the role of β(2)-AR signaling during aging on lipid and glucose metabolism. Our results demonstrate for the first time that age-related increases in hepatic triglyceride accumulation and body weight are attenuated upon β(2)-AR ablation. Although no differences in plasma triglyceride, non-esterified fatty acids or insulin levels were detected between old WT and KO animals, an age-associated increase in hepatic expression of lipid homeostasis regulator Cidea was significantly reduced in old KO mice. Interestingly, we also observed a shift from reduced glucose tolerance in young adult KO animals to significantly improved glucose tolerance in old KO when compared to age-matched WT mice. These results provide evidence for an important role played by β(2)-ARs in the regulation of lipid and glucose metabolism during aging. The effect of β(2)-AR ablation on caloric intake during aging is currently not known and requires investigation. Future studies are also warranted to delineate the β(2)-AR-mediated mechanisms involved in the control of lipid and glucose homeostasis, especially in the context of a growing aging population. Published by Elsevier Inc.

  19. Massive Hepatic Infarction After Pure Ethanol Injection and Radiofrequency Ablation Therapy for Hepatocellular Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Yen-Cheng Chiu


    Full Text Available Hepatic infarction is a rare complication of radiofrequency ablation (RFA for hepatocellular carcinoma. Hepatic infarction is thought to be caused by injury to either the hepatic arterial system or to both the hepatic arterial and portal venous supply. The efficacy of RFA is reduced in the presence of nearby vessels larger than 3 mm in diameter due to a heat-sink effect. Such an effect can be diminished by performing percutaneous pure ethanol injection prior to RFA. Although larger vessels are unlikely to be ablated or obliterated by RFA alone, it can happen and cause massive liver damage, particularly if RFA was preceded by other therapies such as percutaneous pure ethanol injection and/or transcatheter arterial embolization. Here, we report a case of massive liver infarction after sequential use of both treatment modalities for hepatocellular carcinoma.

  20. History, ethics, advantages and limitations of experimental models for hepatic ablation. (United States)

    Ong, Seok Ling; Gravante, Gianpiero; Metcalfe, Matthew S; Dennison, Ashley R


    Numerous techniques developed in medicine require careful evaluation to determine their indications, limitations and potential side effects prior to their clinical use. At present this generally involves the use of animal models which is undesirable from an ethical standpoint, requires complex and time-consuming authorization, and is very expensive. This process is exemplified in the development of hepatic ablation techniques, starting experiments on explanted livers and progressing to safety and efficacy studies in living animals prior to clinical studies. The two main approaches used are ex vivo isolated non-perfused liver models and in vivo animal models. Ex vivo non perfused models are less expensive, easier to obtain but not suitable to study the heat sink effect or experiments requiring several hours. In vivo animal models closely resemble clinical subjects but often are expensive and have small sample sizes due to ethical guidelines. Isolated perfused ex vivo liver models have been used to study drug toxicity, liver failure, organ transplantation and hepatic ablation and combine advantages of both previous models.

  1. Local treatment in unresectable hepatic metastases of carcinoid tumors: Experiences with hepatic artery embolization and radiofrequency ablation

    Directory of Open Access Journals (Sweden)

    van Coevorden Frits


    Full Text Available Abstract Background Hepatic metastases of carcinoid tumors cause incapacitating symptoms, but are usually diffuse and therefore unresectable. In this article we evaluate our experiences with local treatment techniques in the management of carcinoid patients with hepatic metastases and failing systemic treatment. Methods Fifteen consecutive carcinoid patients (11 men and 4 women; median age 60 years; range 45–71 years were treated with either hepatic artery embolization (HAE with Ivalon particles or radiofrequency ablation (RFA (percutaneously or intra-operatively. Follow-up evaluation was performed by CT scan and 24-hours urinary 5-HIAA excretions. Results A total of 18 HAE's was performed in 13 patients, while 10 lesions in 3 patients were treated with RFA. Median follow-up was 12.5 months (2 – 25 months. Median duration of symptoms was 22 months (8 – 193 months. Median overall decrease of 5-HIAA excretion 2 months after HAE was 32% with tumor regression on CT-scan in 4 patients (30% and improvement of symptoms with a median duration of 15 months in 3 of them (23%. Embolization led to fatal hepatic failure in one patient. The 3 patients treated with RFA showed a decrease of urinary 5-HIAA values of 34, 81 and 93% respectively, with tumor regression in all of them. Improvement of symptoms was reported in 2 patients up to 25 months. Conclusion Liver embolization performed late in the clinical course had limited effect on symptoms and biochemical and radiological parameters. First experiences with RFA are favorable and might encourage to apply RFA more widely in metastatic carcinoid.

  2. Robot-assisted radiofrequency ablation of primary and secondary liver tumours: early experience

    Energy Technology Data Exchange (ETDEWEB)

    Abdullah, Basri Johan Jeet [University of Malaya, Department of Biomedical Imaging, Faculty of Medicine, Kuala Lumpur (Malaysia); Yeong, Chai Hong [University of Malaya, University of Malaya Research Imaging Centre, Faculty of Medicine, Kuala Lumpur (Malaysia); Goh, Khean Lee [University of Malaya, Department of Internal Medicine, Faculty of Medicine, Kuala Lumpur (Malaysia); Yoong, Boon Koon [University of Malaya, Department of Surgery, Faculty of Medicine, Kuala Lumpur (Malaysia); Ho, Gwo Fuang [University of Malaya, Department of Oncology, Faculty of Medicine, Kuala Lumpur (Malaysia); Yim, Carolyn Chue Wai [University of Malaya, Department of Anesthesia, Faculty of Medicine, Kuala Lumpur (Malaysia); Kulkarni, Anjali [Perfint Healthcare Corporation, Florence, OR (United States)


    Computed tomography (CT)-compatible robots, both commercial and research-based, have been developed with the intention of increasing the accuracy of needle placement and potentially improving the outcomes of therapies in addition to reducing clinical staff and patient exposure to radiation during CT fluoroscopy. In the case of highly inaccessible lesions that require multiple plane angulations, robotically assisted needles may improve biopsy access and targeted drug delivery therapy by avoidance of the straight line path of normal linear needles. We report our preliminary experience of performing radiofrequency ablation of the liver using a robotic-assisted CT guidance system on 11 patients (17 lesions). Robotic-assisted planning and needle placement appears to have high accuracy, is technically easier than the non-robotic-assisted procedure, and involves a significantly lower radiation dose to both patient and support staff. (orig.)

  3. Comparative Effects of Dexmedetomidine and Propofol on US-Guided Radiofrequency Ablation of Hepatic Neoplasm Under Monitored Anesthesia Care



    Abstract Percutaneous radiofrequency ablation (RFA) is a useful and safe procedure for treating hepatic neoplasm. However, liver RFA causes severe pain, which thereby increases the demand for monitored anesthesia care (MAC). Here, we compared the efficacy and safety of propofol and dexmedetomidine, which are commonly administered during MAC when performing RFA to assess hepatic neoplasm. In this randomized controlled trial, 40 patients were randomly allocated to 2 groups for elective RFA. Pat...

  4. Debulking treatment with CT-guided percutaneous radiofrequency ablation and hepatic artery infusion of floxuridine improves survival of patients with unresectable pulmonary and hepatic metastases of colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Sheng Li; Ni He; Wang Li; Pei-Hong Wu


    The survival of most patients with both unresectable hepatic and pulmonary metastases of colorectal cancer is poor. In this retrospective study, we investigated the efficacy of computed tomography (CT)-guided radiofrequency ablation (RFA) and systemic chemotherapy plus hepatic artery infusion of floxuridine (HAI-FUDR). Sixty-one patients were selected from 1,136 patients with pulmonary and hepatic metastases from colorectal cancer. Patients were treated with RFA and systemic chemotherapy plus HAI-FUDR (ablation group, n=39) or systemic chemotherapy plus HAI-FUDR (FUDR group, n=22). Patients in the two groups were matched by sex, age, number of metastases, and calendar year of RFA or FUDR. Survival data were evaluated by using univariate and multivariate analyses. Clinical characteristics were comparable between the two groups. Al patients in the ablation group underwent RFA and chemotherapy. Median fol ow-up was 56.8 months. The 1-, 3-, and 5-year overall survival (OS) rates were 97%, 64%, and 37%, respectively, for the ablation group, and 82%, 32%, and 19%, respectively, for the FUDR group. The 1-, 3-, and 5-year survival rates after metastasis were 97%, 49%, and 26%for the ablation group, and 72%, 24%, and 24%for the FUDR group, respectively. The median OS times were 45 and 25 months for the ablation and FUDR groups, respectively. In the multivariate analysis, treatment al ocation was a favorable independent prognostic factor for OS (P = 0.001) and survival after metastasis (P = 0.009). These data suggest that the addition of RFA to systemic chemotherapy plus HAI-FUDR improves the survival of patients with both unresectable hepatic and pulmonary metastases from colorectal cancer.

  5. Case Study of Hepatic Radiofrequency Ablation Causing a Systemic Inflammatory Response Under Total Intravenous Anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Schalte, Gereon; Waning, Christian; Rossaint, Rolf; Mahnken, Andreas H. [University Hospital, RWTH Aachen, Aachen, (Germany); Henzler, Dietrich [Dalhousie University, Queen Elisabeth II Health Sciences Center, Halifax (Canada); Tacke, Josef [Interventional Radiology, Klinikum Passau, Passau (Germany)


    To investigate the effects of hepatic radiofrequency ablation (RFA) in patients with malignant liver disease with respect to inflammation activation and stress response. In an observational trial, we investigated the physiologic parameters of 17 patients (20 interventions) who underwent percutaneous RFA under general anesthesia after applying total intravenous anesthesia. TNF{alpha}, IL-6, IL-8, IL-10, adrenaline and noradrenaline, liver enzymes, lactate and creatine kinase were determined pre-interventionally after induction of anesthesia (T1), 90 minutes after initiation of RFA (T2), immediately after the conclusion of the procedure (T3), and 24 hours after the procedure (T4). A significant increase in body temperature (p < 0.001), and mean arterial pressure (p = 0.001) were measured intraoperatively (T2) and the day after the procedure (T4). Increased levels of IL-6 were measured at T3 and T4 (p = 0.001). IL-10 increased immediately after the procedure (T3; p = 0.007). IL-6 levels correlated well with the total energy applied ({gamma} = 0.837). Significant increases in the levels of adrenaline and noradrenaline were present at T3 and T4 (p < 0.001). The RFA-induced destruction of hepatic tissue was associated with increased levels of AST, ALT, GLDH and LDH. Percutaneous RFA of hepatic malignancies causes an inflammatory and endocrine activation, similar to the systemic inflammatory response syndrome. These effects have to be taken in account when dealing with patients susceptible to sepsis or multi-organ failure

  6. Towards the optimisation of acoustic fields for ablative therapies of tumours in the upper abdomen (United States)

    Gélat, P.; ter Haar, G.; Saffari, N.


    The efficacy of high intensity focused ultrasound (HIFU) for the non-invasive treatment of cancer has been demonstrated for a range of different cancers including those of the liver, kidney, prostate and breast. As a non-invasive focused therapy, HIFU offers considerable advantages over other techniques such as chemotherapy and surgical resection, in terms of its non-invasiveness and low risk of harmful side effects. There is, however, a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the ribcage to induce tissue necrosis at the required foci whilst minimising the formation of side lobes and sparing healthy tissue. Ribs both absorb and reflect ultrasound strongly. As such, a common side effect of focusing ultrasound in regions located behind the rib cage is the overheating of bone and surrounding tissue, which can lead to skin burns. Successful treatment of a patient with tumours in the upper abdomen therefore requires a thorough understanding of the way acoustic and thermal energy are deposited. This is likely to rely on a treatment planning procedure in which optimal source velocity distributions are obtained so as to maximise a dose quantity at the treatment sites, whilst ensuring that this quantity does not exceed a specified threshold at other field locations, particularly on the surface of the ribs. Previously, a boundary element approach based on a Generalised Minimal Residual (GMRES) implementation of the Burton-Miller formulation was developed to predict the field of a multi-element HIFU array scattered by human ribs, the topology of which was obtained from CT scan data [1]. This work describes the reformulation of the boundary element equations as a least-squares minimisation problem with non-linear constraints. The methodology was subsequently tested at an excitation frequency of 100 kHz on a spherical multi-element array in the presence

  7. Prospective 1-year follow-up pilot study of CT-guided microwave ablation in the treatment of bone and soft-tissue malignant tumours

    Energy Technology Data Exchange (ETDEWEB)

    Aubry, Sebastien; Kastler, Bruno [University Hospital of Besancon, Department of Musculoskeletal Imaging, Besancon (France); University of Franche-Comte, I4S laboratory, INSERM EA4268, Besancon (France); Dubut, Jonathan; Nueffer, Jean-Philippe [University Hospital of Besancon, Department of Musculoskeletal Imaging, Besancon (France); Chaigneau, Loic [University Hospital of Besancon, Department of Oncology, Besancon (France); Vidal, Chrystelle [University Hospital of Besancon, Clinical Investigation Center, INSERM CIT808, Besancon (France)


    The aims of this work were to assess the feasibility, efficacy, short-term outcome and safety of microwave ablation (MWA) in the treatment of malignant musculoskeletal tumours. Sixteen bone and soft-tissue malignant tumours were prospectively included and were treated by CT-guided MWA. The percentage and size of necrosis of the lesions were measured by contrast-enhanced MRI before the procedure and after 1, 3, 6 and 12 months. mRECIST criteria were used to assess tumour response. Procedural success was defined as ≥80 % necrosis. Patient pain (as assessed using a numeric visual scale (NVS)) and side effects were noted. Six osteolytic metastases, five osteoblastic metastases and five soft tissue sarcomas were treated. At 1 month, 40 % were treated completely, the percentage of necrosis was 85 ± 30.4 %, and the success rate was 80 %. At 3, 6 and 12 months the success rate was 80 %, 76.9 % and 63.6 %, respectively. At 12 months, four lesions (36.3 %) still had no recurrence. Mean NVS during the procedure was 3.5 ± 2.8. One patient had transitory sciatica without neurological deficit that was treated medically. CT-guided MWA of bone and soft-tissue malignant tumours is efficient, well tolerated and has good short-term anti-cancer effects. (orig.)

  8. Laser-induced thermo ablation of hepatic tumors: an update review; Termoablacao a laser de tumores hepaticos: atualizacao

    Energy Technology Data Exchange (ETDEWEB)

    D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail:; Ribeiro, Marcelo [Sao Paulo Univ., SP (Brazil). Hospital das Clinicas. Grupo de Cirurgia de Figado e Hipertensao Portal


    Laser-induced thermo ablation has been used as a reliable method for producing coagulation necrosis in hepatic tumors in patients who are not suitable for surgical treatment. The procedure can be performed percutaneously, using image-guiding methods, by open laparotomy or laparoscopy. We review the current literature and discuss the principles, indications, complications and clinical results as well as the potential limitations and contraindications of this novel technique. (author)

  9. Ablation of PGC-1beta results in defective mitochondrial activity, thermogenesis, hepatic function, and cardiac performance.

    Directory of Open Access Journals (Sweden)

    Christopher J Lelliott


    Full Text Available The transcriptional coactivator peroxisome proliferator-activated receptor-gamma coactivator-1beta (PGC-1beta has been implicated in important metabolic processes. A mouse lacking PGC-1beta (PGC1betaKO was generated and phenotyped using physiological, molecular, and bioinformatic approaches. PGC1betaKO mice are generally viable and metabolically healthy. Using systems biology, we identified a general defect in the expression of genes involved in mitochondrial function and, specifically, the electron transport chain. This defect correlated with reduced mitochondrial volume fraction in soleus muscle and heart, but not brown adipose tissue (BAT. Under ambient temperature conditions, PGC-1beta ablation was partially compensated by up-regulation of PGC-1alpha in BAT and white adipose tissue (WAT that lead to increased thermogenesis, reduced body weight, and reduced fat mass. Despite their decreased fat mass, PGC1betaKO mice had hypertrophic adipocytes in WAT. The thermogenic role of PGC-1beta was identified in thermoneutral and cold-adapted conditions by inadequate responses to norepinephrine injection. Furthermore, PGC1betaKO hearts showed a blunted chronotropic response to dobutamine stimulation, and isolated soleus muscle fibres from PGC1betaKO mice have impaired mitochondrial function. Lack of PGC-1beta also impaired hepatic lipid metabolism in response to acute high fat dietary loads, resulting in hepatic steatosis and reduced lipoprotein-associated triglyceride and cholesterol content. Altogether, our data suggest that PGC-1beta plays a general role in controlling basal mitochondrial function and also participates in tissue-specific adaptive responses during metabolic stress.

  10. Investigation of a spherical-section ultrasound phased array for hepatic ablation

    Institute of Scientific and Technical Information of China (English)


    A 3D ultrasound thermal model with a 3D finite element representation for modeling the thermal diffusion effects for hepatic ablation induced by spherical-section ultrasound phased array was developed. The model was first validated against available published measured data in rat liver. Using the validated model, effects of blood perfusion and heating schemes on lesion formation were studied for both single focus and split-focus intensity patterns. It was shown that for single focus sonication pattern the short-duration (~2 s) and high-intensity (~1250 W/cm2) heating scheme can completely reduce the cooling effect of the blood perfusion. The lesion shape and size were significantly altered by perfusion for split-focus pattern even with a rapid heating scheme when the focus spacing was larger than 2.4 mm. Underdosed areas might be present between two foci. Prolonging exposure time or shortening focus spacing can reduce the cool region between two foci. In addition, the influences of thermal and acoustic parameters were also studied. When the therapy depth is short (<5 cm), the lesion size monotonically increases with increasing attenuation coefficient that ranges from 5.4 to 11 Np/(m·MHz).

  11. Clinical study of ultrasound-guided percutaneous radiofrequency ablation for primary hepatic carcinoma adjacent to the diaphragm

    Directory of Open Access Journals (Sweden)

    LI Meng


    Full Text Available ObjectiveTo investigate the safety and efficacy of ultrasound (US-guided percutaneous radiofrequency ablation (RFA for primary hepatic carcinoma adjacent to the diaphragm. MethodsThis study included 277 patients with 362 lesions of primary hepatic carcinoma managed with US-guided percutaneous RFA in 302 Hospital of PLA from January 2011 to October 2014. Sixty-six patients with 71 hepatocellular carcinomas (HCCs located less than 5 mm from the diaphragm were in study group, and 95 patients with 114 HCCs located more than 10 mm from the hepatic surface were in control group. The patients′ symptoms and complications were observed after the therapy. The complete ablation rate, local tumor progression rate, and complication rate were compared between the two groups. Comparison of continuous data between the two groups was made by independent-samples t test, while comparison of categorical data was made by chi-square test. ResultsAt one month after operation, 65 (91.5% of 71 tumors in the study group and 107 (93.9% of 114 tumors in the control group achieved complete ablation, according to contrast-enhanced CT and MRI, and there was no significant difference between the two groups (χ2=0.36, P=0.55. The postoperative follow-up showed that the local tumor progression rates in the study group and control group were 16.9% and 13.2%, respectively, without significant difference between the two groups (χ2=0.49, P=0.48. In the study group, 22 patients developed adverse reactions, versus 37 patients in the control group (χ2=2.60, P=0.11. ConclusionUS-guided percutaneous RFA is a safe and effective means for the treatment of primary hepatic carcinoma adjacent to the diaphragm.

  12. Novel approaches to treatment of hepatocellular carcinoma and hepatic metastases using thermal ablation and thermosensitive liposomes. (United States)

    Dewhirst, Mark W; Landon, Chelsea D; Hofmann, Christina L; Stauffer, Paul R


    Because of the limitations of surgical resection, thermal ablation is commonly used for the treatment of hepatocellular carcinoma and liver metastases. Current methods of ablation can result in marginal recurrences of larger lesions and in tumors located near large vessels. This review presents a novel approach for extending treatment out to the margins where temperatures do not provide complete treatment with ablation alone, by combining thermal ablation with drug-loaded thermosensitive liposomes. A history of the development of thermosensitive liposomes is presented. Clinical trials have shown that the combination of radiofrequency ablation and doxorubicin-loaded thermosensitive liposomes is a promising treatment.

  13. Mammary gland-specific ablation of focal adhesion kinase reduces the incidence of p53-mediated mammary tumour formation.

    NARCIS (Netherlands)

    Miltenburg, van M.H.; Nimwegen, van M.J.; Tijdens, R.B.; Lalai, R.A.; Kuiper, R.; Klarenbeek, S.; Schouten, P.C.; Vries, de A.; Jonkers, J.M.M..; Water, van de B.


    BACKGROUND Elevated expression of focal adhesion kinase (FAK) occurs in numerous human cancers including colon-, cervix- and breast cancer. Although several studies have implicated FAK in mammary tumour formation induced by ectopic oncogene expression, evidence supporting a role for FAK in spontaneo

  14. Probable hepatic tuberculosis masquerading as Klatskin tumour in an immunocompetent patient. (United States)

    Hanafiah, Mohammad; Alhabshi, Sharifah Majedah Idrus; Bag, Tribeni; Low, Soo Fin


    A 55-year-old immunocompetent woman was presented with features of obstructive jaundice and a clinicoradiological picture suggestive of a hilar cholangiocarcinoma (Klatskin tumour). However, caseating granulomatous lesion associated with miliary nodules were revealed intraoperatively. The lesion responded to standard antituberculous therapy. This unusual presentation highlights the considerable diagnostic challenge in such case.

  15. Hepatic phenotype of liver fatty acid binding protein gene-ablated mice


    Martin, Gregory G.; Atshaves, Barbara P.; Huang, Huan; McIntosh, Avery L.; Williams, Brad J.; Pai, Pei-Jing; Russell, David H.; Kier, Ann B.; Schroeder, Friedhelm


    Although the function of liver fatty acid binding protein in hepatic fatty acid metabolism has been extensively studied, its potential role in hepatic cholesterol homeostasis is less clear. Although hepatic cholesterol accumulation was initially reported in L-FABP-null female mice, that study was performed with early N2 backcross generation mice. To resolve whether the hepatic cholesterol phenotype in these L-FABP−/− mice was attributable to genetic inhomogeneity, these L-FABP−/− mice were fu...

  16. Finite-element analysis and in vitro experiments of placement configurations using triple antennas in microwave hepatic ablation. (United States)

    Phasukkit, Pattarapong; Tungjitkusolmun, Supan; Sangworasil, Manas


    This study presents analyses of triple-antenna configurations and designs for microwave (MW) hepatic ablation using 3-D finite-element (FE) analyses verified by in vitro experiments. Treatment of hepatic cancer often requires removal or destruction of large volume lesions. Using multiple antennas offers a potential solution for creating ablation zones with larger dimensions, as well as varied geometrical shapes. We performed both 3-D FE analyses and in vitro experiments using three identical open-tip MW antennas simultaneously, placing them in three types of configurations-"linear array," "triangular," and "T-shaped" arrangements. We compared coagulation volumes created, as well as temperature distribution characteristics, from the three-antenna arrangements after power delivery of 50 W for 60 s. We also performed additional tests using nonidentical antennas (open tip, slot, and slot with insulating jacket) for the three configurations. The results illustrate that arranging antennas in the "T-shaped" pattern destroyed more unwanted tissues than those found when using "linear array" and "triangular" arrangements, with maximum coagulation width and depth of 46 and 81 mm, respectively, and coagulation volume of 30.7 cm(3) . In addition, using nonidentical triple antennas caused variations in coagulation zone characteristics, and thus, the technique could be applied to treatment situations where nonsymmetric coagulation zones are required.

  17. Liver metastases of neuroendocrine tumours; early reduction of tumour load to improve life expectancy

    Directory of Open Access Journals (Sweden)

    Lips Cornelis JM


    Full Text Available Abstract Background Neuroendocrine tumours frequently metastasize to the liver. Although generally slowly progressing, hepatic metastases are the major cause of carcinoid syndrome and ultimately lead to liver dysfunction, cardiac insufficiency and finally death. Methods A literature review was performed to define the optimal treatment strategy and work-up in patients with neuroendocrine hepatic metastases. Based on this, an algorithm for the management of these patients was established. Results Platelet serotonin and chromogranin A are useful biomarkers for detection and follow-up of neuroendocrine tumour. Helical computed tomography and somatostatin receptor scintigraphy are the most sensitive diagnostic modalities. Surgical debulking is an accepted approach for reducing hormonal symptoms and to establish better conditions for medical treatment, but is frequently impossible due to the extent of disease. A novel approach is the local ablation of tumour by thermal coagulation using therapies such as radiofrequency ablation (RFA or laser induced thermotherapy (LITT. These techniques preserve normal liver tissue. There is a tendency to destroy metastases early in the course of disease, thereby postponing or eliminating the surgically untreatable stage. This can be combined with postoperative radioactive octreotide to eliminate small multiple metastases. In patients with extensive metastases who are not suitable for local destruction, systemic therapy by octreotide, 131I-MIBG treatment or targeted chemo- and radiotherapy should be attempted. A final option for selective patients is orthotopic liver transplantation. Conclusion Treatment for patients with neuroendocrine hepatic metastases must be tailored for each individual patient. When local ablative therapies are used early in the course of the disease, the occurrence of carcinoid syndrome with end stage hepatic disease can be postponed or prevented.

  18. Hepatic Thermal Ablation: Effect of Device and Heating Parameters on Local Tissue Reactions and Distant Tumor Growth. (United States)

    Velez, Erik; Goldberg, S Nahum; Kumar, Gaurav; Wang, Yuanguo; Gourevitch, Svetlana; Sosna, Jacob; Moon, Tyler; Brace, Christopher L; Ahmed, Muneeb


    Purpose To determine whether variable hepatic microwave ablation (MWA) can induce local inflammation and distant pro-oncogenic effects compared with hepatic radiofrequency ablation (RFA) in an animal model. Materials and Methods In this institutional Animal Care and Use Committee-approved study, F344 rats (150 gm, n = 96) with subcutaneous R3230 breast adenocarcinoma tumors had normal non-tumor-bearing liver treated with RFA (70°C × 5 minutes), rapid higher-power MWA (20 W × 15 seconds), slower lower-power MWA (5 W × 2 minutes), or a sham procedure (needle placement without energy) and were sacrificed at 6 hours to 7 days (four time points; six animals per arm per time point). Ablation settings produced 11.4 mm ± 0.8 of coagulation for all groups. Distant tumor growth rates were determined to 7 days after treatment. Liver heat shock protein (HSP) 70 levels (at 72 hours) and macrophages (CD68 at 7 days), tumor proliferative indexes (Ki-67 and CD34 at 7 days), and serum and tissue levels of interleukin 6 (IL-6) at 6 hours, hepatocyte growth factor (HGF) at 72 hours, and vascular endothelial growth factor (VEGF) at 72 hours after ablation were assessed. All data were expressed as means ± standard deviations and were compared by using two-tailed t tests and analysis of variance for selected group comparisons. Linear regression analysis of tumor growth curves was used to determine pre- and posttreatment growth curves on a per-tumor basis. Results At 7 days, hepatic ablations with 5-W MWA and RFA increased distant tumor size compared with 20-W MWA and the sham procedure (5-W MWA: 16.3 mm ± 1.1 and RFA: 16.3 mm ± 0.9 vs sham: 13.6 mm ± 1.3, P < .01, and 20-W MWA: 14.6 mm ± 0.9, P < .05). RFA and 5-W MWA increased postablation tumor growth rates compared with the 20-W MWA and sham arms (preablation growth rates range for all arms: 0.60-0.64 mm/d; postablation: RFA: 0.91 mm/d ± 0.11, 5-W MWA: 0.91 mm/d ± 0.14, P < .01 vs pretreatment; 20-W MWA: 0.69 mm/d ± 0

  19. Hepatic ablation with multiple interstitial ultrasound applicators: initial ex vivo and computational studies (United States)

    Prakash, Punit; Salgaonkar, Vasant A.; Burdette, E. Clif; Diederich, Chris J.


    Radiofrequency (RF) ablation has emerged as an effective method for treating liver tumors under 3 cm in diameter. Multiple applicator devices and techniques - using RF, microwave and other modalities - are under development for thermal ablation of large and irregularly-shaped liver tumors. Interstitial ultrasound (IUS) applicators, comprised of linear arrays of independently powered tubular transducers, enable 3D control of the spatial power deposition profile and simultaneous ablation with multiple applicators. We evaluated IUS applicator configurations (parallel, converging and diverging implants) suitable for percutaneous and laparascopic placement with experiments in ex vivo bovine tissue and computational models. Ex vivo ablation zones measured 4.6+/-0.5 x 4.2+/-0.5 × 3.3+/-0.5 cm3 and 5.6+/-0.5 × 4.9+/-0.5 x 2.8+/-0.3 cm3 using three parallel applicators spaced 2 and 3 cm apart, respectively, and 4.0+/-0.3 × 3.2+/-0.4 × 2.9+/-0.2 cm3 using two parallel applicators spaced 2 cm apart. Computational models indicate in vivo ablation zones up to 4.5 × 4.4 × 5.5 cm3 and 5.7 × 4.8 × 5.2 cm3, using three applicators spaced 2 and 3 cm apart, respectively. Converging and diverging implant patterns can also be employed for conformal ablation of irregularly-shaped tumor margins by tailoring power levels along each device. Simultaneously powered interstitial ultrasound devices can create tailored ablation zones comparable to currently available RF devices and similarly sized microwave antennas.

  20. Flexible applicator systems for radiofrequency ablation (RFA) of hepatic tumors; Flexible Applikatoren zur Radiofrequenzablation (RFA) bei Lebertumoren

    Energy Technology Data Exchange (ETDEWEB)

    Gebauer, B.; Gaffke, G.; Felix, R.; Stroszczynski, C. [Charite, Berlin (Germany). Robert-Roessle-Klinik, Klinik fuer Strahlenheilkunde; Huenerbein, M. [Charite, Berlin (Germany). Robert-Roessle-Klinik, Klinik fuer Chirurgie und chirurgische Onkologie


    Purpose: To report our experience with flexible applicators in radiofrequency ablation (RFA) of hepatic tumors. Materials and Methods: In 6 liver tumors in 6 patients, a flexible RFA-applicator system (RITA StarBurst FLEX, RITA Medical Systems, Mountain View, CA, USA) was placed under CT guidance. The Seldinger technique with an 11G access system (RITA StarBurst Access) was used to place the application system into the liver. Before and within a week after the ablation, all tumors were investigated with contrast-enhanced MRI. Results: The Seldinger technique accommodated the placement of a thin 17.5-gauge needle for the initial puncture, enabling easy adjustment of the position of the needle. The flexible applicator of the RFA system could be placed in 4.5 ({+-}1.8) minutes on average. Conclusion: Flexible applicators facilitate CT-guided RFA and can be placed using the Seldinger technique. (orig.) [German] Ziel: Wir berichten ueber unsere Erfahrungen mit neuartigen flexiblen Applikatorsystemen bei der Radiofrequenzablation (RFA) von Leberturmoren. Material und Methode: Unter computertomographischer (CT) Kontrolle wurde bei 6 Patienten mit insgesamt 6 Tumoren eine RFA mit einem flexiblen Applikatorsystem (RITA StarBurst FLEX 13 G 25 cm, RITA Medical Systems, Mountain View, USA) durchgefuehrt. Dabei wurde das flexible Applikatorsystem in Seldinger-Technik ueber eine 11-G-Schleuse (RITA StarBurst Access) in die Leber eingebracht. Vor und nach Ablation wurde eine kontrastmittelgestuetzte Magnetresonanztomographie (MRT) durchgefuehrt. Ergebnisse: Durch die Seldinger-Technik konnte fuer die initiale Punktion eine vergleichsweise duenne (17,5 G) Nadel verwendet werden, was Lagekorrekturen erleichterte. Das flexible Applikatorsystem in Verbindung mit der Seldinger-Technik erlaubte die Platzierung des Applikators in durchschnittlich 4,5 ({+-}1,8) Minuten. Schlussfolgerung: Flexible Applikatorsysteme erleichtern die RFA in der CT und erlauben eine Platzierung mittels

  1. Hilar Inflammatory Pseudotumour with Hepatic Artery Atheroma- mimicker of Klatskin Tumour. (United States)

    Rastogi, Archana; Bihari, Chhagan; Gupta, Nalini; Deka, Pranjal; Kumar, Arvind; Negi, Sanjay Singh; Arora, Ankur


    Inflammatory pseudotumour of hilar biliary structures is an extremely rare benign lesion that can mimic hilar cholangiocarcinoma. Clinical presentation and imaging findings often pose diagnostic difficulties. Main histopathological findings are the presence of myofibroblastic spindle cells, plasma cells, macrophages, and lymphocytes without cellular atypia or atypical mitotic figures. We describe a case of 62 year old male who presented with surgical obstructive jaundice. Imaging revealed a mass lesion involving the biliary confluence with upstream dilatation of biliary tree. Diagnosis of hilar cholangiocarcinoma with type III hilar block was made. Intraoperately hilar mass lesion was found which was encasing right hepatic artery with no evidence of metastasis. The patient underwent Right hepatectomy with caudate lobectomy with complete common bile duct (CBD) excision with Roux en Y hepaticojejunostomy. Unexpectedly histopathological examination showed no evidence of malignancy and revealed hilar inflammatory pseudotumour with hepatic artery atherosclerosis. Preoperative imaging, operative management, pathologic diagnosis and literature review are being presented in view of rarity of the case.

  2. The role of tumour necrosis factor in hepatitis B infection: Jekyll and Hyde. (United States)

    Valaydon, Zina; Pellegrini, Marc; Thompson, Alexander; Desmond, Paul; Revill, Peter; Ebert, Gregor


    Chronic hepatitis B (CHB) is a major health problem worldwide and is associated with significant long-term morbidity and mortality. The hepatitis B virus (HBV) is a hepatotropic virus that is capable of integrating in the host nucleus permanently resulting in lifelong infection. To date, there is no definitive cure for HBV, as our current treatments cannot eradicate the viral reservoir that has integrated in the liver. Elucidating the immunopathogenesis is key to finding a therapeutic target for HBV as the virus is not in itself cytopathic but the immune response to the virus causes the majority of the cellular injury. In most cases, the virus reaches a state of equilibrium with low viral replication constrained by host immunity. Multiple cytokines have been implicated in the pathogenesis of CHB. Tumor necrosis factor (TNF) has emerged as a key player; on one hand it can facilitate immune-mediated virological control but on the other hand it can cause collateral hepatocyte damage, cirrhosis and possibly promote hepatocellular carcinoma. In this review, we discuss the current understanding of the immunopathogenesis of HBV, focusing on TNF and whether it can be harnessed in therapeutic strategies to cure HBV infection.

  3. Microwave ablation of focal hepatic malignancies regardless of size: A 9-year retrospective study of 64 patients

    Energy Technology Data Exchange (ETDEWEB)

    Alexander, Erica S., E-mail:; Wolf, Farrah J., E-mail:; Machan, Jason T., E-mail:; Charpentier, Kevin P., E-mail:; Beland, Michael D., E-mail:; Iannuccilli, Jason D., E-mail:; Haas, Richard H., E-mail:; Dupuy, Damian E., E-mail:


    Highlights: • MWA appears to be a more effective treatment for larger tumors compared with RFA. • Intraoperative MWA outperformed percutaneous MWA. • Complications related to MWA of liver tumors were minor and self limited. - Abstract: Purpose: To retrospectively evaluate the safety and efficacy of microwave ablation (MWA) as treatment for single, focal hepatic malignancies. Materials and Methods: Institutional review board approval was obtained for this HIPAA-compliant study. From December 2003 to May 2012, 64 patients were treated with MWA for a single hepatic lesion, in 64 sessions. Hepatocellular carcinoma (HCC) was treated in 25 patients (geometric mean tumor size, 3.33-cm; 95% CI, 2.65–4.18-cm; range, 1.0–12.0-cm), metastatic colorectal cancer (CRC) was treated in 27 patients (geometric mean tumor size, 2.7-cm; 95% CI, 2.20–3.40-cm; range, 0.8–6.0-cm), and other histological-types were treated in 12 patients (geometric mean tumor size, 3.79-cm; 95% CI, 2.72–5.26-cm; range, 1.7–8.0-cm). Kaplan–Meier (K–M) method was used to analyze time event data. Chi-square and correlation evaluated the relationship between tumor size and treatment parameters. Results: Technical success rate was 95.3% (61/64). Treatment parameters were tailored to tumor size; as size increased more antennae were used (p < 0.001), treatment with multiple activations increased (p < 0.028), and treatment time increased (p < 0.001). There was no statistically significant relationship between time to recurrence and tumor size, number of activations, number of antennae, and treatment time. At one-year, K–M analysis predicted a likelihood of local recurrence of 39.8% in HCC patients, 45.7% in CRC metastases patients, and 70.8% in patients with other metastases. Median cancer specific survivals for patients were 38.3 months for HCC patients, 36.3 months for CRC metastases, and 13.9 months for other histological-types. Complications occurred in 23.4% (15/64) of sessions

  4. Electrochemotherapy for rat implanted liver tumour

    Institute of Scientific and Technical Information of China (English)


    @@ The most common interventional therapies for liver cancer at present include transcatheter hepatic arterial chemoembolization (TACE),1 percutaneous ethanol injection2 and radiofrequency ablation,3 but all these therapies have some intrinsic disadvantages. Since the advent of electrochemo- therapy (EChT), it has been accepted as a safe and effective therapy for malignant tumors4,5 There are only a few experimental studies reporting the use of EChT in the treatment of liver cancer in the foreign medical literature.6-8 However, there have been some clinical studies, and even fewer reports of experimental studies on EChT for liver cancer in China. We used a rat implanted liver cancer animal model to monitor changes in tumour size, tumour necrosis, cellular apoptosis, expression of peripheral immunological markers (IL-2, sIL-2R, IL-6 and TNF-α) and survival.

  5. Colitogenic role of tumour necrosis factor (TNF) receptors in trinitrobenzene sulphonic acid colitis: TNF-R1 ablation does not affect systemic inflammatory response. (United States)

    Yang, Y; Wang, H; Dou, Y; Wang, Y; Han, G; Wang, Renxi; Wang, L; Guo, R; Xiao, H; Li, X; Shen, B; Shi, Y; Chen, G; Li, Y


    Tumour necrosis factor (TNF)-α plays a critical role in the pathogenesis of T helper type 1-mediated colitis such as Crohn's disease. However, the roles of its two receptors in mediating pathology remain largely unknown. In this study, trinitrobenzene sulphonic acid (TNBS) was used to induce colitis in TNF-receptor single or double knock-out (DKO) BALB/c mice and in wild-type counterparts. TNF-R1(-/-) mice had significantly less weight loss, reduced mortality, colon shortening and oedema, colon histological damage and lower levels of colon myeloperoxidase compared with wild-type (WT) BALB/c mice. A similar manifestation was also observed in TNF-R2(-/-) and TNF-R1(-/-) TNF-R2(-/-) (TNF-R DKO) mice. Strikingly, systemic inflammatory response (including splenomegaly and monocyte expansion) was found in WT and TNF-R1(-/-) mice after TNBS, instead of TNF-R2(-/-) and TNF-R DKO mice. Attenuated pathology of colitis in TNF-R1(-/-) or TNF-R2(-/-) mice correlated with lower amounts of interleukin (IL)-6, IL-1β, monocyte chemotactic protein (MCP)-1, IL-12p70 and interferon (IFN)-γ production in the colons. Importantly, ablation of TNF-R1 or TNF-R2 reduced the number of terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labelling (TUNEL)-positive apoptotic epithelial cells in the affected colons compared with WT TNBS-instilled controls, which might be due to the heightened ratio of Bcl-2/Bax and reduced activity of nuclear factor (NF)-κB. These findings suggest that either TNF-R1 or TNF-R2 plays a pathogenic role in the pathology of colitis and TNF signalling via TNF-R1 or TNF-R2 alone is not sufficient for inducing mucosal damage.

  6. Ablation of hepatic malignant tumors with irreversible electroporation: A systematic review and meta-analysis of outcomes (United States)

    Tian, Guo; Zhao, Qiyu; Chen, Fen; Jiang, Tian’an; Wang, Weilin


    Background Irreversible electroporation (IRE) ablation is a new technique that is used to eliminate malignant tumors through nonthermal approaches. Objective The purpose of this review was to evaluate the efficiency of IRE for hepatic malignant tumors. Methods A systematic search was performed from PubMed, Embase, Web of science, Scopus and other potential literatures from references in relevant articles July 26th, 2016. Overall estimates of pooled standard mean difference (SMD) with 95% confidence interval (CI) were calculated for the changes of the pre- and post-IRE longest diameter, alkaline phosphatase (ALP), aspartate aminotransferase (AST) and serum total bilirubin levels. Sensitivity analysis and publication bias and were performed after the pooled analysis, and the quality of the included literatures was appraised using Newcastle-Ottawa Scale (NOS). Results We finally included 300 patients (mean age: 51 to 66.6 years; male: 182; female: 118) from 9 studies of hepatic malignant tumors. The meta-analysis showed that comparing with the initial values, the longest diameter of the tumors was significantly decreased at the last follow-up months after IRE. Furthermore, the ALP, AST and total bilirubin levels were increased at 1 day after IRE while returned to baseline at the last follow-up month. No risk of publication bias was found, and all literatures were assessed good quality according to NOS. Conclusions The pooled data indicated that IRE could be a minimal invasive and effective approach for patients who had preoperative poor liver function or those whose masses were in refractory locations where surgical resection was unsuitable. PMID:28009979

  7. Hyperplasia and prolapse of hepatocytes into hepatic veins during longterm methyltestosterone therapy: possible relationships of these changes to the developement of peliosis hepatis and liver tumours. (United States)

    Paradinas, F J; Bull, T B; Westaby, D; Murray-Lyon, I M


    We report the pathological changes in liver biopsies from 10 patients (four female transexuals and six impotent males) after treatment with 150 mg methyltestosterone daily for periods of up to 3 years, and in a hemihepatectomy specimen from a female transexual who developed a liver adenoma after 37 months of this treatment. Hepatocyte hyperplasia and mild focal sinusoidal dilatation was found in most cases. In some cases there were microcysts and dissociation of hepatocytes. In nine patients there was accumulation of hepatocytes between the endothelium and the supporting collagen of hepatic veins which often resulted in either partial occlusion of their lumina or disruption of their walls. These vascular changes do not appear to have been reported before. It is postulated that a single pathological process-hyperplasia, perhaps related to the anabolic effect of methyltestosterone--could be partly responsible both for the formation of cysts through mechanical obstruction of hepatic veins and for the formation of nodules and tumours.

  8. Distinguishing radiation fibrosis from tumour recurrence after stereotactic ablative radiotherapy (SABR) for lung cancer: A quantitative analysis of CT density changes

    Energy Technology Data Exchange (ETDEWEB)

    Mattonen, Sarah A.; Ward, Aaron D. [Dept. of Medical Biophysics, Univ. of Western Ontario, London, Ontario (Canada); Palma, David A. [Dept. of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada)], E-mail:; Haasbeek, Cornelis J. A.; Senan, Suresh [Dept. of Radiation Oncology, VU Univ. Medical Center, Amsterdam (Netherlands)


    Background. For patients treated with stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer, benign computed tomography (CT) changes due to radiation-induced lung injury (RILI) can be difficult to differentiate from recurrence. We measured the utility of CT image feature analysis in differentiating RILI from recurrence, compared to Response Evaluation Criteria In Solid Tumours (RECIST). Materials and methods. Twenty-two patients with 24 lesions treated with SABR were selected (11 with recurrence, 13 with substantial RILI). On each follow-up CT, consolidative changes and ground glass opacities (GGO) were contoured. For each lesion, contoured regions were analysed for mean and variation in Hounsfi eld units (HU), 3D volume, and RECIST size during follow-up. Results . One hundred and thirtysix CT scans were reviewed, with a median imaging follow-up of 26 months. The 3D volume and RECIST measures of consolidative changes could significantly distinguish recurrence from RILI, but not until 15 months post-SABR; mean volume at 15 months [all values {+-}95% confidence interval (CI)] of 30.1 {+-} 19.3 cm{sup 3} vs. 5.1 {+-} 3.6 cm{sup 3} (p 0.030) and mean RECIST size at 15 months of 4.34 {+-} 1.13 cm vs. 2.63 {+-} 0.84 cm (p =0.028) respectively for recurrence vs. RILI. At nine months post-SABR, patients with recurrence had significantly higher-density consolidative changes (mean at nine months of -96.4 {+-} 32.7 HU vs. -143.2 {+-} 28.4 HU for RILI; p =0.046). They also had increased variability of HU, an image texture metric, measured as the standard deviation (SD) of HU, in the GGO areas (SD at nine months of 210.6 {+-} 14.5 HU vs. 175.1 {+-} 18.7 HU for RILI; p =0.0078). Conclusions. Quantitative changes in mean HU and GGO textural analysis have the potential to distinguish RILI from recurrence as early as nine months post-SABR, compared to 15 months with RECIST and 3D volume. If validated, this approach could allow for earlier detection

  9. Patterns of histological changes following hepatic electrolytic ablation in an ex-vivo perfused model. (United States)

    Gravante, Gianpiero; Ong, Seok Ling; West, Kevin; McGregor, Angus; Maddern, Guy J; Metcalfe, Matthew S; Lloyd, David M; Dennison, Ashley R


    Electrolytic ablation (EA) destroys the liver by releasing toxic radicles and producing modifications in the local pH without increasing the tissue temperature. We assessed the histological changes produced by EA using an ex-vivo perfused model. Five porcine livers were harvested, preserved in ice and reperfused for six hours in an extracorporeal circuit using autologous normothermic blood. One hour after reperfusion EA was performed and liver biopsies collected at the end of the experiments. The main necrotic zone consisted of coagulative necrosis, sinusoidal dilatation and haemorrhage with an unusual morphological pattern. The coagulative necrosis and haemorrhage affected mainly the peripheral area of the lobule with relative sparing of the area surrounding the centrilobular vein. Contrasting with this sinusoidal dilatation appeared to be more prominent in the centrilobular area. EA produces patterns of tissue destruction that have not been observed with the more commonly used thermal techniques. Further studies should obtain more information about the influence of adjacent biliary and vascular structures so that appropriate clinical trials can be designed.

  10. Liver cancer arterial perfusion modelling and CFD boundary conditions methodology: a case study of the haemodynamics of a patient-specific hepatic artery in literature-based healthy and tumour-bearing liver scenarios. (United States)

    Aramburu, Jorge; Antón, Raúl; Rivas, Alejandro; Ramos, Juan Carlos; Sangro, Bruno; Bilbao, José Ignacio


    Some of the latest treatments for unresectable liver malignancies (primary or metastatic tumours), which include bland embolisation, chemoembolisation, and radioembolisation, among others, take advantage of the increased arterial blood supply to the tumours to locally attack them. A better understanding of the factors that influence this transport may help improve the therapeutic procedures by taking advantage of flow patterns or by designing catheters and infusion systems that result in the injected beads having increased access to the tumour vasculature. Computational analyses may help understand the haemodynamic patterns and embolic-microsphere transport through the hepatic arteries. In addition, physiological inflow and outflow boundary conditions are essential in order to reliably represent the blood flow through arteries. This study presents a liver cancer arterial perfusion model based on a literature review and derives boundary conditions for tumour-bearing liver-feeding hepatic arteries based on the arterial perfusion characteristics of normal and tumorous liver segment tissue masses and the hepatic artery branching configuration. Literature-based healthy and tumour-bearing realistic scenarios are created and haemodynamically analysed for the same patient-specific hepatic artery. As a result, this study provides boundary conditions for computational fluid dynamics simulations that will allow researchers to numerically study, for example, various intravascular devices used for liver disease intra-arterial treatments with different cancer scenarios. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Risk factors for the recurrence of hepatocellular carcinoma after radiofrequency ablation of hepatocellular carcinoma in patients with hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Yutaka Yamanaka; Atsuhiro Nakatsuka; Koichiro Yamakado; Kan Takeda; Katsuya Shiraki; Kazumi Miyashita; Tomoko Inoue; Tomoyuki Kawakita; Yumi Yamaguchi; Yukiko Saitou; Norihiko Yamamoto; Takeshi Nakano


    AIM: To analyze the risk factors of hepatocellular carcinoma (HCC) recurrence after radiofrequency ablation (RFA) treatment with HCV-associated hepatitis. METHODS: Twenty-six patients with HCV-associated HCC who were followed-up for more than 12 mo were selected for this study. Risk factors for distant intrahepatic recurrences of HCC were evaluated for patients in whom complete coagulation was achieved without recurrence in the same subsegment as the primary nodule. Twelve clinical and tumoral factors were examined: Age, gender, nodule diameter, number of primary HCC nodule, Child-Pugh classification, serum platelet, serum albumin, serum AST, post RFA AST, serum ALT, post RFA ALT, post RFA treatment.RESULTS: Distant recurrences of HCC in remnant liver after RFA were observed in 14 cases and in the number of primary HCC nodules (P = 0.047), and the serum platelets (P = 0.030), the clear difference came out by the recurrence group and the non-recurrence group. The cumulative recurrence rates after 1 and 2 years were30.8% and 86.8%, respectively for primary multinodular HCC, and 15.4% and 29.5% respectively, for primary uninodular HCC. In addition the 1-year recurrence rates for patients with serum albumin more than 3.4 g/dL and less than 3.4 g/dL were 23.1% for both, but the 2-years recurrence rates were 89.0% and 23.1%, respectively. The number of primary HCC nodules (relative risk, 6.970; P = 0.016) were found to be a statistically significant predictor for poor distant intrahepatic recurrence by univariate analysis.CONCLUSION: Patients who have multiple HCC nodules, low serum platelets and low serum albumin accompanied by HCV infection, should be carefully followed because of the high incidence of new HCC lesions in the remnant liver, even if coagulation RFA is complete.

  12. Diagnostic pharmaco-scintigraphy with hepatic intra-arterial technetium-99m macroaggregated albumin in the determination of tumour to non-tumour uptake ratio in hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lau, W.Y.; Leung, T.W.T.; Chan, M.; Leung, N.W.Y.; Metreweli, C.; Li, A.K.C. (Prince of Wales Hospital, Shatin (Hong Kong))


    Between October 1990 and March 1993, 124 patients with hepatocellular carcinoma (HCC) underwent diagnostic pharmaco-scintigraphy with hepatic intraarterial technetium-99m macroaggregated albumin (TcMAA) to determine the tumorous to non-tumorous liver tissue uptake ratio (T/N ratio). There were 110 males and 14 females. Ages ranged from 16 to 73 with a median of 55 years. The range of T/N ratio was 0.7 to 19.3 with a median of 3.8. 12 patients with inoperable HCC were subsequently selected by predetermined criteria to undergo treatment with hepatic intraarterial yttrium-90 microspheres and the T/N ratios in these patients were validated by beta probe dosimetry and liquid scintillation count of multiple liver biopsies. The T/N ratio determined by preoperative diagnostic TcMAA scan corrected well with intraoperative beta probe dosimetry, with coefficient of correlation r = 0.82. Preoperative TcMAA scan also correlated well with liquid scintillation count of biopsy specimens. (author).

  13. Fusion dual-tracer SPECT-based hepatic dosimetry predicts outcome after radioembolization for a wide range of tumour cell types

    Energy Technology Data Exchange (ETDEWEB)

    Lam, Marnix G.E.H. [Stanford University, Division of Interventional Radiology, Stanford, CA (United States); University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Heidelberglaan 100, CX, Utrecht (Netherlands); Banerjee, Arjun; Louie, John D.; Sze, Daniel Y. [Stanford University, Division of Interventional Radiology, Stanford, CA (United States); Goris, Michael L.; Iagaru, Andrei H.; Mittra, Erik S. [Stanford University, Division of Nuclear Medicine and Molecular Imaging, Stanford, CA (United States)


    Fusion dual-tracer SPECT imaging enables physiological rather than morphological voxel-based partitioning and dosimetry for {sup 90}Y hepatic radioembolization (RE). We evaluated its prognostic value in a large heterogeneous cohort of patients with extensive hepatic malignancy. A total of 122 patients with primary or secondary liver malignancy (18 different cell types) underwent SPECT imaging after intraarterial injection of {sup 99m}Tc macroaggregated albumin (TcMAA) as a simulation of subsequent {sup 90}Y microsphere distribution, followed by administration of an excess of intravenous {sup 99m}Tc-labelled sulphur colloid (TcSC) as a biomarker for functional liver, and a second SPECT scan. TcMAA distribution was used to estimate {sup 90}Y radiation absorbed dose in tumour (D{sub T}) and in functional liver. Laboratory and clinical follow-up were recorded for 12 weeks after RE, and radiographic responses according to (m)RECIST were evaluated at 3 and 6 months. Dose-response relationships were determined for efficacy and toxicity. Patients were treated with a median of 1.73 GBq activity of resin microspheres (98 patients) or glass microspheres (24 patients), in a whole-liver approach (97 patients) or a lobar approach (25 patients). The objective response rate was 41 % at 3 months and 48 % at 6 months. Response was correlated with D{sub T} (P < 0.01). Median overall survival was 10.1 months (95 % confidence interval 7.4 - 12.8 months). Responders lived for 36.0 months compared to 8.7 months for nonresponders (P < 0.01). Stratified for tumour cell type, D{sub T} was independently associated with survival (P < 0.01). Absorbed dose in functional liver was correlated with toxicity grade change (P < 0.05) and RE-induced liver disease (P < 0.05). Fusion dual-tracer SPECT imaging offers a physiology-based functional imaging tool to predict efficacy and toxicity of RE. This technique can be refined to define dosing thresholds for specific tumour types and treatments, but

  14. A prospective comparison between auto-registration and manual registration of real-time ultrasound with MR images for percutaneous ablation or biopsy of hepatic lesions. (United States)

    Cha, Dong Ik; Lee, Min Woo; Song, Kyoung Doo; Oh, Young-Taek; Jeong, Ja-Yeon; Chang, Jung-Woo; Ryu, Jiwon; Lee, Kyong Joon; Kim, Jaeil; Bang, Won-Chul; Shin, Dong Kuk; Choi, Sung Jin; Koh, Dalkwon; Seo, Bong Koo; Kim, Kyunga


    To compare the accuracy and required time for image fusion of real-time ultrasound (US) with pre-procedural magnetic resonance (MR) images between positioning auto-registration and manual registration for percutaneous radiofrequency ablation or biopsy of hepatic lesions. This prospective study was approved by the institutional review board, and all patients gave written informed consent. Twenty-two patients (male/female, n = 18/n = 4; age, 61.0 ± 7.7 years) who were referred for planning US to assess the feasibility of radiofrequency ablation (n = 21) or biopsy (n = 1) for focal hepatic lesions were included. One experienced radiologist performed the two types of image fusion methods in each patient. The performance of auto-registration and manual registration was evaluated. The accuracy of the two methods, based on measuring registration error, and the time required for image fusion for both methods were recorded using in-house software and respectively compared using the Wilcoxon signed rank test. Image fusion was successful in all patients. The registration error was not significantly different between the two methods (auto-registration: median, 3.75 mm; range, 1.0-15.8 mm vs. manual registration: median, 2.95 mm; range, 1.2-12.5 mm, p = 0.242). The time required for image fusion was significantly shorter with auto-registration than with manual registration (median, 28.5 s; range, 18-47 s, vs. median, 36.5 s; range, 14-105 s, p = 0.026). Positioning auto-registration showed promising results compared with manual registration, with similar accuracy and even shorter registration time.

  15. Microwave Ablation Using Four-Tine Antenna: Effects of Blood Flow Velocity, Vessel Location, and Total Displacement on Porous Hepatic Cancer Tissue (United States)

    Chaichanyut, Montree


    This research is concerned with microwave ablation analyses using a 2.45 GHz four-tine (4T) antenna for hepatic cancer tissue. In the study, three-dimensional finite-element models were utilized to examine the tissue temperature distributions during and after MW ablation. A preliminary study was first carried out with regard to the specific absorption rates along the 4T antenna insertion depths and the temperature distributions inside the solid and porous liver models with either 3 cm-in-diameter tumor or 5 cm-in-diameter tumor. Based on the preliminary results, the porous models were further examined for the effect of varying blood flow velocities (0–200 cm/s) with a 1 cm-in-diameter blood vessel next to the antenna and also for the effect of vessel-antenna locations (0, 0.8, and 1.3 cm) with a constant blood flow velocity of 16.7 cm/s. All scenarios were simulated under temperature-controlled mode (90°C). The findings revealed that the blood flow velocity and vessel location influence the ablation effectiveness and that increased blood flow inhibits heat transfer to the vessel wall. At the nearest and farthest vessel-antenna locations (0 and 1.3 cm), approximately 90.3% and 99.55% of the cancer cells were eradicated except for the areas adjacent to the vessel. In addition, total tissue thermal displacement is 5.9 mm which is 6.59% of the total length of the overall model. PMID:27642364

  16. Microwave Ablation Using Four-Tine Antenna: Effects of Blood Flow Velocity, Vessel Location, and Total Displacement on Porous Hepatic Cancer Tissue

    Directory of Open Access Journals (Sweden)

    Montree Chaichanyut


    Full Text Available This research is concerned with microwave ablation analyses using a 2.45 GHz four-tine (4T antenna for hepatic cancer tissue. In the study, three-dimensional finite-element models were utilized to examine the tissue temperature distributions during and after MW ablation. A preliminary study was first carried out with regard to the specific absorption rates along the 4T antenna insertion depths and the temperature distributions inside the solid and porous liver models with either 3 cm-in-diameter tumor or 5 cm-in-diameter tumor. Based on the preliminary results, the porous models were further examined for the effect of varying blood flow velocities (0–200 cm/s with a 1 cm-in-diameter blood vessel next to the antenna and also for the effect of vessel-antenna locations (0, 0.8, and 1.3 cm with a constant blood flow velocity of 16.7 cm/s. All scenarios were simulated under temperature-controlled mode (90°C. The findings revealed that the blood flow velocity and vessel location influence the ablation effectiveness and that increased blood flow inhibits heat transfer to the vessel wall. At the nearest and farthest vessel-antenna locations (0 and 1.3 cm, approximately 90.3% and 99.55% of the cancer cells were eradicated except for the areas adjacent to the vessel. In addition, total tissue thermal displacement is 5.9 mm which is 6.59% of the total length of the overall model.

  17. Radiofrequency ablation of recurrent cholangiocarcinoma after orthotopic liver transplantation - a case report

    Institute of Scientific and Technical Information of China (English)

    Rakesh Rai; Derek Manas; John Rose


    AIM: To report the use of radiofrequency ablation in the treatment of recurrenct cholangiocarcinoma in the transplanted liver.METHODS: A lady who underwent orthotopic liver transplantation (OLT) for intrahepatic cholangiocarcinoma recurrence of tumour 13 mo after tralsplantation inspite of adjuvant chemotherapy. Her recurrent tumour was treated with radiofrequency ablation.RESULTS: She survived for 18 mo following the recurrence of her tumour.CONCLUSION: Radiofrequency ablation can be used safely in the transplanted liver to treat recurrent tumour.

  18. Hepatitis

    Institute of Scientific and Technical Information of China (English)


    930140 Hepatocyte stimulator peptide and itsclinical significance in viral hepatitis.ZHOUWeiping(周卫平),et al.Instit Viral Hepatitis,Chongqing Med Univ,630010.Chin J InternMed 1992;31(10):626-628.Hepatocyte stimulator peptide(HSP)is anewly developed hepatic stimulator substance.Its monoclonal antibodies have been obtained inour laboratory.In this study,HSP was deter-mined in the sera of 315 subjects including pa-

  19. Hepatitis

    Institute of Scientific and Technical Information of China (English)


    2010349 Relationships between serum hepatitis B virus load in mothers,free maternal DNA in peripheral blood of newborns and hepatitis B virus infection of newborns. WEI Junni(魏俊妮),et al. Dept Epidemiol,Shanxi Med Univ,Taiyuan 030001. Chin J Infect Dis 2010;28(5):297-300. Objective To study the relationships between serum hepatitis B virus (HBV) DNA level

  20. Hepatitis (United States)

    ... inflammation of the liver.” This inflammation can be caused by a wide variety of toxins, drugs, and metabolic diseases, as well as infection. There are at least 5 hepatitis viruses. Hepatitis A is contracted when a child eats food or drinks water that is contaminated with the virus or has ...

  1. Hepatitis

    Institute of Scientific and Technical Information of China (English)


    970349 Primary structure and variability of partialsequences in nonstructural gene 5 region of hepatitis Gvirus, CHANG Jinhong(常锦红), et al. Hepatol Instis,People’s Hosp, Beijing Med Univ, Beijing, 100044. NatlMed J China 1997; 77(3): 178-182. Objective: To sequence partial genome of hepatitis G

  2. Hepatitis

    Institute of Scientific and Technical Information of China (English)


    2009209 Effects of chronic hepatitis B virus infection on human hepatic cytochrome P450 2C9.ZHO Fuping(周福平),et al.Dept Infect Dis,Shanghai Changzheng Hosp,Shanghai 200003.Chin J Infect Dis,2009;27(2):94-98.

  3. Hepatitis

    Institute of Scientific and Technical Information of China (English)


    920691 The determination of serum hepa-titis B virus DNA by polymerase chain rea-ction in hepatitis B patients treated withalpha-interferon. XU. Jianye(徐建业), et al.Centr Lab, Chongqing Cancer Instit, 630030.Chin J Intern Med, 1992; 31(5): 278-280. To clarify the status of HBV in serum of

  4. Hepatitis

    Institute of Scientific and Technical Information of China (English)


    2005226 Characteristics of peripheral blood T lymphocyte subsets in hepatitis B patients. FAN Zhen-ping(范振平),et al. Center Bio Ther, Instit Infect Dis, 302 Hosp Chin PLA, Beijing 100039. World Chin J Digestol, 2005;13(2): 194-197. Objective: To characterize the T-lymphocyte subsets in peripheral blood of patients with acute and chronic hepatitis B, and to explore their relations with the disease state. Methods: Peripheral blood

  5. Tumour necrosis factor -308 and -238 promoter polymorphisms are predictors of a null virological response in the treatment of Brazilian hepatitis C patients

    Directory of Open Access Journals (Sweden)

    Tarciana Grandi


    Full Text Available Certain host single nucleotide polymorphisms (SNPs affect the likelihood of a sustained virological response (SVR to treatment in subjects infected with hepatitis C virus (HCV. SNPs in the promoters of interleukin (IL-10 (-1082 A/G, rs1800896, myxovirus resistance protein 1 (-123 C/A, rs17000900 and -88 G/T, rs2071430 and tumour necrosis factor (TNF (-308 G/A, rs1800629 and -238 G/A, rs361525 genes and the outcome of PEGylated α-interferon plus ribavirin therapy were investigated. This analysis was performed in 114 Brazilian, HCV genotype 1-infected patients who had a SVR and in 85 non-responders and 64 relapsers. A significantly increased risk of having a null virological response was observed in patients carrying at least one A allele at positions -308 [odds ratios (OR = 2.58, 95% confidence intervals (CI = 1.44-4.63, p = 0.001] or -238 (OR = 7.33, 95% CI = 3.59-14.93, p < 0.001 in the TNF promoter. The risk of relapsing was also elevated (-308: OR = 2.87, 95% CI = 1.51-5.44, p = 0.001; -238: OR = 4.20, 95% CI = 1.93-9.10, p < 0.001. Multiple logistic regression of TNF diplotypes showed that patients with at least two copies of the A allele had an even higher risk of having a null virological response (OR = 16.43, 95% CI = 5.70-47.34, p < 0.001 or relapsing (OR = 6.71, 95% CI = 2.18-20.66, p = 0.001. No statistically significant association was found between the other SNPs under study and anti-HCV therapy response.

  6. Local recurrence following hepatic radiofrequency ablation: diagnosis and treatment; Diagnostik und Therapie von Lokalrezidiven nach Radiofrequenzablation an der Leber

    Energy Technology Data Exchange (ETDEWEB)

    Eisele, R.M.; Schumacher, G.; Neuhaus, P. [Klinik fuer Allgemein-, Viszeral- und Transplantationschirurgie, Charite Campus Virchow-Klinikum, Berlin (Germany)


    Background: radiofrequency ablation (RFA) is an established treatment in irresectable malignant liver disease. The most severe constraint is re-occurrence at site of ablation. Whereas factors influencing local recurrence rates have been determined, little is known about the timespan within local recurrence (LR) is to be expected, and further treatment options. Patients and methods: in the presented trial, RFA was performed using two different types of monopolar devices. All procedures were conducted under general anesthesia. Follow-up examinations took part after 3, 6, 12 months and annually. Results: 149 RFAs in 125 patients were enrolled. Percutaneous access was chosen in 74 cases (50%), laparoscopic in 15 (10%) and open surgical in 60 cases (40%). Indications were primary liver tumors in 99 (67%) and metastases in 50 cases (33%). Overall LR rate was 29.5% on a per-patient- and 19.7% on a per-tumor-basis. The majority of LRs (71%) occurred within 9 months after the RFA despite observations beyond 2 years following the treatment (Figure 1). 75% of LR could be treated by targeted interventions (RFA, n = 18, 53%, laser-induced thermo therapy (LITT), n = 2.6%, brachytherapy, n = 2.6% or transarterial chemoembolisation (TACE), n = 2.6%) or resection (n = 6.18%); 4 patients underwent liver transplantation (12%) (Figure 2). Conclusion: local recurrence can be considered rather common after RFA. It is observed during the first 3 years of the follow-up period, and schedules have to be designed according to this finding. Follow-on treatment is feasible in approximately 75% of LR. Factors influencing the secondary success of repeated procedures have yet to be determined. (orig.)

  7. Hepatitis

    Institute of Scientific and Technical Information of China (English)


    2008312 Impact of hepatitis B virus infection on the activity of hematopoietic stem cell.SHI Yanmei(石雁梅),et al.Dept Infect Dis,1st Clin Coll,Harbin Med Univ,Harbin 150001.Chin J Infect Dis 2008;26(4):197-201.Objective To study the impact of hepatitis B virus (HBV)infection on the activity of cord hematopoieticstem cells.Methods CD34+cells were isolated from healthy human cord blood by mini MACS.Cells were

  8. Hepatitis

    Institute of Scientific and Technical Information of China (English)


    2008449 A cross-sectional survey of occult hepatitis B virus infection in HIV-infected patients. MA Jianxin(马建新), et al.Dept Infect Dis, Shanghai Public Health Clin Center, Shanghai 201508. Chin J Intern Med 2008;47(7):574-577. Objective To assess the prevalence of occult HBV infection in HIV-infected patients.

  9. Hepatitis

    Institute of Scientific and Technical Information of China (English)


    2008079 Relationship of HBV genotype and bcp and pc mutations with HBV DNA rebound after lamivudine therapy. SU Minghua(苏明华), et al. Dept Infect Dis Clin Hosp, Guangxi Med Univ, Nanning 530027. World Chin J Digestol 2007;15(33):3507-3513. Objective To investigate the relationship of HBV gene mutations with HBV DNA rebound after lamivudine therapy. Methods Twenty-seven hepatitis B patients with HBV DNA rebound after

  10. Catheter Ablation (United States)

    ... ablation. Visit Cardiac ablation procedures and Cardiac conduction system for more information about this topic. Related ... National Institutes of Health Department of Health and Human Services

  11. Radiofrequency ablation of pulmonary tumors

    Energy Technology Data Exchange (ETDEWEB)

    Crocetti, Laura, E-mail: l.crocetti@med.unipi.i [Division of Diagnostic Imaging and Intervention, Department of Liver Transplants, Hepatology and Infectious Diseases, Pisa University School of Medicine (Italy); Lencioni, Riccardo [Division of Diagnostic Imaging and Intervention, Department of Liver Transplants, Hepatology and Infectious Diseases, Pisa University School of Medicine (Italy)


    The development of image-guided percutaneous techniques for local tumor ablation has been one of the major advances in the treatment of solid tumors. Among these methods, radiofrequency (RF) ablation is currently established as the primary ablative modality at most institutions. RF ablation is accepted as the best therapeutic choice for patients with early-stage hepatocellular carcinoma when liver transplantation or surgical resection are not suitable options and is considered as a viable alternate to surgery for inoperable patients with limited hepatic metastatic disease, especially from colorectal cancer. Recently, RF ablation has been demonstrated to be a safe and valuable treatment option for patients with unresectable or medically inoperable lung malignancies. Resection should remain the standard therapy for non-small cell lung cancer (NSCLC) but RF ablation may be better than conventional external-beam radiation for the treatment of the high-risk individual with NSCLC. Initial favourable outcomes encourage combining radiotherapy and RF ablation, especially for treating larger tumors. In the setting of colorectal cancer lung metastases, survival rates provided by RF ablation in selected patients, are substantially higher than those obtained with any chemotherapy regimens and provide indirect evidence that RF ablation therapy improves survival in patients with limited lung metastatic disease.

  12. Fusion dual-tracer SPECT-based hepatic dosimetry predicts outcome after radioembolization for a wide range of tumour cell types

    NARCIS (Netherlands)

    Lam, Marnix G. E. H.; Banerjee, Arjun; Goris, Michael L.; Iagaru, Andrei H.; Mittra, Erik S.; Louie, John D.; Sze, Daniel Y.


    Purpose Fusion dual-tracer SPECT imaging enables physiological rather than morphological voxel-based partitioning and dosimetry for Y-90 hepatic radioembolization (RE). We evaluated its prognostic value in a large heterogeneous cohort of patients with extensive hepatic malignancy. Methods A total of

  13. Local tumour hyperthermia as immunotherapy for metastatic cancer


    Toraya-Brown, Seiko; Fiering, Steven


    Local tumour hyperthermia for cancer treatment is currently used either for ablation purposes as an alternative to surgery or less frequently, in combination with chemotherapy and/or radiation therapy to enhance the effects of those traditional therapies. As it has become apparent that activating the immune system is crucial to successfully treat metastatic cancer, the potential of boosting anti-tumour immunity by heating tumours has become a growing area of cancer research. After reviewing t...

  14. Early tumour response as a survival predictor in previously- treated patients receiving triplet hepatic artery infusion and intravenous cetuximab for unresectable liver metastases from wild-type KRAS colorectal cancer. (United States)

    Bouchahda, Mohamed; Boige, Valérie; Smith, Denis; Karaboué, Abdoulaye; Ducreux, Michel; Hebbar, Mohamed; Lepère, Céline; Focan, Christian; Guimbaud, Rosine; Innominato, Pasquale; Awad, Sameh; Carvalho, Carlos; Tumolo, Salvatore; Truant, Stephanie; De Baere, Thierry; Castaing, Denis; Rougier, Philippe; Morère, Jean-François; Taieb, Julien; Adam, René; Lévi, Francis


    Early tumour shrinkage has been associated with improved survival in patients receiving cetuximab-based systemic chemotherapy for liver metastases from colorectal cancer (LM-CRC). We tested this hypothesis for previously treated LM-CRC patients receiving cetuximab (500 mg/m(2)) and triplet hepatic artery infusion (HAI) within European trial OPTILIV. Irinotecan (180 mg/m(2)), 5-fluorouracil (2800 mg/m(2)) and oxaliplatin (85 mg/m(2)) were given as chronomodulated or conventional delivery. Patients were retrospectively categorised as early responders (complete or partial RECIST response after three courses) or non-early responders (late or no response). Prognostic factors were determined using multivariate logistic or Cox regression models. Response was assessed in 57 of 64 registered patients (89%), who had previously received one to three prior systemic chemotherapy protocols. An early response occurred at 6 weeks in 16 patients (28%; 9 men, 7 women), aged 33-76 years, with a median of 12 liver metastases (LMs) (2-50), involving five segments (1-8). Ten patients had a late response, and 31 patients had no response. Grade 3-4 fatigue selectively occurred in the non-early responders (0% versus 26%; p = 0.024). Early tumour response was jointly predicted by chronomodulation-odds ratio (OR): 6.0 (1.2-29.8; p = 0.029)-and LM diameter ≤57 mm-OR: 5.3 (1.1-25.0; p = 0.033). Early tumour response predicted for both R0-R1 liver resection-OR: 11.8 (1.4-100.2; p = 0.024) and overall survival-hazard ratio: 0.39 (0.17-0.88; p = 0.023) in multivariate analyses. Early tumour response on triplet HAI and systemic cetuximab predicted for complete macroscopic liver resection and prolonged survival for LM-CRC patients within a multicenter conversion-to-resection medicosurgical strategy. Confirmation is warranted for early response on HAI to guide decision making. Protocol numbers: EUDRACT 2007-004632-24 NCT00852228. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Desmoplastic small round cell tumour

    Energy Technology Data Exchange (ETDEWEB)

    Tan, T.H.L. [North District Hospital, Fanling, Kowloon (Hong Kong). Radiology Department; Ong, K.L. [Prince of Wales Hospital, Shatin, Kowloon (Hong Kong). Accident and Emergency Department; Au, Y.M.C. [Princess Margarete Hospital, Kowloon, (Hong Kong). Department of Radiology


    The present report describes a rare case of primary desmoplastic small cell tumour of the recto-sigmoid colon with hepatic metastases and lymphadenopathy. There are no pathognomonic radiological features and often their features overlap with other diseases including lymphoma. Histology is necessary to confirm this diagnosis. Unfortunately despite aggressive therapy, the prognosis for this disease is poor. Copyright (1998) Blackwell Science Pty Ltd 8 refs., 1 fig.

  16. Tumour Cell Labelling by Magnetic Nanoparticles with Determination of Intracellular Iron Content and Spatial Distribution of the Intracellular Iron

    Directory of Open Access Journals (Sweden)

    Alfred Cuschieri


    Full Text Available Magnetically labelled cells are used for in vivo cell tracking by MRI, used for the clinical translation of cell-base therapies. Studies involving magnetic labelled cells may include separation of labelled cells, targeted delivery and controlled release of drugs, contrast enhanced MRI and magnetic hyperthermia for the in situ ablation of tumours. Dextran-coated super-paramagnetic iron oxide (SPIO ferumoxides are used clinically as an MR contrast agents primarily for hepatic imaging. The material is also widely used for in vitro cell labelling, as are other SPIO-based particles. Our results on the uptake by human cancer cell lines of ferumoxides indicate that electroporation in the presence of protamine sulphate (PS results in rapid high uptake of SPIO nanoparticles (SPIONs by parenchymal tumour cells without significant impairment of cell viability. Quantitative determination of cellular iron uptake performed by colorimetric assay is in agreement with data from the literature. These results on intracellular iron content together with the intracellular distribution of SPIONs by magnetic force microscopy (MFM following in vitro uptake by parenchymal tumour cells confirm the potential of this technique for clinical tumour cell detection and destruction.

  17. Primary hepatic carcinosarcoma:a case report

    Institute of Scientific and Technical Information of China (English)

    王细文; 梁平; 李洪艳


    @@ Primary hepatic carcinosarcoma is defined as a malignant hepatic tumour containing both carcinomatous and sarcomatous elements. Strictly, it should be distinguished from collision tumour and carcinoma with foci of spindle-shaped epithelial cells. Primary hepatic carcinosarcoma is rare, and less than 11 adequately documented cases have been reported. In this article, a case of primary hepatic carcinosarcoma was discussed as to its potential histogenesis.

  18. 经球囊导管肝段热凝固CT与病理对照研究%Comparison of Image Appearance of Hepatic Segmental Ablation by Transcatheter Intraarterial Hyperther-mic Infusion with Pathological Findings

    Institute of Scientific and Technical Information of China (English)

    潘国和; 郑家平


    目的:观察经球囊导管阻断肝动脉高热灌注生理盐水行肝段热凝固CT表现。方法实验猪6头,选用球囊导管阻断肝段动脉血流进行热灌注,导管流出温度设置50~60℃之间。热灌注结束后即刻、14天,行肝动脉DSA检查和肝脏螺旋CT扫描,14天将实验猪全部处死,取出肝脏进行病理检查。结果热灌注后14天,6头实验猪均存活。DSA检查见靶段动脉闭塞,肝组织热灌注区显示充盈缺损。肝脏热灌注区CT影像学表现:热灌注结束后即刻,热灌注区显示大片状低密度改变,无明显强化,边缘显示模糊;热灌注后14天,CT平扫示肝脏热灌注区呈典型楔形低密度改变;CT增强示热灌注区显示“三环征”,由内向外分为低密度无增强区、边缘强化带和移行区透明带。病理上取得6个热凝固灶,CT上低密度无增强区、边缘强化带和移行区透明带分别代表病理的凝固性坏死区、炎性充血带和纤维化带。结论增强CT能准确反映经动脉导管肝段介入性热毁损的病理改变,DSA价值有限。%Objective To explore image appearance of hepatic segmental ablation by trans-ballooncatheter hyper-thermic infusing saline. Methods The hepatic segmental arteries were occluded by ballooncatheter in 6 experimen-tal pigs, then infused 780ml saline warmed to 50℃,55℃,60 ℃,flow rate 1-2ml per second for 10min. All pigs were performed digital subtract angiography (DSA) and X-ray computed tomography (CT) exam before and shortly after and 14 days after hyperthermic infusion. Total 6 pigs were sacrificed and the livers were fetched to observe pathological changes on day 14 after hyperthermic infusion. Results Six experimental pigs were alive on day 14 after hyperthermic infusion. The image appearance of hepatic segmental ablation was as follows:(1)DSA showed that the targeting small arteries were destroyed and disappeared and the segmental hepatic arteries

  19. Gastric Calcifying Fibrous Tumour

    Directory of Open Access Journals (Sweden)

    Tan Attila


    Full Text Available Intramucosal gastric tumours are most commonly found to be gastrointestinal stromal tumours or leiomyomas (smooth muscle tumours; however, a variety of other uncommon mesenchymal tumours can occur in the stomach wall. A rare benign calcifying fibrous tumour is reported and the endoscopic appearance, ultrasound findings and morphology are documented. A review of the literature found only two similar cases.

  20. MR-guided radiofrequency ablation using a wide-bore 1.5-T MR system: clinical results of 213 treated liver lesions

    Energy Technology Data Exchange (ETDEWEB)

    Rempp, Hansjoerg; Waibel, Lorenz; Hoffmann, Ruediger; Claussen, Claus D.; Clasen, Stephan [Eberhard Karls University of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Pereira, Philippe L. [Clinic for Radiology, Nuclear Medicine and Minimal Invasive Therapies, SLK-Clinics, Heilbronn (Germany)


    To evaluate the technical effectiveness, technical success and patient safety of MR-guided radiofrequency (RF) ablation of liver malignancies using a wide-bore 1.5-T MR system. In 110 patients, 56 primary liver lesions and 157 liver metastases were treated in 157 sessions using percutaneous RF ablation. Mean lesion diameter was 20 mm (range 4-54 mm). All planning, procedural and post-interventional control MR investigations were carried out using a wide-bore 1.5-T MR system. Technical success was assessed by a contrast-enhanced MR liver examination immediately after the intervention. Technique effectiveness was assessed by dynamic hepatic MR study 1 month post ablation; mean follow-up period was 24.2 months (range 5-44). Technical success and technique effectiveness were achieved in 210/213 lesions (98.6 %). In 18/210 lesions (8.6 %), local tumour progression occurred 4-28 months after therapy. Seven of these 18 lesions were treated in a second session achieving complete ablation, 6 other lesions were referred to surgery. Overall RF effectiveness rate was 199/213 (93.4 %); overall therapy success (including surgery) was 205/213 (96.2 %). Two major complications (1.3 %) (bleeding and infected biloma) and 14 (8.9 %) minor complications occurred subsequent to 157 interventions. Wide-bore MR-guided RF ablation is a safe and effective treatment option for liver lesions. (orig.)

  1. Wilms' tumour (nephroblastoma)

    African Journals Online (AJOL)

    surgeon who first described this type of tumour in 1899. Wilms' tumour .... Open biopsy should be avoided at all costs, as it. 'upstages' the tumour. Survival ... surgeon. No laparoscopic surgery should be done, as the whole abdomen has to be.

  2. GPU-based RFA simulation for minimally invasive cancer treatment of liver tumours

    NARCIS (Netherlands)

    Mariappan, P.; Weir, P.; Flanagan, R.; Voglreiter, P.; Alhonnoro, T.; Pollari, M.; Moche, M.; Busse, H.; Futterer, J.J.; Portugaller, H.R.; Sequeiros, R.B.; Kolesnik, M.


    PURPOSE: Radiofrequency ablation (RFA) is one of the most popular and well-standardized minimally invasive cancer treatments (MICT) for liver tumours, employed where surgical resection has been contraindicated. Less-experienced interventional radiologists (IRs) require an appropriate planning tool

  3. Evaluation of Therapeutic Effect of Contrast-enhanced Ultrasonography in Hepatic Carcinoma Radiofrequency Ablation and Comparison with Conventional Ultrasonography and Enhanced Computed Tomography

    Directory of Open Access Journals (Sweden)

    Qichao Zheng


    Conclusion: CEUS has important value of clinical application both prior to and after RFA operations. Prior to the operation, CEUS can accurately guide the RFA treatment, whereas after the operation, CEUS is an important method to evaluate the inactivation after the treatment, and can be an important means for follow-up visits for partial treatment of hepatic carcinoma.

  4. Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Xu, H.-X.; Xie, X.-Y.; Lu, M.-D. E-mail:; Chen, J.-W.; Yin, X.-Y.; Xu, Z.-F.; Liu, G.-J


    AIM: To investigate the therapeutic efficacy of thermal ablation for treatment of hepatocellular carcinoma (HCC) using microwave and radiofrequency (RF) energy application. MATERIALS AND METHODS: A total of 190 nodules in 97 patients (84 male, 13 female; mean age 53.4 years, range 24-74 years) with HCC were treated with microwave or RF ablation in the last 4 years. The applicators were introduced into the tumours under conscious analgesic sedation by intravenous administration of fentanyl citrate and droperidol and local anaesthesia in both thermal ablation procedures. The patients were then followed up with contrast-enhanced computed tomography (CT) to evaluate treatment response. Survival was analysed using the Kaplan-Meier method. RESULTS: Complete ablation was obtained in 92.6% (176/190) nodules. The complete ablation rates were 94.6% (106/112) in microwave ablation and 89.7% (70/78) in RF ablation. The complete ablation rates in tumours{<=}2.0, 2.1-3.9 and {>=}4.0 cm were 93.1, 93.8 and 86.4%, respectively. Local recurrence was found in 9.5% nodules and the rates in tumours{<=}2.0, 2.1-3.9 and {>=}4.0 cm in diameter were 3.4, 9.9 and 31.8%, respectively. In the follow-up period, 7.1% nodules ablated by microwave and 12.8% by RF presented local recurrence. The 1, 2 and 3-year distant recurrence-free survivals were 47.2, 34.9 and 31.0%, respectively. Estimated mean survival was 32 months, and 1, 2 and 3-year cumulative survivals were 75.6, 58.5, and 50.0%, respectively. One and 2 years survivals of Child-Pugh class A, B and C patients were 83.8 and 70.4%, 78.2 and 53.2%, 36.3 and 27.3%, respectively. CONCLUSION: Thermal ablation therapy by means of microwave and RF energy application is an effective and safe therapeutic technique for hepatocellular carcinoma. Large tumours can be completely ablated, but have a significantly higher risk of local recurrence at follow-up.

  5. An update on irreversible electroporation of liver tumours. (United States)

    Yeung, Enoch S L; Chung, Max W Y; Wong, Keedon; Wong, Clement Y K; So, Enoch C T; Chan, Albert C Y


    OBJECTIVE. To investigate the clinical efficacy and safety of irreversible electroporation for ablation of liver tumour in humans. DATA SOURCES. The PubMed and MEDLINE databases were systematically searched. STUDY SELECTION. Clinical research published in English in the last 10 years until October 2013 that address clinical issues related to irreversible electroporation of human liver tumours were selected. "Liver tumor", "local ablative therapy", and "irreversible electroporation" were used as the search terms. DATA EXTRACTION AND SYNTHESIS. The data extracted for this review was analysed by the authors, with a focus on the clinical efficacy and the safety of irreversible electroporation. The complete response rates look promising, ranging from 72% to 100%, except in one study in a subgroup of liver tumours in which the complete response rate was only 50% that was likely due to the inclusion of larger-size tumours. In one study, the local recurrence rate at 12 months was approximately 40%. As for the safety of irreversible electroporation, there were only a few reported complications (cardiac arrhythmia, pneumothorax, and electrolyte disturbance) that were mostly transient and not serious. There was no reported mortality related to the use of irreversible electroporation. CONCLUSION. Irreversible electroporation is a potentially effective liver tumour ablative therapy that gives rise to only mild and transient side-effects. Further studies with better patient selection criteria and longer follow-up are needed to clarify its role as a first-line liver tumour treatment modality.

  6. Local tumour hyperthermia as immunotherapy for metastatic cancer. (United States)

    Toraya-Brown, Seiko; Fiering, Steven


    Abstract Local tumour hyperthermia for cancer treatment is currently used either for ablation purposes as an alternative to surgery or less frequently, in combination with chemotherapy and/or radiation therapy to enhance the effects of those traditional therapies. As it has become apparent that activating the immune system is crucial to successfully treat metastatic cancer, the potential of boosting anti-tumour immunity by heating tumours has become a growing area of cancer research. After reviewing the history of hyperthermia therapy for cancer and introducing methods for inducing local hyperthermia, this review describes different mechanisms by which heating tumours can elicit anti-tumour immune responses, including tumour cell damage, tumour surface molecule changes, heat shock proteins, exosomes, direct effects on immune cells, and changes in the tumour vasculature. We then go over in vivo studies that provide promising results showing that local hyperthermia therapy indeed activates various systemic anti-tumour immune responses that slow growth of untreated tumours. Finally, future research questions that will help bring the use of local hyperthermia as systemic immunotherapy closer to clinical application are discussed.

  7. Actual role of radiofrequency ablation of liver metastases

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Philippe L. [Eberhard-Karls-University of Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany)


    The liver is, second only to lymph nodes, the most common site for metastatic disease irrespective of the primary tumour. More than 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improved survival in patients with colorectal metastases, only approximately 20% of patients are eligible for surgery. Thermal ablation and especially radiofrequency ablation emerge as an important additional therapy modality for the treatment of liver metastases. RF ablation shows a benefit in life expectancy and may lead in a selected patient group to cure. Percutaneous RF ablation appears safer (versus cryotherapy), easier (versus laser), and more effective (versus ethanol instillation and transarterial chemoembolisation) compared with other minimally invasive procedures. RF ablation can be performed by a percutaneous, laparoscopical or laparotomic approach, and may be potentially combined with chemotherapy and surgery. At present ideal candidates have tumours with a maximum diameter less than 3.5 cm. An untreatable primary tumour or a systemic disease represents contraindications for performing local therapies. Permanent technical improvements of thermal ablation devices and a better integration of thermal ablation in the overall patient care may lead to prognosis improvement in patients with liver metastases. (orig.)

  8. Evaluation of the In Vivo Efficiency and Safety of Hepatic Radiofrequency Ablation Using a 15-G Octopus® in Pig Liver

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Sun [Department of Radiology, Seoul National University College of Medicine, Seoul 110-744 (Korea, Republic of); Lee, Jeong Min [Department of Radiology, Seoul National University College of Medicine, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul 110-744 (Korea, Republic of); Kim, Kyung Won [Department of Radiology, Seoul National University College of Medicine, Seoul 110-744 (Korea, Republic of); Lee, In Joon [National Cancer Center, Seoul 410-769 (Korea, Republic of); Han, Joon Koo; Choi, Byung Ihn [Department of Radiology, Seoul National University College of Medicine, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul 110-744 (Korea, Republic of)


    To determine in vivo efficacy of radiofrequency ablation (RFA) in porcine liver by using 15-gauge Octopus® (15-G Octopus®) electrodes to create a large coagulation. A total of 18 coagulations were created by using a 180-W generator and 15-G Octopus® electrodes during laparotomy, performed in 14 pigs. Coagulation necrosis was created in the pig livers by the use of one of three RFA protocols: 1) group A, monopolar RFA using a 15-G Octopus® electrode with a 5-mm inter-electrode distance (n = 4); 2) group B, monopolar RFA using a 15-G Octopus® electrode with a 10-mm inter-electrode distance (n = 6); and 3) group C, switching monopolar RFA using two 15-G Octopus® electrodes (n = 8). The energy efficiency, shape, maximum and minimum diameters (Dmx and Dmi), and the volume of the coagulation volume were measured in each group. The Summary statistics were obtained and Mann-Whitney test was were performed. The mean ablated volume of each group was 49.23 cm{sup 3} in A, 64.11 cm{sup 3} in B, and 72.35 cm{sup 3} in C. The mean Dmx and Dmi values were 5.68 cm and 4.58 cm in A and 5.97 cm and 4.97 cm in B, respectively. In group C, the mean diameters of Dmx and Dmi were 6.80 cm and 5.11 cm, respectively. The mean ratios of Dmi/Dmx were 1.25, 1.20, and 1.35 in groups A, B, and C, respectively. There was one animal death during the RFA procedure, the cause of which could not be subsequently determined. However, there were no other significant, procedure-related complications during the seven-hour-delayed CT scans. RFA procedures using 15-G Octopus® electrodes are useful and safe for creating a large ablation in a single electrode model as well as in the multiple electrodes model.

  9. Long-term survival following radiofrequency ablation ofcolorectal liver metastases: A retrospective study

    Institute of Scientific and Technical Information of China (English)

    Simeon Niyi Babawale; Thomas Mandφe Jensen; Jens Brφndum Frφkjaer


    AIM To retrospectively evaluate the long-term survivalof patients that received radiofrequency ablation (RFA)therapies of colorectal liver metastases.METHODS: In 2005 to 2008, RFA of 105 colorectalliver metastases (CRLM) were performed on 49 patientsin our institution. The liver metastases were evaluated,both before and after ablation therapies, with contrastenhanced computerised tomography and contrastenhanced ultrasonography. Histological evidence ofmalignant liver metastases was obtained in the fewinstances where contrast enhanced ultrasonographygave equivocal results. Accesses to the CRLM wereguided ultrasonically in all patients. The data obtainedfrom records of these ablations were retrospectivelyanalysed and survival data were compared with existingstudies in the literature.RESULTS: 1-, 2-, 3-, 4- and 5-year survival rates,when no stringent selection criteria were applied,were 92%, 65%, 51%, 41% and 29% respectively.To explore the impact of the number and size ofCRLM on patients' survival, an exclusion of 13 patients(26.5%) with number of CRLM ≥ 5 and tumour size≥ 40 mm resulted in 1-, 2-, 3-, 4- and 5-year survivalrates improving to 94%, 69%, 53%, 42% and 31%respectively. It is of note that 9 of 49 patients developedextra-hepatic metastases, not visible or seen on pretreatmentscans, just after RFA treatment. Thesepatients had poorer survival. The development ofextra-hepatic metastases in nearly 20% of the patientsincluded in our study can partly account for modestlylower survival rates as compared with earlier studies inthe literature.CONCLUSION: Our study underscores the fact thatoptimum patients' selection before embarking on RFAtreatment is vitally important to achieving a superioroutcome.

  10. Tumours and tumourous diseases; Tumoren, tumoraehnliche Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Winkelmann, W. (ed.)


    This book on tumours and tumourous diseases comprises two parts: 1. Bone tumours and tumourous lesions. 2. Soft tissue tumours and tumourous lesions. Details are presented on pathology, diagnosis, conservative and perioperative therapy, surgical therapy, complications after resection, indicators for amputation, recommendations for follow-up treatment, radiotherapy, radionuclide therapy, alternative therapies, therapy concepts in case of metastases, tissue engineering and plastic surgery. (uke) [German] Der vorliegende Band der Reihe Orthopaedie und orthopaedische Chirurgie behandelt das Thema Tumoren und tumoraehnliche Erkrankungen. Der Band teilt sich in zwei Kapitel: 1. Knochentumoren und tumorartige Laesionen und 2. Weichteiltumoren und tumorartige Laesionen. Dargestellt werden Pathologie, Diagnostik, konservative und perioperative Therapie, chirurgische Therapie, Komplikationen nach Resektion, Indikatoren zur Amputation, Nachsorgeempfehlung, Strahlentherapie, Radionuklidtherapie, alternative Therapieverfahren, Therapiekonzepte bei Metastasen, Tissue Engineering und plastisch-chirurgische Massnahmen. (uke)

  11. Targeting tumour Cell Plasticity

    Institute of Scientific and Technical Information of China (English)

    Elizabeth D. WILLIAMS


    @@ Her research is focused on understanding the mechanisms of tumour progression and metastasis, particularly in uro-logical carcinomas (bladder and prostate). Tumour cell plasticity, including epithelial-mesenchymal transition, is a cen-tral theme in Dr Williams' work.

  12. Cardiac tumours in children

    Directory of Open Access Journals (Sweden)

    Parsons Jonathan M


    Full Text Available Abstract Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT and Magnetic Resonance Imaging (MRI of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor.

  13. Endobronchial laser ablation in the management of epithelial-myoepithelial carcinoma of the trachea

    Directory of Open Access Journals (Sweden)

    David McCracken


    We present the first documented case to be treated with endobronchial laser ablation therapy with discussion of the incidence, presentation and characteristics of these tumours including the treatment options, as well as the use of laser ablation in the management of benign and malignant endobronchial lesions.

  14. First clinical experience with a dedicated MRI-guided high-intensity focused ultrasound system for breast cancer ablation

    Energy Technology Data Exchange (ETDEWEB)

    Merckel, Laura G.; Knuttel, Floor M.; Peters, Nicky H.G.M.; Mali, Willem P.T.M.; Bosch, Maurice A.A.J. van den [University Medical Center Utrecht, Department of Radiology, HP E 01.132, Utrecht (Netherlands); Deckers, Roel; Moonen, Chrit T.W.; Bartels, Lambertus W. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Dalen, Thijs van [Diakonessenhuis Utrecht, Department of Surgery, Utrecht (Netherlands); Schubert, Gerald [Philips Healthcare, Best (Netherlands); Weits, Teun [Diakonessenhuis Utrecht, Department of Radiology, Utrecht (Netherlands); Diest, Paul J. van [University Medical Center Utrecht, Department of Pathology, Utrecht (Netherlands); Vaessen, Paul H.H.B. [University Medical Center Utrecht, Department of Anesthesiology, Utrecht (Netherlands); Gorp, Joost M.H.H. van [Diakonessenhuis Utrecht, Department of Pathology, Utrecht (Netherlands)


    To assess the safety and feasibility of MRI-guided high-intensity focused ultrasound (MR-HIFU) ablation in breast cancer patients using a dedicated breast platform. Patients with early-stage invasive breast cancer underwent partial tumour ablation prior to surgical resection. MR-HIFU ablation was performed using proton resonance frequency shift MR thermometry and an MR-HIFU system specifically designed for breast tumour ablation. The presence and extent of tumour necrosis was assessed by histopathological analysis of the surgical specimen. Pearson correlation coefficients were calculated to assess the relationship between sonication parameters, temperature increase and size of tumour necrosis at histopathology. Ten female patients underwent MR-HIFU treatment. No skin redness or burns were observed in any of the patients. No correlation was found between the applied energy and the temperature increase. In six patients, tumour necrosis was observed with a maximum diameter of 3-11 mm. In these patients, the number of targeted locations was equal to the number of areas with tumour necrosis. A good correlation was found between the applied energy and the size of tumour necrosis at histopathology (Pearson = 0.76, p = 0.002). Our results show that MR-HIFU ablation with the dedicated breast system is safe and results in histopathologically proven tumour necrosis. (orig.)

  15. Hepatitis C (United States)

    ... Events Follow Us Home Health Information Liver Disease Hepatitis (Viral) Hepatitis C Related Topics English English Español Section Navigation Hepatitis (Viral) What Is Viral Hepatitis? Hepatitis A Hepatitis B ...

  16. Imaging of sacral tumours

    Energy Technology Data Exchange (ETDEWEB)

    Gerber, S.; Ollivier, L.; Brisse, H.; Neuenschwander, S. [Institut Curie, Department of Radiology, Paris (France); Leclere, J. [Institut Gustave Roussy, Department of Radiology, Villejuif (France); Vanel, D. [The Rizzoli Institute, Department of Radiology, Bologna (Italy); Missenard, G. [Institut Gustave Roussy, Comite de pathologie tumorale de l' appareil locomoteur, Villejuif (France); Pinieux, G. de [CHRU de Tours, Department of Pathology, Hopital Trousseau, Tours (France)


    All components of the sacrum (bone, cartilage, bone marrow, meninges, nerves, notochord remnants, etc.) can give rise to benign or malignant tumours. Bone metastases and intraosseous sites of haematological malignancies, lymphoma and multiple myeloma are the most frequent aetiologies, while primary bone tumours and meningeal or nerve tumours are less common. Some histological types have a predilection for the sacrum, especially chordoma and giant cell tumour. Clinical signs are usually minor, and sacral tumours are often discovered in the context of nerve root or pelvic organ compression. The roles of conventional radiology, CT and MRI are described and compared with the histological features of the main tumours. The impact of imaging on treatment decisions and follow-up is also reviewed. (orig.)

  17. Endoscopic ultrasound-guided ethanol ablation ofpancreatic neuroendocrine tumours: A case study andliterature review

    Institute of Scientific and Technical Information of China (English)


    Here we offer a review of the literature regardingendoscopic ultrasound-guided ethanol ablation forpancreatic neuroendocrine tumours and describe thecase of a cystic tumour completely ablated after amultisession procedure. A total of 35 PubMed indexedcases of treated functioning and non-functioningpancreatic neuroendocrinetumours resulted fromour search, 29 of which are well-documented andsummarised. Endoscopic ultrasound-guided ethanolablation appears as a local, minimallyinvasive treatmentof pancreatic neuroendocrinetumours, suitable forselected patients. This techniqueappears feasible,relatively safe and efficient, especiallywhen applied tosymptom relief in functioning tumours, aiming at loss ofendocrine secretion. For non-functioning tumours, wherethe goal is complete tissue ablation, eus guided ethanolablation can provide good results for patients whoare unfit for surgery or for those who refuse surgicalresection. Its role in "fit for surgery" patients requiresassessment through further studies.

  18. Spontaneous tumour lysis syndrome in hepatocellular carcinoma presenting with hypocalcemic tetany: An unusual case and systematic literature review. (United States)

    Agarwala, Roshan; Batta, Akash; Suryadevera, Varun; Kumar, Vivek; Sharma, Vishal; Rana, Surinder Singh


    Tumour lysis syndrome is an oncological emergency which is usually seen following chemotherapy for rapidly proliferating haematological malignancies. Spontaneous tumour lysis syndrome is rare in solid tumour and even rarer with hepatocellular carcinoma (HCC). Tumour lysis syndrome in the setting of HCC is usually reported as a consequence of therapeutic interventions like sorafenib administration or trans-arterial chemoembolization. We report about a case of a young lady with chronic hepatitis B related HCC who developed spontaneous tumour lysis syndrome and presented with hypocalcemic tetany. We also compare this case with the previously reported cases of spontaneous tumour lysis syndrome in hepatocellular carcinoma. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Parapharyngeal space primary tumours. (United States)

    Grilli, Gianluigi; Suarez, Vanessa; Muñoz, María Gabriela; Costales, María; Llorente, José Luis

    The aim of this study is to present our experience with the diagnostic and therapeutic approaches for parapharyngeal space tumours. This study is a retrospective review of 90 patients diagnosed with tumours of the parapharyngeal space and treated surgically between 1984 and 2015. Patients whose tumours were not primary but invaded the parapharyngeal space expanding from another region, tumours originating in the deep lobe of the parotid gland and head and neck metastasis were excluded from this study. 74% percent of the parapharyngeal space neoplasms were benign and 26% were malignant. Pleomorphic adenoma was the most common neoplasm (27%), followed by paragangliomas (25%), miscellaneous malignant tumours (16%), neurogenic tumours (12%), miscellaneous benign tumours (10%), and malignant salivary gland tumours (10%). The transcervical approach was used in 56 cases, cervical-transparotid approach in 15 cases, type A infratemporal fossa approach in 13 cases, transmandibular approach in 4 cases and transoral approach in 2 cases. The most common complications were those deriving from nervous injuries. Most parapharyngeal space tumours can be removed surgically with a low rate of complications and recurrence. The transcervical approach is the most frequently used. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  20. Percutaneous thermal ablation of renal neoplasms; Perkutane Thermoablation von Nierentumoren

    Energy Technology Data Exchange (ETDEWEB)

    Tacke, J. [Inst. fuer Diagnostische und Interventionelle Radiologie/Neuroradiologie, Klinikum Passau (Germany); Mahnken, A.H.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum Aachen (Germany)


    Due to modern examination techniques such as multidetector computed tomography and high-field magnetic resonance imaging, the detection rate of renal neoplasms is continually increasing. Even though tumors exceeding 4 cm in diameter rarely metastasize, all renal lesions that are possible neoplasms should be treated. Traditional treatment techniques include radical nephrectomy or nephron-sparing resection, which are increasingly performed laparoscopically. Modern thermal ablation techniques such as hyperthermal techniques like radiofrequency ablation RFA, laser induced thermal ablation LITT, focused ultrasound FUS and microwave therapy MW, as well as hypothermal techniques (cryotherapy) may be a useful treatment option for patients who are unfit for or refuse surgical resection. Cryotherapy is the oldest and best known thermal ablation technique and can be performed laparoscopically or percutaneously. Since subzero temperatures have no antistyptic effect, additional maneuvers must be performed to control bleeding. Percutaneous cryotherapy of renal tumors is a new and interesting method, but experience with it is still limited. Radiofrequency ablation is the most frequently used method. Modern probe design allows volumes between 2 and 5 cm in diameter to be ablated. Due to hyperthermal tract ablation, the procedure is deemed to be safe and has a low complication rate. Although there are no randomized comparative studies to open resection, the preliminary results for renal RFA are promising and show RFA to be superior to other thermal ablation techniques. Clinical success rates are over 90% for both, cryo- and radiofrequency ablation. Whereas laser induced thermal therapy is established in hepatic ablation, experience is minimal with respect to renal application. For lesions of more than 2 cm in diameter, additional cooling catheters are required. MR thermometry offers temperature control during ablation. Microwave ablation is characterized by small ablation volumes

  1. Biochemistry of neuroendocrine tumours. (United States)

    de Herder, Wouter W


    Several circulating or urinary tumour markers can be used for the diagnosis and follow-up of functioning and clinically non-functioning neuroendocrine tumours of the pancreatic islet cells and intestinal tract. Among the specific tumour markers are serotonin and its metabolites--e.g. 5-hydroxyindoleacetic acid (5-HIAA)--in carcinoid tumours and the carcinoid syndrome, insulin and its precursors or breakdown products in insulinoma, and gastrin in gastrinoma. Plasma vasointestinal polypeptide (VIP) determinations have been used in the diagnosis of VIPoma, plasma glucagon for glucagonoma, and serum somatostatin for somatostatinoma. Among the tumour-non-specific markers are: chromogranins, neuron-specific enolase (NSE), alpha-subunits of the glycoprotein hormones, catecholamines, pancreatic polypeptide (PP), ghrelin and adrenomedullin.

  2. Microvascular Architecture of Hepatic Metastases in a Mouse Model

    Directory of Open Access Journals (Sweden)

    Darshini Kuruppu


    Full Text Available Development of effective treatment for hepatic metastases can be initiated by a better understanding of tumour vasculature and blood supply. This study was designed to characterise the microvascular architecture of hepatic metastases and observe the source of contributory blood supply from the host. Metastases were induced in mice by an intrasplenic injection of colon carcinoma cells (106 cells/ml. Vascularization of tumours was studied over a three week period by scanning electron microscopy of microvascular corrosion casts. Metastatic liver involvement was observed initially within a week post induction, as areas approximately 100 μm in diameter not perfused by the casting resin. On histology these spaces corresponded to tumour cell aggregates. The following weeks highlighted the angiogenesis phase of these tumours as they received a vascular supply from adjacent hepatic sinusoids. Direct sinusoidal supply of metastases was maintained throughout tumour growth. At the tumour periphery most sinusoids were compressed to form a sheath demarcating the tumour from the hepatic vasculature. No direct supply from the hepatic artery or the portal vein was observed. Dilated vessels termed vascular lakes dominated the complex microvascular architecture of the tumours, most tapering as they traversed towards the periphery. Four vascular branching patterns could be identified as true loops, bifurcations and trifurcations, spirals and capillary networks. The most significant observation in this study was the direct sinusoidal supply of metastases, together with the vascular lakes and the peripheral sinusoidal sheaths of the tumour microculature.

  3. CT-guided radiofrequency tumor ablation in children

    Energy Technology Data Exchange (ETDEWEB)

    Botsa, Evanthia [National and Kapodistrian University of Athens, First Pediatric Clinic, Agia Sofia Children' s Hospital, Athens (Greece); Poulou, Loukia S.; Koundouraki, Antonia; Thanos, Loukas [Sotiria General Hospital for Chest Diseases, Department of Medical Imaging and Interventional Radiology, Athens (Greece); Koutsogiannis, Ioannis [General Military Hospital NIMTS, Department of Medical Imaging, Athens (Greece); Ziakas, Panayiotis D. [Warren Alpert Medical School of Brown University Rhode Island Hospital, Division of Infectious Diseases, Providence, RI (United States); Alexopoulou, Efthimia [Attikon University Hospital, Second Department of Radiology, Athens University School of Medicine, Athens (Greece)


    Image-guided radiofrequency ablation is a well-accepted technique of interventional oncology in adults. To evaluate the efficacy and safety of CT-guided radiofrequency ablation as a minimally invasive treatment for metastatic neoplasms in children. A total of 15 radiofrequency ablation sessions were performed in 12 children and young adults (median age 9.5; range 5-18 years) with metastatic malignancies. Seven children and young adults had secondary hepatic lesions, three had pulmonary and two had bone lesions. Radiofrequency ablation was performed under conscious sedation. The median lesion size was 1.7 cm (range 1.3-2.8 cm). The median time for ablation was 8 min (range 7-10 min). Radiofrequency procedures were technically successful in all tumors. Postablation imaging immediately after, and 1 month and 3 months after radiofrequency ablation showed total necrosis in all patients. At 6-month follow-up, three patients (all with lesion size >2 cm) had local recurrence and underwent a second radiofrequency ablation session. At 2-year follow-up no patient had recurrence of the treated tumor. Post-ablation syndrome occurred in four children. No major complication occurred. CT-guided radiofrequency tumor ablation was safe and efficient for palliative treatment in our cohort of patients. (orig.)

  4. The Acyclic Retinoid Peretinoin Inhibits Hepatitis C Virus Replication and Infectious Virus Release in Vitro (United States)

    Shimakami, Tetsuro; Honda, Masao; Shirasaki, Takayoshi; Takabatake, Riuta; Liu, Fanwei; Murai, Kazuhisa; Shiomoto, Takayuki; Funaki, Masaya; Yamane, Daisuke; Murakami, Seishi; Lemon, Stanley M.; Kaneko, Shuichi


    Clinical studies suggest that the oral acyclic retinoid Peretinoin may reduce the recurrence of hepatocellular carcinoma (HCC) following surgical ablation of primary tumours. Since hepatitis C virus (HCV) infection is a major cause of HCC, we assessed whether Peretinoin and other retinoids have any effect on HCV infection. For this purpose, we measured the effects of several retinoids on the replication of genotype 1a, 1b, and 2a HCV in vitro. Peretinoin inhibited RNA replication for all genotypes and showed the strongest antiviral effect among the retinoids tested. Furthermore, it reduced infectious virus release by 80-90% without affecting virus assembly. These effects could be due to reduced signalling from lipid droplets, triglyceride abundance, and the expression of mature sterol regulatory element-binding protein 1c and fatty acid synthase. These negative effects of Peretinoin on HCV infection may be beneficial in addition to its potential for HCC chemoprevention in HCV-infected patients.

  5. of brain tumours

    African Journals Online (AJOL)

    'psychiatric' indicators of possible brain tumour are sudden ... found to have weakness and/or loss of sensation in the lower extremities. Even when there is no clear weakness or hearing impairment, they may respond poorly, or not at all,.

  6. [Gastric mesenchymal tumours (GIST)]. (United States)

    Spivach, Arrigo; Fezzi, Margherita; Sartori, Alberto; Belgrano, Manuel; Rimondini, Alessandra; Cuttin-Zernich, Roberto; Covab, Maria Assunta; Bonifacio, Daniela; Buri, Luigi; Pagani, Carlo; Zanconati, Fabrizio


    The incidence of gastrointestinal stromal tumours (GIST) has increased in recent years. A number of authors have attempted to define the actual nature of these tumours. Immunohistochemistry highlighting the positivity of tyrosine-kinase (CD117/c-Kit) has revealed the difference between gastrointestinal stromal tumours and other mesenchymal tumours and, therefore, the possibility of medical rather than surgical therapy. We retrospectively reviewed 19 patients affected by primary gastric GIST, who underwent surgery in recent years with subsequent follow-up. Gastroscopy and gastrointestinal tract radiography were used not only to obtain the diagnosis but also to establish the size, density, contours, ulceration, regional lymphadenopathy, mesenteric infiltration and the presence of metastases. The aim of this study was to evaluate the roles of endoscopy and radiology in this pathology and the advantages and limitations of each individual technique.

  7. Bilateral Malignant Brenner Tumour

    Directory of Open Access Journals (Sweden)

    Nasser D Choudhary, S.Manzoor Kadri, Ruby Reshi, S. Besina, Mansoor A. Laharwal, Reyaz tasleem, Qurrat A. Chowdhary


    Full Text Available Bilateral malignant Brenner tumour ofovary is extremely rate. A case ofmalignant Brenner tumourinvolving both the ovaries with mctastasis to mesentery in a 48 year femalc is presented. Grosslyo'arian masses were firm with soft areas, encapsulated and having bosselated external surfaces.Cut sections showed yellowish white surface with peripheral cysts (in both tumours. Microscopyrevealed transitional cell carcinoma with squamoid differentiation at places. Metastatic deposits werefound in the mesentery. Endometrium showed cystic glandular hyperplasia.

  8. Radiofrequency ablation in the treatment of liver tumors in children

    NARCIS (Netherlands)

    van Laarhoven, Stijn; van Baren, Robertine; Tamminga, Rienk Yde Johan; de Jong, Koert Pieter

    Hepatoblastoma and liver metastasis of Wilms' tumors are rare hepatic tumors in children. Treatment of both tumors consists of a combination of chemotherapy and liver surgery. Radiofrequency ablation (RFA) is frequently used for the treatment of adult liver tumors but is rarely mentioned as a

  9. Improving Outcomes with Surgical Resection and Other Ablative Therapies in HCC

    Directory of Open Access Journals (Sweden)

    Rahul Deshpande


    Full Text Available With rising incidence and emergence of effective treatment options, the management of hepatocellular carcinoma (HCC is a complex multidisciplinary process. There is still little consensus and uniformity about clinicopathological staging systems. Resection and liver transplantation have been the cornerstone of curative surgical treatments with recent emergence of ablative techniques. Improvements in diagnostics, surgical techniques, and postoperative care have lead to dramatically improved results over the years. The most appropriate treatment plan has to be individualised and depends on a variety of patient and tumour-related factors. Very small HCCs discovered on surveillance have the best outcomes. Patients with advanced cirrhosis and tumours within Milan criteria should be offered transplantation. Resection is best for small solitary tumours with preserved liver function. Ablative techniques are suitable for low volume tumours in patients unfit for either resection or transplantation. The role of downstaging and bridging therapy is not clearly established.

  10. Efficacy of intraductal cooling to prevent the bile duct injury during radiofrequency ablation associated with hepatic blood occlusion%胆管内冷盐水灌注冷却预防肝血流阻断合并射频消融术中胆管损伤的研究

    Institute of Scientific and Technical Information of China (English)

    李静怡; 苏永辉; 蔡潮农; 郭辉; 林宇静


    目的 评价活体兔肝予肝血流阻断合并射频消融(radiofrequency ablation,RFA)术中行胆管内冷盐水灌注冷却(intraductal chilled saline perfusion,ICSP)对胆管的保护作用.方法 新西兰大白兔16只,分为2组:ICSP组于RFA术前行胆总管置管,于RFA术中夹闭入肝血流,并经胆总管置管行ICSP;非ICSP组仅于RFA术中夹闭入肝血流.术中射频针针尖距肝门部主胆管距离约5 mm.RFA术后行超声造影比较两组消融灶大小;术后6周超声观察兔肝内胆管结构,并取肝大体标本,对两组消融灶旁主胆管行病理学检查以比较损伤程度.结果 RFA术后超声造影示两组间消融灶大小差异无统计学意义(P>0.05),RFA术后6周超声检查示非ICSP组胆管扩张较为明显(P<0.05),病理学检查示非ICSP组主胆管损伤程度较严重(P <0.05).结论 行入肝血流阻断合并肝脏RFA时,采用ICSP能有效预防术中胆道热损伤.%Objective To explore the efficacy of intraductal chilled saline perfusion (ICSP) to reduce the thermal bile duct injury during the treatment of radiofrequency ablation (RFA) associating with occlusion of hepatic blood supply in rabbits.Methods 16 healthy New Zealand white rabbits were divided into 2 groups.Rabbits of the ICSP group were placed tubes in the common bile duct after laparotomy,and ICSP was performed during the RFA procedure accompanied with hepatic blood occlusion.While for rabbits of the non-ICSP group,hepatic blood occlusion and RFA were performed without ICSP.RFA electrodes were placed about 5 mm away from the hilus hepatis approximately.Contrast-enhanced ultrasonography (CEUS) was administrated to evaluate the sizes of the ablative zones after the procedure.On post-procedure 6 week,ultrasonography was prerformed to evaluate the changes of the biliary structure,and liver specimens of rabbits wcrc obtained for histopathologic observation of main bile ducts.Results Post-procedure CEUS examination showed that there

  11. Radiofrequency ablation for incidentally identified primary intrahepatic cholangiocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Witold Zgodzinski; N.Joseph Espat


    Cholangiocarcinoma is the second most common primary hepato-biliary malignancy. The majority of patients with primary hepatic tumors are not suitable candidates for resection, due to advanced stage of the disease at presentation, anatomic limitations and medical comorbidities. At present, radiofrequency ablation (RFA) may offer an alternative, feasible and safe therapy for selected patients with hepatic tumors, who are not otherwise candidates for hepatic resection. Herein, we present the case of successful RFA in a patient with a solitary, primary intrahepatic cholangiocarcinoma. The patient remained free of disease 24 mo after the procedure, and is still followed up. This is the first report of RFA application inthe treatment of primary intrahepatic cholangiocarcinoma.

  12. Laser ablation principles and applications

    CERN Document Server


    Laser Ablation provides a broad picture of the current understanding of laser ablation and its many applications, from the views of key contributors to the field. Discussed are in detail the electronic processes in laser ablation of semiconductors and insulators, the post-ionization of laser-desorbed biomolecules, Fourier-transform mass spectroscopy, the interaction of laser radiation with organic polymers, laser ablation and optical surface damage, laser desorption/ablation with laser detection, and laser ablation of superconducting thin films.

  13. Liver Transplantation for Hepatic Epithelioid Hemangioendothelioma: The Canadian Multicentre Experience

    Directory of Open Access Journals (Sweden)

    Carmine G Nudo


    Full Text Available INTRODUCTION: Hepatic epithelioid hemangioendothelioma (HEHE is a rare entity. At the present time, there is no standardized effective therapy. Liver transplantation (LT has emerged as a treatment for this rare tumour.

  14. Parallel evolution of tumour subclones mimics diversity between tumours. (United States)

    Martinez, Pierre; Birkbak, Nicolai Juul; Gerlinger, Marco; McGranahan, Nicholas; Burrell, Rebecca A; Rowan, Andrew J; Joshi, Tejal; Fisher, Rosalie; Larkin, James; Szallasi, Zoltan; Swanton, Charles


    Intratumour heterogeneity (ITH) may foster tumour adaptation and compromise the efficacy of personalized medicine approaches. The scale of heterogeneity within a tumour (intratumour heterogeneity) relative to genetic differences between tumours (intertumour heterogeneity) is unknown. To address this, we obtained 48 biopsies from eight stage III and IV clear cell renal cell carcinomas (ccRCCs) and used DNA copy-number analyses to compare biopsies from the same tumour with 440 single tumour biopsies from the Cancer Genome Atlas (TCGA). Unsupervised hierarchical clustering of TCGA and multi-region ccRCC samples revealed segregation of samples from the same tumour into unrelated clusters; 25% of multi-region samples appeared more similar to unrelated samples than to any other sample originating from the same tumour. We found that the majority of recurrent DNA copy number driver aberrations in single biopsies were not present ubiquitously in late-stage ccRCCs and were likely to represent subclonal events acquired during tumour progression. Such heterogeneous subclonal genetic alterations within individual tumours may impair the identification of robust ccRCC molecular subtypes classified by distinct copy number alterations and clinical outcomes. The co-existence of distinct subclonal copy number events in different regions of individual tumours reflects the diversification of individual ccRCCs through multiple evolutionary routes and may contribute to tumour sampling bias and impact upon tumour progression and clinical outcome.

  15. Post biopsy Liver Hemorrhage Successfully Controlled by Ultrasound-guided Percutaneous Microwave Ablation

    Directory of Open Access Journals (Sweden)

    Ophelia Ka Heng Wai


    Full Text Available Percutaneous microwave coagulation therapy has been one of the major new developments in tumor ablation. Microwave ablation has also been used intraoperatively to achieve hemostasis at surgical margins in laparotomy. However, the use of microwave ablation for coagulation and hemostasis through percutaneous approach has not been described in the literature. Here, we report a case of hepatic amyloidosis with massive post biopsy liver hemorrhage, which could not be by transarterial embolization, and subsequently controlled by ultrasound-guided percutaneous microwave ablation. To the best of our knowledge, this is the first reported case of this technology application in human.

  16. Acute changes in liver tumour perfusion measured non-invasively with arterial spin labelling (United States)

    Johnson, S Peter; Ramasawmy, Rajiv; Campbell-Washburn, Adrienne E; Wells, Jack A; Robson, Mathew; Rajkumar, Vineeth; Lythgoe, Mark F; Pedley, R Barbara; Walker-Samuel, Simon


    Background: Non-invasive measures of tumour vascular perfusion are desirable, in order to assess response to vascular targeting (or modifying) therapies. In this study, hepatic arterial spin labelling (ASL) magnetic resonance imaging (MRI) was investigated to measure acute changes in perfusion of colorectal cancer in the liver, in response to vascular disruption therapy with OXi4503. Methods: SW1222 and LS174T tumours were established in the liver of MF1 nu/nu mice via intrasplenic injection. Perfusion and R2* MRI measurements were acquired with an Agilent 9.4T horizontal bore scanner, before and at 90 min after 40 mg kg−1 OXi4503. Results: A significant decrease in SW1222 tumour perfusion was observed (−43±33%, Pchange in tumour perfusion and the proximity to large vessels, with pre-treatment blood flow predictive of subsequent response. Histological evaluation confirmed the onset of necrosis and evidence of heterogeneous response between tumour deposits. Conclusions: Hepatic ASL-MRI can detect acute response to targeted tumour vascular disruption entirely non-invasively. Hepatic ASL of liver tumours has potential for use in a clinical setting. PMID:27031853

  17. Percutaneous renal tumour biopsy. (United States)

    Delahunt, Brett; Samaratunga, Hemamali; Martignoni, Guido; Srigley, John R; Evans, Andrew J; Brunelli, Matteo


    The use of percutaneous renal tumour biopsy (RTB) as a diagnostic tool for the histological characterization of renal masses has increased dramatically within the last 30 years. This increased utilization has paralleled advances in imaging techniques and an evolving knowledge of the clinical value of nephron sparing surgery. Improved biopsy techniques using image guidance, coupled with the use of smaller gauge needles has led to a decrease in complication rates. Reports from series containing a large number of cases have shown the non-diagnostic rate of RTB to range from 4% to 21%. Re-biopsy has been shown to reduce this rate, while the use of molecular markers further improves diagnostic sensitivity. In parallel with refinements of the biopsy procedure, there has been a rapid expansion in our understanding of the complexity of renal cell neoplasia. The 2013 Vancouver Classification is the current classification for renal tumours, and contains five additional entities recognized as novel forms of renal malignancy. The diagnosis of tumour morphotype on RTB is usually achievable on routine histology; however, immunohistochemical studies may be of assistance in difficult cases. The morphology of the main tumour subtypes, based upon the Vancouver Classification, is described and differentiating features are discussed.

  18. cell tumours of childhood

    African Journals Online (AJOL)

    neuron-specific-enolase, vimentin and neurofilament us- .... ated on a 4-point scale based on the number of positive cells: Negative staining (—) = no tumour cell stained. Minimal .... the same laboratory, have been shown previously to be.

  19. Optimization of the generator settings for endobiliary radiofrequency ablation

    Institute of Scientific and Technical Information of China (English)

    Maximilien; Barret; Sarah; Leblanc; Ariane; Vienne; Alexandre; Rouquette; Frederic; Beuvon; Stanislas; Chaussade; Frederic; Prat


    AIM:To determine the optimal generator settings for endobiliary radiofrequency ablation. METHODS:Endobiliary radiofrequency ablation was performed in live swine on the ampulla of Vater,the common bile duct and in the hepatic parenchyma. Radiofrequency ablation time,"effect",and power were allowed to vary. The animals were sacrificed two hours after the procedure. Histopathological assessment of the depth of the thermal lesions was performed. RESULTS:Twenty-five radiofrequency bursts were applied in three swine. In the ampulla of Vater(n = 3),necrosis of the duodenal wall was observed starting with an effect set at 8,power output set at 10 W,and a 30 s shot duration,whereas superficial mucosal damage of up to 350 μm in depth was recorded for an effect set at 8,power output set at 6 W and a 30 s shot duration. In the common bile duct(n = 4),a 1070 μm,safe and efficient ablation was obtained for an effect set at 8,a power output of 8 W,and an ablation time of 30 s. Within the hepatic parenchyma(n = 18),the depth of tissue damage varied from 1620 μm(effect = 8,power = 10 W,ablation time = 15 s) to 4480 μm(effect = 8,power = 8 W,ablation time = 90 s). CONCLUSION:The duration of the catheter application appeared to be the most important parameter influencing the depth of the thermal injury during endobiliary radiofrequency ablation. In healthy swine,the currently recommended settings of the generator may induce severe,supratherapeutic tissue damage in the biliary tree,especially in the high-risk area of the ampulla of Vater.

  20. Combined liver transplantation plus imatinib for unresectable metastases of gastrointestinal stromal tumours. (United States)

    Serralta, Alfonso S; Sanjuan, Fernando R; Moya, Angel H; Orbis, Francisco C; López-Andújar, Rafael; Pareja, Eugenia I; Vila, Juan C; Rayón, Miguel; Juan, Manuel B; Mir, José P


    Therapeutic options for treating unresectable hepatic metastases of leiomyosarcomas were scarce until a few years ago. Recent advances in the study of the biology of intestinal tumours have radically changed our knowledge of their pathogenesis. Many of the tumours previously considered as leiomyosarcomas are now identified as gastrointestinal stromal tumours (GISTs). The introduction of imatinib (an antineoplasic drug that specifically acts on the pathogenesis of these tumours) has shown promising results in patients with advanced GISTs. We present three patients with the initial diagnosis of unresectable hepatic metastases of leiomyosarcomas. They received liver transplants. All three had tumour recurrences after transplantation. Histological re-evaluation identified a stromal origin of the tumours, and the patients were treated with imatinib therapy (400 mg/day). Recurrence occurred in all patients after a mean of 38.3 months, but imatinib treatment achieved control of the tumours. The current survival times with the combination of transplantation and imatinib are 92, 48 and 46 months for the three patients. This series is small and inconclusive, but imatinib treatment showed promising results. The treatment options for patients with unresectable metastases of GISTs must be defined, as in these three patients liver transplantation achieved a disease-free status but all had tumour recurrences before starting the imatinib treatment.

  1. [Diffuse hepatic hemangiomatosis--case report]. (United States)

    Mihalache, Carmen; Dumitrache, Dana


    Hemangiomatosis of the liver is growing in the last decades, because of the abdominal imaging progresses: brain CT scan, MRI. In the presented case, the onset was with symptoms and biochemical disorders characteristic for acute viral hepatitis, with negative serological markers for the A and B hepatitis viruses. The persistence of the clinical symptoms and of the hepatic and biliary retention tests, determined the abdominal echography; which orient the diagnosis to vascular tumour with liver metastasis. Intraoperatively was found: diffuse hemangiomatosis of the liver. The patient didn't benefit from liver transplantation and died due to subfulminant hepatic failure.

  2. 穴位按摩缓解肝癌射频消融治疗术中疼痛的研究%The study of acupoint massage relieving the pain caused by radio-frequency ablation for hepatic cancer

    Institute of Scientific and Technical Information of China (English)

    顾迪; 杨婷; 谈丽萍


    目的:观察穴位按摩对肝癌患者接受射频消融治疗术中疼痛的影响。方法采取随机对照试验法,128例接受射频消融治疗的肝癌患者分为观察组和对照组。观察组在术前30 min使用地西泮,同时给予穴位按摩疗法;对照组术前30 min使用地西泮与吗啡。用汉密尔顿焦虑量表(HAMA)与数字疼痛评分法(NPRS)评估患者术中焦虑与疼痛症状。记录基础HAMA评分(术前30 min地西泮注射后HAMA评分)、术中HAMA评分(射频消融术中最大痛觉时评分)和相对HAMA评分(术中HAMA评分减去基础HAMA评分);记录基础NPRS评分(术前30 min地西泮注射后NPRS评分)、术中NPRS评分(射频消融术中最大痛觉评分)和相对NPRS评分结果(术中NPRS评分减去基础NPRS评分),对2组患者射频消融术中焦虑和疼痛程度进行比较。结果对照组相对HAMA评分为(5.18±4.17)分;相对NPRS评分为(5.16±2.08)分。观察组相对HAMA评分为(-0.22±2.64)分;相对NPRS评分为(3.01±1.91)分。2组患者不同临床特征对相对HAMA与相对NPRS评分差异无统计学意义(P>0.05);观察组相对HAMA及NPRS评分均低于对照组(P<0.01)。结论穴位按摩能降低患者焦虑程度,减轻疼痛程度,能延长患者疼痛间隔时间,提高患者的耐受性。%Objective To the impact of acupoint massage on the post-operative pain caused by radio-frequency ablation(RFA) for hepatic cancer(HC). Methods A total of 128 HC patients who had received RFA were randomized divided into observation group and control group. Observation group received diazepam and meanwhile point massage 30 min before RFA. Control group received diazepam and morphine 30 min before RFA. Hamilton Anxiety Scale (HAMA) and Numerical Pain Rating Scale (NPRS) were used for assessing the anxiety and pain during RFA. Baseline HAMA score (the score at 30 min before RFA), post-operative HAMA

  3. Radiofrequency ablation in dermatology

    Directory of Open Access Journals (Sweden)

    Sachdeva Silonie


    Full Text Available Radiofreqeuency ablation is a versatile dermatosurgical procedure used for surgical management of skin lesions by using various forms of alternating current at an ultra high frequency. The major modalities in radiofrequency are electrosection, electrocoagulation, electrodessication and fulguration. The use of radiofrequency ablation in dermatosurgical practice has gained importance in recent years as it can be used to treat most of the skin lesions with ease in less time with clean surgical field due to adequate hemostasis and with minimal side effects and complications. This article focuses on the major tissue effects and factors influencing radiofrequency ablation and its application for various dermatological conditions.

  4. Hepatitis A FAQs (United States)

    ... Policy and Programs Resource Center Viral Hepatitis Hepatitis A Questions and Answers for the Public Recommend on ... Hepatitis C. What is the difference between Hepatitis A, Hepatitis B, and Hepatitis C? Hepatitis A , Hepatitis ...

  5. Hepatitis A (United States)

    ... care, food, or sewage industry Other common hepatitis virus infections include hepatitis B and hepatitis C. Hepatitis A is the least serious and mildest of these diseases. Symptoms ... most often show up 2 to 6 weeks after being exposed to the hepatitis A virus. They are most often mild, but may last ...

  6. Malignant salivary gland tumours

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, S.H. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Oral Pathology)


    The most frequent malignant salivary gland tumours are the mucoepidermoid tumour, adenoid cystic carcinoma and adenocarcinoma. The major salivary glands and the minor glands of the mouth and upper respiratory tract may potentially develop any of these malignant lesions. Malignant lesions most frequently present as a palpable mass and tend to enlarge more rapidly than benign neoplasms. Pain, paresthesia, muscle paralysis and fixation to surrounding tissue are all ominous signs and symptoms. The only reliable means of differential diagnosis of these lesions is biopsy and histologic analysis. Therapy involves surgery or a combination of surgery and radiation therapy. The ultimate prognosis is governed by the intrinsic biologic behaviour of the neoplasms, the extent of disease and adequate clinical therapy.

  7. Skull base tumours

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Instituto Portugues de Oncologia Francisco Gentil, Servico de Radiologia, Rua Professor Lima Basto, 1093 Lisboa Codex (Portugal)], E-mail:


    With the advances of cross-sectional imaging radiologists gained an increasing responsibility in the management of patients with skull base pathology. As this anatomic area is hidden to clinical exam, surgeons and radiation oncologists have to rely on imaging studies to plan the most adequate treatment. To fulfil these endeavour radiologists need to be knowledgeable about skull base anatomy, about the main treatment options available, their indications and contra-indications and needs to be aware of the wide gamut of pathologies seen in this anatomic region. This article will provide a radiologists' friendly approach to the central skull base and will review the most common central skull base tumours and tumours intrinsic to the bony skull base.

  8. Thermal ablation for hepatocellular carcinoma: a large-scale analysis of long-term outcome and prognostic factors. (United States)

    Ding, J; Jing, X; Wang, Y; Wang, F; Wang, Y; Du, Z


    To investigate the long-term outcome and prognostic factors when treating hepatocellular carcinoma (HCC) with thermal ablation. A total of 846 HCC patients, diagnosed histopathologically and/or radiologically, underwent thermal ablation from October 2001 to May 2013. Thermal ablation included both radiofrequency ablation (RFA) and microwave ablation (MWA), and was performed by percutaneous, open, and laparoscopic approaches. Clinical data, especially focused on disease-free survival, were retrospectively analysed by univariate and multivariate analyses. A total of 1,185 thermal ablation treatments were performed, corresponding to 1,240 tumours. The complete ablation rate was 97.1%. The 12-, 24-, 36-, and 60-month disease-free survival rates after thermal ablation were 72.3%, 52.7%, 33.5%, and 16.1%, respectively. Multivariate analysis indicated that the serum alkaline phosphatase levels (ALP) and the number of tumours were independent risk factors affecting disease-free survival. The 12-, 36-, 60-, 84-, and 120-month overall survival rates of all patients were 92.9%, 74.7%, 58.1%, 41.3%, and 15.8%, respectively. Multivariate analysis indicated that age, ALP, number of tumours, and treatment sessions per case were independent risk factors related to overall survival. Thermal ablation was a relatively safe and effective procedure. Patients with increased serum ALP levels and/or multiple tumours had a higher incidence of recurrence and poorer prognosis, and therefore, should be monitored closely in clinical practice. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  9. Moldable cork ablation material (United States)


    A successful thermal ablative material was manufactured. Moldable cork sheets were tested for density, tensile strength, tensile elongation, thermal conductivity, compression set, and specific heat. A moldable cork sheet, therefore, was established as a realistic product.

  10. femtosecond laser ablation


    Margetic, Vanja


    Femtosecond laser ablation was investigated as a solid sampling method for elemental chemical analysis. In comparison to the sampling with longer laser pulses, two aspects could be improved by using ultrashort pulses: elimination of the elemental fractionation from the ablation crater, which is necessary for an accurate quantitative analysis, and better control of the material removal (especially for metals), which increases the spatial resolution of microanalysis. Basic aspects of ultrashort...

  11. Hepatitis E (United States)

    ... sheets Fact files Questions & answers Features Multimedia Contacts Hepatitis E Fact sheet Updated July 2016 Key facts ... et al. Lancet 2012;380:2095-2128. World Hepatitis Day Know hepatitis - Act now Event notice Key ...

  12. The effect of radiofrequency ablation on different organs: Ex vivo and in vivo comparative studies

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoo Na [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Rhim, Hyunchul, E-mail: [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Choi, Dongil; Kim, Young-sun; Lee, Min Woo; Chang, Ilsoo; Lee, Won Jae; Lim, Hyo K. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of)


    Objective: The purposes of this study are to evaluate the ex vivo and in vivo efficacy of radiofrequency ablation (RFA) on different porcine tissues by the ablation of three different sites simultaneously. Materials and methods: A multichannel RFA system, enables three separate tumors to be ablated simultaneously, was used. RFA procedures were applied to normal porcine liver, kidney, and muscle together ex vivo (n = 12) and in vivo (n = 17). Pre-impedances, defined as baseline systemic impedances of tissues before beginning RFA, and the areas of ablation zones were measured and compared. Results: The areas of ablation zones among three organs had a significant difference in decreasing order as follows: liver, muscle, and kidney in the ex vivo study (p = 0.001); muscle, liver, and kidney in the in vivo study (p < 0.0001). The areas of ablation zones between ex vivo and in vivo had a significant difference in the liver and muscle (each p < 0.05). There was no significant correlation between the areas of ablation zones and pre-impedances in both studies. Conclusions: Renal RFA produced the smallest ablation zone in both in vivo and ex vivo studies. Muscular RFA demonstrated the largest ablation zone in the in vivo study, and hepatic RFA showed the largest ablation zone in the ex vivo study. This variability in the tissues should be considered for performing an optimized RFA for each organ site.

  13. Α case of multiple bilateral testicular capsule mast cell tumours in a dog. (United States)

    Oikonomidis, I L; Tsouloufi, T K; Brellou, G D; Soubasis, N; Ververidis, C; Vlemmas, I; Kritsepi-Konstantinou, M


    A 5-year-old intact male German Shepherd dog was referred with a diagnosis of leishmaniasis. Several testicular masses were palpated during the physical examination, while the diagnostic screening yielded no remarkable findings. Fine needle aspiration cytology of the masses revealed the presence of intermediately differentiated mast cell tumours. Scrotal ablation and orchiectomy were performed as a definitive treatment option. The pathological examination of the surgical specimens confirmed the diagnosis of grade II mast cell tumours and showed that they were all confined to the testicular capsule. At 7 months post-admission, the dog exhibited neither postsurgical complications nor metastatic foci and was, therefore, given a favourable prognosis. Despite their exceptionally rare occurrence, mast cell tumours should be considered for the differential diagnosis of testicular tumours.

  14. Vaginal haemangioendothelioma: an unusual tumour.

    LENUS (Irish Health Repository)

    Mohan, H


    Vaginal tumours are uncommon and this is a particularly rare case of a vaginal haemangioendothelioma in a 38-year-old woman. Initial presentation consisted of symptoms similar to uterovaginal prolapse with "something coming down". Examination under anaesthesia demonstrated a necrotic anterior vaginal wall tumour. Histology of the lesion revealed a haemangioendothelioma which had some features of haemangiopericytoma. While the natural history of vaginal haemangioendothelioma is uncertain, as a group, they have a propensity for local recurrence. To our knowledge this is the third reported case of a vaginal haemangioendothelioma. Management of this tumour is challenging given the paucity of literature on this tumour. There is a need to add rare tumours to our "knowledge bank" to guide management of these unusual tumours.

  15. Primary bone tumours in infants

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Beluffi, G.; Cohen, D.H.; Padovani, J.; Tamaela, L.; Azouz, M.; Bale, P.; Martin, H.C.; Nayanar, V.V.; Arico, M.


    Ten cases of primary bone tumours in infants (1 osteosarcoma, 3 Ewing's sarcoma, 1 chondroblastoma and 5 angiomastosis) are reported. All cases of angiomatosis showed characteristic radiographic findings. In all the other tumours the X-ray appearances were different from those usually seen in older children and adolescents. In the auhtors' opinion the precise diagnosis of malignant bone tumours in infancy is very difficult as no characteristic X-ray features are present in this age period.

  16. LET-painting increases tumour control probability in hypoxic tumours. (United States)

    Bassler, Niels; Toftegaard, Jakob; Lühr, Armin; Sørensen, Brita Singers; Scifoni, Emanuele; Krämer, Michael; Jäkel, Oliver; Mortensen, Lise Saksø; Overgaard, Jens; Petersen, Jørgen B


    LET-painting was suggested as a method to overcome tumour hypoxia. In vitro experiments have demonstrated a well-established relationship between the oxygen enhancement ratio (OER) and linear energy transfer (LET), where OER approaches unity for high-LET values. However, high-LET radiation also increases the risk for side effects in normal tissue. LET-painting attempts to restrict high-LET radiation to compartments that are found to be hypoxic, while applying lower LET radiation to normoxic tissues. Methods. Carbon-12 and oxygen-16 ion treatment plans with four fields and with homogeneous dose in the target volume, are applied on an oropharyngeal cancer case with an identified hypoxic entity within the tumour. The target dose is optimised to achieve a tumour control probability (TCP) of 95% when assuming a fully normoxic tissue. Using the same primary particle energy fluence needed for this plan, TCP is recalculated for three cases assuming hypoxia: first, redistributing LET to match the hypoxic structure (LET-painting). Second, plans are recalculated for varying hypoxic tumour volume in order to investigate the threshold volume where TCP can be established. Finally, a slight dose boost (5-20%) is additionally allowed in the hypoxic subvolume to assess its impact on TCP. Results. LET-painting with carbon-12 ions can only achieve tumour control for hypoxic subvolumes smaller than 0.5 cm(3). Using oxygen-16 ions, tumour control can be achieved for tumours with hypoxic subvolumes of up to 1 or 2 cm(3). Tumour control can be achieved for tumours with even larger hypoxic subvolumes, if a slight dose boost is allowed in combination with LET-painting. Conclusion. Our findings clearly indicate that a substantial increase in tumour control can be achieved when applying the LET-painting concept using oxygen-16 ions on hypoxic tumours, ideally with a slight dose boost.

  17. Staging of Klatskin tumours (hilar cholangiocarcinomas): comparison of MR cholangiography, MR imaging, and endoscopic retrograde cholangiography. (United States)

    Vogl, Thomas J; Schwarz, Wolfram O; Heller, Matthias; Herzog, Christopher; Zangos, Stephan; Hintze, Rainer E; Neuhaus, Peter; Hammerstingl, Renate M


    The aim of the study was to compare prospectively magnetic resonance cholangiography (MRC) and magnetic resonance imaging (MRI) with endoscopic retrograde cholangiography (ERC) in the diagnosis and staging of Klatskin tumours of the biliary tree (hilar cholangiocarcinomas). Forty-six patients with suspected Klatskin tumours of the biliary tract underwent MRI and heavily T2-weighted, non-breathhold, respiratory-triggered fast spin-echo MRC. Forty-two patients underwent ERC within 24 h; in four patients, ERC was not feasible, and percutaneous trans-hepatic cholangiography (PTC) was carried out instead. Two independent investigators evaluated imaging results for the presence of tumour, bile duct dilatation, and stenosis. Clinical and histopathological correlation revealed Klatskin tumours in 33 patients. MRI revealed a slightly hyperintense signal of infiltrated bile ducts in T2-weighted fast spin-echo sequences. The malignant lesion was regularly visualized as a hypointense area in T1-weighted gradient-echo sequences with substantial contrast enhancement along the involved bile duct walls. MRC revealed the location and extension of the tumour in 31 of 33 cases correctly (sensitivity 94%, specificity 100%, diagnostic accuracy 95%). In 27 of 31 cases, ERC enabled accurate staging and diagnosis of Klatskin tumours with a sensitivity of 87%. ERC and PTC combined yielded a sensitivity of 84% and a specificity of 97%. Tumours were grouped according to the Bismuth classification, with MRC allowing correct identification of type I tumour in seven patients, type II tumour in four patients, type III tumour in 12 patients, and type IV tumour in ten patients. MRC provided superior visualization of completely obstructed peripheral systems. MRC in combination with MRI is a reliable non-invasive diagnostic method for the pre-therapeutic staging of Klatskin tumours.

  18. Staging of Klatskin tumours (hilar cholangiocarcinomas): comparison of MR cholangiography, MR imaging, and endoscopic retrograde cholangiography

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J.; Schwarz, Wolfram O.; Heller, Matthias; Herzog, Christopher; Zangos, Stephan; Hammerstingl, Renate M. [Johann Wolfgang Goethe University of Frankfurt am Main, Department of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Hintze, Rainer E. [Humboldt University of Berlin, Department of Gastroenterology, Berlin (Germany); Neuhaus, Peter [Humboldt University of Berlin, Department of Surgery, Berlin (Germany)


    The aim of the study was to compare prospectively magnetic resonance cholangiography (MRC) and magnetic resonance imaging (MRI) with endoscopic retrograde cholangiography (ERC) in the diagnosis and staging of Klatskin tumours of the biliary tree (hilar cholangiocarcinomas). Forty-six patients with suspected Klatskin tumours of the biliary tract underwent MRI and heavily T2-weighted, non-breathhold, respiratory-triggered fast spin-echo MRC. Forty-two patients underwent ERC within 24 h; in four patients, ERC was not feasible, and percutaneous trans-hepatic cholangiography (PTC) was carried out instead. Two independent investigators evaluated imaging results for the presence of tumour, bile duct dilatation, and stenosis. Clinical and histopathological correlation revealed Klatskin tumours in 33 patients. MRI revealed a slightly hyperintense signal of infiltrated bile ducts in T2-weighted fast spin-echo sequences. The malignant lesion was regularly visualized as a hypointense area in T1-weighted gradient-echo sequences with substantial contrast enhancement along the involved bile duct walls. MRC revealed the location and extension of the tumour in 31 of 33 cases correctly (sensitivity 94%, specificity 100%, diagnostic accuracy 95%). In 27 of 31 cases, ERC enabled accurate staging and diagnosis of Klatskin tumours with a sensitivity of 87%. ERC and PTC combined yielded a sensitivity of 84% and a specificity of 97%. Tumours were grouped according to the Bismuth classification, with MRC allowing correct identification of type I tumour in seven patients, type II tumour in four patients, type III tumour in 12 patients, and type IV tumour in ten patients. MRC provided superior visualization of completely obstructed peripheral systems. MRC in combination with MRI is a reliable non-invasive diagnostic method for the pre-therapeutic staging of Klatskin tumours. (orig.)

  19. Microwave ablation in combination with TACE for the treatment of primary hepatic carcinoma%微波消融结合肝动脉栓塞化疗治疗原发性肝癌的疗效分析

    Institute of Scientific and Technical Information of China (English)

    彭吉润; 朱继业; 冷希圣; 朱卫华; 张大方; 公磊; 甘丽云; 李澍; 金仲田; 王福顺; 陈雷


    Objective To evaluate the therapeutic effect of microwave ablation in combination with TACE for the treatment of primary liver carcinoma (PLC). Methods From Jan. 2004 to Dec. 2008, 63 PLC patients underwent ultrasound-guided microwave ablation (percutaneous or open) under general anesthesia. Repeated microwave ablation or TACE was used when an incompleted ablation or recurrence was found during postoperative regular follow-up. Results These 63 PLC patients have received a total of 82 sessions of microwave ablation procedure (1 to 5 sessions for each patient). There were 2 early postoperative deaths with a procedure-related mortality of 3.2%. At the end of the follow-up, 22 patients were alive and 38 died,and the other one was lost to follow-up. The survival rates in 1,2 and 3 years were 63.3%,42.1% and 26.5%, respectively, with a median survival of 20 months for all patients. The survival for PLC patients with early stage (TNM Ⅰ and Ⅱ) was significantly longer than that of advanced stage (TNM Ⅲ and Ⅳ). The 1,2 and 3 year's cumulative survival rate was 93.3%,86.7% and 65.0% respectively in those 15 cases with only single tumor and the diameter≤3 cm, which were significantly longer than that of other PLC patients. Of 23 patients with recurrence,9 had solitary tumor without lymphnode and distal metastases, for which the survival rates in 1,2 and 3 years were 100%,88.9%, and 35.6%, respectively, whereas in other recurrent patients the survival rates in 1,2 and 3 years were 21.4%, 10.7% and 0%, respectively(P< 0.01). Conclusions Ultrasound-guided microwave ablation in combination with TACE is effective for PLC patients with early stage. In recurrent PLC patients after ablation therapy with solitary tumor and no lymphnode and distal metastases the survival is significantly longer than that of the others.%目的 分析微波消融结合肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)治疗原发性肝癌的疗效.方法 2004年1月至2008

  20. Radiofrequency ablation of a misdiagnosed Brodie's abscess. (United States)

    Chan, Rs; Abdullah, Bjj; Aik, S; Tok, Ch


    Radiofrequency ablation (RFA) therapy is recognised as a safe and effective treatment option for osteoid osteoma. This case report describes a 27-year-old man who underwent computed tomography (CT)-guided percutaneous RFA for a femoral osteoid osteoma, which was diagnosed based on his clinical presentation and CT findings. The patient developed worsening symptoms complicated by osteomyelitis after the procedure. His clinical progression and subsequent MRI findings had led to a revised diagnosis of a Brodie's abscess, which was further supported by the eventual resolution of his symptoms following a combination of antibiotics treatment and surgical irrigations. This case report illustrates the unusual MRI features of osteomyelitis mimicking soft tissue tumours following RFA of a misdiagnosed Brodie's abscess and highlights the importance of a confirmatory histopathological diagnosis for an osteoid osteoma prior to treatment.

  1. Computed tomography changes following cryotherapy for hepatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    King, J.; Morris, D. L. [University of NSW, Sydney (Australia). Department of Surgery; Glenn, D. [St George Hospital, Kogarah, Sydney (Australia). Department of Radiology


    Encouraging survival and tumour marker results have been described in patients where the focally destructive technique, hepatic cryotherapy, is used to treat primary and secondary hepatic malignancy. Radiology allows assessment of the cryotherapy procedure and follow-up treatment. This paper aims to review and describe the appearance of hepatic cryotherapy by computed tomography which allows assessment of the adequacy of surgical technique and offers the ability to identify recurrences that may be suitable for further treatment. 11 refs., 1 tab., 9 figs.

  2. Local recurrence of hepatocellular carcinoma after radiofrequency ablation

    Institute of Scientific and Technical Information of China (English)


    A 51-year-old Chinese male with a 20-year history of hepatitis B was diagnosed with hepatocellular carcinoma in the right anterior portion of the liver, sized 3.5 cm × 3.2 cm, and was treated with radiofrequency ablation (RFA) on December 18, 2001. The patient did not receive antiviral therapy for hepatitis B virus after RFA. The treated lesion reduced gradually and reached its minimum size of 1.7 cm × 1.5 cm seven years later on November 18, 2008. However computed tomography findings revealed that a recurr...

  3. Transient Ablation of Teflon Hemispheres (United States)

    Arai, Norio; Karashima, Kei-ichi; Sato, Kiyoshi


    For high-speed entry of space vehicles into atmospheric environments, ablation is a practical method for alleviating severe aerodynamic heating. Several studies have been undertaken on steady or quasi-steady ablation. However, ablation is a very complicated phenomenon in which a nonequilibrium chemical process is associated with an aerodynamic process that involves changes in body shape with time. Therefore, it seems realistic to consider that ablation is an unsteady phenomenon. In the design of an ablative heat-shield system, since the ultimate purpose of the heat shield is to keep the internal temperature of the space vehicle at a safe level during entry, the transient heat conduction characteristics of the ablator may be critical in the selection of the material and its thickness. This note presents an experimental study of transient ablation of Teflon, with particular emphasis on the change in body shape, the instantaneous internal temperature distribution, and the effect of thermal expansion on ablation rate.

  4. Power Laser Ablation Symposia

    CERN Document Server

    Phipps, Claude


    Laser ablation describes the interaction of intense optical fields with matter, in which atoms are selectively driven off by thermal or nonthermal mechanisms. The field of laser ablation physics is advancing so rapidly that its principal results are seen only in specialized journals and conferences. This is the first book that combines the most recent results in this rapidly advancing field with authoritative treatment of laser ablation and its applications, including the physics of high-power laser-matter interaction. Many practical applications exist, ranging from inertial confinement fusion to propulsion of aerostats for pollution monitoring to laser ignition of hypersonic engines to laser cleaning nanoscale contaminants in high-volume computer hard drive manufacture to direct observation of the electronic or dissociative states in atoms and molecules, to studying the properties of materials during 200kbar shocks developed in 200fs. Selecting topics which are representative of such a broad field is difficu...

  5. Tumours in the Small Bowel

    Directory of Open Access Journals (Sweden)

    N. Kurniawan


    Full Text Available Small bowel tumours are rare and originate from a wide variety of benign and malignant entities. Adenocarcinomas are the most frequent primary malignant small bowel tumours. Submucosal tumours like gastrointestinal stromal tumours (GIST or neuroendocrine tumours (NET may show a central umbilication, pathologic vessels, bridging folds or an ulceration of the overlying mucosa. These signs help to differentiate them from harmless bulges caused by impression from outside, e.g. from other intestinal loops. Sarcomas of the small bowel are rare neoplasias with mesenchymal origin, sometimes presenting as protruding masses. Benign tumours like lipoma, fibrolipoma, fibroma, myoma, and heterotopias typically present as submucosal masses. They cannot be differentiated endoscopically from those with malignant potential as GIST or NET. Neuroendocrine carcinomas may present with diffuse infiltration, which may resemble other malignant tumours. The endoscopic appearance of small bowel lymphomas has a great variation from mass lesions to diffuse infiltrative changes. Melanoma metastases are the most frequent metastases to the small bowel. They may be hard to distinguish from other tumours when originating from an amelanotic melanoma.

  6. Stereotactic ablative radiotherapy and immunotherapy combinations: turning the future into systemic therapy? (United States)

    Walshaw, Richard C; Honeychurch, Jamie; Illidge, Tim M


    Radiotherapy (RT) is effective at cytoreducing tumours and until relatively recently the focus in radiobiology has been on the direct effects of RT on the tumour. Increasingly, however, the effect of RT on the tumour vasculature, tumour stroma and immune system are recognized as important to the overall outcome. RT is known to lead to the induction of immunogenic cell death (ICD), which can generate tumour-specific immunity. However, systemic immunity leading to "abscopal effects" resulting in tumour shrinkage outside of the RT treatment field is rare, which is thought to be caused by the immunosuppressive nature of the tumour microenvironment. Recent advances in understanding the nature of this immunosuppression and therapeutics targeting immune checkpoints such as programmed death 1 has led to durable clinical responses in a range of cancer types including malignant melanoma and non-small-cell lung cancer. The effects of RT dose and fraction on the generation of ICD and systemic immunity are largely unknown and are currently under investigation. Stereotactic ablative radiotherapy (SABR) provides an opportunity to deliver single or hypofractionated large doses of RT and potentially increase the amount of ICD and the generation of systemic immunity. Here, we review the interplay of RT and the tumour microenvironment and the rationale for combining SABR with immunomodulatory agents to generate systemic immunity and improve outcomes.

  7. Unusual tumours of the lung. (United States)

    Wright, E S; Pike, E; Couves, C M


    Unusual lung tumors are not simply pathological curiosities. They demonstrate features of major significance in diagnosis, treatment, and prognosis. Six of these tumours are discussed: (1) Carcinosarcoma is rarely found in the lung. The histogenis of the lesion is unclear and the prognosis is poor. (2) Only three cases of pleomorphic adenoma have previously been described. Differentiation from other "mixed tumours" of the lung is essential. (3) A rare case of bronchial adenoma producing ectopic ACTH is described. Early recognition of these polypeptide hormone-secreting tumours is stressed. (4) Oat cell carcinoma with the myasthenic (Eaton-Lambert) syndrome shows the clinical features which should permit early tumour diagnosis. The hazards of muscle relaxants must be recognized. (5) Prostatic carcinoma with endobronchial metastases is is discussed. The importance of localization of the primary tumour is emphasized. (6) An example of double primary carcinoma is presented. The rarity of this finding may be related to the poor prognosis of patients with bronchogenesis carcinoma.

  8. Intraspinal tumours in the Kenya African. (United States)

    Ruberti, R F; Carmagnani, A L


    Thirty-one cases of intraspinal tumours in the African have been described, with age, sex incidence, frequency, site and histopathology shown. Intraspinal tumours in this series are compared with the larger series. Extradural and intramedullary tumours together with cervical spine tumours appear to be more frequent in this series. There is a high incidence of dumbell tumours in the neurinomas. Sarcomas are the most common type of tumours and mainly affect the thoracic spine.

  9. Improving thermal ablation delineation with electrode vibration elastography using a bidirectional wave propagation assumption. (United States)

    DeWall, Ryan J; Varghese, Tomy


    Thermal ablation procedures are commonly used to treat hepatic cancers and accurate ablation representation on shear wave velocity images is crucial to ensure complete treatment of the malignant target. Electrode vibration elastography is a shear wave imaging technique recently developed to monitor thermal ablation extent during treatment procedures. Previous work has shown good lateral boundary delineation of ablated volumes, but axial delineation was more ambiguous, which may have resulted from the assumption of lateral shear wave propagation. In this work, we assume both lateral and axial wave propagation and compare wave velocity images to those assuming only lateral shear wave propagation in finite element simulations, tissue-mimicking phantoms, and bovine liver tissue. Our results show that assuming bidirectional wave propagation minimizes artifacts above and below ablated volumes, yielding a more accurate representation of the ablated region on shear wave velocity images. Area overestimation was reduced from 13.4% to 3.6% in a stiff-inclusion tissue-mimicking phantom and from 9.1% to 0.8% in a radio-frequency ablation in bovine liver tissue. More accurate ablation representation during ablation procedures increases the likelihood of complete treatment of the malignant target, decreasing tumor recurrence. © 2012 IEEE

  10. Three-dimension finite-element analyses of multiple electrodes bipolar RF global endometrial ablation (United States)

    Hu, Tao; Panhao, Tang; Xiao, Jiahua


    Radio-frequency ablation (RFA) is a minimally invasive surgical procedure to thermally ablate the targeted diseased tissue. There have been many finite-element method (FEM) studies of cardiac and hepatic RFA, but hardly find any FEM study on endometrial ablation for abnormal uterine bleeding. In this paper, a FEM model was generated to analyze the temperature distribution of bipolar RF global endometrial ablation with three pairs of bipolar electrodes placed at the perimeter of the uterine cavity. COMSOL was utilized to calculate the RF electric fields and temperature fields by numerically solving the bioheat equation in the triangle uterine cavity range. The 55°C isothermal surfaces show the shape of the ablation dimensions (depth and width), which reasonably matched the experimental results.

  11. Real-time monitoring of radiofrequency ablation of liver tumors using thermal-dose calculation by MR temperature imaging: initial results in nine patients, including follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Lepetit-Coiffe, Matthieu; Quesson, Bruno; Moonen, Chrit T.W. [Universite Victor Segalen Bordeaux 2, Laboratoire Imagerie Moleculaire et Fonctionnelle: de la physiologie a la therapie CNRS UMR 5231, Bordeaux Cedex (France); Laumonier, Herve; Trillaud, Herve [Universite Victor Segalen Bordeaux 2, Laboratoire Imagerie Moleculaire et Fonctionnelle: de la physiologie a la therapie CNRS UMR 5231, Bordeaux Cedex (France); Service de Radiologie, Hopital Saint-Andre, CHU Bordeaux, Bordeaux (France); Seror, Olivier [Universite Victor Segalen Bordeaux 2, Laboratoire Imagerie Moleculaire et Fonctionnelle: de la physiologie a la therapie CNRS UMR 5231, Bordeaux Cedex (France); Service de Radiologie, Hopital Jean Verdier, Bondy (France); Sesay, Musa-Bahazid [Service d' Anesthesie Reanimation III, Hopital Pellegrin, CHU Bordeaux, Bordeaux (France); Grenier, Nicolas [Universite Victor Segalen Bordeaux 2, Laboratoire Imagerie Moleculaire et Fonctionnelle: de la physiologie a la therapie CNRS UMR 5231, Bordeaux Cedex (France); Service d' Imagerie Diagnostique et Therapeutique de l' Adulte, Hopital Pellegrin, CHU Bordeaux, Bordeaux (France)


    To assess the practical feasibility and effectiveness of real-time magnetic resonance (MR) temperature monitoring for the radiofrequency (RF) ablation of liver tumours in a clinical setting, nine patients (aged 49-87 years, five men and four women) with one malignant tumour (14-50 mm, eight hepatocellular carcinomas and one colorectal metastasis), were treated by 12-min RF ablation using a 1.5-T closed magnet for real-time temperature monitoring. The clinical monopolar RF device was filtered at 64 MHz to avoid electromagnetic interference. Real-time computation of thermal-dose (TD) maps, based on Sapareto and Dewey's equation, was studied to determine its ability to provide a clear end-point of the RF procedure. Absence of local recurrence on follow-up MR images obtained 45 days after the RF ablation was used to assess the apoptotic and necrotic prediction obtained by real-time TD maps. Seven out of nine tumours were completely ablated according to the real-time TD maps. Compared with 45-day follow-up MR images, TD maps accurately predicted two primary treatment failures, but were not relevant in the later progression of one case of secondary local tumour. The real-time TD concept is a feasible and promising monitoring method for the RF ablation of liver tumours. (orig.)

  12. Tumor ablations in IMRI

    Institute of Scientific and Technical Information of China (English)

    Roberto Blanco Sequeiros


    @@ IntroductionMagnetic resonance imaging based guidance control and monitoring of minimally invasive intervention has developed from a hypothetical concept to a practical possibility. Magnetic-resonance-guided interstitial therapy in principle is defined as a treatment technique for ablating deepseated tumors in the human body.

  13. Radiofrequency Ablation: Inflammatory Changes in the Periablative Zone Can Induce Global Organ Effects, including Liver Regeneration. (United States)

    Rozenblum, Nir; Zeira, Evelyne; Bulvik, Baruch; Gourevitch, Svetlana; Yotvat, Hagit; Galun, Eithan; Goldberg, S Nahum


    To determine the kinetics of innate immune and hepatic response to the coagulation necrosis area that remains in situ after radiofrequency (RF) ablation, the cytokine profile of this response, and its local and global effect on the whole organ in a small-animal model. A standardized RF ablation dose (70°C for 5 minutes) was used to ablate more than 7% of the liver in 91 C57BL6 mice (wild type) according to a protocol approved by the animal care committee. The dynamic cellular response in the border zone surrounding ablation-induced coagulation and in the ablated lobe and an untreated lobe were characterized with immunohistochemistry 24 hours, 72 hours, 7 days, and 14 days after ablation (the time points at which cells migrate to necrotic tissues). After characterization of the cellular populations that reacted to the RF treatment, cytokines secreted by these cells were blocked, either by using interleukin-6 knockout mice (n = 24) or c-met inhibitor PHA 665752 (n = 15), to elucidate the key factors facilitating the wound healing response to RF ablation. Statistical significance was assessed with nonparametric analysis of variance. RF ablation induces a strong time-dependent immunologic response at the perimeter of the necrotic zone. This includes massive accumulation of neutrophils, activated myofibroblasts, and macrophages peaking at 24 hours, 7 days, and 14 days after ablation, respectively. In correlation with myofibroblast accumulation, RF ablation induced hepatocyte proliferation in both the ablated lobe and an untreated lobe (mean, 165.15 and 230.4 cyclin-dependent kinase 47-positive cells per ×20 field, respectively, at day 7; P RF ablation induces not only a local periablational inflammatory zone but also more global proliferative effects on the liver. These IL-6- and/or c-met-mediated changes could potentially account for some of the local and distant tumor recurrence observed after treatment. © RSNA, 2015 Online supplemental material is available for

  14. Percutaneous laser ablation of unresectable primary and metastatic adrenocortical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Pacella, Claudio M. [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)], E-mail:; Stasi, Roberto; Bizzarri, Giancarlo; Pacella, Sara; Graziano, Filomena Maria; Guglielmi, Rinaldo; Papini, Enrico [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)


    Purpose: To evaluate the feasibility, safety, and clinical benefits of percutaneous laser ablation (PLA) in patients with unresectable primary and metastatic adrenocortical carcinoma (ACC). Patients and methods: Four patients with hepatic metastases from ACC and a Cushing's syndrome underwent ultrasound-guided PLA. In one case the procedure was performed also on the primary tumor. Results: After three sessions of PLA, the primary tumor of 15 cm was ablated by 75%. After 1-4 (median 1) sessions of PLA, five liver metastases ranging from 2 to 5 cm were completely ablated, while the sixth tumor of 12 cm was ablated by 75%. There were no major complications. Treatment resulted in an improvement of performance status and a reduction of the daily dosage of mitotane in all patients. The three patients with liver metastases presented a marked decrease of 24-h urine cortisol levels, an improved control of hypertension and a mean weight loss of 2.8 kg. After a median follow-up after PLA of 27.0 months (range, 9-48 months), two patients have died of tumor progression, while two other patients remain alive and free of disease. Conclusions: Percutaneous laser ablation is a feasible, safe and well tolerated procedure for the palliative treatment of unresectable primary and metastatic ACC. Further study is required to evaluate the impact of PLA on survival.

  15. Genetic analysis of an orbital metastasis from a primary hepatic neuroendocrine carcinoma

    DEFF Research Database (Denmark)

    Rasmussen, Jacob Ø; Von Holstein, Sara Linea; Prause, Jan U;


    and immunohistochemical features, and high-resolution, array-based comparative genomic hybridization demonstrated loss of one copy each of chromosomes 3 and 18, and gain of 1q both in the primary hepatic neuroendocrine carcinoma and in the orbital tumour. The orbital mass was diagnosed as a metastasis from the primary...... hepatic neuroendocrine carcinoma. Primary hepatic neuroendocrine tumours are extremely rare, and the orbit is an extremely rare location for a neuroendocrine carcinoma metastasis. This is the first reported case of an orbital metastasis with origin from a primary hepatic neuroendocrine carcinoma....

  16. Primary vertebral tumours in children

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Beluffi, G.; Masel, J.; Diard, F.; Ferrari-Ciboldi, F.; Le Dosseur, P.; Labatut, J.


    20 cases of primary benign and malignant bone tumours in children were reported. The most common tumours were Ewing's sarcoma, aneurismal bone cyst, benign osteoblastoma and osteoid osteoma. Some rare primary bone tumours in children (osteochondroma, chondroblastoma 6F, primary lymphoma of bone and neurofibromatosis with unusual cervical spinal changes) were also reported. The authors believe that radiographic findings together with clinical history and clinical examination may yield a high percentage of accurate diagnoses. Although microscopy is essential in the final diagnosis, the microscopic report should be also accepted with caution.

  17. Outcome and CT differentiation of gallbladder neuroendocrine tumours from adenocarcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae-Hyung [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Kim, Se Hyung [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Hospital and Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Kyoung Boon [Seoul National University Hospital, Department of Pathology, Seoul (Korea, Republic of); Han, Joon Koo [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of)


    To retrospectively investigate clinical outcome and differential CT features of gallbladder (GB) neuroendocrine tumours (NETs) from adenocarcinomas (ADCs). Nineteen patients with poorly-differentiated (PD) NETs and 19 patients with PD ADCs were enrolled. Clinical outcome was compared by the Kaplan-Meier method. We assessed qualitative and quantitative CT features to identify significant differential CT features of PD NETs from ADCs using univariate and multivariate analyses. Receiver operating characteristic (ROC) analysis was used for quantitative CT features. PD NETs showed poorer prognosis with significantly shorter median survival days than ADCs (363 vs. 590 days, P = 0.03). On univariate analysis, NETs more frequently manifested as GB-replacing type and showed well-defined margins accompanied with intact overlying mucosa. On multivariate analysis, well-defined margin was the sole significant CT differentiator (odds ratio = 27.817, P = 0.045). Maximum size of hepatic and lymph node (LN) metastases was significantly larger in NETs (11.0 cm and 4.62 cm) than ADCs (2.40 cm and 2.41 cm). Areas under ROC curves for tumour-to-mucosa ratio, maximum size of hepatic and LN metastasis were 0.772, 0.932 and 0.919, respectively (P < 0.05). GB PD NETs show poorer prognosis than ADCs. Well-defined margin, larger hepatic and LN metastases are useful CT differentiators of GB NETs from ADCs. (orig.)

  18. Peripheral primitive neuroectodermal tumour in a lumbar vertebra and the liver of a dromedary camel (Camelus dromedarius). (United States)

    Weiss, R; Walz, P H


    A 9-year-old castrated male dromedary camel developed weakness and ataxia, progressing to sternal recumbency and hindlimb paralysis. Necropsy revealed multiple liver tumours and a mass in the 3rd lumbar vertebra, compressing the spinal cord. The hepatic and vertebral masses consisted of uniform sheets of primitive cells, with perivascular pseudorosettes and small numbers of neuroblastic Homer-Wright rosettes. Immunohistochemically, the tumour cells were uniformly positive for vimentin and variably positive for neuron-specific enolase and glial fibrillary acidic protein. The histopathological and immunohistochemical findings indicated a peripheral primitive neuroectodermal tumour (pPNET) exhibiting neuroblastic, glial and ependymomatous differentiation, probably reflecting the tumour's primitive multipotential neuroepithelial nature. To the authors' knowledge, this is the first reported case in the camel of a pPNET, presumably intraosseous in origin with hepatic metastasis, and morphologically similar to Ewing's sarcoma in man.

  19. Hepatitis C and Incarceration (United States)

    HEPATITIS C & INCARCERATION What is hepatitis? “Hepatitis” means inflammation or swelling of the liver. The liver is an important ... viral hepatitis: Hepatitis A, Hepatitis B, and Hepatitis C. They are all different from each other and ...

  20. Hepatic Encephalopathy

    Medline Plus

    Full Text Available ... of terms Donate Today Enroll in 123 What is Hepatic Encephalopathy? Hepatic Encephalopathy, sometimes referred to as portosystemic encephalopathy or PSE, is a condition that causes temporary worsening of brain ...

  1. Hepatitis A (United States)

    ... an inflammation of the liver. One type, hepatitis A, is caused by the hepatitis A virus (HAV). The disease spreads through contact with ... washed in untreated water Putting into your mouth a finger or object that came into contact with ...

  2. Hepatitis B (United States)

    ... information on hepatitis, both in the context of HIV coinfection and as a separate illness. NATAP provides coverage of key conferences, maintains a selection of hepatitis articles, and features an ask-the-expert forum on ...

  3. Hepatitis B (United States)

    ... personal items (such as toothbrush, razor, and nail clippers) with a person who has the virus Were ... B virus Digestive system Aggressive hepatitis Gianotti-Crosti syndrome on the leg Hepatitis B References Kim DK, ...

  4. The Heidelberg classification of renal cell tumours

    NARCIS (Netherlands)

    Kovacs, G; Akhtar, M; Beckwith, BJ; Bugert, P; Cooper, CS; Delahunt, B; Eble, JN; Fleming, S; Ljungberg, B; Medeiros, LJ; Moch, H; Reuter, VE; Ritz, E; Roos, G; Schmidt, D; Srigley, [No Value; Storkel, S; VandenBerg, E; Zbar, B


    This paper presents the conclusions of a workshop entitled 'Impact of Molecular Genetics on the Classification of Renal Cell Tumours', which was held in Heidelberg in October 1996, The focus on 'renal cell tumours' excludes any discussion of Wilms' tumour and its variants, or of tumours metastatic t

  5. Soft tissue tumours: imaging strategy

    Energy Technology Data Exchange (ETDEWEB)

    Brisse, Herve J. [Institute Curie, Department of Radiology, Paris (France); Orbach, Daniel [Institute Curie, Department of Paediatric Oncology, Paris (France); Klijanienko, Jerzy [Institute Curie, Department of Pathology, Paris (France)


    Vascular tumours and malformations, fibrous and fibrohistiocytic tumours and pseudotumours are the most common benign soft-tissue masses observed in children, and can be treated conservatively. Rhabdomyosarcomas are the most frequent malignant tumours, accounting for about half of soft tissue sarcomas. A child referred for a soft-tissue mass should ideally be managed by a multidisciplinary team and primary excision should be proscribed until a definite diagnosis has been established. Clinical examination, conventional radiography and US with Doppler represent the first-line examinations and are sometimes sufficient to make a diagnosis. In all other situations, MRI is mandatory to establish the aggressiveness and extension of the tumour. This technique provides the relevant data to guide the decision regarding tissue sampling. (orig.)

  6. Hepatitis C (United States)

    ... an inflammation of the liver. One type, hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with ... childbirth. Most people who are infected with hepatitis C don't have any symptoms for years. If ...

  7. Tumour markers in gastrointestinal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lamerz, R.


    For non-endocrine gastrointestinal tumours the following tumour markers are of clinical interest: For esophageal cancer CEA (sensitivity, s: 40-60%) and SCC (squamous cell carcinoma antigen, x: 20-50%); for gastric cancer CEA (s: 30-40%) as well as CA 19-9 (s: 30-40%) because of complementary results (additive s: 50-60); for hepatocellular cancer AFP (first choice, s: 70-90%; second choice CA 19-9, s: 50-70%); for cholangiocellular cancer CA 19-9 (s: 40-70%); for secondary liver cancer in general CEA; for biliary tract cancer CA 19-9 (s: 40-70%) as well as for excretory pancreatic cancer (s: 70-90%); for colorectal cancer CEA (s: 40-70%) as a first choice marker, and CA 19-9 (s: 20-60%) as a second choice marker, and for anal cancer SCC. The frequency of tumour marker determinations depends on follow-up care recommendations for different tumour diseases (e.g. 1-3 monthly during the 1st and 2nd postoperative year, following chemotherapy courses, on change of therapy, on restaging and at unclear alteration of the clinical state). Tumour markers are only valuable adjuncts to the medical care of tumour patients and therefore useless as solitary findings or on missing therapeutic consequence.

  8. MRI characteristics of midbrain tumours

    Energy Technology Data Exchange (ETDEWEB)

    Sun, B. [Chinese Academy of Medical Science, Beijing (China). Neurosurgical Inst.]|[Department of Neuroradiology, Beijing Tiantan Hospital (China); Wang, C.C.; Wang, J. [Chinese Academy of Medical Science, Beijing (China). Neurosurgical Inst.


    We diagnosed 60 cases of midbrain tumours by MRI between 1993 to 1997. There were 39 males and 21 females, aged 2-64 years, mean 25.6 years. We found 38 patients with true intramedullary midbrain tumours, 11 predominantly in the tectum, 20 in the tegmentum and 7 with a downward extension to the pons; there were 7 within the cerebral aqueduct. There were 22 patients with infiltrating midbrain tumours extending from adjacent structures, 11 cases each from the thalamus and pineal region. All patients received surgical treatment. Gross total resection was achieved in 42 cases, subtotal (> 75 %) resection in 18. Pathological diagnoses included 16 low-grade and 15 high-grade astrocytomas; 5 oligodendroastrocytomas; 2 ependymomas; 11 glioblastomas; and 11 pineal parenchymal or germ-cell tumours. Midbrain tumours are a heterogeneous group of neoplasms, with wide variation in clinical and MRI features, related to the site and type of tumour. MRI not only allows precise analysis of their growth pattern, but also can lead to a correct preoperative diagnosis in the majority of cases. (orig.) (orig.) With 3 figs., 3 tabs., 19 refs.

  9. Somatostatin receptor expression, tumour response, and quality of life in patients with advanced hepatocellular carcinoma treated with long-acting octreotide. (United States)

    Cebon, J; Findlay, M; Hargreaves, C; Stockler, M; Thompson, P; Boyer, M; Roberts, S; Poon, A; Scott, A M; Kalff, V; Garas, G; Dowling, A; Crawford, D; Ring, J; Basser, R; Strickland, A; Macdonald, G; Green, M; Nowak, A; Dickman, B; Dhillon, H; Gebski, V


    Octreotide may extend survival in hepatocellular carcinoma (HCC). Forty-one per cent of HCCs have high-affinity somatostatin receptors. We aimed to determine the feasibility, safety, and activity of long-acting octreotide in advanced HCC; to identify the best method for assessing somatostatin receptor expression; to relate receptor expression to clinical outcomes; and to evaluate toxicity. Sixty-three patients with advanced HCC received intramuscular long-acting octreotide 20 mg monthly until progression or toxicity. Median age was 67 years (range 28-81 years), male 81%, Child-Pugh A 83%, and B 17%. The aetiologies of chronic liver disease were alcohol (22%), viral hepatitis (44%), and haemochromatosis (6%). Prior treatments for HCC included surgery (8%), chemotherapy (2%), local ablation (11%), and chemoembolisation (6%). One patient had an objective partial tumour response (2%, 95% CI 0-9%). Serum alpha-fetoprotein levels decreased more than 50% in four (6%). Median survival was 8 months. Thirty four of 61 patients (56%) had receptor expression detected by scintigraphy; no clear relationship with clinical outcomes was identified. There were few grade 3 or 4 toxicities: hyperglycaemia (8%), hypoglycaemia (2%), diarrhoea (5%), and anorexia (2%). Patients reported improvements in some symptoms, but no major changes in quality of life were detected. Long-acting octreotide is safe in advanced HCC. We found little evidence of anticancer activity. A definitive randomised trial would identify whether patients benefit from this treatment in other ways.

  10. Lesion size in relation to ablation site during radiofrequency ablation

    DEFF Research Database (Denmark)

    Petersen, H H; Chen, X; Pietersen, A;


    convective cooling by induction of a flow around the electrode tip increases lesion dimensions and power consumptions. Furthermore we conclude that for the given target temperature the power consumption is positively correlated with lesion volume (p ...This study was designed to investigate the effect of the convective cooling of the tip of the ablation electrode during temperature controlled radiofrequency ablation. In vivo two different application sites in the left ventricle of anaesthetised pigs were ablated and in vitro ablation...... larger for septal applications than apical applications (p convective cooling by induction of flow yielded larger lesion volume, depth and width (p

  11. Case Experience of Radiofrequency Ablation for Benign Thyroid Nodules: From an Ex Vivo Animal Study to an Initial Ablation in Taiwan

    Directory of Open Access Journals (Sweden)

    Ming-Tsang Lee


    Full Text Available Radiofrequency ablation (RFA is a minimally invasive technique, used with ultrasound or computed tomography guidance, which can produce tissue coagulation necrosis in various kinds of tumors in the human body. In the past 10 years, numerous studies about RFA in benign thyroid nodules have been published. Reviewing these studies, we noticed that the effectiveness of ablation was higher when it was performed with the “moving-shot technique” via an internally cooled electrode. A consensus statement published from the Korean Society of Radiology also suggested the moving-shot technique as a standard ablation procedure for benign thyroid nodule ablation in Korea. In Taiwan, most symptomatic benign nodules are currently treated with surgical removal. RFA for mass lesions is primarily performed for the treatment of metastatic hepatic tumors. In our case, we have attempted to introduce RFA for benign thyroid nodules in Taiwan. Because endocrinologists in Taiwan were not familiar with this technique, we adopted a stepwise approach in learning how to perform RFA. We conducted ex vivo animal ablation exercises to gain experience in setting the radiofrequency generator for the right ablation mode and appropriate power output. The thyroid nodule volume reduction rate after 1 year of follow up was approximately 50% in this case. The most important thing we learned from this trial is that we confirmed the safety of thyroid nodule ablation. To the best of our knowledge, this is the first reported study of RFA of a thyroid nodule in Taiwan.

  12. Hypoksisk hepatitis

    DEFF Research Database (Denmark)

    Amadid, Hanan; Schiødt, Frank Vinholt


    Hypoxic hepatitis (HH), also known as ischaemic hepatitis or shock liver, is an acute liver injury caused by hepatic hypoxia. Cardiac failure, respiratory failure and septic shock are the main underlying conditions. In each of these conditions, several haemodynamic mechanisms lead to hepatic...... hypoxia. A shock state is observed in only 50% of cases. Thus, shock liver and ischaemic hepatitis are misnomers. HH can be a diagnostic pitfall but the diagnosis can be established when three criteria are met. Prognosis is poor and prompt identification and treatment of the underlying conditions...

  13. Targeting of liver tumour in rats by selective delivery of holmium-166 loaded microspheres: a biodistribution study

    Energy Technology Data Exchange (ETDEWEB)

    Nijsen, F.; Rook, D.; Zonnenberg, B.; Klerk, J. de; Rijk, P. van; Schip, F. van het [Dept. of Nuclear Medicine, University Medical Center, Utrecht (Netherlands); Brandt, C. [Animal Inst., Utrecht Univ. (Netherlands); Meijer, R. [Dept. of Radiology, Univ. Medical Center, Utrecht (Netherlands); Dullens, H. [Dept. of Pathology, Univ. Medical Center, Utrecht (Netherlands); Hennink, W. [Dept. of Pharmaceutics, Utrecht Univ. (Netherlands)


    Intra-arterial administration of beta-emitting particles that become trapped in the vascular bed of a tumour and remain there while delivering high doses, represents a unique approach in the treatment of both primary and metastatic liver tumours. Studies on selective internal radiation therapy of colorectal liver metastases using yttrium-90 glass microspheres have shown encouraging results. This study describes the biodistribution of 40-{mu}m poly lactic acid microspheres loaded with radioactive holmium-166, after intra-arterial administration into the hepatic artery of rats with implanted liver tumours. Radioactivity measurements showed >95% retention of injected activity in the liver and its resident tumour. The average activity detected in other tissues was {<=}0.1%ID/g, with incidental exceptions in the lungs and stomach. Very little {sup 166}Ho activity was detected in kidneys (<0.1%ID/g), thereby indicating the stability of the microspheres in vivo. Tumour targeting was very effective, with a mean tumour to liver ratio of 6.1{+-}2.9 for rats with tumour (n=15) versus 0.7{+-}0.5 for control rats (n=6; P<0.001). These ratios were not significantly affected by the use of adrenaline. Histological analysis showed that five times as many large (>10) and medium-sized (4-9) clusters of microspheres were present within tumour and peritumoural tissue, compared with normal liver. Single microspheres were equally dispersed throughout the tumour, as well as normal liver parenchyma. (orig.)

  14. 单肺通气联合人工胸水辅助经皮热消融治疗肝膈顶部肝癌%Artificial hydrothorax combined with one-lung ventilation to aid percutaneous ablation treatment of liver carcinoma in the hepatic dome

    Institute of Scientific and Technical Information of China (English)

    郭光辉; 许尔蛟; 郑荣琴; 曾庆劲; 李凯


    Objective To evaluate the clinical value of artificial hydrothorax combined with one-lung ventilation to aid ablation treatment of liver carcinoma in the hepatic dome.Methods Twenty-one patients with liver carcinoma located in the hepatic dome and affected by the lung gas were enrolled.Double lumen endobronchial intubation anesthesia was used and thoracical tube was used to apply artificial pleural effusion.The lesions'ultrasound image were recorded for the patients without artificial hydrothorax,or with artificial hydrothorax only and artificial hydrothorax combined with one-lung ventilation.Ultrasound images were reviewed and scored as 1-5 according to the clarity and completeness of the lesion.Ablation efficacy and adverse reactions were recorded in the follow-up.Results Twenty-one patients were successfully applied artificial hydrothorax and one lung ventilation.The average normal saline used for artificial hydrothorax were (738± 260)ml.The ultrasound score for not using artificial hydrothorax,using artificial hydrothorax only and artificial hydrothorax combined with one lung ventilation were 1.13 ± 0.35 (1-2),3.00 ± 0.85 (2-5) and 4.53 ± 0.64(3-5),respectively,statistical difference was found between each method(P <0.05).Artificial hydrothorax combined with one-lung ventilation had much higher ultrasound score than the other 2 methods.No complication related to artificial hydrothorax or one-lung ventilation was found.CT/MRI at one month after ablation showed that all the lesions were completely ablated.In the follow-up for 2-14 months on average,1 case of local tumor progression and 1 case of intrahapetic relapse were found.Conclusions Artificial hydrothorax combine one-lung ventilation could effectively enhance ultrasound image for the lesions in the dome whose acoustic window was affected by lung gas.%目的 探讨单肺通气联合人工胸水辅助经皮热消融治疗肝膈顶部肝癌的临床价值.方法 选取位于肝膈顶位置、超声显

  15. Ultrasound-guided percutaneous radiofrequency ablation of liver tumors: How we do it safety and completely

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woong; Shin, Sang Soo; Heo, Suk Hee; Hong, Jun Hyung; Lim, Hyo Soon; Seon, Hyun Ju; Hur, Young Hoe; Park, Chang Hwan; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Medical School, Gwangju (Korea, Republic of)


    Ultrasound-guided percutaneous radiofrequency (RF) ablation has become one of the most promising local cancer therapies for both resectable and nonresectable hepatic tumors. Although RF ablation is a safe and effective technique for the treatment of liver tumors, the outcome of treatment can be closely related to the location and shape of the tumors. There may be difficulties with RF ablation of tumors that are adjacent to large vessels or extrahepatic heat-vulnerable organs and tumors in the caudate lobe, possibly resulting in major complications or treatment failure. Thus, a number of strategies have been developed to overcome these challenges, which include artificial ascites, needle track ablation, fusion imaging guidance, parallel targeting, bypass targeting, etc. Operators need to use the right strategy in the right situation to avoid the possibility of complications and incomplete thermal tissue destruction; with the right strategy, RF ablation can be performed successfully, even for hepatic tumors in high-risk locations. This article offers technical strategies that can be used to effectively perform RF ablation as well as to minimize possible complications related to the procedure with representative cases and schematic illustrations.


    Directory of Open Access Journals (Sweden)

    Senthilvel Arumugam


    Full Text Available Wilms’ tumour also called as nephroblastoma is a malignant renal neoplasm of childhood that arises from remnant of immature kidney. About 80% of Wilms’ tumour cases occur before age 5 with a median age of 3.5 years. But adult Wilms’ tumour can occur at any age from 16 to 70 years, the median age in young adult is around 24. CASE REPORT A 16-year-old girl came with history of mass right abdomen, which she noticed for 1 week duration; no urinary symptoms. Her recent blood pressure was 140/90 mmHg. Per abdomen a 10 x 9 cm mass palpable in the right lumbar region, surface smooth, firmto-hard in consistency, non-tender, well defined, no bruit. Urine routine examination was normal; urine culture was sterile; renal and liver function tests were within normal limits; Sr. calcium 9.5 mg/dL. CT abdomen plain and contrast showed a 10 x 9 cm heterodense lesion equivocal with renal cell carcinoma and angiomyolipoma. MR angiogram was done. It showed well-defined encapsulated heterointense mass of size 12 x 8 x 7cm, IVC and bilateral renal vein normal. Since findings were inconclusive, we did a CT-guided biopsy and report came as feature positive for small round cell tumour. Hence, proceeded with right radical nephrectomy. The final histopathology report came as Wilms’ tumour spindle cell variant. Margins clear and ureter not involved. She was then started on adjuvant chemotherapy Inj. Vincristine 2 mg weekly for 27 weeks. She is on regular followup now. CONCLUSION Wilms’ tumour should be considered in a patient who presents with a renal mass with or without loin pain, haematuria especially in young adults. Every attempt should be made to differentiate it from renal cell carcinoma. The outcome for adult Wilms’ tumour is steadily improving with current multimodality treatment approach.

  17. A fatal pseudo-tumour: disseminated basidiobolomycosis

    Directory of Open Access Journals (Sweden)

    Bemelman Willem A


    Full Text Available Abstract Background Basidiobolomycosis is a rare disease caused by the fungus Basidiobolus ranarum, member of the class Zygomycetes, order Entomophthorales, found worldwide. Usually basidiobolomycosis is a subcutaneous infection but rarely gastrointestinal manifestations have been described; 13 adults and 10 children and a few retroperitoneal or pulmonary cases. In gastrointestinal basidiobolomycosis the colon is most frequently involved, usually presenting with subacute mild abdominal pain. In contrast to children only very few described adult patients had hepatic masses. Definitive diagnosis requires culture, serological testing can be helpful. The fungal morphology and the Splendore-Hoeppli phenomenon are characteristic histological features. There are no prominent risk factors. Usually surgery and prolonged antifungal therapy are required. Case presentation A 61 year old man presented with progressive left abdominal pain and constipation since a few months. Colonoscopy showed an obstructing tumour in the descending colon, and a hemicolectomy was performed. Histology showed inflammation, possibly caused by a fungal or parasitic infection, without definite identification of an organism. A few weeks postoperatively a CT scan made because of abdominal discomfort, revealed a livermass (6 cm. Treatment with metronidazole, directed against an amoebic liver abscess, was unsuccessful. He developed a marked eosinophilia (27.7%. A liver biopsy was performed and the patient was referred to a university hospital. A repeated CT scan showed a livermass of 9 cm diameter. Review of colon and liver biopsy samples showed extensive necrosis and histiocytes, multinucleated giant cells and numerous eosinophils. Grocott stained sections contained unusually large hyphae surrounded by strongly eosinophilic material in haematoxylin and eosin stained sections (Splendore-Hoeppli phenomenon. A presumptive diagnosis of Basidiobolus spp. infection was made and treated

  18. Hepatitis A through E (Viral Hepatitis) (United States)

    ... Nutrition Clinical Trials Primary Sclerosing Cholangitis Wilson Disease Hepatitis (Viral) View or Print All Sections What is Viral Hepatitis? Viral hepatitis is an infection that causes liver inflammation ...

  19. Ablation of solids by femtosecond lasers ablation mechanism and ablation thresholds for metals and dielectrics

    CERN Document Server

    Gamaly, E G; Tikhonchuk, V T; Luther-Davies, B


    The mechanism of ablation of solids by intense femtosecond laser pulses is described in an explicit analytical form. It is shown that at high intensities when the ionization of the target material is complete before the end of the pulse, the ablation mechanism is the same for both metals and dielectrics. The physics of this new ablation regime involves ion acceleration in the electrostatic field caused by charge separation created by energetic electrons escaping from the target. The formulae for ablation thresholds and ablation rates for metals and dielectrics, combining the laser and target parameters, are derived and compared to experimental data. The calculated dependence of the ablation thresholds on the pulse duration is in agreement with the experimental data in a femtosecond range, and it is linked to the dependence for nanosecond pulses.

  20. Ablation of solids by femtosecond lasers: ablation mechanism and ablation thresholds for metals and dielectrics


    Gamaly, E. G.; Rode, A. V.; Tikhonchuk, V. T.; Luther-Davies, B.


    The mechanism of ablation of solids by intense femtosecond laser pulses is described in an explicit analytical form. It is shown that at high intensities when the ionization of the target material is complete before the end of the pulse, the ablation mechanism is the same for both metals and dielectrics. The physics of this new ablation regime involves ion acceleration in the electrostatic field caused by charge separation created by energetic electrons escaping from the target. The formulae ...

  1. Cone-Beam Computed Tomography (CBCT) Versus CT in Lung Ablation Procedure: Which is Faster?

    Energy Technology Data Exchange (ETDEWEB)

    Cazzato, Roberto Luigi, E-mail:; Battistuzzi, Jean-Benoit, E-mail:; Catena, Vittorio, E-mail: [Institut Bergonié, Department of Radiology (France); Grasso, Rosario Francesco, E-mail:; Zobel, Bruno Beomonte, E-mail: [Università Campus Bio-Medico di Roma, Department of Radiology and Diagnostic Imaging (Italy); Schena, Emiliano, E-mail: [Università Campus Bio-Medico di Roma, Unit of Measurements and Biomedical Instrumentations, Biomedical Engineering Laboratory (Italy); Buy, Xavier, E-mail:; Palussiere, Jean, E-mail: [Institut Bergonié, Department of Radiology (France)


    AimTo compare cone-beam CT (CBCT) versus computed tomography (CT) guidance in terms of time needed to target and place the radiofrequency ablation (RFA) electrode on lung tumours.Materials and MethodsPatients at our institution who received CBCT- or CT-guided RFA for primary or metastatic lung tumours were retrospectively included. Time required to target and place the RFA electrode within the lesion was registered and compared across the two groups. Lesions were stratified into three groups according to their size (<10, 10–20, >20 mm). Occurrences of electrode repositioning, repositioning time, RFA complications, and local recurrence after RFA were also reported.ResultsForty tumours (22 under CT, 18 under CBCT guidance) were treated in 27 patients (19 male, 8 female, median age 67.25 ± 9.13 years). Thirty RFA sessions (16 under CBCT and 14 under CT guidance) were performed. Multivariable linear regression analysis showed that CBCT was faster than CT to target and place the electrode within the tumour independently from its size (β = −9.45, t = −3.09, p = 0.004). Electrode repositioning was required in 10/22 (45.4 %) tumours under CT guidance and 5/18 (27.8 %) tumours under CBCT guidance. Pneumothoraces occurred in 6/14 (42.8 %) sessions under CT guidance and in 6/16 (37.5 %) sessions under CBCT guidance. Two recurrences were noted for tumours receiving CBCT-guided RFA (2/17, 11.7 %) and three after CT-guided RFA (3/19, 15.8 %).ConclusionCBCT with live 3D needle guidance is a useful technique for percutaneous lung ablation. Despite lesion size, CBCT allows faster lung RFA than CT.

  2. Tumour banking: the Spanish design. (United States)

    Morente, M M; de Alava, E; Fernandez, P L


    In the last decade the technical advances in high throughput techniques to analyze DNA, RNA and proteins have had a potential major impact on prevention, diagnosis, prognosis and treatment of many human diseases. Key pieces in this process, mainly thinking about the future, are tumour banks and tumour bank networks. To face these challenges, diverse suitable models and designs can be developed. The current article presents the development of a nationwide design of tumour banks in Spain based on a network of networks, specially focusing on its harmonization efforts mainly regarding technical procedures, ethical requirements, unified quality control policy and unique sample identification. We also describe our most important goals for the next years. This model does not correspond to a central tumour bank, but to a cooperative and coordinated network of national and regional networks. Independently from the network in which it is included, sample collections reside in their original institution, where it can be used for further clinical diagnosis, teaching and research activities of each independent hospital. The herein described 'network of networks' functional model could be useful for other countries and/or international tumour bank activities.

  3. Value or waste: Perfusion imaging following radiofrequency ablation - early experience. (United States)

    Thieme, Stefan F; Vahldiek, Janis L; Tummler, Katja; Poch, Franz; Gemeinhardt, Ole; Hiebl, Bernhard; Lehmann, Kai S; Hamm, B; Niehues, Stefan M


    Radiofrequency ablation (RFA) is an evolving technique in treatment of hepatic malignant tumors. By heating local tissue it leads to coagulative necrotic areas around the ablation probe. Temperature falls with increasing distance to the probe, risking incomplete necrosis at the margins of the RFA-induced lesion. Therefore, immediate non-invasive and precise detection of incomplete ablation is necessary for early enlargement of the ablation if needed. This in vivo pig study compares early experiences of immediate post-interventional computed tomography (CT) perfusion volume analysis to macroscopic and CT image evaluation in healthy pig liver. RFA was performed in vivo in healthy pig livers. Different CT perfusion algorithms (Maximum slope analysis and Patlak plot) were used to quantify three different perfusion parameters. Data points were acquired from rectangular grids. These grids were semiautomatically overlayed to macroscopic images documented after liver explantation. Each data point was visually assigned to zones defined as "inner" and "outer necrotic zone", "margin" or "vital tissue". Significant differences between necrotic zones and vital tissue are shown for equivalent blood volume (p <  0.0001), arterial flow (p <  0.01) and flow extraction product (p <  0.001). Looking at equivalent blood volume and flow extraction product, there were also significant differences (EquivBV: p <  0.0001, FE: p <  0.001) between margins, necrotic and vital areas. In a porcine model these early results could show that all of the used CT perfusion parameters allowed discrimination of necrosis from vital tissue after RFA at high levels of significance. In addition, the parameters EquivBV and FE that give an estimate of the tissue blood volume and the permeability, were able to precisely discern different zones also seen macroscopically. From this data CT perfusion analysis could be precise tool for measurement and visualization of ablated liver lesions and

  4. [Autoimmune hepatitis]. (United States)

    Ostojić, Rajko


    Autoimmune hepatitis is an unresolving, hepatocellular inflammation of unknown cause that is characterized by the presence of periportal hepatitis on histologic examination, tissue autoantibodies in serum, and hypergammaglobulinemia. By international consensus, the designation autoimmune hepatitis has replaced alternative terms for the condition. Three types of autoimmune hepatitis have been proposed based on immunoserologic findings. Type 1 autoimmune hepatitis is characterized by the presence of antinuclear antibodies (ANA) or smooth muscle antibodies (SMA) (or both) in serum. Seventy percent of patients with type 1 of autoimmune hepatitis are women. This type is the most common form and accounts for at least 80% of cases. Type 2 is characterized by the presence of antibodies to liver-kidney microsome type 1 (anti-LKM1) in serum. Patients with this type of autoimmune hepatitis are predominantly children. Type 3 autoimmune hepatitis is characterized by the presence of antibodies to soluble liver antigen (anti-SLA) in serum. There are no individual features that are pathognomonic of autoimmune hepatitis, and its diagnosis requires the confident exclusion of other conditions. The large majority of patients show satisfactory response to corticosteroid (usually prednisone or prednisolone) therapy. For the past 30 years it has been customary to add azathioprine as a "steroid sparing" agent to allow lower doses of steroids to be used and remission, once achieved, can be sustained in many patients with azathioprine alone after steroid withdrawal. Patients with autoimmune hepatitis who have decompensated during or after corticosteroid therapy are candidates for liver transplantation.

  5. Pitfalls in colour photography of choroidal tumours. (United States)

    Schalenbourg, A; Zografos, L


    Colour imaging of fundus tumours has been transformed by the development of digital and confocal scanning laser photography. These advances provide numerous benefits, such as panoramic images, increased contrast, non-contact wide-angle imaging, non-mydriatic photography, and simultaneous angiography. False tumour colour representation can, however, cause serious diagnostic errors. Large choroidal tumours can be totally invisible on angiography. Pseudogrowth can occur because of artefacts caused by different methods of fundus illumination, movement of reference blood vessels, and flattening of Bruch's membrane and sclera when tumour regression occurs. Awareness of these pitfalls should prevent the clinician from misdiagnosing tumours and wrongfully concluding that a tumour has grown.

  6. Pitfalls in colour photography of choroidal tumours (United States)

    Schalenbourg, A; Zografos, L


    Colour imaging of fundus tumours has been transformed by the development of digital and confocal scanning laser photography. These advances provide numerous benefits, such as panoramic images, increased contrast, non-contact wide-angle imaging, non-mydriatic photography, and simultaneous angiography. False tumour colour representation can, however, cause serious diagnostic errors. Large choroidal tumours can be totally invisible on angiography. Pseudogrowth can occur because of artefacts caused by different methods of fundus illumination, movement of reference blood vessels, and flattening of Bruch's membrane and sclera when tumour regression occurs. Awareness of these pitfalls should prevent the clinician from misdiagnosing tumours and wrongfully concluding that a tumour has grown. PMID:23238442

  7. Preoperative shunts in thalamic tumours.

    Directory of Open Access Journals (Sweden)

    Goel A


    Full Text Available Thirty one patients with thalamic glioma underwent a pre-tumour resection shunt surgery. The procedure was uneventful in 23 patients with relief from symptoms of increased intracranial pressure. Eight patients worsened after the procedure. The level of sensorium worsened from excessively drowsy state to unconsciousness in seven patients. Three patients developed hemiparesis, 4 developed paresis of extra-ocular muscles and altered pupillary reflexes, and 1 developed incontinence of urine and persistent vomiting. Alteration in the delicately balanced intracranial pressure and movements in the tumour and vital adjacent brain areas could be the probable cause of the worsening in the neurological state in these 8 patients. On the basis of these observations and on review of literature, it is postulated that the ventricular dilatation following an obstruction in the path of the cerebrospinal fluid flow by a tumour could be a natural defense phenomenon of the brain.

  8. Radiofrequency ablation of atrial fibrillation

    NARCIS (Netherlands)

    Wiesfeld, ACP; Tan, ES; Van Veldhuisen, DJ; Crijns, HJGM; Van Gelder, IC


    Twenty-five patients (16 males, mean age 46 years.) underwent radiofrequency ablation because of either paroxysmal (13 patients) or persistent atrial fibrillation (12 patients). Ablation aimed at earliest activation of spontaneous and catheter-induced repetitive ectopy in left and right atria and ap

  9. Laser ablation in analytical chemistry. (United States)

    Russo, Richard E; Mao, Xianglei; Gonzalez, Jhanis J; Zorba, Vassilia; Yoo, Jong


    In 2002, we wrote an Analytical Chemistry feature article describing the Physics of Laser Ablation in Microchemical Analysis. In line with the theme of the 2002 article, this manuscript discusses current issues in fundamental research, applications based on detecting photons at the ablation site (LIBS and LAMIS) and by collecting particles for excitation in a secondary source (ICP), and directions for the technology.

  10. Radiofrequency ablation of osteoid osteoma

    NARCIS (Netherlands)

    Vanderschueren, Geert Maria Joris Michael


    The main purpose of this thesis was to evaluate the effectiveness and safety of CT-guided radiofrequency ablation for the treatment of spinal and non-spinal osteoid osteomas. Furthermore, the technical requirements needed for safe radiofrequency ablation and the clinical outcome after radiofrequency

  11. Tumour endothelial cells in high metastatic tumours promote metastasis via epigenetic dysregulation of biglycan (United States)

    Maishi, Nako; Ohba, Yusuke; Akiyama, Kosuke; Ohga, Noritaka; Hamada, Jun-ichi; Nagao-Kitamoto, Hiroko; Alam, Mohammad Towfik; Yamamoto, Kazuyuki; Kawamoto, Taisuke; Inoue, Nobuo; Taketomi, Akinobu; Shindoh, Masanobu; Hida, Yasuhiro; Hida, Kyoko


    Tumour blood vessels are gateways for distant metastasis. Recent studies have revealed that tumour endothelial cells (TECs) demonstrate distinct phenotypes from their normal counterparts. We have demonstrated that features of TECs are different depending on tumour malignancy, suggesting that TECs communicate with surrounding tumour cells. However, the contribution of TECs to metastasis has not been elucidated. Here, we show that TECs actively promote tumour metastasis through a bidirectional interaction between tumour cells and TECs. Co-implantation of TECs isolated from highly metastatic tumours accelerated lung metastases of low metastatic tumours. Biglycan, a small leucine-rich repeat proteoglycan secreted from TECs, activated tumour cell migration via nuclear factor-κB and extracellular signal–regulated kinase 1/2. Biglycan expression was upregulated by DNA demethylation in TECs. Collectively, our results demonstrate that TECs are altered in their microenvironment and, in turn, instigate tumour cells to metastasize, which is a novel mechanism for tumour metastasis. PMID:27295191

  12. Hepatic oleate regulates adipose tissue lipogenesis and fatty acid oxidation. (United States)

    Burhans, Maggie S; Flowers, Matthew T; Harrington, Kristin R; Bond, Laura M; Guo, Chang-An; Anderson, Rozalyn M; Ntambi, James M


    Hepatic steatosis is associated with detrimental metabolic phenotypes including enhanced risk for diabetes. Stearoyl-CoA desaturases (SCDs) catalyze the synthesis of MUFAs. In mice, genetic ablation of SCDs reduces hepatic de novo lipogenesis (DNL) and protects against diet-induced hepatic steatosis and adiposity. To understand the mechanism by which hepatic MUFA production influences adipose tissue stores, we created two liver-specific transgenic mouse models in the SCD1 knockout that express either human SCD5 or mouse SCD3, that synthesize oleate and palmitoleate, respectively. We demonstrate that hepatic de novo synthesized oleate, but not palmitoleate, stimulate hepatic lipid accumulation and adiposity, reversing the protective effect of the global SCD1 knockout under lipogenic conditions. Unexpectedly, the accumulation of hepatic lipid occurred without induction of the hepatic DNL program. Changes in hepatic lipid composition were reflected in plasma and in adipose tissue. Importantly, endogenously synthesized hepatic oleate was associated with suppressed DNL and fatty acid oxidation in white adipose tissue. Regression analysis revealed a strong correlation between adipose tissue lipid fuel utilization and hepatic and adipose tissue lipid storage. These data suggest an extrahepatic mechanism where endogenous hepatic oleate regulates lipid homeostasis in adipose tissues.

  13. Radiofrequency ablation of hepatocellular carcinoma: pros and cons. (United States)

    Rhim, Hyunchul; Lim, Hyo K


    Among locoregional treatments for hepatocellular carcinoma (HCC), radiofrequency ablation (RFA) has been accepted as the most popular alternative to curative transplantation or resection, and it shows an excellent local tumor control rate and acceptable morbidity. The benefits of RFA have been universally validated by the practice guidelines of international societies of hepatology. The main advantages of RFA include 1) it is minimally invasive with acceptable morbidity, 2) it enables excellent local tumor control, 3) it has promising long-term survival, and 4) it is a multimodal approach. Based on these pros, RFA will play an important role in managing the patient with early HCC (smaller than 3 cm with fewer than four tumors). The main limitations of current RFA technology in hepatic ablation include 1) limitation of ablation volume, 2) technically infeasible in some tumors due to conspicuity and dangerous location, and 3) the heat-sink effect. Many technical approaches have been introduced to overcome those limitations, including a novel guiding modality, use of artificial fluid or air, and combined treatment strategies. RFA will continue to play a role as a representative ablative modality in the management of HCC, even in the era of targeted agents.

  14. Hepatitis B and Hepatitis C in Pregnancy (United States)

    ... and hepatitis C infections during pregnancy? • How is hepatitis B virus infection spread? • What is acute hepatitis B virus infection? • What is chronic hepatitis B virus infection? • Can ...

  15. Feature Hepatitis: Hepatitis Can Strike Anyone (United States)

    ... Navigation Bar Home Current Issue Past Issues Feature Hepatitis Hepatitis Can Strike Anyone Past Issues / Spring 2009 Table ... from all walks of life are affected by hepatitis, especially hepatitis C, the most common form of ...

  16. Cardiac tumours in intrauterine life.


    Groves, A.M.; Fagg, N. L.; Cook, A C; Allan, L. D.


    Since 1980, 11 examples of cardiac tumour have been detected in the fetus out of a total of 794 congenital cardiac malformations. Patients were referred because of fetal hydrops in two, a family history of tuberous sclerosis in two, and because of the detection of a tumour mass during a scan at the local hospital in seven. The gestational age range at presentation was from 20-34 weeks. Of eight fetuses where death occurred, the histological type was rhabdomyoma in seven and teratoma in one. I...

  17. Hepatitis (For Parents) (United States)

    ... of three viruses: the hepatitis A virus the hepatitis B virus the hepatitis C virus In some rare cases, ... also called serum hepatitis) is caused by the hepatitis B virus (HBV). HBV can cause a wide range of ...

  18. Travelers' Health: Hepatitis C (United States)

    ... 3 - Hepatitis B Chapter 3 - Hepatitis E Hepatitis C Deborah Holtzman INFECTIOUS AGENT Hepatitis C virus (HCV), ... to child. Map 3-05. Prevalence of hepatitis C virus infection 1 PDF Version (printable) 1 Disease ...

  19. Hepatitis (For Parents) (United States)

    ... Old Feeding Your 1- to 2-Year-Old Hepatitis KidsHealth > For Parents > Hepatitis Print A A A ... to Call the Doctor en español Hepatitis About Hepatitis The word hepatitis simply means an inflammation of ...

  20. Travelers' Health: Hepatitis B (United States)

    ... Chapter 3 - Hepatitis A Chapter 3 - Hepatitis C Hepatitis B Francisco Averhoff INFECTIOUS AGENT Hepatitis B is ... their exposures. Map 3-04. Prevalence of chronic hepatitis B virus infection among adults PDF Version (printable) ...

  1. Travelers' Health: Hepatitis C (United States)

    ... Chapter 3 - Hepatitis B Chapter 3 - Hepatitis E Hepatitis C Deborah Holtzman INFECTIOUS AGENT Hepatitis C virus ( ... human blood Map 3-05. Global epidemiology of hepatitis C virus infection 1 PDF Version (printable) 1 ...

  2. Simulation of Pellet Ablation (United States)

    Parks, P. B.; Ishizaki, Ryuichi


    In order to clarify the structure of the ablation flow, 2D simulation is carried out with a fluid code solving temporal evolution of MHD equations. The code includes electrostatic sheath effect at the cloud interface.(P.B. Parks et al.), Plasma Phys. Contr. Fusion 38, 571 (1996). An Eulerian cylindrical coordinate system (r,z) is used with z in a spherical pellet. The code uses the Cubic-Interpolated Psudoparticle (CIP) method(H. Takewaki and T. Yabe, J. Comput. Phys. 70), 355 (1987). that divides the fluid equations into non-advection and advection phases. The most essential element of the CIP method is in calculation of the advection phase. In this phase, a cubic interpolated spatial profile is shifted in space according to the total derivative equations, similarly to a particle scheme. Since the profile is interpolated by using the value and the spatial derivative value at each grid point, there is no numerical oscillation in space, that often appears in conventional spline interpolation. A free boundary condition is used in the code. The possibility of a stationary shock will also be shown in the presentation because the supersonic ablation flow across the magnetic field is impeded.

  3. CT differentiation of poorly-differentiated gastric neuroendocrine tumours from well-differentiated neuroendocrine tumours and gastric adenocarcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Ho; Kim, Se Hyung; Shin, Cheong-il; Han, Joon Koo; Choi, Byung Ihn [Seoul National University Hospital, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Seoul National University Hospital, Institute of Radiation Medicine, Jongno-gu, Seoul (Korea, Republic of); Kim, Min-A [Seoul National University Hospital, Department of Pathology, Jongno-gu, Seoul (Korea, Republic of)


    To evaluate the differential CT features of gastric poorly-differentiated neuroendocrine tumours (PD-NETs) from well-differentiated NETs (WD-NETs) and gastric adenocarcinomas (ADCs) and to suggest differential features of hepatic metastases from gastric NETs and ADCs. Our study population was comprised of 36 patients with gastric NETs (18 WD-NETs, 18 PD-NETs) and 38 patients with gastric ADCs who served as our control group. Multiple CT features were assessed to identify significant differential CT findings of PD-NETs from WD-NETs and ADCs. In addition, CT features of hepatic metastases including the metastasis-to-liver ratio were analyzed to differentiate metastatic NETs from ADCs. The presence of metastatic lymph nodes was the sole differentiator of PD-NETs from WD-NETs (P =.001, odds ratio = 56.67), while the presence of intact overlying mucosa with mucosal tenting was the sole significant CT feature differentiating PD-NETs from ADCs (P =.047, odds ratio = 15.3) For hepatic metastases, metastases from NETs were more hyper-attenuated than those from ADCs. The presence of metastatic LNs and intact overlying mucosa with mucosal tenting are useful CT discriminators of PD-NETs from WD-NETs and ADCs, respectively. In addition, a higher metastasis-to-liver ratio may help differentiate hepatic metastases of gastric NETs from those of gastric ADCs with high accuracy. (orig.)

  4. Autoimmune hepatitis following infliximab therapy for ankylosing spondylitis. (United States)

    Ozorio, Gerard; McGarity, Bruce; Bak, Haesung; Jordan, Andrew S; Lau, Henry; Marshall, Cathy


    Autoimmune hepatitis is a rare but increasingly recognised serious complication of treatment with the tumour necrosis factor-alpha (TNF-alpha) blocking agent, infliximab. This report adds to the small but growing number of articles describing this significant adverse effect. Baseline liver function should be routinely tested in all patients receiving anti-TNF-alpha agents, and periodic monitoring for the development of hepatitis is important.

  5. Follicular infundibulum tumour presenting as cutaneous horn

    Directory of Open Access Journals (Sweden)

    Jayaraman M


    Full Text Available Tumour of follicular infundibulum is an organoid tumour with a plate like growth attached to the epidermis with connection from the follicular epithelium. We are reporting such a case unusually presenting as cutaneous horn.

  6. Primary brain tumours in adults. (United States)

    Ricard, Damien; Idbaih, Ahmed; Ducray, François; Lahutte, Marion; Hoang-Xuan, Khê; Delattre, Jean-Yves


    Important advances have been made in the understanding and management of adult gliomas and primary CNS lymphomas--the two most common primary brain tumours. Progress in imaging has led to a better analysis of the nature and grade of these tumours. Findings from large phase 3 studies have yielded some standard treatments for gliomas, and have confirmed the prognostic value of specific molecular alterations. High-throughput methods that enable genome-wide analysis of tumours have improved the knowledge of tumour biology, which should lead to a better classification of gliomas and pave the way for so-called targeted therapy trials. Primary CNS lymphomas are a group of rare non-Hodgkin lymphomas. High-dose methotrexate-based regimens increase survival, but the standards of care and the place of whole-brain radiotherapy remain unclear, and are likely to depend on the age of the patient. The focus now is on the development of new polychemotherapy regimens to reduce or defer whole-brain radiotherapy and its delayed complications.

  7. Intraoral myxoid nerve sheath tumour

    NARCIS (Netherlands)

    Schortinghuis, J; Hille, JJ; Singh, S


    A case of an intraoral myxoid nerve sheath tumour of the dorsum of the tongue in a 73-year-old Caucasian male is reported. This case describes the oldest patient with this pathology to date. Immunoperoxidase staining for neuronspecific enolase (NSE) and epithelial membrane antigen (EMA) expression d

  8. Intraoral myxoid nerve sheath tumour

    NARCIS (Netherlands)

    Schortinghuis, J; Hille, JJ; Singh, S


    A case of an intraoral myxoid nerve sheath tumour of the dorsum of the tongue in a 73-year-old Caucasian male is reported. This case describes the oldest patient with this pathology to date. Immunoperoxidase staining for neuronspecific enolase (NSE) and epithelial membrane antigen (EMA) expression d

  9. PET imaging in endocrine tumours. (United States)

    Khan, S; Lloyd, C; Szyszko, T; Win, Z; Rubello, D; Al-Nahhas, A


    The role of PET in the assessment of endocrine tumours has been, until recently, restricted to the use of (18)F-fluoro-deoxy-D-glucose ((18)F-FDG). Being a marker of metabolically active lesions that show high grading and low differentiation, FDG is not ideal for this purpose since the majority of endocrine tumours are slow growing and highly differentiated. It is however useful when dedifferentiation takes place and provides excellent prognostic information. A number of hormone precursors and amino acids are labelled with (11)C and used successfully in the management of parathyroid, adrenal and pituitary tumours. However, the short half-life of (11)C radiopharmaceuticals restricts their use to centres with access to an on-site cyclotron, while the high cost of production may limit their use to research purposes. A promising new positron-emission tomography (PET) tracer is Gallium-68 obtained by elution from a long shelf-life generator that makes it economic and cyclotron-independent. Its short half-life and flexible labelling ability to a wide range of peptides and antibodies makes it ideal for PET imaging. In addition to imaging GEP-NETs and phaeochromocytoma, it has the potential to be used in a wider range of endocrine tumours.

  10. Transarterial ablation of hepatocellular carcinoma. Status and developments; Transvaskulaere Ablation des hepatozellulaeren Karzinoms. Ist Chemotherapie alles

    Energy Technology Data Exchange (ETDEWEB)

    Radeleff, B.A.; Stampfl, U.; Sommer, C.M.; Bellemann, N.; Kauczor, H.U. [Universitaetsklinikum Heidelberg, Abt. Diagnostische und Interventionelle Radiologie, Radiologische Klinik, Heidelberg (Germany); Hoffmann, K. [Universitaetsklinikum Heidelberg, Abt. fuer Allgemein-, Viszeral- und Transplantationschirurgie, Chirurgische Klinik, Heidelberg (Germany); Ganten, T.; Ehehalt, R. [Universitaetsklinikum Heidelberg, Medizinische Klinik IV, Gastroenterologie, Infektionskrankheiten, Vergiftungen, Heidelberg (Germany)


    Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and represents the main cause of death among European patients with liver cirrhosis. Only 30-40% of patients diagnosed with HCC are candidates for curative treatment options (e.g. surgical resection, liver transplantation or ablation). The remaining majority of patients must undergo local regional and palliative therapies. Transvascular ablation of HCC takes advantage of the fact that the hypervascularized HCC receives most of its blood supply from the hepatic artery. In this context transvascular ablation describes different therapy regimens which can be assigned to four groups: cTACE (conventional transarterial chemoembolization), bland embolization (transarterial embolization TAE), DEB-TACE (TACE with drug-eluting beads, DEB) and SIRT (selective internal radiation therapy, radioembolization). Conventional TACE is the most common type of transvascular ablation and represents a combination of intra-arterial chemotherapy and embolization with occlusion of the arterial blood supply. However, there is no standardized regimen with respect to the chemotherapeutic drug, the embolic agent, the usage of lipiodol and the interval between the TACE procedures. Even the exact course of a cTACE procedure (order of chemotherapy or embolization) is not standardized. It remains unclear whether or not intra-arterial chemotherapy is definitely required as bland embolization using very small, tightly calibrated spherical particles (without intra-arterial administration of a chemotherapeutic drug) shows tumor necrosis comparable to cTACE. For DEB-TACE microparticles loaded with a chemotherapeutic drug combine the advantages of cTACE and bland embolization. Thereby, a continuing chemotherapeutic effect within the tumor might cause a further increase in intratumoral cytotoxicity and at the same time a decrease in systemic toxicity. (orig.) [German] Das hepatozellulaere Karzinom (HCC) ist weltweit betrachtet das

  11. Laparoscopic microwave ablation and enucleation of small renal masses: preliminary experience. (United States)

    Muto, Giovanni; Castelli, Emanuele; Migliari, Roberto; D'Urso, Leonardo; Coppola, Pietro; Collura, Devis


    Advancements in imaging and laparoscopy have led to the expansion of minimally invasive techniques in the ablation of small renal masses (SRMs). We report the results of a study aimed at assessing the efficacy of thermoablative microwave (MW) effects on SRMs and the haemostatic as well as necrotic MW effects on the parenchyma surrounding the neoplasm. From November 2008 to October 2010, 10 patients with SRMs underwent laparoscopy-guided Tru-Cut biopsy, MW tumour ablation, and enucleation. Mean age was 66 yr (range: 46-84 yr). Mean renal tumour diameter was 2.75 cm (range: 1.3-4.2 cm). MW antennas were applied one to three times depending on tumour volume, location, and shape. After MW thermoablation, laparoscopic enucleation was performed to evaluate the histopathologic and haemostatic effects of MW. The mean MW antenna application time was 14.1 min (range: 4-30 min). Enucleation did not require renal pedicle clamping in any of the cases because no significant bleeding took place. Preablation pathology revealed clear cell renal carcinoma of Fuhrman grade I-II in all cases. Postablation pathology showed extensive coagulative necrosis without skipped tumour areas. No intra- or postoperative complications were reported. Histopathologic effects on SRMs provide consistent proof of principle for future studies.

  12. [Abdominal tomometry. Application to study of the liver. Experimental study, initial clinical results and perspectives in the exploration of tumour pathology (author's transl)]. (United States)

    Lamarque, J L; Bruel, J M; Dondelinger, R; Sénac, J P; Rabischong, P; Bonnel, F; Laval-Jeantet, M; Laval-Jeantet, A M


    Over a period of two months, 120 patients were studied using an Acta-Scanner tomometer for various hepatic disorders. In parallel, comparative tomometric and pathological studies were carried out in cadavers and isolated livers. These made possible the recognition of normal structures in tomometry and the identification of certain hepatic images which might be potential sources of error. Serial axial transverse sections were used to reconstruct the volume of the liver in space, thus making in possible to eliminate certain forms of pseudo-tumoural hepatomegaly. Systematic densitometric analysis was made by radiological anatomical study and in hepatic pathology. This new type of analysis led to a quantified diagnosis of certain diffuse hepatic diseases and a histological approach to tumour lesions. Hepatography using liposoluble agents in very low dosage was used in hepatic tomometry after animal experimentation. The method, free of untoward effects, makes possible the diagnosis of hepato-splenic tumor lesions less than one centimetre in diameter.

  13. Melanotic neuroectodermal tumour of the pineal region

    Energy Technology Data Exchange (ETDEWEB)

    Gorhan, C.; Soto-Ares, G.; Pruvo, J.P. [Dept. of Neuroradiology, Hopital Roger Salengro, CHRU Lille, Lille (France); Ruchoux, M.M. [Dept. of Neuropathology, Hopital Roger Salengro, CHRU Lille (France); Blond, S. [Dept. of Neurosurgery, Hopital Roger Salengro, CHRU Lille (France)


    We describe CT and MR findings in a 23-month-old infant with a melanotic neuroectodermal tumour of the pineal gland. The tumour has been stereotactically biopsied and surgically resected. The pathological diagnosis was made on the resected piece. Embryology of the pineal gland and the histology of melanotic neuroectodermal tumour of infancy are discussed. (orig.)

  14. FDG uptake, a surrogate of tumour hypoxia?

    NARCIS (Netherlands)

    Dierckx, Rudi Andre; de Wiele, Christophe Van


    Introduction Tumour hyperglycolysis is driven by activation of hypoxia-inducible factor-1 (HIF-1) through tumour hypoxia. Accordingly, the degree of 2-fluro-2-deoxy-D-glucose (FDG) uptake by tumours might indirectly reflect the level of hypoxia, obviating the need for more specific radiopharmaceutic

  15. Radiofrequency for the treatment of liver tumours.

    NARCIS (Netherlands)

    Ruers, T.J.M.; Jong, K.P. de; Ijzermans, J.N.M.


    Resection should still be considered the gold standard for many liver tumours. There is, however, growing interest in the use of radiofrequency (RFA) for the treatment of liver tumours. By RFA, tumour tissue can be destructed selectively without significant damage to vascular structures in the

  16. Radiofrequency for the treatment of liver tumours

    NARCIS (Netherlands)

    Ruers, TJM; de Jong, KP; Ijzermans, JNM


    Resection should still be considered the gold standard for many liver tumours. There is, however, growing interest in the use of radiofrequency (RFA) for the treatment of liver tumours. By RFA, tumour tissue can be destructed selectively without significant damage to vascular structures in the

  17. Hepatitis A (United States)

    ... inflammation of the liver.” This inflammation can be caused by a wide variety of toxins, drugs, and metabolic diseases, as well as infection. There are at least 5 hepatitis viruses. Hepatitis A is contracted when a child eats food or drinks water that is contaminated with the virus or has ...

  18. Imaging of salivary gland tumours

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Y.Y.P.; Wong, K.T.; King, A.D. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong (Hong Kong); Ahuja, A.T. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong (Hong Kong)], E-mail:


    Salivary gland neoplasms account for <3% of all tumors. Most of them are benign and parotid gland is the commonest site. As a general rule, the smaller the involved salivary gland, the higher is the possibility of the tumor being malignant. The role of imaging in assessment of salivary gland tumour is to define intra-glandular vs. extra-glandular location, detect malignant features, assess local extension and invasion, detect nodal metastases and systemic involvement. Image guided fine needle aspiration cytology provides a safe means to obtain cytological confirmation. For lesions in the superficial parotid and submandibular gland, ultrasound is an ideal tool for initial assessment. These are superficial structures accessible by high resolution ultrasound and FNAC which provides excellent resolution and tissue characterization without a radiation hazard. Nodal involvement can also be assessed. If deep tissue extension is suspected or malignancy confirmed on cytology, an MRI or CT is mandatory to evaluate tumour extent, local invasion and perineural spread. For all tumours in the sublingual gland, MRI should be performed as the risk of malignancy is high. For lesions of the deep lobe of parotid gland and the minor salivary glands, MRI and CT are the modalities of choice. Ultrasound has limited visualization of the deep lobe of parotid gland which is obscured by the mandible. Minor salivary gland lesions in the mucosa of oral cavity, pharynx and tracheo-bronchial tree, are also not accessible by conventional ultrasound. Recent study suggests that MR spectroscopy may differentiate malignant and benign salivary gland tumours as well as distinguishing Warthin's tumor from pleomorphic adenoma. However, its role in clinical practice is not well established. Similarly, the role of nuclear medicine and PET scan, in imaging of parotid masses is limited. Sialography is used to delineate the salivary ductal system and has limited role in assessment of tumour extent.

  19. Complications of image-guided radiofrequency ablation of renal cell carcinoma: causes, imaging features and prevention methods

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Kwan; Kim, Chan Kyo [Sungkyunkwan University School of Medicine, The Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea)


    Radiofrequency (RF) ablation is an alternative treatment for renal cell carcinoma (RCC) in patients unable to undergo surgery. Although RF ablation has a low complication rate because of its minimally invasive nature, unintended heat may be conducted by several critical organs during ablation procedures, leading to a variety of complications. Major complications that usually require treatment include bowel injury, ureteral injury, massive bleeding and residual or recurrent tumour. Minor complications that may require only observation include pain, haematoma, haematuria, neuromuscular injury, pneumothorax, infarction and inflammatory tract mass. The most common cause of complications is the tumour's proximity to neighbouring organs. In addition, careless electrode manipulation and the patient's comorbidities may also lead to complications. To avoid many of these complications, the distance between the tumour and neighbouring organs should be widened using methods such as changing the patient's position, using the RF electrode as a lever and hydrodissection. Furthermore, carefully manipulating the RF electrode and assessing the patient's general condition help to prevent complications. In this review, we discuss the complications resulting from RF ablation of RCC with an emphasis on causes, imaging features and prevention methods. (orig.)

  20. “Edgeboost”: A Novel Technique to Extend the Ablation Zone Lateral to a Two-Probe Bipolar Radiofrequency Device

    Energy Technology Data Exchange (ETDEWEB)

    Huo, Ya Ruth, E-mail:; Pillai, Krishna, E-mail:; Akhter, Javed, E-mail:; Morris, David L., E-mail: [St George Hospital, Hepatobiliary and Surgical Oncology Unit, UNSW Department of Surgery (Australia)


    BackgroundThe dual-electrode bipolar-RFA (B-RFA) is increasingly used to ablate large liver tumours (3–7 cm). However, the challenging aspect of B-RFA is the placement of the two electrodes around the tumour. Realignment often requires the electrodes to be extracted and reinserted.AimThe aim of this study is to examine “Edgeboost”, a novel technique to increase the lateral ablation dimension without requiring any realignment of the electrodes.Methods and MaterialsAn egg-white model and an ex vivo calf liver model were used compare the standard bipolar mode ablation to Edgeboost-1 (reaching full impedance in bipolar mode initially, then cycling in unipolar mode between left and right probes) and Edgeboost-2 (similar to Edgeboost-1 but not reaching full impedance initially in bipolar mode in order to minimize charring and, thus, to increase total ablation time).ResultsA significantly larger outer lateral ablation dimension to the probe was achieved with Edgeboost-1 compared to the standard method in the liver model (1.14 cm, SD: 0.16 vs. 0.44 cm, SD: 0.24, p = 0.04). Edgeboost-2 achieved the largest outer lateral ablation dimension of 1.75 cm (SD: 0.35). A similar association was seen in the egg model. Edgeboost-2 almost doubled the mass ablated with standard bipolar alone (mass ratio: 1:1.94 in egg white and 1:1.84 in liver).ConclusionThis study demonstrates that the novel “Edgeboost” technique can increase the outer lateral ablation dimension without requiring the two inserted electrodes to be reinserted. This would be beneficial for interventionists who use the dual B-RFA.

  1. Magnetic and robotic navigation for catheter ablation: "joystick ablation". (United States)

    Ernst, Sabine


    Catheter ablation has become the treatment of choice to cure various arrhythmias in the last decades. The newest advancement of this general concept is made on the navigation ability using remote-controlled ablation catheters. This review summarizes the concept of the two currently available systems, followed by a critical review of the published clinical reports for each system, respectively. Despite the limited amount of data, an attempt to compare the two systems is made.

  2. Total {sup 18}F-dopa PET tumour uptake reflects metabolic endocrine tumour activity in patients with a carcinoid tumour

    Energy Technology Data Exchange (ETDEWEB)

    Fiebrich, Helle-Brit; Walenkamp, Annemiek M.; Vries, Elisabeth G.E. de [University Medical Centre Groningen, Department of Medical Oncology, Groningen (Netherlands); Jong, Johan R. de; Koopmans, Klaas Pieter; Dierckx, Rudi A.J.O.; Brouwers, Adrienne H. [University Medical Centre Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); Kema, Ido P. [University Medical Centre Groningen, Department of Laboratory Medicine, Groningen (Netherlands); Sluiter, Wim; Links, Thera P. [University Medical Centre Groningen, Department of Endocrinology, Groningen (Netherlands)


    Positron emission tomography (PET) using 6-[{sup 18}F]fluoro-L-dihydroxyphenylalanine ({sup 18}F-dopa) has an excellent sensitivity to detect carcinoid tumour lesions. {sup 18}F-dopa tumour uptake and the levels of biochemical tumour markers are mediated by tumour endocrine metabolic activity. We evaluated whether total {sup 18}F-dopa tumour uptake on PET, defined as whole-body metabolic tumour burden (WBMTB), reflects tumour load per patient, as measured with tumour markers. Seventy-seven consecutive carcinoid patients who underwent an {sup 18}F-dopa PET scan in two previously published studies were analysed. For all tumour lesions mean standardised uptake values (SUVs) at 40% of the maximal SUV and tumour volume on {sup 18}F-dopa PET were determined and multiplied to calculate a metabolic burden per lesion. WBMTB was the sum of the metabolic burden of all individual lesions per patient. The 24-h urinary serotonin, urine and plasma 5-hydroxindoleacetic acid (5-HIAA), catecholamines (nor)epinephrine, dopamine and their metabolites, measured in urine and plasma, and serum chromogranin A served as tumour markers. All but 1 were evaluable for WBMTB; 74 patients had metastatic disease. {sup 18}F-dopa PET detected 979 lesions. SUV{sub max} on {sup 18}F-dopa PET varied up to 29-fold between individual lesions within the same patients. WBMTB correlated with urinary serotonin (r = 0.51) and urinary and plasma 5-HIAA (r = 0.78 and 0.66). WBMTB also correlated with urinary norepinephrine, epinephrine, dopamine and plasma dopamine, but not with serum chromogranin A. Tumour load per patient measured with {sup 18}F-dopa PET correlates with tumour markers of the serotonin and catecholamine pathway in urine and plasma in carcinoid patients, reflecting metabolic tumour activity. (orig.)

  3. Tumours of the fetal body: a review

    Energy Technology Data Exchange (ETDEWEB)

    Avni, Fred E.; Massez, Anne; Cassart, Marie [University Clinics of Brussels - Erasme Hospital, Department of Medical Imaging, Brussels (Belgium)


    Tumours of the fetal body are rare, but lesions have been reported in all spaces, especially in the mediastinum, the pericardial space, the adrenals, the kidney, and the liver. Lymphangioma and teratoma are the commonest histological types encountered, followed by cardiac rhabdomyoma. Adrenal neuroblastoma is the commonest malignant tumour. Imaging plays an essential role in the detection and work-up of these tumours. In addition to assisting clinicians it also helps in counselling parents. Most tumours are detected by antenatal US, but fetal MRI is increasingly used as it brings significant additional information in terms of tumour extent, composition and complications. (orig.)

  4. Field enhancement induced laser ablation

    DEFF Research Database (Denmark)

    Fiutowski, Jacek; Maibohm, Christian; Kjelstrup-Hansen, Jakob

    Sub-diffraction spatially resolved, quantitative mapping of strongly localized field intensity enhancement on gold nanostructures via laser ablation of polymer thin films is reported. Illumination using a femtosecond laser scanning microscope excites surface plasmons in the nanostructures...

  5. Ablative Approaches for Pulmonary Metastases. (United States)

    Boyer, Matthew J; Ricardi, Umberto; Ball, David; Salama, Joseph K


    Pulmonary metastases are common in patients with cancer for which surgery is considered a standard approach in appropriately selected patients. A number of patients are not candidates for surgery due to a medical comorbidities or the extent of surgery required. For these patients, noninvasive or minimally invasive approaches to ablate pulmonary metastases are potential treatment strategies. This article summarizes the rationale and outcomes for non-surgical treatment approaches, including radiotherapy, radiofrequency and microwave ablation, for pulmonary metastases.

  6. Radiofrequency Ablation in Barrett's Esophagus

    Directory of Open Access Journals (Sweden)

    Vani J.A. Konda


    Full Text Available Radiofrequency ablation (RFA is an endoscopic modality used in the treatment of Barrett's esophagus. RFA may be performed using a balloon-based catheter or using one of the probe catheters that attaches to the distal end of the endoscope. Here we demonstrate step-by-step instruction in using radiofrequency ablation in the treatment of Barrett's esophagus and highlight key concepts in the technique.

  7. Local recurrence rates after radiofrequency ablation or resection of colorectal liver metastases. Analysis of the European Organisation for Research and Treatment of Cancer #40004 and #40983

    NARCIS (Netherlands)

    Tanis, E.; Nordlinger, B.; Mauer, M.; Sorbye, H.; van Coevorden, F.; Gruenberger, T.M.; Schlag, P.M.; Punt, C.J.A.; Ledermann, J.; Ruers, Theo J.M.


    Aim The aim of this study is to describe local tumour control after radiofrequency ablation (RFA) and surgical resection (RES) of colorectal liver metastases (CLM) in two independent European Organisations for Research and Treatment of Cancer (EORTC) studies. Background Only 10–20% of patients with

  8. Local recurrence rates after radiofrequency ablation or resection of colorectal liver metastases. Analysis of the European Organisation for Research and Treatment of Cancer #40004 and #40983

    NARCIS (Netherlands)

    Tanis, E.; Nordlinger, B.; Mauer, M.; Sorbye, H.; Coevorden, van F.; Gruenberger, T.M.; Schlag, P.M.; Punt, C.J.A.; Ledermann, J.; Ruers, T.J.M.


    Aim The aim of this study is to describe local tumour control after radiofrequency ablation (RFA) and surgical resection (RES) of colorectal liver metastases (CLM) in two independent European Organisations for Research and Treatment of Cancer (EORTC) studies. Background Only 10–20% of patients with

  9. Laparoscopic radiofrequency ablation of neuroendocrine liver metastases. (United States)

    Berber, Eren; Flesher, Nora; Siperstein, Allan E


    We previously reported on the safety and efficacy of laparoscopic radiofrequency thermal ablation (RFA) for treating hepatic neuroendocrine metastases. The aim of this study is to report our 5-year RFA experience in the treatment of these challenging group of patients. Of the 222 patients with 803 liver primary and secondary tumors undergoing laparoscopic RFA between January 1996 and August 2001, a total of 34 patients with 234 tumors had neuroendocrine liver metastases. There were 25 men and 9 women with a mean +/- SEM age of 52 +/- 2 years who underwent 42 ablations. Primary tumor types included carcinoid tumor in 18 patients, medullary thyroid cancer in 7, secreting islet cell tumor in 5, and nonsecreting islet cell tumor in 4. There was no mortality, and the morbidity was 5%. The mean hospital stay was 1.1 days. Symptoms were ameliorated in 95%, with significant or complete symptom control in 80% of the patients for a mean of 10+ months (range 6-24 months). All patients were followed for a mean +/- SEM of 1.6 +/- 0.2 years (range 1.0-5.4 years). During this period new liver lesions developed in 28% of patients, new extrahepatic disease in 25%, and local liver recurrence in 13%; existing liver lesions progressed in 13%. Overall 41% of patients showed no progression of their cancer. Nine patients (27%) died. Mean +/- SEM survivals after diagnosis of primary disease, detection of liver metastases, and performance of RFA were 5.5 +/- 0.8 years, 3.0 +/- 0.3 years, and 1.6 +/- 0.2 years, respectively. Sixty-five percent of the patients demonstrated a partial or significant decrease in their tumor markers during follow-up. In conclusion, RFA provides excellent local tumor control with overnight hospitalization and low morbidity in the treatment of liver metastases from neuroendocrine tumors. It is a useful modality in the management of these challenging group of patients.

  10. Tumour targeting with systemically administered bacteria.

    LENUS (Irish Health Repository)

    Morrissey, David


    Challenges for oncology practitioners and researchers include specific treatment and detection of tumours. The ideal anti-cancer therapy would selectively eradicate tumour cells, whilst minimising side effects to normal tissue. Bacteria have emerged as biological gene vectors with natural tumour specificity, capable of homing to tumours and replicating locally to high levels when systemically administered. This property enables targeting of both the primary tumour and secondary metastases. In the case of invasive pathogenic species, this targeting strategy can be used to deliver genes intracellularly for tumour cell expression, while non-invasive species transformed with plasmids suitable for bacterial expression of heterologous genes can secrete therapeutic proteins locally within the tumour environment (cell therapy approach). Many bacterial genera have been demonstrated to localise to and replicate to high levels within tumour tissue when intravenously (IV) administered in rodent models and reporter gene tagging of bacteria has permitted real-time visualisation of this phenomenon. Live imaging of tumour colonising bacteria also presents diagnostic potential for this approach. The nature of tumour selective bacterial colonisation appears to be tumour origin- and bacterial species- independent. While originally a correlation was drawn between anaerobic bacterial colonisation and the hypoxic nature of solid tumours, it is recently becoming apparent that other elements of the unique microenvironment within solid tumours, including aberrant neovasculature and local immune suppression, may be responsible. Here, we consider the pre-clinical data supporting the use of bacteria as a tumour-targeting tool, recent advances in the area, and future work required to develop it into a beneficial clinical tool.

  11. Inflammatory myofibroblastic tumour of maxilla

    Directory of Open Access Journals (Sweden)

    Deshingkar S


    Full Text Available Inflammatory myofibroblastic tumour (IMT is a biologically controversial entity that was originally described as non-neoplastic lesion in the lungs and designated initially as inflammatory pseudotumour. The lesion has recently been recognized to occur at various sites but rarely affects head and neck region. Controversies still exist regarding its reactive versus neoplastic nature. The lesion has a potential for recurrence, persistent local growth, progression to frank sarcoma and metastasis. Hence IMT can best be regarded as a low-grade sarcoma. A case of a 30-year-old female with swelling in the right maxilla and associated ophthalmic manifestations is discussed here. Contribution of immunohistochemistry for diagnosis of IMT is emphasized. Additional cytogenetic studies of this highly enigmatic and minimally studied tumour are warranted.

  12. Reconstructive options in pelvic tumours

    Directory of Open Access Journals (Sweden)

    Mayilvahanan N


    Full Text Available Background: Pelvic tumours present a complex problem. It is difficult to choose between limb salvage and hemipelvectomy. Method: Forty three patients of tumours of pelvis underwent limb salvage resection with reconstruction in 32 patients. The majority were chondrosarcomas (20 cases followed by Ewing sarcoma. Stage II B was the most common stage in malignant lesions and all the seven benign lesions were aggressive (B3. Surgical margins achieved were wide in 31 and marginal in 12 cases. Ilium was involved in 51% of cases and periacetabular involvement was seen in 12 patients. The resections done were mostly of types I &II of Enneking′s classification of pelvic resection. Arthrodesis was attempted in 24 patients. Customized Saddle prosthesis was used in seven patients and no reconstruction in 12 patients. Adjuvant chemotherapy was given to all high-grade malignant tumours, combined with radiotherapy in 7 patients. Results: With a mean follow up of 48.5 months and one patient lost to follow up, the recurrence rate among the evaluated cases was 16.6%. Oncologically, 30 patients were continuously disease free with 7 local recurrences and 4 deaths due to disseminated disease and 2 patients died of other causes. During the initial years, satisfactory functional results were achieved with prosthetic replacement. Long-term functional result of 36 patients who were alive at the time of latest follow up was satisfactory in 75% who underwent arthrodesis and in those where no reconstruction was used. We also describe a method of new classification of pelvic resections that clarifies certain shortcomings of the previous systems of classification. Conclusion: Selection of a procedure depends largely on the patient factors, the tumour grade, the resultant defect and the tissue factors. Resection with proper margins gives better functional and oncological results

  13. Notch as a tumour suppressor. (United States)

    Nowell, Craig S; Radtke, Freddy


    The Notch signalling cascade is an evolutionarily conserved pathway that has a crucial role in regulating development and homeostasis in various tissues. The cellular processes and events that it controls are diverse, and continued investigation over recent decades has revealed how the role of Notch signalling is multifaceted and highly context dependent. Consistent with the far-reaching impact that Notch has on development and homeostasis, aberrant activity of the pathway is also linked to the initiation and progression of several malignancies, and Notch can in fact be either oncogenic or tumour suppressive depending on the tissue and cellular context. The Notch pathway therefore represents an important target for therapeutic agents designed to treat many types of cancer. In this Review, we focus on the latest developments relating specifically to the tumour-suppressor activity of Notch signalling and discuss the potential mechanisms by which Notch can inhibit carcinogenesis in various tissues. Potential therapeutic strategies aimed at restoring or augmenting Notch-mediated tumour suppression will also be highlighted.

  14. Atrial fibrillation ablation using a closed irrigation radiofrequency ablation catheter. (United States)

    Golden, Keith; Mounsey, John Paul; Chung, Eugene; Roomiani, Pahresah; Morse, Michael Andew; Patel, Ankit; Gehi, Anil


    Catheter ablation is an effective therapy for symptomatic, medically refractory atrial fibrillation (AF). Open-irrigated radiofrequency (RF) ablation catheters produce transmural lesions at the cost of increased fluid delivery. In vivo models suggest closed-irrigated RF catheters create equivalent lesions, but clinical outcomes are limited. A cohort of 195 sequential patients with symptomatic AF underwent stepwise AF ablation (AFA) using a closed-irrigation ablation catheter. Recurrence of AF was monitored and outcomes were evaluated using Kaplan-Meier survival analysis and Cox proportional hazards models. Mean age was 59.0 years, 74.9% were male, 56.4% of patients were paroxysmal and mean duration of AF was 5.4 years. Patients had multiple comorbidities including hypertension (76.4%), tobacco abuse (42.1%), diabetes (17.4%), and obesity (mean body mass index 30.8). The median follow-up was 55.8 weeks. Overall event-free survival was 73.6% with one ablation and 77.4% after reablation (reablation rate was 8.7%). Median time to recurrence was 26.9 weeks. AF was more likely to recur in patients being treated with antiarrhythmic therapy at the time of last follow-up (recurrence rate 30.3% with antiarrhythmic drugs, 13.2% without antiarrhythmic drugs; hazard ratio [HR] 2.2, 95% confidence interval [CI] 1.1-4.4, P = 0.024) and in those with a history of AF greater than 2 years duration (HR 2.7, 95% CI 1.1-6.9, P = 0.038). Our study represents the largest cohort of patients receiving AFA with closed-irrigation ablation catheters. We demonstrate comparable outcomes to those previously reported in studies of open-irrigation ablation catheters. Given the theoretical benefits of a closed-irrigation system, a large head-to-head comparison using this catheter is warranted. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

  15. The role of S100a4 (Mts1) in Apc- and Smad4-driven tumour onset and progression

    DEFF Research Database (Denmark)

    Atlasi, Yaser; Noori, Rubina; Marolin, Ivana


    Introduction S100a4 is a calcium-binding protein belonging to the family of S100-proteins, highly expressed in different stromal cell types. S100A4 has been reported as a prognostic marker in colorectal cancer in association with tumour progression and metastasis. Methods In this study, we analysed...... the in vivo role of S100a4 in intestinal tumour initiation and progression using different transgenic and knockout mouse models. Results We found that genetic ablation or overexpression of S100a4 in both Apc- and Smad4-mutant mice do not affect tumour initiation in the intestinal tract. In contrast, S100a4...... epithelial overexpression in Apc1638N/+/KRASV12G mice increases the dissemination of intestinal tumour cells to the liver, in agreement with its role in tumour metastasis. Moreover, we report a novel role for S100a4 in desmoid formation where S100a4 deficiency results in a significant reduction of the tumour...

  16. Hepatic Encephalopathy

    Medline Plus

    Full Text Available ... Symptoms to look for Caregiver Support Caregiver Stories Home › What is Hepatic Encephalopathy? Why Your Liver is ... questions about HE, one step at a time. Home About Us Ways to Give Contact Us Privacy ...

  17. Hepatitis A (United States)

    ... Hepatitis A is more common in parts of Africa, Asia, Central and South America, and Eastern Europe ... la salud en español Health Statistics Healthy Moments Radio Broadcast Clinical Trials For Health Professionals Diabetes Discoveries & ...

  18. Autoimmune hepatitis. (United States)

    Heneghan, Michael A; Yeoman, Andrew D; Verma, Sumita; Smith, Alastair D; Longhi, Maria Serena


    Autoimmune hepatitis is a disease of the hepatic parenchyma that can present in acute or chronic forms. In common with many autoimmune diseases, autoimmune hepatitis is associated with non-organ-specific antibodies in the context of hepatic autoimmunity. This dichotomy has made definition of a unifying hypothesis in the pathophysiology of the disease difficult, although data from the past 8 years have drawn attention to the role of regulatory T cells. Several triggers have been identified, and the disease arises in genetically susceptible individuals. Clinical and biochemical remission is achievable in up to 85% of cases. For the remaining patients, alternative immunosuppression strategies are an option. Liver transplantation provides an excellent outcome for patients with acute liver failure or complications of end-stage liver disease, including hepatocellular carcinoma. Variant or overlapping syndromes are worthy of consideration when unexpected disease features arise.

  19. Hepatic Encephalopathy

    Medline Plus

    Full Text Available ... Get Worse? How is HE Diagnosed? Prior to Treatment Who treats HE? Preparing for your Medical Appointment Hepatic Encephalopathy Treatment Options Treatment Basics Treatment Medications Importance of Adhering ...

  20. Hepatic Encephalopathy

    Medline Plus

    Full Text Available ... is a condition that causes temporary worsening of brain function in people with advanced liver disease. When ... travel through your body until they reach your brain, causing mental and physical symptoms of HE. Hepatic ...

  1. Hepatitis B (United States)

    ... using an infected person’s razor, toothbrush, or nail clippers You can’t get hepatitis B from being ... personal items such as toothbrushes, razors, or nail clippers using a latex or polyurethane condom during sex ...

  2. Hepatic ischemia (United States)

    ... or oxygen, causing injury to liver cells. Causes Low blood pressure from any condition can lead to hepatic ischemia. ... leading to reduced blood flow (vasculitis) Symptoms If low blood pressure continues for a long time, you may feel ...

  3. Hepatic Encephalopathy

    Medline Plus

    Full Text Available ... Get Worse? How is HE Diagnosed? Prior to Treatment Who treats HE? Preparing for your Medical Appointment Hepatic Encephalopathy Treatment Options Treatment Basics Treatment Medications Importance of Adhering ...

  4. Hepatic Encephalopathy

    Medline Plus

    Full Text Available ... the Stages of Hepatic Encephalopathy? What Triggers or Can Cause HE to Get Worse? How is HE ... liver disease. When your liver is damaged it can no longer remove toxic substances from your blood. ...

  5. Hepatic Encephalopathy

    Medline Plus

    Full Text Available ... to Treatment Who treats HE? Preparing for your Medical Appointment Hepatic Encephalopathy Treatment Options Treatment Basics Treatment ... treatment. Being a fully-informed participant in your medical care is an important factor in staying as ...

  6. Hepatic Encephalopathy

    Medline Plus

    Full Text Available ... is a condition that causes temporary worsening of brain function in people with advanced liver disease. When ... travel through your body until they reach your brain, causing mental and physical symptoms of HE. Hepatic ...

  7. Hepatic Encephalopathy

    Medline Plus

    Full Text Available ... Hepatic Encephalopathy so you can tell your doctor right away if you think you may have it. ... American Liver Foundation © 2017 American Liver Foundation. All rights reserved. Funding for the HE123 - Diagnosis, Treatment and ...

  8. Hepatitis autoinmune.




    Three patients with autoinmune hepatitis type 1 diagnosed at the Hospital Nacional Arzobispo Loayza in Lima-Perú, between 1993 and 1995, are here reported, emphasis is made on the clinical, histological and therapeutical aspects.

  9. Hepatitis B Foundation (United States)

    ... worldwide 2 Billion People have been infected with Hepatitis B Worldwide The Hepatitis B Foundation is working on ... of people living with hepatitis B. Learn About Hepatitis B in 11 Other Languages . Resource Video See More ...

  10. Hepatitis A Test (United States)

    ... be limited. Home Visit Global Sites Search Help? Hepatitis A Testing Share this page: Was this page ... HAV-Ab total; Anti-HAV Formal name: Viral Hepatitis A Antibody Related tests: Hepatitis B Testing ; Hepatitis ...

  11. Hepatitis Risk Assessment (United States)

    ... Requirements for Viral Hepatitis Liver Cancer and Viral Hepatitis Viral Hepatitis and Young Persons Who Inject Drugs National Academies’ ... Sources for IG & HBIG About the Division of Viral Hepatitis Contact Us Anonymous Feedback File Formats Help: How ...

  12. Travelers' Health: Hepatitis A (United States)

    ... 3 - Helminths, Soil-Transmitted Chapter 3 - Hepatitis B Hepatitis A Noele P. Nelson, Trudy V. Murphy INFECTIOUS ... hepatitis/HAV Table 3-02. Vaccines to prevent hepatitis A VACCINE TRADE NAME (MANUFACTURER) AGE (Y) DOSE ...

  13. Delta agent (Hepatitis D) (United States)

    Hepatitis D virus ... Hepatitis D virus (HDV) is found only in people who carry the hepatitis B virus. HDV may make liver ... B virus but who never had symptoms. Hepatitis D infects about 15 million people worldwide. It occurs ...

  14. Esophageal papilloma: Flexible endoscopic ablation byradiofrequency

    Institute of Scientific and Technical Information of China (English)

    Gianmattia del Genio; Federica del Genio; Pietro Schettino; Paolo Limongelli; Salvatore Tolone; Luigi Brusciano; Manuela Avellino; Chiara Vitiello; Giovanni Docimo; Angelo Pezzullo; Ludovico Docimo


    Squamous papilloma of the esophagus is a rare benignlesion of the esophagus. Radiofrequency ablation is anestablished endoscopic technique for the eradication ofBarrett esophagus. No cases of endoscopic ablation ofesophageal papilloma by radiofrequency ablation (RFA)have been reported. We report a case of esophagealpapilloma successfully treated with a single sessionof radiofrequency ablation. Endoscopic ablation ofthe lesion was achieved by radiofrequency using anew catheter inserted through the working channelof endoscope. The esophageal ablated tissue wasremoved by a specifically designed cup. Completeablation was confirmed at 3 mo by endoscopy withbiopsies. This case supports feasibility and safety of asa new potential indication for BarrxTM RFA in patientswith esophageal papilloma.

  15. Feature Hepatitis: Hepatitis Symptoms, Diagnosis, Treatment & Prevention (United States)

    ... Navigation Bar Home Current Issue Past Issues Feature Hepatitis Hepatitis: Symptoms, Diagnosis, Treatment & Prevention Past Issues / Spring 2009 ... No appetite Fever Headaches Diagnosis To check for hepatitis viruses, your doctor will test your blood. You ...

  16. Experimental Hepatic Carcinogenesis: Oxidative Stress and Natural Antioxidants

    Directory of Open Access Journals (Sweden)

    Velid Unsal


    Full Text Available Hepatocellular carcinoma is one of the most common cancers in the world, and it is influenced by agents such as DEN, 2-AAF, phenobarbital, alcohol, aflatoxin B1 metabolite or hepatitis viruses (B and C. Oxidative stress is becoming recognized as a key factor in the progression of hepatocarcinogenesis. Reactive oxygen species can play a leading role in initiation and promotion of hepatic carcinogenesis. The metabolites of DEN Diethylnitrosamine (DEN mediate the binding of tumour promoters by covalently binding to the DNA with one or two oxidation-providing electrons. 2-AAF is the inducer of DEN, and it is involved in tumour formation in the bladder and liver. Reactive Oxygen species (ROS; carbohydrates, lipids, DNA and enzymes, such as affect all important structures. Additionally, an excessive amount of ROS is highly toxic to cells. Antioxidants are protects against ROS, toxic substances, carcinogens. This review focuses on the literature on studies of Hepatic Carcinogenesis, oxidative stress and antioxidant therapy.

  17. Radiofrequency ablation for hepatocellular carcinoma: surgeon’s views

    Directory of Open Access Journals (Sweden)

    Zhi-qiang HUANG


    Full Text Available The clinical efficacy of hepatectomy and radiofrequency ablation (RFA in treatment of hepatocellular carcinoma (HCC was reviewed in present article. Currently, although hepatectomy remains the prior option for the treatment of liver cancer, an equivalent treatment result for the extirpation of small HCC (less than 3cm in diameter can be achieved by RFA. Because of limitation in term of size, location of tumor and technique of physician, there were still drawbacks to RFA application. To make a breakthrough in RFA application and to achieve equivalent result as resection, it is essential to abide by the principle of hepatic surgery and to destroy the liver tumor totally in only single ablation. Nowadays, with assistance of laparoscope, the technique has been developed to achieve complete ablation in one operation in treatment of HCC in particular location or of certain size (larger than 3cm in diameter, and the process was safe, painless and less invasive. Therefore, the treatment to HCC could be further improved in the future by combining minimally invasive surgery and RFA based on surgical principle.

  18. Movement disorders caused by brain tumours.

    Directory of Open Access Journals (Sweden)

    Bhatoe H


    Full Text Available Movement disorders are uncommon presenting features of brain tumours. Early recognition of such lesions is important to arrest further deficit. We treated seven patients with movement disorders secondary to brain tumours over a period of seven years. Only two of these were intrinsic thalamic tumours (astrocytomas while the rest were extrinsic tumours. The intrinsic tumours were accompanied by hemichorea. Among the extrinsic tumours, there was one pituitary macroadenoma with hemiballismus and four meningiomas with parkinsonism. Symptoms were unilateral in all patients except one with anterior third falcine meningioma who had bilateral rest tremors. There was relief in movement disorders observed after surgery. Imaging by computed tomography or magnetic resonance imaging is mandatory in the evaluation of movement disorders, especially if the presentation is atypical, unilateral and/or accompanied by long tract signs.

  19. Malignant tumours of the kidney: imaging strategy

    Energy Technology Data Exchange (ETDEWEB)

    Smets, Anne M. [Academic Medical Center, Department of Radiology G1, Amsterdam (Netherlands); Kraker, Jan de [Paediatric Oncology-Academic Medical Center, Amsterdam (Netherlands)


    Primitive malignant renal tumours comprise 6% of all childhood cancers. Wilms tumour (WT) or nephroblastoma is the most frequent type accounting for more than 90%. Imaging alone cannot differentiate between these tumours with certainty but it plays an important role in screening, diagnostic workup, assessment of therapy response, preoperative evaluation and follow-up. The outcome of WT after therapy is excellent with an overall survival around 90%. In tumours such as those where the outcome is extremely good, focus can be shifted to a risk-based stratification to maintain excellent outcome in children with low risk tumours while improving quality of life and decreasing toxicity and costs. This review will discuss the imaging issues for WT from the European perspective and briefly discuss the characteristics of other malignant renal tumours occurring in children and new imaging techniques with potential in this matter. (orig.)

  20. Clinical relevance of intermittent tumour blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Durand, Ralph E.; Aquino-Parsons, Christina [British Columbia Cancer Research Centre, Vancouver (Canada)


    One of the goals of translational cancer research is to understand basic 'phenomena' so that tumour response to therapy can be improved. One such phenomenon is intermittent tumour blood flow. The impact of the transient hypoxia that results from decreased tumour blood flow is now beginning to be appreciated in preclinical systems, and also receiving some attention in clinical practise. Thus in this article we review the nature and frequency of microregional blood flow changes in preclinical and clinical tumours and examine the impact of those changes on response to both radiotherapy and chemotherapy. Additionally, the implications of non-constant blood flow for both the growth of the unperturbed tumour and the regrowth of surviving tumour clonogens during and after therapy are examined.

  1. Femtosecond laser ablation of enamel (United States)

    Le, Quang-Tri; Bertrand, Caroline; Vilar, Rui


    The surface topographical, compositional, and structural modifications induced in human enamel by femtosecond laser ablation is studied. The laser treatments were performed using a Yb:KYW chirped-pulse-regenerative amplification laser system (560 fs and 1030 nm) and fluences up to 14 J/cm2. The ablation surfaces were studied by scanning electron microscopy, grazing incidence x-ray diffraction, and micro-Raman spectroscopy. Regardless of the fluence, the ablation surfaces were covered by a layer of resolidified material, indicating that ablation is accompanied by melting of hydroxyapatite. This layer presented pores and exploded gas bubbles, created by the release of gaseous decomposition products of hydroxyapatite (CO2 and H2O) within the liquid phase. In the specimen treated with 1-kHz repetition frequency and 14 J/cm2, thickness of the resolidified material is in the range of 300 to 900 nm. The micro-Raman analysis revealed that the resolidified material contains amorphous calcium phosphate, while grazing incidence x-ray diffraction analysis allowed detecting traces of a calcium phosphate other than hydroxyapatite, probably β-tricalcium phosphate Ca3), at the surface of this specimen. The present results show that the ablation of enamel involves melting of enamel's hydroxyapatite, but the thickness of the altered layer is very small and thermal damage of the remaining material is negligible.

  2. Radiofrequency ablation of a misdiagnosed Brodie’s abscess (United States)

    Chan, RS; Abdullah, BJJ; Aik, S; Tok, CH


    Radiofrequency ablation (RFA) therapy is recognised as a safe and effective treatment option for osteoid osteoma. This case report describes a 27-year-old man who underwent computed tomography (CT)-guided percutaneous RFA for a femoral osteoid osteoma, which was diagnosed based on his clinical presentation and CT findings. The patient developed worsening symptoms complicated by osteomyelitis after the procedure. His clinical progression and subsequent MRI findings had led to a revised diagnosis of a Brodie’s abscess, which was further supported by the eventual resolution of his symptoms following a combination of antibiotics treatment and surgical irrigations. This case report illustrates the unusual MRI features of osteomyelitis mimicking soft tissue tumours following RFA of a misdiagnosed Brodie’s abscess and highlights the importance of a confirmatory histopathological diagnosis for an osteoid osteoma prior to treatment. PMID:22291860

  3. [Solitary fibrous tumours of the kidney]. (United States)

    Gres, Pascal; Avances, Christophe; Ben Naoum, Kamel; Chapuis, Héliette; Costa, Pierre


    Solitary fibrous tumours (SFT) are mesenchymal tumours that usually arise from the pleura. Renal SFT are exceptional (9 cases reported in the literature). The authors report a new case discovered during assessment of HT and treated by radical right nephrectomy. The histological appearance is characteristic: a tumour with a fibrous centre, composed of a monomorphic proliferation of spindle cells, with positive CD 34, CD 99, and bcl 2 labelling. The prognosis after complete resection is generally favourable.

  4. An unusual presentation of a glomus tumour.

    LENUS (Irish Health Repository)

    Nugent, N


    Glomus tumours are benign, soft tissue tumours, usually of fingertips. Classically they present with severe pain, temperature sensitivity and localised tenderness. The diagnosis is often delayed due to sometimes non-specific symptoms and rarity of the disorder. While usually a clinical diagnosis, imaging may be necessary for diagnosis and localisation. We present a case of glomus tumour of the fingertip with an unusual history.

  5. [Adenomatoid tumour of the adrenal gland]. (United States)

    Bandier, Philippe Claus; Hansen, Alastair; Thorelius, Lars


    An adenomatoid tumour in the right suprarenal gland was discovered during clinical cancer staging of a 73-year-old woman. Adenomatoid tumours in the suprarenal glands are rare and are most often found incidentally. A definitive diagnosis is made on the basis of histology since imaging methods are non-specific. Differential diagnoses comprise malignant vascular neoplasm or adenocarcinoma. Immunohistochemistry or electron microscopy allows uncomplicated distinction between these tumours. In general, it is recommended to obtain biopsies from suprarenal processes.

  6. Ex-vivo HRMAS of adult brain tumours: metabolite quantification and assignment of tumour biomarkers.

    NARCIS (Netherlands)

    Wright, A.J.; Fellows, G.A.; Griffiths, J.R.; Wilson, M.; Bell, B.A.; Howe, F.A.


    BACKGROUND: High-resolution magic angle spinning (HRMAS) NMR spectroscopy allows detailed metabolic analysis of whole biopsy samples for investigating tumour biology and tumour classification. Accurate biochemical assignment of small molecule metabolites that are "NMR visible" will improve our inter

  7. Ex-vivo HRMAS of adult brain tumours: metabolite quantification and assignment of tumour biomarkers.

    NARCIS (Netherlands)

    Wright, A.J.; Fellows, G.A.; Griffiths, J.R.; Wilson, M.; Bell, B.A.; Howe, F.A.


    BACKGROUND: High-resolution magic angle spinning (HRMAS) NMR spectroscopy allows detailed metabolic analysis of whole biopsy samples for investigating tumour biology and tumour classification. Accurate biochemical assignment of small molecule metabolites that are "NMR visible" will improve our inter

  8. Hepatitis C: Diet and Nutrition (United States)

    ... with Hepatitis » Daily Living: Diet and Nutrition Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... have high cholesterol and have fatty liver. How hepatitis C affects diet If you have hepatitis, you ...

  9. Liver Cancer and Hepatitis B (United States)

    ... Our Accomplishments Annual Reports Our Videos What Is Hepatitis B? What Is Hepatitis B? The ABCs of Viral Hepatitis Liver Cancer and Hepatitis B Hepatitis Delta Coinfection Hepatitis C Coinfection HIV/AIDS ...

  10. Elevated tumour marker: an indication for imaging?

    LENUS (Irish Health Repository)

    McMahon, Colm J


    INTRODUCTION: The purpose of this study was to evaluate the utility of imaging examinations in patients with elevated tumour markers when (a) the tumour marker is not validated for as a primary diagnostic test; (b) the patient had no personal history of cancer and (c) the patient had no other imaging indication. MATERIALS AND METHODS: Patients without known cancer who had abnormal carcinoembryonic antigen, CA19-9, CA125 and\\/or CA15-3 serology over a one-year period were included. A retrospective medical record review was performed to assess the number of these cases who underwent imaging because of \\'elevated tumour marker\\' in the absence of a clinical indication for imaging. The number and result of these imaging studies were evaluated. RESULTS: Eight hundred and nineteen patients were included. Of those, 25 patients (mean age: 67.8 [range 41-91] y), were imaged to evaluate: \\'elevated tumour marker\\'. They underwent 29 imaging studies (mean [+\\/-standard deviation (SD)] per patient = 1.2 [+\\/-0.4]), and had 42 elevated tumour marker serology tests (mean [+\\/-SD] per patient = 1.7 [+\\/-0.7]). Four patients had >1 imaging test. No patient had an imaging study which diagnosed a malignancy or explained the elevated tumour marker. CONCLUSION: The non-judicious use of tumour markers can prompt further unnecessary investigations including imaging. In this study, there was no positive diagnostic yield for imaging performed for investigation of \\'elevated tumour marker\\'. \\'Elevated tumour marker\\

  11. Prognosis of Brain Tumours with Epilepsy



    The prognosis of 560 patients with a clinical and CT diagnosis of intrinsic supratentorial brain tumour was examined retrospectively at the Department of Neurosciences, Walton Hospital, Liverpool, England.

  12. Autoimmune hepatitis

    Directory of Open Access Journals (Sweden)

    F Motamed


    Full Text Available Autoimmune hepatitis is (AIH is a chronic hepatitis that occurs in children and adults of all ages. It is characterized by immunologic and autoimmune features, including circulating auto antibodies and high serum globulin concentrations. It was first described in the 1950s by term of chronic active hepatitis. It has 2 types with different auto antibodies. Diagnosis is based upon serologic and histologic findings and exclusion of other forms of chronic liver disease.   A scoring system should be used in assessment based upon: 1 Auto anti bodie titer 2 Serum IgG level  3 Liver histology 4 Absence of viral and other causes of hepatitis. Clear indications for treatment: 1   rise of aminotrasferases 2   clinical symptoms of liver disease 3   histological features in liver biopsy 4   Children with AIH initial treatment involve glucocorticoid with or without azathioprine. For patients with fulminant hepatitis liver transplantation, should be kept in mind.   Remission is defined by: 1   Resolution of symptoms 2   Normalization of serum trasaminases 3   Normalization of serum bilirubin and gamma globuline levels. 4   Improvement in liver histology 5   Treatment is continued for at least 2-5 years, glucocorticoids are with drawn first, by tapering over six weeks. Azathioprine will be with drawn.  

  13. [Chronic hepatitis]. (United States)

    Figueroa Barrios, R


    Medical literature about chronic hepatitis is reviewed. This unresolving disease caused by viruses, drugs or unknown factors may progress to in cirrhosis and hepatocarcinoma. A classification based on liver biopsy histology into chronic persistent and chronic active types has been largely abandoned and emphasis is placed on recognizing the etiology of the various types. One is associated with continuing hepatitis B virus infection; another is related to chronic hepatitis C virus infection and the third is termed autoinmune, because of the association with positive serum autoantibodies. A fourth type with similar clinical functional and morphologic features is found with some drug reactions. Long term corticoesteroid therapy is usually successful in autoinmune type. Associations between antibodies to liver-kidney microsomes and the hepatitis C virus can cause diagnostic difficulties. Antiviral treatment of chronic hepatitis B and C with interpheron alfa is employed, controlling symptoms and abnormal biochemistry and the progression to cirrhosis and liver cancer in 30 to 40% patients. Alternative therapies or combinations with interpheron are being evaluated waiting for final results.

  14. Complications of radiofrequency ablation for liver cancer in high-risk locations and their prevention

    Directory of Open Access Journals (Sweden)

    ZHANG Junchao


    Full Text Available Radiofrequency ablation (RFA is one of the most important methods for the treatment of liver cancer and has the advantages of small trauma, simple operation, and repeatability. However, for tumors in high-risk locations within 5 mm of the first and second branches of the hepatic portal vein, near the hepatic vein, the inferior vena cava, or the gallbladder, within 5 mm of the intestinal tract, under the Glisson’s capsule, and in the diaphragm, RFA has the issues of a low complete ablation rate, a high local recurrence rate, and serious complications. This article introduces the complications of RFA for liver cancer in high-risk locations and their prevention and points out that with the promotion of individualized and standardized RFA, liver cancer in these high-risk locations is no longer a contradiction for RFA.

  15. Successful percutaneous CT-guided microwave ablation of adrenal gland for ectopic Cushing syndrome. (United States)

    Zener, Rebecca; Zaleski, Andrew; Van Uum, Stan H; Gray, Daryl K; Mujoomdar, Amol

    Adrenocorticotropic hormone production by pancreatic neuroendocrine tumor (PNET) is rare and results in hyperstimulation of the adrenal gland to produce ectopic Cushing syndrome. Our case showcases the safety and effectiveness of percutaneous CT-guided microwave ablation of the adrenal gland in a 49-year-old female with PNET and hepatic metastases who presented with ectopic Cushing syndrome despite surgical resection of the primary pancreatic tumor and left adrenal gland. Prior to ablation, the right adrenal gland measured 4.3×1.6×2.0cm and the patient had malignant hypertension with elevated morning serum cortisol level (1976nmol/L). After microwave ablation of the right adrenal gland, the hypertension resolved and the cortisol level decreased dramatically (74nmol/L). As expected after successful treatment, the patient developed adrenal insufficiency and was placed on glucocorticoid and mineralocorticoid supplementation. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Laser ablation studies of nanocomposites

    Directory of Open Access Journals (Sweden)

    Oleg V. Mkrtychev


    Full Text Available The first experimental measurements of the threshold energy density values for the laser ablation of glass nanocomposites with nanodimensional coatings have been carried out under the action of the YAG–Nd laser power pulse radiation. The coatings in question were of different compositions and had been created by the sol–gel technology. The procedure for determining the laser ablation threshold energy density values was worked out on the base of the breakdown probability level of 0.5. The statistical processing of the measurement data over all the samples allowed obtaining the dependence of the ablation destruction threshold energy parameters on the coating physical and chemical properties such as the sample transmission in the visible region of the spectrum, coating thickness, the chemical composition of the film-forming solution, and on the pulse duration of laser radiation.

  17. Diagnostic utility of Wilms′ tumour-1 protein (WT-1 immunostaining in paediatric renal tumours

    Directory of Open Access Journals (Sweden)

    Surbhi Goyal


    Interpretation & conclusions: WT1 helps to differentiate Wilms′ tumour from other paediatric renal tumours. It may help in differentiating the two subgroups of Wilms′ tumour which have distinct molecular pathogenesis and biological behaviour, however, further prospective studies are required for validation of this hypothesis.

  18. Granular cell tumour of the neurohypophysis: a rare sellar tumour with specific radiological and operative features.

    LENUS (Irish Health Repository)

    Aquilina, K


    Symptomatic granular cell tumours of the neurohypophysis are rare sellar lesions. Preoperative prediction of the diagnosis on the basis of radiological appearance is useful as these tumours carry specific surgical difficulties. This is possible when the tumour arises from the pituitary stalk, rostral to a normal pituitary gland. This has not been emphasized previously.

  19. Microwave ablation of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)


    Although surgical resection is still the optimal treatmentoption for early-stage hepatocellular carcinoma(HCC) in patients with well compensated cirrhosis,thermal ablation techniques provide a valid nonsurgicaltreatment alternative, thanks to their minimalinvasiveness, excellent tolerability and safety profile,proven efficacy in local disease control, virtuallyunlimited repeatability and cost-effectiveness. Differentenergy sources are currently employed in clinics asphysical agents for percutaneous or intra-surgicalthermal ablation of HCC nodules. Among them, radiofrequency(RF) currents are the most used, whilemicrowave ablations (MWA) are becoming increasinglypopular. Starting from the 90s', RF ablation (RFA) rapidlybecame the standard of care in ablation, especially inthe treatment of small HCC nodules; however, RFAexhibits substantial performance limitations in thetreatment of large lesions and/or tumors located nearmajor heat sinks. MWA, first introduced in the FarEastern clinical practice in the 80s', showing promisingresults but also severe limitations in the controllabilityof the emitted field and in the high amount of poweremployed for the ablation of large tumors, resultingin a poor coagulative performance and a relativelyhigh complication rate, nowadays shows better resultsboth in terms of treatment controllability and of overallcoagulative performance, thanks to the improvementof technology. In this review we provide an extensiveand detailed overview of the key physical and technicalaspects of MWA and of the currently available systems,and we want to discuss the most relevant published dataon MWA treatments of HCC nodules in regard to clinicalresults and to the type and rate of complications, both inabsolute terms and in comparison with RFA.

  20. Transhemangioma Ablation of Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei, E-mail: [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)


    Radiofrequency ablation (RFA) is a well-established treatment modality in the treatment of early hepatocellular carcinoma (HCC) [1]. Safe trajectory of the RFA probe is crucial in decreasing collateral tissue damage and unwarranted probe transgression. As a percutaneous technique, however, the trajectory of the needle is sometimes constrained by the available imaging plane. The presence of a hemangioma beside an HCC is uncommon but poses the question of safety related to probe transgression. We hereby describe a case of transhemangioma ablation of a dome HCC.

  1. Resection and radiofrequency ablation of multiple liver adenomas secondary to anti-conceptive pills. (United States)

    Hashimoto, Luis; Dabbs, Andy; Sewell, Patrick; Doherty, Mike


    A case of multiple hepatic adenomas associated with birth control pills in a 25-year-old female is presented. Her only complaint was abdominal pain, and an elevated alkaline phosphatase was the only laboratory abnormality. The largest adenoma was located in the caudate lobe and was resected. The other two were small, located deep in the right lobe, and treated with radiofrequency ablation. Currently, the patient is asymptomatic and her alkaline phosphatase has returned to normal levels.

  2. Percutaneous Management of a Bronchobiliary Fistula after Radiofrequency Ablation in a Patient with Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Dok Hyun; Shim, Ju Hyun; Lee, Wook Jin; Kim, Pyo Nyun; Shin, Ji Hoon; Kim, Kang Mo [Asan Medical Center, Seoul (Korea, Republic of)


    Radiofrequency ablation (RFA) is a minimally invasive, image-guided procedure for the treatment of hepatic tumors. While RFA is associated with relatively low morbidity, sporadic bronchobiliary fistulae due to thermal damage may occur after RFA, although the incidence is rare. We describe a patient with a bronchobiliary fistula complicated by a liver abscess that occurred after RFA. This fistula was obliterated after placement of an external drainage catheter into the liver abscess for eight weeks.

  3. Feasibility of abdomino-pelvic T1-weighted real-time thermal mapping of laser ablation. (United States)

    Dick, Elizabeth A; Wragg, Paul; Joarder, Rita; de Jode, Michael; Lamb, Gabrielle; Gould, Stuart; Gedroyc, Wladyslaw M W


    To prove the hypothesis that T1-weighted (T1W) thermal mapping is reliable and achievable in magnetic resonance (MR)-guided laser tumor ablation. Near real-time gray and color-scale T1W thermal maps in 111 MR-guided laser thermal ablations (LTA) of liver, kidney, and uterine tumors were studied. After laser fiber placement, near real-time gray and color-scale thermal maps were produced. Previous work showed T1 signal is inversely proportional to temperature below 55 degrees C (the point of irreversible necrosis). Thermal mapping was successful in 84% of uterine, 74% of hepatic, and 20% of renal ablations. For hepatic and uterine tumors, size and conspicuity of thermal lesions were significantly greater on subtracted colorized images rather than gray-scale raw image mapping (P = 0.001, paired Student's t-test). Patient movement (N = 24), fiber charring N = 2), magnetic field distortion, and reconstruction errors (N = 2) caused mapping failure. For both renal and hepatic tumors, comparison of near real-time T1W colorized thermal map and follow up gadolinium-enhanced MR imaging revealed moderate correlation (Pearson correlation coefficient of 0.55 and 0.5, respectively). In hepatic, renal, and uterine thermal maps, the color scale produced significantly greater sized lesions with significantly greater conspicuity than the gray scale. T1W thermal mapping was reliable and successfully achieved in 73.7% of procedures, and predicted the ablated area of the tumor moderately well. Copyright 2003 Wiley-Liss, Inc.

  4. Ablation of Solid Hydrogen in a Plasma

    DEFF Research Database (Denmark)

    Jørgensen, L. W.; Sillesen, Alfred Hegaard


    Several hydrogen pellet ablation models based on the formation of a shielding neutral cloud have been reported by different authors. The predicted ablation rates are shown to follow almost the same scaling law and this is used to explain the authors' ablation experiment....

  5. Soft thrombus formation in radiofrequency catheter ablation

    NARCIS (Netherlands)

    Demolin, JM; Eick, OJ; Munch, K; Koullick, E; Nakagawa, H; Wittkampf, FHM


    During RF catheter ablation, local temperature elevation can result in coagulum formation on the ablation electrode, resulting in impedance rise. A recent study has also demonstrated the formation of a so-called soft thrombus during experimental ablations. This deposit poorly adhered to the catheter

  6. Catheter ablation of parahisian premature ventricular complex. (United States)

    Kim, Jun; Kim, Jeong Su; Park, Yong Hyun; Kim, June Hong; Chun, Kook Jin


    Catheter ablation is performed in selected patients with a symptomatic premature ventricular complex (PVC) or PVC-induced cardiomyopathy. Ablation of PVC from the His region has a high risk of inducing a complete atrioventricular block. Here we report successful catheter ablation of a parahisian PVC in a 63-year-old man.

  7. Laser ablation at the hydrodynamic regime

    Directory of Open Access Journals (Sweden)

    Gojani Ardian B.


    Full Text Available Laser ablation of several metals and PVC polymer by high energy nanosecond laser pulses is investigated experimentaly. Visualization by shadowgraphy revealed the dynamics of the discontinuities in ambient air and ablation plume above the target surface, while surface profiling allowed for determination of the ablated mass.

  8. Laser ablation at the hydrodynamic regime


    Gojani Ardian B.


    Laser ablation of several metals and PVC polymer by high energy nanosecond laser pulses is investigated experimentaly. Visualization by shadowgraphy revealed the dynamics of the discontinuities in ambient air and ablation plume above the target surface, while surface profiling allowed for determination of the ablated mass.

  9. Laser ablation and optical surface damage (United States)

    Chase, L. L.; Hamza, A. V.; Lee, H. W. H.

    Laser ablation usually accompanies optical surface damage to bare surfaces and coatings. Investigations of optical damage mechanisms by observation of ablation processes at laser fluences very close to the optical damage threshold are described. Several promising surface characterization methods for investigating damage mechanisms are also described. The possible role of laser ablation in initiating or promoting optical surface damage is discussed.

  10. Laser ablation mechanisms and optical surface damage (United States)

    Chase, L. L.; Hamza, A. V.; Lee, H. W. H.


    Laser ablation usually accompanies optical surface damage to bare surfaces and coatings. Investigations of optical damage mechanisms by observation of ablation processes at laser fluences very close to the optical damage threshold are described. Several promising surface characterization methods for investigating damage mechanisms are also described. The possible role of laser ablation in initiating or promoting optical surface damage is discussed.

  11. Nanosecond laser ablation of bulk Al, Bronze, and Cu: ablation rate saturation and laserinduced oxidation


    R. Maisterrena-Epstein; S. Camacho-López; L. Escobar-Alarcón; M. A. Camacho-López


    In this work we report about the characteristics of nanosecond laser ablation, in atmospheric air, of bulk Al, Bronze, and Cu. Average per pulse laser ablation rate and its dependence on ablation depth is presented for these three metals. We will demonstrate and discuss some distinctive features of the ablation saturation effect of the above metals. We will also present results on laser-induced oxidation of the metals which results off the ablation event. We studied the laser-induced oxidatio...

  12. Nanotechnology combined therapy: tyrosine kinase-bound gold nanorod and laser thermal ablation produce a synergistic higher treatment response of renal cell carcinoma in a murine model. (United States)

    Liu, James; Abshire, Caleb; Carry, Connor; Sholl, Andrew B; Mandava, Sree Harsha; Datta, Amrita; Ranjan, Manish; Callaghan, Cameron; Peralta, Donna V; Williams, Kristen S; Lai, Weil R; Abdel-Mageed, Asim B; Tarr, Matthew; Lee, Benjamin R


    To investigate tyrosine kinase inhibitors (TKI) and gold nanorods (AuNRs) paired with photothermal ablation in a human metastatic clear cell renal cell carcinoma (RCC) mouse model. Nanoparticles have been successful as a platform for targeted drug delivery in the treatment of urological cancers. Likewise, the use of nanoparticles in photothermal tumour ablation, although early in its development, has provided promising results. Our previous in vitro studies of nanoparticles loaded with both TKI and AuNRs and activated with photothermal ablation have shown significant synergistic cell kill greater than each individual arm alone. This study is a translation of our initial findings to an in vivo model. Immunologically naïve nude mice (athymic nude-Foxn1(nu) ) were injected subcutaneously bilaterally in both flanks (n = 36) with 2.5 × 10(6) cells of a human metastatic renal cell carcinoma cell line (RCC 786-O). Subcutaneous xenograft tumours developed into 1-cm palpable nodules. AuNRs encapsulated in human serum albumin protein (HSA) nanoparticles were synthesised with or without a TKI and injected directly into the tumour nodule. Irradiation was administered with an 808-nm light-emitting diode laser for 6 min. Mice were humanely killed 14 days after irradiation; tumours were excised, formalin fixed, paraffin embedded, and evaluated for size and the percentage of necrosis by a genitourinary pathologist. The untreated contralateral flank tumours were used as controls. In mice that did not receive irradiation, TKI alone yielded 4.2% tumour necrosis on the injected side and administration of HSA-AuNR-TKI alone yielded 11.1% necrosis. In the laser-ablation models, laser ablation alone yielded 62% necrosis and when paired with HSA-AuNR there was 63.4% necrosis. The combination of laser irradiation and HSA-AuNR-TKI had cell kill rate of 100%. In the absence of laser irradiation, TKI treatment alone or when delivered via nanoparticles produced moderate necrosis. Irradiation

  13. Percutaneously implanted markers in peripheral lung tumours

    DEFF Research Database (Denmark)

    Persson, G.F.; Josipovic, Mirjana; Nygaard, Ditte Eklund


    A letter to the editor is presented which is concerned with research which investigated percutaneously implanted markers in peripheral lung tumours and their complications.......A letter to the editor is presented which is concerned with research which investigated percutaneously implanted markers in peripheral lung tumours and their complications....

  14. Skull metastasis from rectal gastrointestinal stromal tumours. (United States)

    Gil-Arnaiz, Irene; Martínez-Trufero, Javier; Pazo-Cid, Roberto Antonio; Felipo, Francesc; Lecumberri, María José; Calderero, Verónica


    Gastrointestinal stromal tumours (GIST) are the most common mesenchymal neoplasm of the gastrointestinal tract. Rectum localisation is infrequent for these neoplasms, accounting for about 5% of all cases. Distant metastases of GIST are also rare. We present a patient with special features: the tumour is localised in rectum and it has an uncommon metastatic site, the skull, implying a complex differential diagnosis approach.

  15. Thermal resistance in a spontaneous murine tumour. (United States)

    Maher, J; Urano, M; Rice, L; Suit, H D


    Resistance to subsequent hyperthermia as a result of prior heating was investigated using a spontaneous murine tumour implanted into the feet of C3H/Sed mice. Tumours were treated by immersing the tumour-bearing foot into a constant-temperature hot water bath set at 45.5 degrees C and were given single and split doses of heat. Response was assessed using a tumour-growth time assay. Three aspects of thermally-induced resistance were particularly considered: the time course of development and decay; the importance of the magnitude of the priming dose and the influence of the size of the tumour at the time of treatment. Substantial resistance was induced in this tumour by short priming doses at 45.5 degrees C, rising rapidly 1-2 days after the first treatment and then starting to decay. There was no significant difference in the kinetics of thermal resistance induced in tumours treated at 4mm and those treated at 8 mm in size, although the large tumours were more sensitive to single doses of heat. Increasing the magnitude of the priming dose of heat resulted in an increase in the magnitude of resistance to the second dose. The results of this study are compared with results of similar studies in this and other laboratories using murine normal tissues and cells in culture. Possible clinical implications are considered.

  16. Occurrence studies of intracranial tumours

    Energy Technology Data Exchange (ETDEWEB)

    Larjavaara, S.


    Intracranial tumours are a histopathologically heterogeneous group of tumours. This thesis focused on three types of intracranial tumours; gliomas, meningiomas and vestibular schwannomas (VS). The main objectives of the dissertation were to estimate the occurrence of intracranial tumours by different subtypes, and to assess the validity and completeness of the cancer registry data. The specific aims of the publications were to evaluate the validity of reported incidence rates of meningioma cases, to describe the trends of VS incidence in four Nordic countries, and to define the anatomic distribution of gliomas and to investigate their location in relation to mobile phone use. Completeness of meningioma registration was examined by comparing five separate sources of information, and by defining the frequencies of cases reported to the Finnish Cancer Registry (FCR). Incidence trends of VS were assessed in the four Nordic countries over a twenty-one-year period (1987 - 2007) using cancer registry data. The anatomic site of gliomas was evaluated using both crude locations in the cerebral lobes and, in more detail, a three-dimensional (3D) distribution in the brain. In addition, a study on specific locations of gliomas in relation to the typical position of mobile phones was conducted using two separate approaches: a case-case and a case-specular analysis. The thesis was based on four sets of materials. Data from the international Interphone study were used for the studies on gliomas, while the two other studies were register-based. The dataset for meningiomas included meningioma cases from the FCR and four clinical data sources in Tampere University Hospital (neurosurgical clinic, pathology database, hospital discharge register and autopsy register). The data on VS were obtained from the national cancer registries of Denmark, Finland, Norway and Sweden. The coverage of meningiomas was not comprehensive in any of the data sources. The completeness of FCR was

  17. Autoimmune hepatitis. (United States)

    Strassburg, Christian P


    Autoimmune hepatitis is a chronic inflammatory disease of the liver with a dismal prognosis when left untreated. Key for the improvement of prognosis is a timely diagnosis before cirrhosis has developed. This is reached by the exclusion of other causes of hepatitis, elevated immunoglobulin G, autoantibody profile and histological assessment. Treatment achieves remission rates in 80% of individuals and consists of immunosuppression with corticosteroids and azathioprine. A recent randomised controlled multicenter trial has added budesonide to the effective treatment options in non-cirrhotic patients and leads to a reduction of unwanted steroid side effects. Autoimmune hepatitis is an autoimmune disease of unknown aetiology. Association studies of major histocompatibility complex and other genes demonstrate an influence of immunogenetics. However, apart from the autoimmune polyglandular syndrome type 1, in which 10% of patients suffer from an autoantibody-positive autoimmune hepatitis linked to mutations of the autoimmune regulator gene, there is no clear evidence for a hereditary aetiology of this disease. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. Hepatitis A vaccine associated with autoimmune hepatitis

    Institute of Scientific and Technical Information of China (English)

    PA Berry; G Smith-Laing


    To describe a case of probable relapsing autoimmune hepatitis associated with vaccination against hepatitis A virus (HAV). A case report and review of literature were written concerning autoimmune hepatitis in association with hepatitis A and other hepatotropic viruses. Soon after the administration of formalin-inactivated hepatitis A vaccine, a man who had recently recovered from an uncharacterized but self-limiting hepatitic illness,experienced a severe deterioration (AST 1687 U/L, INR 1.4). Anti-nuclear antibodies were detectable, and liver biopsy was compatible with autoimmune hepatitis. The observation supports the role of HAV as a trigger of autoimmune hepatitis. Studies in helper T-cell activity and antibody expression against hepatic proteins in the context of hepatitis A infection are summarized, and the concept of molecular mimicry with regard to other forms of viral hepatitis and autoimmunity is briefly explored.

  19. Photochemical Ablation of Organic Solids (United States)

    Garrison, Barbara


    As discovered by Srinivasan in 1982, irradiation of materials by far UV laser light can lead to photochemical ablation, a process distinct from normal thermal ablation in which the laser primarily heats the material. A versatile mesoscopic model for molecular dynamics simulations of the laser ablation phenomena is presented. The model incorporates both the thermal and photochemical events, that is, both heating of the system and UV induced bond-cleavage followed by abstraction and radical-radical recombination reactions. The results from the simulations are compared to experimental data and the basic physics and chemistry for each irradiation regime are discussed. Initial results from polymer ablation simulations will be presented. L. V. Zhigilei, P. B. S. Kodali and B. J. Garrison, J. Phys. Chem. B, 102, 2845-2853 (1998); L. V. Zhigilei and B. J. Garrison, Journal of Applied Physics, 88, 1281-1298 (2000). Y. G. Yingling, L. V. Zhigilei and B. J. Garrison, J. Photochemistry and Photobiology A: Chemistry, 145, 173-181 (2001); Y. G. Yingling and B. J. Garrison, Chem. Phys. Lett., 364, 237-243 (2002).

  20. Radiofrequency ablation of small liver malignancies under magnetic resonance guidance: progress in targeting and preliminary observations with temperature monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Terraz, Sylvain; Cernicanu, Alexandru; Lepetit-Coiffe, Matthieu; Viallon, Magalie; Salomir, Rares; Becker, Christoph D. [University Hospitals of Geneva, Department of Radiology, Geneva 14 (Switzerland); Mentha, Gilles [University Hospitals of Geneva, Department of Visceral Surgery and Transplantation, Geneva (Switzerland)


    To evaluate the feasibility and effectiveness of magnetic resonance (MR)-guided radiofrequency (RF) ablation for small liver tumours with poor conspicuity on both contrast-enhanced ultrasonography (US) and computed tomography (CT), using fast navigation and temperature monitoring. Sixteen malignant liver nodules (long-axis diameter, 0.6-2.4 cm) were treated with multipolar RF ablation on a 1.5-T wide-bore MR system in ten patients. Targeting was performed interactively, using a fast steady-state free precession sequence. Real-time MR-based temperature mapping was performed, using gradient echo-echo planar imaging (GRE-EPI) and hardware filtering. MR-specific treatment data were recorded. The mean follow-up time was 19 {+-} 7 months. Correct placement of RF electrodes was obtained in all procedures (image update, <500 ms; mean targeting time, 21 {+-} 11 min). MR thermometry was available for 14 of 16 nodules (88%) with an accuracy of 1.6 C in a non-heated region. No correlation was found between the size of the lethal thermal dose and the ablation zone at follow-up imaging. The primary and secondary effectiveness rates were 100% and 91%, respectively. RF ablation of small liver tumours can be planned, targeted, monitored and controlled with MR imaging within acceptable procedure times. Temperature mapping is technically feasible, but the clinical benefit remains to be proven. (orig.)

  1. Large benign retroperitoneal tumour in pregnancy. (United States)

    Berczi, Csaba; Osvath, Peter; Flasko, Tibor


    A 31-year-old female was in the 13th week of pregnancy when an abdominal ultrasound examination revealed a large retroperitoneal tumour. Magnetic resonance imaging was carried out and the imaging described a 10-cm mass in diameter extending from the right kidney. Given that the patient was in her first trimester and that there was a suspicion of malignancy, further surgical exploration of the tumour was warranted. During the operation, the tumour was removed, but nephrectomy was not necessary. Histologic analysis of the resected tumour showed a mucinous cystic adenoma, and no signs of malignancy were present. Following the surgery, the pregnancy was otherwise uneventful and further complications did not occur. This case illustrates that surgery is recommended in patients with a retroperitoneal tumour early during a pregnancy, when a malignancy cannot be excluded.

  2. Computed tomography guided navigation assisted percutaneous ablation of osteoid osteoma in a 7-year-old patient: the low dose approach

    Energy Technology Data Exchange (ETDEWEB)

    Krokidis, Miltiadis; Tappero, Carlo; Bogdanovic, Daniel; Stamm, Anna-Christina [Inselspital, Bern University Hospital, Department of Diagnostic, Interventional and Pediatric Radiology, Bern (Switzerland); Ziebarth, Kai [Inselspital, Bern University Hospital, Department of Pediatric Surgery, Bern (Switzerland)


    Osteoid osteoma (OO) is a benign tumour that can cause severe pain and functional limitation to children and young adults; the treatment of choice is image-guided ablation. Due to the very small size of the lesion, detection and accurate needle placement may be challenging. Computed tomography (CT) offers very detailed imaging of the skeleton and is the modality of choice for the detection of small OO and for ablation guidance. Nevertheless, CT-guided positioning of the ablation applicator is linked to significant radiation exposure, particularly for the paediatric population. This case describes the successful use of a novel CT-based navigation system that offers the possibility of accurate ablation with only minimal radiation exposure in a paediatric patient. (orig.)

  3. Catheter ablation - new developments in robotics. (United States)

    Chun, K R Julian; Schmidt, Boris; Köktürk, Bülent; Tilz, Roland; Fürnkranz, Alexander; Konstantinidou, Melanie; Wissner, Erik; Metzner, Andreas; Ouyang, Feifan; Kuck, Karl-Heinz


    Catheter ablation has become the curative treatment modality for various arrhythmias. Extending the indications for catheter ablation from simple supraventricular tachycardias to complex arrhythmias such as ventricular tachycardia or atrial fibrillation, the investigator faces prolonged procedure times, fluoroscopy exposure and the need for stable and reproducible catheter movement. Recently, remote-controlled robotic catheter ablation has emerged as a novel ablation concept to meet these requirements. This review describes the two available robotic ablation systems and summarizes their clinical applications and current human experience.

  4. Hydrodynamic instabilities in an ablation front

    Energy Technology Data Exchange (ETDEWEB)

    Piriz, A R; Portugues, R F [E.T.S.I. Industriales, Universidad de Castilla-La Mancha, 13071 Ciudad Real (Spain)


    The hydrodynamic stability of an ablation front is studied for situations in which the wavelength of the perturbations is larger than the distance to the critical surface where the driving radiation is absorbed. An analytical model is presented, and it shows that under conditions in which the thermal flux is limited within the supercritical region of the ablative corona, the front may behave like a flame or like an ablation front, depending on the perturbation wavelength. For relatively long wavelengths the critical and ablation surfaces practically lump together into a unique surface and the front behaves like a flame, whereas for the shortest wavelengths the ablation front substructure is resolved.

  5. Comprehensive assessment of renal tumour complexity in a large percutaneous cryoablation cohort. (United States)

    Bhindi, Bimal; Thompson, Robert Houston; Mason, Ross J; Haddad, Mustafa M; Geske, Jennifer R; Kurup, Anil Nicholas; Hannon, James D; Boorjian, Stephen A; Leibovich, Bradley C; Atwell, Thomas D; Schmit, Grant D


    To evaluate the association between renal tumour complexity and outcomes in a large cohort of patients undergoing percutaneous cryoablation (PCA). Patients with renal tumours treated with PCA were identified using our prospectively maintained ablation registry (2003-2015). Salvage procedures and inherited tumour syndromes were excluded. The associations between R.E.N.A.L. nephrometry score (NS) and risk of complications, renal function impairment, local failure and cancer-specific mortality (CSM) were evaluated using univariate and multivariable logistic, linear and Cox regression models. The cohort included 618 tumours treated during 580 procedures in 565 patients. The median (interquartile range [IQR]) follow-up was 34 (14.66) months. Complications (any grade) during a procedure (n[total] = 87, 15%) were more frequent with higher NS (NS 4-6: 10%; NS 7-9: 14%; NS 10-12: 36%; P < 0.001). Higher NS was independently associated with risk of complications (odds ratio [OR; per 1 point] = 1.3; 95% confidence interval [CI] 1.2-1.5; P < 0.001). Of all the NS components, tumour size was the most strongly associated with complication risk (OR 3.4; 95% CI 2.2-5.2; P < 0.001). The median (IQR) decline in glomerular filtration rate (GFR) from baseline was 9% (0, 22) at last follow-up. Each additional point in NS was associated with a 1.3% (95% CI 0.4-2.1; P = 0.005) greater GFR decline from baseline. NS was not significantly associated with local failure (n [total] = 14, 2%; NS 4-6: 2%; NS 7-9: 3%; NS 10-12: 5%; P = 0.32) or CSM (n [total] = 8, 2%; NS 4-6: 2%; NS 7-9: 3%; NS 10-12: 2%; P = 0.88). In high-complexity tumours PCA was associated with a tumour size-driven increased risk of post-procedural complications. Higher NS was associated with a small, clinically minor additional decline in renal function. Risks for local failure and CSM were low, regardless of tumour complexity. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons

  6. Hepatic amebiasis

    Directory of Open Access Journals (Sweden)

    José Maria Salles


    Full Text Available Amebiasis can be considered the most aggressive disease of the human intestine, responsible in its invasive form for clinical syndromes, ranging from the classic dysentery of acute colitis to extra-intestinal disease, with emphasis on hepatic amebiasis, unsuitably named amebic liver abscess. Found worldwide, with a high incidence in India, tropical regions of Africa, Mexico and other areas of Central America, it has been frequently reported in Amazonia. The trophozoite reaches the liver through the portal system, provoking enzymatic focal necrosis of hepatocytes and multiple micro-abscesses that coalesce to develop a single lesion whose central cavity contains a homogeneous thick liquid, with typically reddish brown and yellow color similar to "anchovy paste". Right upper quadrant pain, fever and hepatomegaly are the predominant symptoms of hepatic amebiasis. Jaundice is reported in cases with multiple lesions or a very large abscess, and it affects the prognosis adversely. Besides chest radiography, ultrasonography and computerized tomography have brought remarkable contributions to the diagnosis of hepatic abscesses. The conclusive diagnosis is made however by the finding of Entamoeba histolytica trophozoites in the pus and by the detection of serum antibodies to the amoeba. During the evolution of hepatic amebiasis, in spite of the availability of highly effective drugs, some important complications may occur with regularity and are a result of local perforation with extension into the pleural and pericardium cavities, causing pulmonary abscesses and purulent pericarditis, respectively The ruptures into the abdominal cavity may lead to subphrenic abscesses and peritonitis. The treatment of hepatic amebiasis is made by medical therapy, with metronidazole as the initial drug, followed by a luminal amebicide. In patients with large abscesses, showing signs of imminent rupture, and especially those who do not respond to medical treatment, a

  7. The ‘Pantie' Tumour

    Directory of Open Access Journals (Sweden)

    Silada Kanokrungsee


    Full Text Available We present a case of radiation-associated angiosarcoma. A 67-year-old Thai woman was diagnosed with endometrium carcinoma stage IC and was treated with surgery and radiations. Ten years later, she presented with a gradually enlarging mass on the pubic area, in the shape of a pair of panties. Skin biopsy of lesions confirmed angiosarcoma. The diagnosis was radiation-associated angiosarcoma. She was treated with chemotherapy due to unresectable tumour. The chemotherapy was started with paclitaxel 70 mg/m2 every 2 weeks. After completing the fifth cycle of paclitaxel, the lesion was markedly decreased in size and the symptoms previously described were also completely resolved.

  8. LTβR signalling preferentially accelerates oncogenic AKT-initiated liver tumours (United States)

    Scarzello, Anthony J; Jiang, Qun; Back, Timothy; Dang, Hien; Hodge, Deborah; Hanson, Charlotte; Subleski, Jeffrey; Weiss, Jonathan M; Stauffer, Jimmy K; Chaisaingmongkol, Jitti; Rabibhadana, Siritida; Ruchirawat, Mathuros; Ortaldo, John; Wang, Xin Wei; Norris, Paula S; Ware, Carl F; Wiltrout, Robert H


    Objectives The relative contributions of inflammatory signalling and sequential oncogenic dysregulation driving liver cancer pathogenesis remain incompletely understood. Lymphotoxin-β receptor (LTβR) signalling is critically involved in hepatitis and liver tumorigenesis. Therefore, we explored the interdependence of inflammatory lymphotoxin signalling and specific oncogenic pathways in the progression of hepatic cancer. Design Pathologically distinct liver tumours were initiated by hydrodynamic transfection of oncogenic V-Akt Murine Thymoma Viral Oncogene Homolog 1 (AKT)/β-catenin or AKT/Notch expressing plasmids. To investigate the relationship of LTβR signalling and specific oncogenic pathways, LTβR antagonist (LTβR-Fc) or agonist (anti-LTβR) were administered post oncogene transfection. Initiated livers/tumours were investigated for changes in oncogene expression, tumour proliferation, progression, latency and pathology. Moreover, specific LTβR-mediated molecular events were investigated in human liver cancer cell lines and through transcriptional analyses of samples from patients with intrahepatic cholangiocarcinoma (ICC). Results AKT/β-catenin-transfected livers displayed increased expression of LTβ and LTβR, with antagonism of LTβR signalling reducing tumour progression and enhancing survival. Conversely, enforced LTβR-activation of AKT/β-catenin-initiated tumours induced robust increases in proliferation and progression of hepatic tumour phenotypes in an AKT-dependent manner. LTβR-activation also rapidly accelerated ICC progression initiated by AKT/Notch, but not Notch alone. Moreover, LTβR-accelerated development coincides with increases of Notch, Hes1, c-MYC, pAKT and β-catenin. We further demonstrate LTβR signalling in human liver cancer cell lines to be a regulator of Notch, pAKTser473 and β-catenin. Transcriptome analysis of samples from patients with ICC links increased LTβR network expression with poor patient survival, increased

  9. Precisely shaped acoustic ablation of tumors utilizing steerable needle and 3D ultrasound image guidance (United States)

    Boctor, Emad M.; Stolka, Philipp; Kang, Hyun-Jae; Clarke, Clyde; Rucker, Caleb; Croom, Jordon; Burdette, E. Clif; Webster, Robert J., III


    Many recent studies have demonstrated the efficacy of interstitial ablative approaches for the treatment of hepatic tumors. Despite these promising results, current systems remain highly dependent on operator skill, and cannot treat many tumors because there is little control of the size and shape of the zone of necrosis, and no control over ablator trajectory within tissue once insertion has taken place. Additionally, tissue deformation and target motion make it extremely difficult to place the ablator device precisely into the target. Irregularly shaped target volumes typically require multiple insertions and several overlapping (thermal) lesions, which are even more challenging to accomplish in a precise, predictable, and timely manner without causing excessive damage to surrounding normal tissues. In answer to these problems, we have developed a steerable acoustic ablator called the ACUSITT with the ability of directional energy delivery to precisely shape the applied thermal dose . In this paper, we address image guidance for this device, proposing an innovative method for accurate tracking and tool registration with spatially-registered intra-operative three-dimensional US volumes, without relying on an external tracking device. This method is applied to guid-ance of the flexible, snake-like, lightweight, and inexpensive ACUSITT to facilitate precise placement of its ablator tip within the liver, with ablation monitoring via strain imaging. Recent advancements in interstitial high-power ultrasound applicators enable controllable and penetrating heating patterns which can be dynamically altered. This paper summarizes the design and development of the first synergistic system that integrates a novel steerable interstitial acoustic ablation device with a novel trackerless 3DUS guidance strategy.

  10. Evidence of distinct tumour-propagating cell populations with different properties in primary human hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Federico Colombo

    Full Text Available BACKGROUND AND AIMS: Increasing evidence that a number of malignancies are characterised by tumour cell heterogeneity has recently been published, but there is still a lack of data concerning liver cancers. The aim of this study was to investigate and characterise tumour-propagating cell (TPC compartments within human hepatocellular carcinoma (HCC. METHODS: After long-term culture, we identified three morphologically different tumour cell populations in a single HCC specimen, and extensively characterised them by means of flow cytometry, fluorescence microscopy, karyotyping and microarray analyses, single cell cloning, and xenotransplantation in NOD/SCID/IL2Rγ/⁻ mice. RESULTS: The primary cell populations (hcc-1, -2 and -3 and two clones generated by means of limiting dilutions from hcc-1 (clone-1/7 and -1/8 differently expressed a number of tumour-associated stem cell markers, including EpCAM, CD49f, CD44, CD133, CD56, Thy-1, ALDH and CK19, and also showed different doubling times, drug resistance and tumorigenic potential. Moreover, we found that ALDH expression, in combination with CD44 or Thy-1 negativity or CD56 positivity identified subpopulations with a higher clonogenic potential within hcc-1, hcc-2 and hcc-3 primary cell populations, respectively. Karyotyping revealed the clonal evolution of the cell populations and clones within the primary tumour. Importantly, the primary tumour cell population with the greatest tumorigenic potential and drug resistance showed more chromosomal alterations than the others and contained clones with epithelial and mesenchymal features. CONCLUSIONS: Individual HCCs can harbor different self-renewing tumorigenic cell types expressing a variety of morphological and phenotypical markers, karyotypic evolution and different gene expression profiles. This suggests that the models of hepatic carcinogenesis should take into account TPC heterogeneity due to intratumour clonal evolution.

  11. Use of shear waves for diagnosis and ablation monitoring of prostate cancer: a feasibility study (United States)

    Gomez, A.; Rus, G.; Saffari, N.


    Prostate cancer remains as a major healthcare issue. Limitations in current diagnosis and treatment monitoring techniques imply that there is still a need for improvements. The efficacy of prostate cancer diagnosis is still low, generating under and over diagnoses. High intensity focused ultrasound ablation is an emerging treatment modality, which enables the noninvasive ablation of pathogenic tissue. Clinical trials are being carried out to evaluate its longterm efficacy as a focal treatment for prostate cancer. Successful treatment of prostate cancer using non-invasive modalities is critically dependent on accurate diagnostic means and is greatly benefited by a real-time monitoring system. While magnetic resonance imaging remains the gold standard for prostate imaging, its wider implementation for prostate cancer diagnosis remains prohibitively expensive. Conventional ultrasound is currently limited to guiding biopsy. Elastography techniques are emerging as a promising real-time imaging method, as cancer nodules are usually stiffer than adjacent healthy prostatic tissue. In this paper, a new transurethral approach is proposed, using shear waves for diagnosis and ablation monitoring of prostate cancer. A finite-difference time domain model is developed for studying the feasibility of the method, and an inverse problem technique based on genetic algorithms is proposed for reconstructing the location, size and stiffness parameters of the tumour. Preliminary results indicate that the use of shear waves for diagnosis and monitoring ablation of prostate cancer is feasible.

  12. Carcinoid tumours of the lung and the ‘PEPPS’ approach: evaluation of preoperative bronchoscopic tumour debulking as preparation for subsequent parenchyma-sparing surgery (United States)

    Neuberger, Michael; Hapfelmeier, Alexander; Schmidt, Michael; Gesierich, Wolfgang; Reichenberger, Frank; Morresi-Hauf, Alicia; Hatz, Rudolf A; Lindner, Michael


    Background Preoperative bronchoscopic tumour ablation has been suggested as a beneficial treatment for bronchopulmonary carcinoid tumours, although data regarding its effects and long-term outcome are lacking. Methods In our case-matched cohort study with 208 patients with bronchopulmonary carcinoid tumours we investigated the role of preoperative bronchoscopic interventions before subsequent surgery and analysed the safety of this Procedure of Endobronchial Preparation for Parenchyma-sparing Surgery (PEPPS) based on metastasis and recurrence rates as well as survival data from 1991 to 2010. The subsequent surgery was classified into parenchyma-sparing procedures and classical lobectomies, bilobectomies and pneumonectomies. Data were obtained from the tumour registry and medical reports. Outcomes were the frequency of parenchyma-sparing surgery after bronchoscopic treatment as well as rates of metastasis, recurrence and survival. Results 132 of 208 carcinoids were located centrally. Among them, 77 patients could be recanalised preoperatively. After bronchoscopic preparation, the rate of subsequent parenchyma-sparing surgery methods was higher (p=0.021). The effect was measured by the number of segments removed. The 10-year survival rate was 89% (typical carcinoids) and 68% (atypical carcinoids), respectively. After applying PEPPS, long-term survival was slightly higher (p=0.23). Metastasis and recurrence rates showed no relevant differences between the bronchoscopically treated or non-treated groups, or between the two types of surgery classes or between the PEPPS and non-PEPPS groups. Conclusions After preoperative bronchoscopic treatment, parenchyma-sparing surgery techniques can be applied more frequently. Furthermore, we detected no negative effects after PEPPS based on metastasis, recurrence and survival rates. PMID:26203359

  13. Dosimetric impact of a change in breathing period on VMAT stereotactic ablative body radiotherapy (United States)

    Olding, T.; Alexander, KM


    The dosimetric impact of a change in breathing period during treatment was assessed for a volumetric modulated arc therapy (VMAT) stereotactic ablative radiotherapy (SABR) lung plan optimized according to our centre’s planning protocol. Plan delivery was evaluated at three breathing rates ranging from 7 to 23 breaths-per-minute (BPM) against the planning anatomy (15 BPM) calculated dose. Dynamic ion chamber, EBT3 film and Fricke-xylenol orange-gelatin (FXG) gel measurements were acquired using a motion phantom with appropriate inserts for each dosimeter. The results show good agreement between measured and calculated plan dose within the internal gross tumour volume (IGTV) target.

  14. MRI of pineal region tumours: relationship between tumours and adjacent structures

    Energy Technology Data Exchange (ETDEWEB)

    Satoh, H. [Hiroshima University, School of Medicine (Japan). Dept. of Neurosurgery; Uozumi, T. [Hiroshima University, School of Medicine (Japan). Dept. of Neurosurgery; Kiya, K. [Dept. of Neurosurgery, Hiroshima Prefectural Hospital, Hiroshima (Japan); Kurisu, K. [Hiroshima University, School of Medicine (Japan). Dept. of Neurosurgery; Arita, K. [Hiroshima University, School of Medicine (Japan). Dept. of Neurosurgery; Sumida, M. [Hiroshima University, School of Medicine (Japan). Dept. of Neurosurgery; Ikawa, F. [Dept. of Neurosurgery, Hiroshima Prefectural Hospital, Hiroshima (Japan)


    A variety of tumours may arise in the pineal region; accurate diagnosis is important in the selection of treatment and prognosis. A retrospective analysis of the MRI studies of 25 patients with pathologically proven pineal region tumours was performed, focused on the relationship between the tumour and neighbouring structures. Compression of the tectal plate was classified as expansive or invasive, and compression of the corpus callosum as inferior, anterior or posterior. In 10 of the 14 patients (71 %) with germ cell tumours tectal compression was of the invasive type; 8 patients (57 %) had multiple tumours and in 13 (93 %) the tumour margins were irregular. Teratomas were readily diagnosed because of characteristic heterogeneous signal intensity. Pineal cell tumours were differentiated from germ cell tumours by their rounded shape, solid nature, sharp margins, and expansive type of tectal compression. Meningiomas were characterised by their falcotentorial attachments, posterior callosal compression, and a low-intensity rim on T2-weighted images. Gd-DTPA injection enabled clear demonstration of the site and extent of tumour spread and was useful in differentiating cystic and solid components. The appearances described, while not pathognomonic, are helpful in the differential diagnosis of pineal region tumours, and valuable in planning appropriate treatment. (orig.). With 4 figs., 6 tabs.

  15. Acute Pancreatitis Secondary to Pancreatic Neuroendocrine Tumours

    Directory of Open Access Journals (Sweden)

    Grinó P


    Full Text Available CONTEXT: Pancreatic neoplasms are an uncommon aetiology of acute pancreatitis. Pancreatic neuroendocrine tumours are a rare subgroup of pancreatic neoplasms. CASE REPORT: We report on three patients having acute pancreatitis secondary to pancreatic neuroendocrine tumours, one of them with severe pancreatitis, and review the published cases up to now. Only 22 patients with acute pancreatitis secondary to pancreatic neuroendocrine tumours have been reported (including the present cases. Most of these cases were of non-functioning neoplasms and the course of the pancreatitis tended to be mild. In the most recent reports and in the present cases, the initial diagnostic method was CT scan. Less than half had metastases when the tumour was diagnosed and mortality from these neoplasms reached approximately 50%. CONCLUSIONS: Pancreatic neuroendocrine tumours can cause acute pancreatitis even in patients under 50 years of age. On many occasions, the tumours are non-functioning; therefore, acute pancreatitis may be the first clinical symptom. Consequently, faced with acute pancreatitis of unknown origin, a non-functioning neuroendocrine tumour should be ruled out.

  16. Mechanisms of tumour escape from immune surveillance

    Directory of Open Access Journals (Sweden)

    Lisiecka Urszula


    Full Text Available The progressive growth and spread of tumour cells in the form of metastases requires an interaction of healthy host cells, such as endothelial cells, fibroblasts, and other cells of mesenchymal origin with immune cells taking part in innate and adaptive responses within the tumour lesion and entire body. The host cells interact with tumour cells to create a dynamic tumour microenvironment, in which healthy cells can both positively and negatively influence the growth and spread of the tumour. The balance of cellular homeostasis and the effect of substances they secrete on the tumour microenvironment determine whether the tumour has a tendency to grow or disappear, and whether the cells remain within the lesion or are capable of metastasis to other regions of the body. Intercellular interactions also determine the tumour’s susceptibility to radiation or other types of cancer treatment. They may also be a rational explanation for differences in treatment outcomes, in which some metastases regress and others progress in response to the same treatment method.

  17. Glue septal ablation: A promising alternative to alcohol septal ablation

    Directory of Open Access Journals (Sweden)

    Sercan Okutucu


    Full Text Available Hypertrophic cardiomyopathy (HCM is defined as myocardial hypertrophy in the absence of another cardiac or systemic disease capable of producing the magnitude of present hypertrophy. In about 70% of patients with HCM, there is left ventricular outflow tract (LVOT obstruction (LVOTO and this is known as obstructive type of hypertrophic cardiomyopathy (HOCM. Cases refractory to medical treatment have had two options either surgical septal myectomy or alcohol septal ablation (ASA to alleviate LVOT gradient. ASA may cause some life-threatening complications including conduction disturbances and complete heart block, hemodynamic compromise, ventricular arrhythmias, distant and massive myocardial necrosis. Glue septal ablation (GSA is a promising technique for the treatment of HOCM. Glue seems to be superior to alcohol due to some intrinsic advantageous properties of glue such as immediate polymerization which prevents the leak into the left anterior descending coronary artery and it is particularly useful in patients with collaterals to the right coronary artery in whom alcohol ablation is contraindicated. In our experience, GSA is effective and also a safe technique without significant complications. GSA decreases LVOT gradient immediately after the procedure and this reduction persists during 12 months of follow-up. It improves New York Heart Association functional capacity and decrease interventricular septal wall thickness. Further studies are needed in order to assess the long-term efficacy and safety of this technique.

  18. Oncogenic extracellular vesicles in brain tumour progression

    Directory of Open Access Journals (Sweden)

    Esterina eD'Asti


    Full Text Available The brain is a frequent site of neoplastic growth, including both primary and metastatic tumours. The clinical intractability of many brain tumours and their distinct biology are implicitly linked to the unique microenvironment of the central nervous system (CNS and cellular interactions within. Among the most intriguing forms of cellular interactions is that mediated by membrane-derived extracellular vesicles (EVs. Their biogenesis (vesiculation and uptake by recipient cells serves as a unique mechanism of intercellular trafficking of complex biological messages including the exchange of molecules that cannot be released through classical secretory pathways, or that are prone to extracellular degradation. Tumour cells produce EVs containing molecular effectors of several cancer-related processes such as growth, invasion, drug resistance, angiogenesis, and coagulopathy. Notably, tumour-derived EVs (oncosomes also contain oncogenic proteins, transcripts, DNA and microRNA (miR. Uptake of this material may change properties of the recipient cells and impact the tumour microenvironment. Examples of transformation-related molecules found in the cargo of tumour-derived EVs include the oncogenic epidermal growth factor receptor (EGFRvIII, tumour suppressors (PTEN and oncomirs (miR-520g. It is postulated that EVs circulating in blood or cerebrospinal fluid (CSF of brain tumour patients may be used to decipher molecular features (mutations of the underlying malignancy, reflect responses to therapy or molecular subtypes of primary brain tumours (e.g. glioma or medulloblastoma. It is possible that metastases to the brain may also emit EVs with clinically relevant oncogenic signatures. Thus EVs emerge as a novel and functionally important vehicle of intercellular communication that can mediate multiple biological effects. In addition, they provide a unique platform to develop molecular biomarkers in brain malignancies.

  19. Hepatic autoregulation

    DEFF Research Database (Denmark)

    Staehr, Peter; Hother-Nielsen, Ole; Beck-Nielsen, Henning


    The effect of increased glycogenolysis, simulated by galactose's conversion to glucose, on the contribution of gluconeogenesis (GNG) to hepatic glucose production (GP) was determined. The conversion of galactose to glucose is by the same pathway as glycogen's conversion to glucose, i.e., glucose 1......-phosphate --> glucose 6-phosphate --> glucose. Healthy men (n = 7) were fasted for 44 h. At 40 h, hepatic glycogen stores were depleted. GNG then contributed approximately 90% to a GP of approximately 8 Galactose, 9 g/h, was infused over the next 4 h. The contribution of GNG to GP...... declined from approximately 90% to 65%, i.e., by approximately 2 The rate of galactose conversion to blood glucose, measured by labeling the infused galactose with [1-(2)H]galactose (n = 4), was also approximately 2 The 41st h GP rose by approximately 1...

  20. Hepatitis C Test (United States)

    ... products and services. Advertising & Sponsorship: Policy | Opportunities Hepatitis C Testing Share this page: Was this page helpful? Also known as: Hepatitis C Antibody; Anti-HCV; HCV-PCR; HCV-RNA; Hepatitis ...

  1. HIV and Hepatitis B (United States)

    ... AIDS-Related Opportunistic Infections and Coinfections HIV and Hepatitis B (Last updated 8/31/2016; last reviewed ... should be treated for both diseases. What is hepatitis B? Hepatitis B is a liver disease caused ...

  2. Drug-induced hepatitis (United States)

    Toxic hepatitis ... to get liver damage. Some drugs can cause hepatitis with small doses, even if the liver breakdown ... liver. Many different drugs can cause drug-induced hepatitis. Painkillers and fever reducers that contain acetaminophen are ...

  3. HIV and Hepatitis C (United States)

    ... AIDS-Related Opportunistic Infections and Coinfections HIV and Hepatitis C (Last updated 8/31/2016; last reviewed ... the medicines for any side effects. What is hepatitis C? Hepatitis C is a liver disease caused ...

  4. Hepatitis B Test (United States)

    ... helpful? Also known as: HBV Tests; Hep B; anti-HBs; Hepatitis B Surface Antibody; HBsAg; Hepatitis B Surface ... including "HBV carrier" state. Hepatitis B surface antibody (anti-HBs) Detects antibody produced in response to HBV surface ...

  5. Preventing hepatitis A (United States)

    Hepatitis A is inflammation (irritation and swelling) of the liver caused by the hepatitis A virus. You can take several steps to ... reduce your risk of spreading or catching the hepatitis A virus: Always wash your hands thoroughly after ...

  6. Travelers' Health: Hepatitis E (United States)

    ... Chapter 3 - Hepatitis C Chapter 3 - Histoplasmosis Hepatitis E Chong-Gee Teo INFECTIOUS AGENT Infection is caused ... for infection. Map 3-06. Distribution of hepatitis E virus infection 1 PDF Version (printable) 1 Disease ...

  7. Hepatitis B virus (image) (United States)

    Hepatitis B is also known as serum hepatitis and is spread through blood and sexual contact. It is ... population. This photograph is an electronmicroscopic image of hepatitis B virus particles. (Image courtesy of the Centers for ...

  8. Carcinoid tumour of the middle ear

    LENUS (Irish Health Repository)

    Baig, Salman


    A case of middle ear mass in a young female from Ireland is described, who presented with left ear hearing loss and intermittent bloody discharge from the same ear. Examination under microscope revealed occlusive polyp in the left ear and a biopsy had been taken under general anaesthesia. Histopathology report described an adenoma \\/ carcinoid tumour of the middle ear confirmed by positive immunohistochemical staining. CT temporal bones revealed the extension of the disease. The patient underwent left tympanotomy and excision of the tumour. In general, these tumours are regarded as benign but may be mistaken for adenocarcinomas because of their histological heterogenecity.

  9. Pulmonary tumour microembolism clinically mimicking alveolitis (United States)

    Lo, A W I; Tse, G M K; Chu, W C W; Chan, A B W


    A 56 year old man with previously unsuspected recurrence of squamous cell carcinoma of the oesophagus presented with dyspnoea. Bronchoscopy and computed tomography suggested bronchopneumonic changes with an infectious cause. He suffered a rapidly deteriorating course and died despite active treatment, including antibiotics and mechanical ventilation. Necropsy revealed a florid pulmonary tumour microembolism mimicking alveolitis. No bronchopneumonia was seen. The emboli arose from loosely attached tumour vegetations in the tricuspid valve. In a patient with known malignancy, tumour microembolism should be considered as an uncommon cause of rapid respiratory failure, refractory to antibiotic treatment. PMID:14600135

  10. Radiopharmaceuticals as probes to characterize tumour tissue

    Energy Technology Data Exchange (ETDEWEB)

    Alam, Israt S.; Arshad, Mubarik A.; Nguyen, Quang-De; Aboagye, Eric O. [Imperial College London, Comprehensive Cancer Imaging Centre, London (United Kingdom)


    Tumour cells exhibit several properties that allow them to grow and divide. A number of these properties are detectable by nuclear imaging methods. We discuss crucial tumour properties that can be described by current radioprobe technologies, further discuss areas of emerging radioprobe development, and finally articulate need areas that our field should aspire to develop. The review focuses largely on positron emission tomography and draws upon the seminal 'Hallmarks of Cancer' review article by Hanahan and Weinberg in 2011 placing into context the present and future roles of radiotracer imaging in characterizing tumours. (orig.)

  11. Hepatitis C. (United States)

    Sharara, A I; Hunt, C M; Hamilton, J D


    To review the virology, epidemiology, pathogenesis, natural history, clinical manifestations, and current treatment of hepatitis C virus (HCV) infection. The MEDLINE database (1966 to 1996) was searched for English-language articles and abstracts on HCV and non-A, non-B hepatitis. Papers cited in relevant primary articles were also reviewed. More than 500 original and review articles were evaluated, and the most relevant were selected. Data were extracted and reviewed by all authors. In most patients, HCV infection results in chronic hepatitis. The disease is insidious and subclinical but may progress over decades into end-stage liver disease and hepatocellular carcinoma, which makes HCV cirrhosis a leading indication for orthotopic liver transplantation. Current diagnostic methods are highly sensitive and specific, and quantitative assessment of viral load may help to predict and monitor response to treatment. The only available therapeutic option is interferon, and this agent is effective in only a small subset of patients. Infection with HCV is a significant public health problem that has important clinical and financial consequences. The tailoring of specific therapy according to viral load or genotype, better patient selection, and use of combination drug regimens may improve the chance of viral clearance and sustained biochemical and histologic response. Further understanding of the basic virology of HCV and the exact mechanisms of viral persistence and tissue injury is needed to help define future therapeutic and preventive strategies.

  12. [Hepatitis E]. (United States)

    Scotto, Gaetano; Bulla, Fabio; Campanale, Francesca; Tartaglia, Alessandra; Fazio, Vincenzina


    Hepatitis E virus (HEV) represents the main aetiological agent of enteric non-A hepatitis and is the only member of a new virus, Hepevirus, belonging to the family of Hepeviridae. HEV is the single most important cause of acute clinical hepatitis among adults in many areas of the developing world, specifically the Indian subcontinent and Southeast Asia, the Middle East and North Africa, where it is a common cause of sporadic and epidemic waterborne outbreaks and results in a high rate of morbidity and death, especially in pregnant women. Once thought of as an infection confined to developing countries, it is now recognized as a geographically widely distributed disease. In low-endemic regions (Western countries), sporadic cases of locally-acquired HEV infection are reported, acquired possibly through zoonotic transmission from pigs, wild boars or deer. In persons with pre-existing chronic liver disease, HEV superinfection can present as acute-on-chronic liver disease. In European countries, chronic infection, which may progress to liver cirrhosis, has been reported among immunosuppressed persons. Two testing vaccines proved to be highly effective in preventing the disease; these vaccines should be of particular use in groups that are at high risk of HEV infection.

  13. Hepatitis Information for the Public (United States)

    ... Requirements for Viral Hepatitis Liver Cancer and Viral Hepatitis Viral Hepatitis and Young Persons Who Inject Drugs National ... Recommend on Facebook Tweet Share Compartir What is Viral Hepatitis? The word "hepatitis" means inflammation of the liver . ...

  14. Hepatic OATP Transporter and Thyroid Hormone Receptor Interplay Determines Cholesterol and Glucose Homeostasis


    Meyer zu Schwabedissen, Henriette E; Ware, Joseph A; Finkelstein, David; Chaudhry, Amarjit S.; Lemay, Sara; Leon-Ponte, Matilde; Strom, Stephen C.; Zaher, Hani; Schwarz, Ute I; Freeman, David J.; Schuetz, Erin G; Tirona, Rommel G; Kim, Richard B


    The role of Organic Anion Transporting Polypeptides (OATPs), particularly the members of OATP1B-subfamily, in hepatocellular handling of endogenous and exogenous compounds is an important and emerging area of research. Using a mouse model lacking Slco1b2, the murine ortholog of the OATP1B-subfamily, we previously demonstrated that genetic ablation causes reduced hepatic clearance capacity for substrates. In this report we focused on the physiological function of the hepatic OATP1B transporters.

  15. Laser Ablation Propulsion A Study (United States)

    Irfan, Sayed A.; Ugalatad, Akshata C.

    Laser Ablation Propulsion (LAP) will serve as an alternative propulsion system for development of microthrusters. The principle of LAP is that when a laser (pulsed or continuous wave) with sufficient energy (more than the vaporization threshold energy of material) is incident on material, ablation or vaporization takes place which leads to the generation of plasma. The generated plasma has the property to move away from the material hence pressure is generated which leads to the generation of thrust. Nowadays nano satellites are very common in different space and defence applications. It is important to build micro thruster which are useful for orienting and re-positioning small aircraft (like nano satellites) above the atmosphere. modelling of LAP using MATLAB and Mathematica. Schematic is made for the suitable optical configuration of LAP. Practical experiments with shadowgraphy and self emission techniques and the results obtained are analysed taking poly (vinyl-chloride) (PVC) as propellant to study the

  16. Odontogenic ghost cell tumour with clear cell components: clear cell odontogenic ghost cell tumour? (United States)

    Yoon, Jung Hoon; Ahn, Sang Gun; Kim, Su Gwan; Kim, Jin


    A case of odontogenic ghost cell tumour (OGCT) with clear cell components was encountered in the mandible of a 63-year-old man. The tumour revealed ameloblastomatous-type epithelial components accompanied by clusters of ghost cells and dentinoid juxtaposed to the odontogenic epithelium. In addition, some areas of the tumour tissue showed sheets and islands of clear, glycogen containing epithelial cells, which were separated by a thin fibrous connective tissue stroma. Both ameloblastic and clear cells exhibited positive immunoreactivities for cytokeratin 19 and AE1/3. It is not known whether this tumour represents a clear cell change of a pre-existing OGCT or a separate and distinct neoplasm derived de novo from the odontogenic epithelium. This tumour was given the term 'clear cell OGCT' because it captures the clear cell components, which is one of the most prominent distinguishing features of the tumour.

  17. Hepatitis B Vaccine (United States)

    ... a combination product containing Haemophilus influenzae type b, Hepatitis B Vaccine) ... combination product containing Diphtheria, Tetanus Toxoids, Acellular Pertussis, Hepatitis B, Polio Vaccine)

  18. Liver tumours in children: diagnostic and therapeutic approach in the Tropics

    Directory of Open Access Journals (Sweden)

    Yao Atteby


    Full Text Available Liver tumours in children are rare and their prognosis are poor. Through a cross and retrospective study, we examined the epidemiological, clinical and therapeutic aspects on a number of patients in our hospital to try and improve the management of cases. This study involved 66 children admitted to the pediatric oncology unit of University Hospital of Treichville in Abidjan between 1991 and 2007. The average age of children was 7.2 years and the sex ratio of 1.4. 42 children lived in the countryside and 52 children were from disadvantaged areas. 63.2% of children were not vaccinated against hepatitis B. The abdominal mass was the primary sign of discovery and these tumours were dominated in both their primitive and secondary forms by the Burkitt's lymphoma.

  19. Symptoms and time to diagnosis in children with brain tumours

    DEFF Research Database (Denmark)

    Klitbo, Ditte Marie; Nielsen, Rine; Illum, Niels Ove;


    Clinical symptoms in brain tumours in children are variable at onset and diagnosis is often delayed. Symptoms were investigated with regard to brain tumour localisation, prediagnostic symptomatic intervals and malignancy.......Clinical symptoms in brain tumours in children are variable at onset and diagnosis is often delayed. Symptoms were investigated with regard to brain tumour localisation, prediagnostic symptomatic intervals and malignancy....

  20. Interactions of human monocytes with TMVs (tumour-derived microvesicles). (United States)

    Baj-Krzyworzeka, Monika; Baran, Jarosław; Szatanek, Rafał; Mytar, Bożenna; Siedlar, Maciej; Zembala, Marek


    The tumour microenvironment represents a dynamic complex milieu, which includes tumour cells, cells of the immune system and other (cellular and non-cellular) components. The role of these particular 'puzzle pieces' may change substantially due to their mutual interactions. The present review concerns different opinions on interactions that occur between monocytes, tumour cells and TMVs (tumour-derived microvesicles).

  1. Computed tomography-guided interstitial high dose rate brachytherapy for centrally located liver tumours: a single institution study

    Energy Technology Data Exchange (ETDEWEB)

    Tselis, Nikolaos; Chatzikonstantinou, Georgios; Zamboglou, Nikolaos [Klinikum Offenbach, Department of Radiation Oncology, Offenbach am Main (Germany); Kolotas, Christos [Hirslanden Medical Center, Institute for Radiotherapy, Aarau (Switzerland); Milickovic, Natasa; Baltas, Dimos [Klinikum Offenbach, Department of Medical Physics and Engineering, Offenbach am Main (Germany)


    To evaluate the clinical outcome of computed tomography (CT)-guided interstitial (IRT) high-dose-rate (HDR) brachytherapy (BRT) in the treatment of unresectable primary and secondary liver malignancies. This report updates and expands our previously described experience with this treatment technique. Forty-one patients with 50 tumours adjacent to the liver hilum and bile duct bifurcation were treated in 59 interventions of CT-guided IRT HDR BRT. The tumours were larger than 4 cm with a median volume of 84 cm{sup 3} (38-1,348 cm{sup 3}). The IRT HDR BRT delivered a median total physical dose of 20.0 Gy (7.0-32.0 Gy) in twice daily fractions of median 7.0 Gy (4.0-10.0 Gy) in 19 patients and in once daily fractions of median 8.0 Gy (7.0-14.0 Gy) in 22 patients. With a median follow-up of 12.4 months, the local control for metastatic hepatic tumours was 89 %, 73 % and 63 % at 6, 12 and 18 months respectively. The local control for primary hepatic tumours was 90 %, 81 % and 50 % at 6, 12 and 18 months respectively. Severe side effects occurred in 5.0 % of interventions with no treatment-related deaths. CT-guided IRT HDR BRT is a promising procedure for the radiation treatment of centrally located liver malignancies. (orig.)

  2. Neutron kerma coefficient: Reference tissue for tumours

    Energy Technology Data Exchange (ETDEWEB)

    Paredes, L., E-mail: lydia.paredes@inin.gob.m [National Institute of Nuclear Research (Mexico); Azorin, J. [Basic Sciences Division, Autonomous Metropolitan University (Mexico); Balcazar, M. [National Institute of Nuclear Research (Mexico); Francois, J.L. [Engineering Faculty, Autonomous National University of Mexico (Mexico)


    Neutron kerma coefficients were calculated in different media: 4 malignant tumours, 5 normal tissues and 3 tissue substitute in the range 11 eV-29 MeV. The objective was to identify which is the material that better reproduces the behavior of these tumours and tissues. These tissues have clinical interest in interstitial brachytherapy applications with fast neutron source (Cf-252). The small differences of elemental composition among these tissues produce variation in the neutron kerma coefficients. The results show that the neutron kerma coefficients for malignant tumours are smaller than soft tissue from 6% to 9%. Also, the muscle is the tissue that best represents the dosimetric behavior for the tumours and tissues analyzed in this paper for neutron energies >1 keV, where this coefficients show minor variation.

  3. Laser ablation inductively coupled plasma mass spectrometry imaging of metals in experimental and clinical Wilson's disease. (United States)

    Boaru, Sorina Georgiana; Merle, Uta; Uerlings, Ricarda; Zimmermann, Astrid; Flechtenmacher, Christa; Willheim, Claudia; Eder, Elisabeth; Ferenci, Peter; Stremmel, Wolfgang; Weiskirchen, Ralf


    Wilson's disease is an autosomal recessive disorder in which the liver does not properly release copper into bile, resulting in prominent copper accumulation in various tissues. Affected patients suffer from hepatic disorders and severe neurological defects. Experimental studies in mutant mice in which the copper-transporting ATPase gene (Atp7b) is disrupted revealed a drastic, time-dependent accumulation of hepatic copper that is accompanied by formation of regenerative nodes resembling cirrhosis. Therefore, these mice represent an excellent exploratory model for Wilson's disease. However, the precise time course in hepatic copper accumulation and its impact on other trace metals within the liver is yet poorly understood. We have recently established novel laser ablation inductively coupled plasma mass spectrometry protocols allowing quantitative metal imaging in human and murine liver tissue with high sensitivity, spatial resolution, specificity and quantification ability. By use of these techniques, we here aimed to comparatively analyse hepatic metal content in wild-type and Atp7b deficient mice during ageing. We demonstrate that the age-dependent accumulation of hepatic copper is strictly associated with a simultaneous increase in iron and zinc, while the intrahepatic concentration and distribution of other metals or metalloids is not affected. The same findings were obtained in well-defined human liver samples that were obtained from patients suffering from Wilson's disease. We conclude that in Wilson's disease the imbalances of hepatic copper during ageing are closely correlated with alterations in intrahepatic iron and zinc content.

  4. Simulating tumour removal in neurosurgery. (United States)

    Radetzky, A; Rudolph, M


    In this article the software system ROBO-SIM is described. ROBO-SIM is a planning and simulation tool for minimally invasive neurosurgery. Different to the most other simulation tools, ROBO-SIM is able to use actual patient's datasets for simulation. Same as in real neurosurgery a planning step, which provides more functionality as up-to-date planning systems on the market, is performed before undergoing the simulated operation. The planning steps include the definition of the trepanation point for entry into the skull and the target point within the depth of the brain, checking the surgical track and doing virtual trepanations (virtual craniotomy). For use with an intra-operative active manipulator, which is guided by the surgeon during real surgery (robotic surgery), go- and non-go-areas can be defined. During operation, the robot restricts the surgeon from leaving these go-areas. After planning, an additional simulation system, which is understood as an extension to the planning step, is used to simulate whole surgical interventions directly on the patient's anatomy basing on the planning data and by using the same instruments as for the real intervention. First tests with ROBO-SIM are performed on a phantom developed for this purpose and on actual patient's datasets with ventricular tumours.

  5. Transient Ablation Regime in Circuit Breakers

    Institute of Scientific and Technical Information of China (English)

    Alexandre MARTIN; Jean-Yves TREPANIER; Marcelo REGGIO; GUO Xue-yan


    Nozzle wall ablation caused by high temperature electric arcs is studied in the context of high voltage SF6 circuit breakers.The simplified ablation model used in litterature has been updated to take into account the unsteady state of ablation.Ablation rate and velocity are now calculated by a kinetic model using two layers of transition,between the bulk plasma and the ablating wall.The first layer (Knudsen layer),right by the wall,is a kinetic layer of a few mean-free path of thickness.The second layer is collision dominated and makes the transition between the kinetic layer and the plasma bulk.With this new coupled algorithm,it is now possible to calculate the temperature distribution inside the wall,as well as more accurate ablation rates.

  6. Pineal anlage tumour - a rare entity with divergent histology. (United States)

    Ahuja, Arvind; Sharma, Mehar Chand; Suri, Vaishali; Sarkar, Chitra; Sharma, B S; Garg, Ajay


    Pineal anlage tumour is a rare tumour of the pineal gland that is not listed in the 2007 World Health Organization classification of tumours of the central nervous system. Pineal anlage has been defined as a primary pineal tumour with both neuroepithelial and ectomesenchymal differentiation but without endodermal differentiation. We report a pineal anlage tumour in a 4-month-old boy, the youngest patient reported with this rare tumour, with a brief review of the literature. Clinicians and neuropathologists should be aware of this entity as it is likely to be misdiagnosed as a teratoma or a melanocytic tumour of the central nervous system.

  7. 'Pseudo-Alzheimer's' and primary brain tumour.


    O'Mahony, D; Walsh, J. B.; Coakley, D.


    Primary brain tumour may present in the elderly purely as a dementing illness before the onset or detection of sensorimotor neurological symptoms or signs. Although neurological examination may indicate no definite signs, close attention to accepted DSM-IIIR and NINCDS-ADRDA diagnostic criteria for primary degenerative dementia and 'probable' Alzheimer's disease respectively will suggest a process other than a degenerative one. This was the case in two patients with primary brain tumour prese...

  8. Diagnosis and treatment of bronchopulmonary neuroendocrine tumours

    DEFF Research Database (Denmark)

    Tabaksblat, Elizaveta Mitkina; Langer, Seppo W; Knigge, Ulrich;


    Bronchopulmonary neuroendocrine tumours (BP-NET) are a heterogeneous population of neoplasms with different pathology, clinical behaviour and prognosis compared to the more common lung cancers. The management of BP-NET patients is largely based on studies with a low level of evidence and extrapol...... and extrapolation of data obtained from more common types of neuroendocrine tumours. This review reflects our view of the current state of the art of diagnosis and treatment of patients with BP-NET....

  9. Serum tumour markers in malignant mesothelioma

    Directory of Open Access Journals (Sweden)

    Rao Pallavi


    Full Text Available Malignant mesothelioma is a rare malignancy of the body cavities with dismal prognosis. It has been a diagnostic dilemma for years with many clinical and pathological mimics. Discovery of a reliable tumour marker will definitely be of value in screening individuals with a history of asbestos exposure, diagnosis, treatment and follow up of malignant mesothelioma. Many tumour markers have been studied and speculatively associated with the malignant mesothelioma, but much still needs to be proven.

  10. Prolonged acute hepatitis A mimicking autoimmune hepatitis

    Institute of Scientific and Technical Information of China (English)

    Rintaro Mikata; Osamu Yokosuka; Fumio Imazeki; Kenichi Fukai; Tatsuo Kanda; Hiromitsu Saisho


    AIM: We report a case with a prolonged course of hepatitisA, with alanine aminotransferase (ALT) higher than 500 IU/Lfor more than 2 mo.METHODS: A middle-aged woman had an elevated IgG level of more than 2 000 mg/dL, positive arti-nudear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), but no evidence of persistent hepatitis A virus (HAV) infection. Liver biopsy findings were compatible with prolonged acute hepatitis, although acute onset of autoimmune hepatitis could not be ruled out.RESULTS: It was assumed that she developed a course of hepatitis similar to autoimmune hepatitis triggered by HAV infection. Ursodeoxycholic acid (UDCA) treatment was initiated and a favorable outcome was obtained. CONCLUSION: We describe a case of a middle-aged woman who showed a prolonged course of acute hepatitis A mimicking autoimmune hepatitis. Treatment with UDCAproved to be effective.

  11. Neocuproine Ablates Melanocytes in Adult Zebrafish


    O'Reilly-Pol, Thomas; Johnson, Stephen L.


    The simplest regeneration experiments involve the ablation of a single cell type. While methods exist to ablate the melanocytes of the larval zebrafish,1,2 no convenient method exists to ablate melanocytes in adult zebrafish. Here, we show that the copper chelator neocuproine (NCP) causes fragmentation and disappearance of melanin in adult zebrafish melanocytes. Adult melanocytes expressing eGFP under the control of a melanocyte-specific promoter also lose eGFP fluorescence in the presence of...

  12. Consensus on biomarkers for neuroendocrine tumour disease (United States)

    Oberg, Kjell; Modlin, Irvin M; De Herder, Wouter; Pavel, Marianne; Klimstra, David; Frilling, Andrea; Metz, David C; Heaney, Anthony; Kwekkeboom, Dik; Strosberg, Jonathan; Meyer, Timothy; Moss, Steven F; Washington, Kay; Wolin, Edward; Liu, Eric; Goldenring, James


    Management of neuroendocrine neoplasia represents a clinical challenge because of its late presentation, lack of treatment options, and limitations in present imaging modalities and biomarkers to guide management. Monoanalyte biomarkers have poor sensitivity, specificity, and predictive ability. A National Cancer Institute summit, held in 2007, on neuroendocrine tumours noted biomarker limitations to be a crucial unmet need in the management of neuroendocrine tumours. A multinational consensus meeting of multidisciplinary experts in neuroendocrine tumours assessed the use of current biomarkers and defined the perquisites for novel biomarkers via the Delphi method. Consensus (at >75%) was achieved for 88 (82%) of 107 assessment questions. The panel concluded that circulating multianalyte biomarkers provide the highest sensitivity and specificity necessary for minimum disease detection and that this type of biomarker had sufficient information to predict treatment effectiveness and prognosis. The panel also concluded that no monoanalyte biomarker of neuroendocrine tumours has yet fulfilled these criteria and there is insufficient information to support the clinical use of miRNA or circulating tumour cells as useful prognostic markers for this disease. The panel considered that trials measuring multianalytes (eg, neuroendocrine gene transcripts) should also identify how such information can optimise the management of patients with neuroendocrine tumours. PMID:26370353

  13. Brain tumour-associated status epilepticus. (United States)

    Goonawardena, Janindu; Marshman, Laurence A G; Drummond, Katharine J


    We have reviewed the scant literature on status epilepticus in patients with brain tumours. Patients with brain tumour-associated epilepsy (TAE) appear less likely to develop status epilepticus (TASE) than patients with epilepsy in the general population (EGP) are to develop status epilepticus (SEGP). TASE is associated with lesions in similar locations as TAE; in particular, the frontal lobes. However, in contrast to TAE, where seizures commence early in the course of the disease or at presentation, TASE is more likely to occur later in the disease course and herald tumour progression. In marked contrast to TAE, where epilepsy risk is inversely proportional to Word Health Organization tumour grade, TASE risk appears to be directly proportional to tumour grade (high grade gliomas appear singularly predisposed). Whilst anti-epileptic drug (AED) resistance is more common in TAE than EGP (with resistance directly proportional to tumour grade and frontal location), TASE appears paradoxically more responsive to simple AED regimes than either TAE or SEGP. Although some results suggest that mortality may be higher with TASE than with SEGP, it is likely that (as with SEGP) the major determinant of mortality is the underlying disease process. Because all such data have been derived from retrospective studies, because TASE and SEGP are less common than TAE and EGP, and because TASE and SEGP classification has often been inconsistent, findings can only be considered preliminary: multi-centre, prospective studies are required. Whilst preliminary, our review suggests that TASE has a distinct clinical profile compared to TAE and SEGP.

  14. Myeloid cells in tumour-immune interactions. (United States)

    Kareva, Irina; Berezovskaya, Faina; Castillo-Chavez, Carlos


    Despite highly developed specific immune responses, tumour cells often manage to escape recognition by the immune system, continuing to grow uncontrollably. Experimental work suggests that mature myeloid cells may be central to the activation of the specific immune response. Recognition and subsequent control of tumour growth by the cells of the specific immune response depend on the balance between immature (ImC) and mature (MmC) myeloid cells in the body. However, tumour cells produce cytokines that inhibit ImC maturation, altering the balance between ImC and MmC. Hence, the focus of this manuscript is on the study of the potential role of this inhibiting mechanism on tumour growth dynamics. A conceptual predator-prey type model that incorporates the dynamics and interactions of tumour cells, CD8(+) T cells, ImC and MmC is proposed in order to address the role of this mechanism. The prey (tumour) has a defence mechanism (blocking the maturation of ImC) that prevents the predator (immune system) from recognizing it. The model, a four-dimensional nonlinear system of ordinary differential equations, is reduced to a two-dimensional system using time-scale arguments that are tied to the maturation rate of ImC. Analysis shows that the model is capable of supporting biologically reasonable patterns of behaviour depending on the initial conditions. A range of parameters, where healing without external influences can occur, is identified both qualitatively and quantitatively.

  15. Perfusion imaging of parotid gland tumours: usefulness of arterial spin labeling for differentiating Warthin's tumours

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Hiroki; Watanabe, Haruo [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Kanematsu, Masayuki [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Gifu University Hospital, High-level Imaging Diagnosis Center, Gifu (Japan); Kajita, Kimihiro [Gifu University Hospital, High-level Imaging Diagnosis Center, Gifu (Japan); Mizuta, Keisuke; Aoki, Mitsuhiro [Gifu University School of Medicine, Department of Otolaryngology, Gifu (Japan); Okuaki, Tomoyuki [Philips Healthcare, Tokyo (Japan)


    To assess prospectively the efficacy of arterial spin labelling (ASL) against conventional and diffusion-weighted (DW) MR imaging for differentiating parotid gland tumours. We included 10 pleomorphic adenomas, 12 Warthin's tumours, and nine malignant tumours of the parotid glands. Only tumours larger than 10 mm were included in this study. All parotid gland tumours underwent T1-weighted, T2-weighted, DW, and ASL imaging. Tumour-to-parotid gland signal intensity ratios (SIRs) and apparent diffusion coefficients (ADCs) of solid components were correlated with these pathologies. SIRs on T2-weighted images and ADCs were higher in pleomorphic adenomas than in Warthin's tumours (p <.01) and malignant tumours (p <.01). SIRs on ASL were higher in Warthin's tumours than in pleomorphic adenomas (p <.01) and malignant tumours (p <.05). Az value of SIRs on ASL for differentiating Warthin's tumours from the other pathologies was 0.982. The sensitivity, specificity, and accuracy of SIRs on ASL for the diagnosis of Warthin's tumours at an optimal SIR threshold of over 8.70 were 91.7 %, 94.7 %, and 93.5 %, respectively. ASL with SIR measurements could non-invasively evaluate tumour blood flow of parotid gland tumours and differentiate Warthin's tumours from pleomorphic adenomas and malignant tumours. (orig.)

  16. Acyl CoA synthetase 5 (ACSL5 ablation in mice increases energy expenditure and insulin sensitivity and delays fat absorption

    Directory of Open Access Journals (Sweden)

    Thomas A. Bowman


    Conclusions: In summary, ACSL5−/− mice have increased hepatic and serum FGF21 levels, reduced adiposity, improved insulin sensitivity, increased energy expenditure and delayed triglyceride absorption. These studies suggest that ACSL5 is an important regulator of whole-body energy metabolism and ablation of ACSL5 may antagonize the development of obesity and insulin resistance.

  17. Cryoballoon Catheter Ablation in Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Cevher Ozcan


    Full Text Available Pulmonary vein isolation with catheter ablation is an effective treatment in patients with symptomatic atrial fibrillation refractory or intolerant to antiarrhythmic medications. The cryoballoon catheter was recently approved for this procedure. In this paper, the basics of cryothermal energy ablation are reviewed including its ability of creating homogenous lesion formation, minimal destruction to surrounding vasculature, preserved tissue integrity, and lower risk of thrombus formation. Also summarized here are the publications describing the clinical experience with the cryoballoon catheter ablation in both paroxysmal and persistent atrial fibrillation, its safety and efficacy, and discussions on the technical aspect of the cryoballoon ablation procedure.

  18. Aromatic Thermosetting Copolyesters for Ablative TPS Project (United States)

    National Aeronautics and Space Administration — Better performing ablative thermal protection systems than currently available are needed to satisfy requirements of the most severe crew exploration vehicles, such...

  19. The atrial fibrillation ablation pilot study

    DEFF Research Database (Denmark)

    Arbelo, Elena; Brugada, Josep; Hindricks, Gerhard


    AIMS: The Atrial Fibrillation Ablation Pilot Study is a prospective registry designed to describe the clinical epidemiology of patients undergoing an atrial fibrillation (AFib) ablation, and the diagnostic/therapeutic processes applied across Europe. The aims of the 1-year follow-up were to analyse...... tachycardia, and 4 patients died (1 haemorrhagic stroke, 1 ventricular fibrillation in a patient with ischaemic heart disease, 1 cancer, and 1 of unknown cause). CONCLUSION: The AFib Ablation Pilot Study provided crucial information on the epidemiology, management, and outcomes of catheter ablation of AFib...

  20. Femtosecond ultraviolet laser ablation of silver and comparison with nanosecond ablation

    DEFF Research Database (Denmark)

    Christensen, Bo Toftmann; Doggett, B.; Budtz-Jørgensen, C.


    The ablation plume dynamics arising from ablation of silver with a 500 fs, 248 nm laser at ~2 J cm-2 has been studied using angle-resolved Langmuir ion probe and thin film deposition techniques. For the same laser fluence, the time-of-flight ion signals from femtosecond and nanosecond laser ablat...

  1. Analysis of iodinated contrast delivered during thermal ablation: is material trapped in the ablation zone? (United States)

    Wu, Po-hung; Brace, Chris L.


    Intra-procedural contrast-enhanced CT (CECT) has been proposed to evaluate treatment efficacy of thermal ablation. We hypothesized that contrast material delivered concurrently with thermal ablation may become trapped in the ablation zone, and set out to determine whether such an effect would impact ablation visualization. CECT images were acquired during microwave ablation in normal porcine liver with: (A) normal blood perfusion and no iodinated contrast, (B) normal perfusion and iodinated contrast infusion or (C) no blood perfusion and residual iodinated contrast. Changes in CT attenuation were analyzed from before, during and after ablation to evaluate whether contrast was trapped inside of the ablation zone. Visualization was compared between groups using post-ablation contrast-to-noise ratio (CNR). Attenuation gradients were calculated at the ablation boundary and background to quantitate ablation conspicuity. In Group A, attenuation decreased during ablation due to thermal expansion of tissue water and water vaporization. The ablation zone was difficult to visualize (CNR  =  1.57  ±  0.73, boundary gradient  =  0.7  ±  0.4 HU mm-1), leading to ablation diameter underestimation compared to gross pathology. Group B ablations saw attenuation increase, suggesting that iodine was trapped inside the ablation zone. However, because the normally perfused liver increased even more, Group B ablations were more visible than Group A (CNR  =  2.04  ±  0.84, boundary gradient  =  6.3  ±  1.1 HU mm-1) and allowed accurate estimation of the ablation zone dimensions compared to gross pathology. Substantial water vaporization led to substantial attenuation changes in Group C, though the ablation zone boundary was not highly visible (boundary gradient  =  3.9  ±  1.1 HU mm-1). Our results demonstrate that despite iodinated contrast being trapped in the ablation zone, ablation visibility was

  2. Exophytic benign mixed epithelial stromal tumour of the kidney: case report of a rare tumour entity

    Directory of Open Access Journals (Sweden)

    Küster Jens


    Full Text Available Abstract Background Mixed epithelial and stromal tumour (MEST represents a recently described benign composite neoplasm of the kidney, which predominantly affects perimenopausal females. Most tumours are benign, although rare malignant cases have been observed. Case report A 47-year-old postmenopausal female presented to the urologist with flank pain. A CT scan of the abdomen showed a 30-mm-in-diameter uniform mass adjacent to the pelvis of the left kidney. Surgical exploration showed a tumour arising from the lower anterior hilus of the left kidney. The tumour could be excised by preserving the kidney. By intraoperative frozen section the tumour showed characteristic features of MEST with epithelial-covered cysts embedded in an "ovarian-like" stroma. Additional immunohistochemistry investigations showed expression for hormone receptors by the stromal component of the tumour. Discussion MEST typically presents in perimenopausal women as a primarily cystic mass. Commonly, the tumour arises from the renal parenchyma or pelvis. The tumour is composed of an admixture of cystic and sometimes more solid areas. The stromal cells typically demonstrate an ovarian-type stroma showing expression for the estrogen and progesterone receptors. Conclusion MEST represents a distinctive benign tumour entity of the kidney, which affects perimenopausal woman. The tumour should be distinguished from other cystic renal neoplasms. By imaging studies it is difficult to distinguish between a benign or malignant nature of the tumour. Thus, intraoperative frozen section is necessary for conservative surgery, since the overall prognosis is favourable and renal function can be preserved in most cases.

  3. Automatic control of finite element models for temperature-controlled radiofrequency ablation

    Directory of Open Access Journals (Sweden)

    Haemmerich Dieter


    Full Text Available Abstract Background The finite element method (FEM has been used to simulate cardiac and hepatic radiofrequency (RF ablation. The FEM allows modeling of complex geometries that cannot be solved by analytical methods or finite difference models. In both hepatic and cardiac RF ablation a common control mode is temperature-controlled mode. Commercial FEM packages don't support automating temperature control. Most researchers manually control the applied power by trial and error to keep the tip temperature of the electrodes constant. Methods We implemented a PI controller in a control program written in C++. The program checks the tip temperature after each step and controls the applied voltage to keep temperature constant. We created a closed loop system consisting of a FEM model and the software controlling the applied voltage. The control parameters for the controller were optimized using a closed loop system simulation. Results We present results of a temperature controlled 3-D FEM model of a RITA model 30 electrode. The control software effectively controlled applied voltage in the FEM model to obtain, and keep electrodes at target temperature of 100°C. The closed loop system simulation output closely correlated with the FEM model, and allowed us to optimize control parameters. Discussion The closed loop control of the FEM model allowed us to implement temperature controlled RF ablation with minimal user input.

  4. The terminology of hepatitis* (United States)


    It is proposed that the diseases formerly known as “infectious hepatitis” and “serum hepatitis” be referred to as viral hepatitis type A and viral hepatitis type B, respectively. It is further recommended that the “Australia” antigen be referred to as hepatitis B antigen (HB Ag) and the corresponding antibody as hepatitis B antibody (HB Ab). PMID:4544683

  5. Hepatitis A and HIV (United States)

    ... Hepatitis B and Hepatitis C . Hepatitis A and HIV Hepatitis A is preventable with a vaccine, and ... Notice Network • • HIV/AIDS Service Locator Locator Widgets • Instructions • API Find ...

  6. Hepatitis B (HBV) (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hepatitis B (HBV) KidsHealth > For Teens > Hepatitis B (HBV) Print A A A What's in this ... poisons). There are several different types of hepatitis . Hepatitis B is a type that can move from one ...

  7. Hepatitis B (HBV) (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hepatitis B (HBV) KidsHealth > For Teens > Hepatitis B (HBV) A A A What's in this article? ... poisons). There are several different types of hepatitis . Hepatitis B is a type that can move from one ...

  8. Guidelines for the management of gastroenteropancreatic neuroendocrine tumours (including bronchopulmonary and thymic neoplasms). Part II-specific NE tumour types

    DEFF Research Database (Denmark)

    Oberg, Kjell; Astrup, Lone Bording; Eriksson, Barbro;


    Part II of the guidelines contains a description of epidemiology, histopathology, clinical presentation, diagnostic procedure, treatment, and survival for each type of neuroendocrine tumour. We are not only including gastroenteropancreatic tumours but also bronchopulmonary and thymic neuroendocrine...... tumours. These guidelines essentially cover basic knowledge in the diagnosis and management of the different forms of neuroendocrine tumour. We have, however, tried to give more updated information about the epidemiology and histopathology, which is essential for the clinical management of these tumours....

  9. Catheter ablation for atrial fibrillation after an unsuccessful surgical ablation and biological prosthetic mitral valve replacement: A pilot study

    Directory of Open Access Journals (Sweden)

    Sergey E. Mamchur


    Conclusion: Catheter ablation is an effective method for AF treatment following an ineffective surgical RF ablation procedure and biological prosthetic MV replacement. The use of bioprosthetic MVs allows for performing safe catheter ablation without subsequent prosthetic dysfunction.

  10. Influence of tumours on protective anti-tumour immunity and the effects of irradiation

    Directory of Open Access Journals (Sweden)

    Gemma Ann Foulds


    Full Text Available Innate and adaptive immunity play important roles in the development and progression of cancer and it is becoming apparent that tumours can influence the induction of potentially protective responses in a number of ways. The prevalence of immunoregulatory T cell populations in the circulation and tumours of patients with cancer is increased, and the presence of these cells appears to present a major barrier to the induction of tumour immunity. One aspect of tumour-mediated immunoregulation which has received comparatively little attention is that which is directed towards natural killer (NK cells, although evidence that the phenotype and function of NK cell populations are modified in patients with cancer is accumulating.Although the precise mechanisms underlying these localised and systemic immunoregulatory effects remain unclear, tumour-derived factors appear, in part at least, to be involved. The effects could be manifested by an altered function and/or via an influence on the migratory properties of individual cell subsets. A better insight into endogenous immunoregulatory mechanisms and the capacity of tumours to modify the phenotype and function of innate and adaptive immune cells might assist the development of new immunotherapeutic approaches and improve the management of patients with cancer.This article reviews current knowledge relating to the influence of tumours on protective anti-tumour immunity and considers the potential influence that radiation-induced effects might have on the prevalence, phenotype and function of innate and adaptive immune cells in patients with cancer.

  11. MicroRNA Regulation of Brain Tumour Initiating Cells in Central Nervous System Tumours

    Directory of Open Access Journals (Sweden)

    Neha Garg


    Full Text Available CNS tumours occur in both pediatric and adult patients and many of these tumours are associated with poor clinical outcome. Due to a paradigm shift in thinking for the last several years, these tumours are now considered to originate from a small population of stem-like cells within the bulk tumour tissue. These cells, termed as brain tumour initiating cells (BTICs, are perceived to be regulated by microRNAs at the posttranscriptional/translational levels. Proliferation, stemness, differentiation, invasion, angiogenesis, metastasis, apoptosis, and cell cycle constitute some of the significant processes modulated by microRNAs in cancer initiation and progression. Characterization and functional studies on oncogenic or tumour suppressive microRNAs are made possible because of developments in sequencing and microarray techniques. In the current review, we bring recent knowledge of the role of microRNAs in BTIC formation and therapy. Special attention is paid to two highly aggressive and well-characterized brain tumours: gliomas and medulloblastoma. As microRNA seems to be altered in the pathogenesis of many human diseases, “microRNA therapy” may now have potential to improve outcomes for brain tumour patients. In this rapidly evolving field, further understanding of miRNA biology and its contribution towards cancer can be mined for new therapeutic tools.

  12. Microwave ablation: results in ex vivo and in vivo porcine livers with 2450-MHz cooled-shaft antenna

    Institute of Scientific and Technical Information of China (English)

    ZHOU Qi; JIN Xing; JIAO De-chao; ZHANG Fu-jun; ZHANG Liang; HAN Xin-wei; DUAN Guang-feng; LI Chuan-xing; HAN Jian-jun


    Background Imaging-guided thermal ablation using different energy sources continues to gain favor as a minimally invasive technique for the treatment of primary and metastatic hepatic malignant tumors.This study aimed to evaluate the performance of microwave ablation with 2450-MHz internally cooled-shaft antenna in ex vivo and in vivo porcine livers.Methods All studies were animal care and ethics committee approved.Microwave ablation was performed using a noncooled or cooled-shaft antenna in 23 ex vivo (92 ablations) and eight in vivo (36 ablations) porcine livers.Diameters of the coagulation zone were observed on gross specimens.The coagulation diameters achieved in different microwave ablation parameter groups were compared.Curve estimation analysis was performed to characterize the relationship between applied power and treatment duration and coagulation diameter (including short-axis and long-axis diameter).Results Coagulation zones were elliptical and an arrowed-shaped carbonization zone around the shaft was observed in all groups.But the antenna track was also coagulated in the noncooled-shaft antenna groups.In ex vivo livers,the short-axis diameter correlated with the power output in a quadratic curve fashion (R2=0.95) by fixing ablation duration to 10 minutes,and correlated with the ablation duration in a logarithmic curve fashion (R2=0.98) by fixing power output to 80 W.The short-axis reached a relative plateau within 25 minutes.In in vivo livers,short-axis diameter correlated with the coagulation duration in a sigmoidal curve fashion (60 W group R2=0.76,80 W group R2=0.87),with a relative plateau achieved within 10 minutes for power settings of 60 W and 80 W.Conclusions The internally cooled microwave antenna may be advantageous to minimize collateral damage.The short-axis diameter enlargement has a plateau by fixing power output.

  13. Diagnostic yield of a biopsy performed immediately after lung radiofrequency ablation. (United States)

    Tselikas, Lambros; de Baere, Thierry; Deschamps, Frederic; Hakimé, Antoine; Besse, Benjamin; Teriitehau, Christophe; de Montpreville, Vincent; Adam, Julien


    To evaluate the diagnostic performance of lung biopsies performed immediately after radiofrequency ablation (RFA). Twenty consecutive patients were treated with lung RFA. A biopsy was performed immediately after RFA, through the cannula used to insert the RFA probe to avoid hampering the RFA probe placement. Biopsies were analysed for diagnostic of malignancy and tumour morphological characteristics. Recurrence of RFA and procedure-related complications are reported. Mean tumour size was 17.3 mm (±6.2 mm). Ninety per cent (18/20) of biopsies were able to help diagnose malignancy. Cancer subtype and origin were determined in 70 % (14/20) of tumours, including 12 metastases and two primary lung cancers. During a median follow-up of 24 months, one tumour demonstrated local progression (5 %). The overall survival, lung disease-free survival and progression-free survival rates at 12 months were 100 %, 75 % and 65 %, respectively. Adverse events of the procedure including RFA and biopsy were five pneumothoraces requiring chest tube placement (25 %), seven minor pneumothoraces (35 %) and one subsegmental intrapulmonary haemorrhage (5 %) not requiring any treatment. A biopsy performed immediately after lung RFA allowed diagnosis of malignancy in 90 % of cases. This diagnosis is obtained without the need for additional puncture and does not hamper the accuracy of the initial RF probe placement. • Treatment and biopsy are feasible during the same procedure, avoiding multiple punctures. • The best puncture path can be preserved to treat the lung tumour. • Malignancy can be determined on a post-RFA biopsy in 90 % of cases. • Cancer classification can be assessed in 70 % of cases after lung RFA.

  14. Loss of the tumour suppressor gene AIP mediates the browning of human brown fat tumours. (United States)

    Magnusson, Linda; Hansen, Nils; Saba, Karim H; Nilsson, Jenny; Fioretos, Thoas; Rissler, Pehr; Nord, Karolin H


    Human brown fat tumours (hibernomas) show concomitant loss of the tumour suppressor genes MEN1 and AIP. We hypothesized that the brown fat phenotype is attributable to these mutations. Accordingly, in this study, we demonstrate that silencing of AIP in human brown preadipocytic and white fat cell lines results in the induction of the brown fat marker UCP1. In human adipocytic tumours, loss of MEN1 was found both in white (one of 51 lipomas) and in brown fat tumours. In contrast, concurrent loss of AIP was always accompanied by a brown fat morphology. We conclude that this white-to-brown phenotype switch in brown fat tumours is mediated by the loss of AIP. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  15. Desmoplastic nested spindle cell tumours and nested stromal epithelial tumours of the liver. (United States)

    Misra, Sunayana; Bihari, Chhagan


    Desmoplastic nested spindle cell tumour of liver (DNSTL), nested stromal-epithelial tumour (NSET) and calcifying nested stromal-epithelial tumour (CNSET) are recently described entities with similar morphology, immunohistochemistry and molecular genetics. These are rare entities with only three large case series described till date. These tumours commonly present in the paediatric age group. NSETs, in addition have been described to be associated with ectopic adrenocorticotropic hormone (ACTH) production and Cushingoid features. It is important to discuss this rare group of tumours with a low malignant potential as the most common radiological differential diagnosis is hepatoblastoma, which has a relatively poorer prognosis. Thus, a pathologist needs to keep this entity in mind, so as to offer a correct histological diagnosis.

  16. Synergic anti-tumour effect of B7.1 gene modified tumour vaccine combined with allicin for murine bladder tumour

    Institute of Scientific and Technical Information of China (English)

    WANG Jian; LIN Li-guo; LIU Jian-jun; LIU Xin-guang; HE Cheng-wei; HE Hui-juan; WU ping; HUANG Ping-ping; CHEN Xiao-wen; DONG Zhong; WU Xiu-dong


    @@ In the previous study, we found that B7.1 gene transduction failed to induce sufficient anti-tumour response when it is used as a tumour vaccine. It is necessary to develop immunity by a combination of appropriate cytokines to stimulate effective tumour immunity in a therapeutic setting.

  17. Possible role for cryoballoon ablation of right atrial appendage tachycardia when conventional ablation fails. (United States)

    Amasyali, Basri; Kilic, Ayhan


    Focal atrial tachycardia arising from the right atrial appendage usually responds well to radiofrequency ablation; however, successful ablation in this anatomic region can be challenging. Surgical excision of the right atrial appendage has sometimes been necessary to eliminate the tachycardia and prevent or reverse the resultant cardiomyopathy. We report the case of a 48-year-old man who had right atrial appendage tachycardia resistant to multiple attempts at ablation with use of conventional radiofrequency energy guided by means of a 3-dimensional mapping system. The condition led to cardiomyopathy in 3 months. The arrhythmia was successfully ablated with use of a 28-mm cryoballoon catheter that had originally been developed for catheter ablation of paroxysmal atrial fibrillation. To our knowledge, this is the first report of cryoballoon ablation without isolation of the right atrial appendage. It might also be an alternative to epicardial ablation or surgery when refractory atrial tachycardia originates from the right atrial appendage.

  18. Lack of Anatomical Concordance between Preablation and Postablation CT Images: A Risk Factor Related to Ablation Site Recurrence. (United States)

    Kele, Petra G; Van der Jagt, Eric J; Krabbe, Paul F M; de Jong, Koert P


    Objective. Variation in the position of the liver between preablation and postablation CT images hampers assessment of treatment of colorectal liver metastasis (CRLM). The aim of this study was to test the hypothesis that discordant preablation and postablation imaging is associated with more ablation site recurrences (ASRs). Methods. Patients with CRLM were included. Index-tumor size, location, number, RFA approachs and ablative margins were obtained on CT scans. Preablation and postablation CT images were assigned a "Similarity of Positioning Score" (SiPS). A suitable cutoff was determined. Images were classified as identical (SiPS-id) or nonidentical (SiPS-diff). ASR was identified prospectively on follow-up imaging. Results. Forty-seven patients with 97 tumors underwent 64 RFA procedures (39 patients/63 tumors open RFA, 25 patients/34 tumours CT-targeted RFA, 12 patients underwent >1 RFA). Images of 52 (54%) ablation sites were classified as SiPS-id, 45 (46%) as SiPS-diff. Index-tumor size, tumor location and number, concomitant partial hepatectomy, and RFA approach did not influence the SiPS. ASR developed in 11/47 (23%) patients and 20/97 (21%) tumours. ASR occurred less frequently after open RFA than after CT targeted RFA (P 20 mm and CT-targeted RFA as independent risk factors for ASR. Conclusion. Variation in anatomical concordance between preablation and postablation images, index-tumor size, and a CT-targeted approach are risk factors for ASR in CRLM.

  19. Attitudes Towards Catheter Ablation for Atrial Fibrillation

    DEFF Research Database (Denmark)

    Vadmann, Henrik; Pedersen, Susanne S; Nielsen, Jens Cosedis;


    BACKGROUND: Catheter ablation for atrial fibrillation (AF) is an important but expensive procedure that is the subject of some debate. Physicians´ attitudes towards catheter ablation may influence promotion and patient acceptance. This is the first study to examine the attitudes of Danish...

  20. Laser systems for ablative fractional resurfacing

    DEFF Research Database (Denmark)

    Paasch, Uwe; Haedersdal, Merete


    Ablative fractional resurfacing (AFR) creates microscopic vertical ablated channels that are surrounded by a thin layer of coagulated tissue, constituting the microscopic treatment zones (MTZs). AFR induces epidermal and dermal remodeling, which raises new possibilities for the treatment of a var...

  1. Therapy of HCC-radiofrequency ablation. (United States)

    Buscarini, L; Buscarini, E


    Radiofrequency interstitial hyperthermia has been used for percutaneous ablation of hepatocellular carcinoma, under ultrasound guidance in local anesthesia. Conventional needle electrodes require a mean number of 3 sessions to treat tumors of diameter hemotorax in one case; a fluid collection in the site of ablated tumor in one patient treated by combination of transcatheter arterial embolization and radiofrequency application.

  2. Effective temperatures of polymer laser ablation (United States)

    Furzikov, Nickolay P.


    Effective temperatures of laser ablation of certain polymers are extracted from experimental dependences of ablation depths on laser fluences. Dependence of these temperatures on laser pulse durations is established. Comparison with the known thermodestruction data shows that the effective temperature corresponds to transient thermodestruction proceeding by the statistically most probable way.

  3. VUV laser ablation of polymers. Photochemical aspect (United States)

    Castex, M. C.; Bityurin, N.; Olivero, C.; Muraviov, S.; Bronnikova, N.; Riedel, D.


    A photochemical theory of laser ablation owing to the direct chain scission process is considered in quite general form taking into account the modification of material. The formulas obtained can be used for estimating mechanisms of VUV laser ablation of polymers.

  4. Testosterone regulates cell proliferation in aggressive fibromatosis (desmoid tumour) (United States)

    Hong, H; Nadesan, P; Poon, R; Alman, B A


    Background: Aggressive fibromatosis (desmoid tumour) is a locally invasive tumour caused by mutations resulting in β-catenin protein stabilisation. Apc1638N mice are predisposed to developing aggressive fibromatosis tumours, and male mice develop greater numbers of tumours than female mice, suggesting a role for androgens in this tumour type. Methods: Human aggressive fibromatosis tumours were examined for the expression of the androgen receptor, and primary human tumour cell cultures were treated with testosterone. Orchidectomised Apc1638N mice were investigated for the development of tumours, and were treated with testosterone to study the effect of tumour formation and the level of β-catenin. Results: Androgen receptors are universally expressed in human aggressive fibromatosis tumours. Testosterone increased the proliferation rate and β-catenin protein level in a dose-dependent manner in human aggressive fibromatosis tumours. Orchiectomy reduced the number and size of tumours that formed in male Apc1638N mice to a similar level as observed in female mice. Testosterone treatment increased the number of tumours that formed in orchidectomised male mice, and resulted in a marked increase in β-catenin protein levels. Conclusion: Testosterone regulates β-catenin protein level and proliferation rate in this mesenchymal tumour. This work identifies the therapeutic use of testosterone blockade in aggressive fibromatosis as an area for further investigation. PMID:21468052

  5. Anorexia and Impaired Glucose Metabolism in Mice With Hypothalamic Ablation of Glut4 Neurons (United States)

    Ren, Hongxia; Lu, Taylor Y.; McGraw, Timothy E.


    The central nervous system (CNS) uses glucose independent of insulin. Nonetheless, insulin receptors and insulin-responsive glucose transporters (Glut4) often colocalize in neurons (Glut4 neurons) in anatomically and functionally distinct areas of the CNS. The apparent heterogeneity of Glut4 neurons has thus far thwarted attempts to understand their function. To answer this question, we used Cre-dependent, diphtheria toxin–mediated cell ablation to selectively remove basal hypothalamic Glut4 neurons and investigate the resulting phenotypes. After Glut4 neuron ablation, mice demonstrate altered hormone and nutrient signaling in the CNS. Accordingly, they exhibit negative energy balance phenotype characterized by reduced food intake and increased energy expenditure, without locomotor deficits or gross neuronal abnormalities. Glut4 neuron ablation affects orexigenic melanin-concentrating hormone neurons but has limited effect on neuropeptide Y/agouti-related protein and proopiomelanocortin neurons. The food intake phenotype can be partially normalized by GABA administration, suggesting that it arises from defective GABAergic transmission. Glut4 neuron–ablated mice show peripheral metabolic defects, including fasting hyperglycemia and glucose intolerance, decreased insulin levels, and elevated hepatic gluconeogenic genes. We conclude that Glut4 neurons integrate hormonal and nutritional cues and mediate CNS actions of insulin on energy balance and peripheral metabolism. PMID:25187366

  6. Anorexia and impaired glucose metabolism in mice with hypothalamic ablation of Glut4 neurons. (United States)

    Ren, Hongxia; Lu, Taylor Y; McGraw, Timothy E; Accili, Domenico


    The central nervous system (CNS) uses glucose independent of insulin. Nonetheless, insulin receptors and insulin-responsive glucose transporters (Glut4) often colocalize in neurons (Glut4 neurons) in anatomically and functionally distinct areas of the CNS. The apparent heterogeneity of Glut4 neurons has thus far thwarted attempts to understand their function. To answer this question, we used Cre-dependent, diphtheria toxin-mediated cell ablation to selectively remove basal hypothalamic Glut4 neurons and investigate the resulting phenotypes. After Glut4 neuron ablation, mice demonstrate altered hormone and nutrient signaling in the CNS. Accordingly, they exhibit negative energy balance phenotype characterized by reduced food intake and increased energy expenditure, without locomotor deficits or gross neuronal abnormalities. Glut4 neuron ablation affects orexigenic melanin-concentrating hormone neurons but has limited effect on neuropeptide Y/agouti-related protein and proopiomelanocortin neurons. The food intake phenotype can be partially normalized by GABA administration, suggesting that it arises from defective GABAergic transmission. Glut4 neuron-ablated mice show peripheral metabolic defects, including fasting hyperglycemia and glucose intolerance, decreased insulin levels, and elevated hepatic gluconeogenic genes. We conclude that Glut4 neurons integrate hormonal and nutritional cues and mediate CNS actions of insulin on energy balance and peripheral metabolism.

  7. Targeting the tumour microenvironment in ovarian cancer. (United States)

    Hansen, Jean M; Coleman, Robert L; Sood, Anil K


    The study of cancer initiation, growth, and metastasis has traditionally been focused on cancer cells, and the view that they proliferate due to uncontrolled growth signalling owing to genetic derangements. However, uncontrolled growth in tumours cannot be explained solely by aberrations in cancer cells themselves. To fully understand the biological behaviour of tumours, it is essential to understand the microenvironment in which cancer cells exist, and how they manipulate the surrounding stroma to promote the malignant phenotype. Ovarian cancer is the leading cause of death from gynaecologic cancer worldwide. The majority of patients will have objective responses to standard tumour debulking surgery and platinum-taxane doublet chemotherapy, but most will experience disease recurrence and chemotherapy resistance. As such, a great deal of effort has been put forth to develop therapies that target the tumour microenvironment in ovarian cancer. Herein, we review the key components of the tumour microenvironment as they pertain to this disease, outline targeting opportunities and supporting evidence thus far, and discuss resistance to therapy.

  8. Augmented reality in bone tumour resection (United States)

    Park, Y. K.; Gupta, S.; Yoon, C.; Han, I.; Kim, H-S.; Choi, H.; Hong, J.


    Objectives We evaluated the accuracy of augmented reality (AR)-based navigation assistance through simulation of bone tumours in a pig femur model. Methods We developed an AR-based navigation system for bone tumour resection, which could be used on a tablet PC. To simulate a bone tumour in the pig femur, a cortical window was made in the diaphysis and bone cement was inserted. A total of 133 pig femurs were used and tumour resection was simulated with AR-assisted resection (164 resection in 82 femurs, half by an orthropaedic oncology expert and half by an orthopaedic resident) and resection with the conventional method (82 resection in 41 femurs). In the conventional group, resection was performed after measuring the distance from the edge of the condyle to the expected resection margin with a ruler as per routine clinical practice. Results The mean error of 164 resections in 82 femurs in the AR group was 1.71 mm (0 to 6). The mean error of 82 resections in 41 femurs in the conventional resection group was 2.64 mm (0 to 11) (p Augmented reality in bone tumour resection: An experimental study. Bone Joint Res 2017;6:137–143. PMID:28258117

  9. Imaging tumours of the brachial plexus

    Energy Technology Data Exchange (ETDEWEB)

    Saifuddin, Asif [Department of Radiology, The Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, HA7 4LP, Stanmore (United Kingdom)


    Tumours of the brachial plexus are rare lesions and may be classified as benign or malignant. Within each of these groups, they are further subdivided into those that are neurogenic in origin (schwannoma, neurofibroma and malignant peripheral nerve sheath tumour) and those that are non-neurogenic. Careful pre-operative diagnosis and staging is essential to the successful management of these lesions. Benign neurogenic tumours are well characterized with pre-operative MRI, appearing as well-defined, oval soft-tissue masses, which are typically isointense on T1-weighted images and show the ''target sign'' on T2-weighted images. Differentiation between schwannoma and neurofibroma can often be made by assessing the relationship of the lesion to the nerve of origin. Many benign non-neurogenic tumours, such as lipoma and fibromatosis, are also well characterized by MRI. This article reviews the imaging features of brachial plexus tumours, with particular emphasis on the value of MRI in differential diagnosis. (orig.)

  10. Tumour-host dynamics under radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Placeres Jimenez, Rolando, E-mail: [Departamento de Fi' sica, Universidade Federal de Sao Carlos, Sao Carlos - SP (Brazil); Ortiz Hernandez, Eloy [Centre of Medicine and Complexity, Medical University Carlos J. Finlay, Carretera Central s/n, Camagueey (Cuba)


    Highlight: > Tumour-host interaction is modelled by Lotka-Volterra equations. > A brief review of the motion integral and analysis of linear stability is presented. > Radiotherapy is introduced into the model, using a periodic Dirac delta function. > A two-dimensional logistic map is derived from the modified Lotka-Volterra model. > It is shown that tumour can be controlled by a correct selection of therapy strategy. - Abstract: Tumour-host interaction is modelled by the Lotka-Volterra equations. Qualitative analysis and simulations show that this model reproduces all known states of development for tumours. Radiotherapy effect is introduced into the model by means of the linear-quadratic model and the periodic Dirac delta function. The evolution of the system under the action of radiotherapy is simulated and parameter space is obtained, from which certain threshold of effectiveness values for the frequency and applied doses are derived. A two-dimensional logistic map is derived from the modified Lotka-Volterra model and used to simulate the effectiveness of radiotherapy in different regimens of tumour development. The results show the possibility of achieving a successful treatment in each individual case by employing the correct therapeutic strategy.

  11. TUMOUR CASE IN KOI CARP (Cyprinus carpio

    Directory of Open Access Journals (Sweden)

    Lili Sholichah


    Full Text Available A case study of tumour in koi carp (Cyprinus carpio was observed in rearing periode. This tumour occurs solitary, large, pale red, fleshy masses under the lips and dental plates on the outside, and by reason of its size, may prevent closure the mouth. Moreover, this tumour goes through into the inside of the mouth. At necropsy, there were two soft, firm, small mass at inside of the mouth and the bigger mass at outside the mouth. Samples of this tumour were fixed in 10% formalin were used for histology analysis. The clinical course of the tumour is one of relatively slow but progressive growth. The proliferative stage of the neoplastic process is preceded and accompanied by a striking vascular reaction. Intensed hyperemia invariably occurs in that region of the mucosal surface which later becomes the site of neoplastic proliferation. Neoplastic cells lied around lamina propria and submucosal. These cells were joined together to make vacuolization and the other cells become pleiomorphism with hyperchromatic nucleus and N/C ratio cells are 1:1. In some area, there were many empty holes, around the holes there were debris cells, inflammation cells, and erythrocytes.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND Pituitary gland is known as the “Master Gland” of the body as it controls majority of the endocrine glands of the body. Embryologically, they are formed by two parts. There are two types of malignancies encountered namely adenomas and carcinomas. Vast majority of the neoplasms located in the sella turcica are benign pituitary adenomas derived from adenohypophyseal cells. The aim is to study the pituitary malignancies. METHODS The sample size included 100 cases of intra-cranial neoplasms that turned in the Department of Medicine in KVG Medical College, Sullia and different local private hospitals of Sullia and Mangalore. RESULTS Pituitary tumours comprised 6(6% of all the tumour studies. They occurred maximally in the age above 14 years. Tumours showed a male predominance. All the tumours were located in pituitary fossa. Principal presenting complaint was visual disturbance. Microscopically, the tumour was composed of small polyhedral to round cells with a uniform darkly staining round nucleus and scant eosinophilic cytoplasm. The cells formed papillary structures or were arranged in a trabecular pattern. CONCLUSION There is a male predominance in this study and the percentage of cases was found to be less in this region of Karnataka

  13. [Tumours of the upper cervical spine]. (United States)

    Hernández García, Borja Jesús; Isla Guerrero, Alberto; Castaño, Ana; Alvarez Ruiz, Fernando; Gómez de la Riva, Alvaro


    Vertebral tumours arising in the upper cervical spine are rare. We present our experience in managing these neoplasms. We retrospectively reviewed the case histories of patients treated at our institution between January 2000 and June 2011. There were 9 patients with tumours in C1-C2-C3: 2metastases, 3chordomas, 2plasmocytomas, 1chondrosarcoma and 1osteochondroma. All patients complained of neck pain at the time of diagnosis. Three patients underwent an anterior and posterior approach, 3 an exclusively posterior approach and 3 an exclusively anterior surgical approach. Tumour resection was intralesional in 7 cases. Chemo-radiotherapy was used as adjuvant therapy in patients with malignant tumours. Vertebral tumours in the upper cervical spine are usually malignant. Achieving en bloc resection is particularly challenging and is technically unfeasible in many cases. This worsens the prognosis and makes adjuvant treatment very important. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  14. High Heat Flux Block Ablator-in-Honeycomb Heat Shield Using Ablator/Aerogel-Filled Foam Project (United States)

    National Aeronautics and Space Administration — Ultramet and ARA Ablatives Laboratory previously developed and demonstrated advanced foam-reinforced carbon/phenolic ablators that offer substantially increased high...

  15. Long-term outcomes of hepatectomy vs percutaneous ablation for treatment of hepatocellular carcinoma ≤4 cm

    Institute of Scientific and Technical Information of China (English)

    Toshifumi Wakai; Yutaka Aoyagi; Katsuyoshi Hatakeyama; Yoshio Shirai; Takeshi Suda; Naoyuki Yokoyama; Jun Sakata; Pauldion V Cruz; Hirokazu Kawai; Yasunobu Matsuda; Masashi Watanabe


    AIM: To determine which treatment modality -hepatectomy or percutaneous ablation - is more beneficial for patients with small hepatocellular carcinoma (HCC) (≤ 4 cm) in terms of long-term outcomes.METHODS: A retrospective analysis of 149 patients with HCC ≤4 cm was conducted. Eighty-five patients underwent partial hepatectomy (anatomic in 47 and nonanatomic in 38) and 64 underwent percutaneous ablation (percutaneous ethanol injection in 37, radiofrequency ablation in 21, and microwave coagulation in 6). The median follow-up period was 69 mo.RESULTS: Hepatectomy was associated with larger tumor size (P<0.001), whereas percutaneous ablation was significantly associated with impaired hepatic functional reserve. Local recurrence was less frequent following hepatectomy (P< 0.0001). Survival was better following hepatectomy (median survival time:122 mo) than following percutaneous ablation (median survival time: 66 mo; P=0.0123). When tumor size was divided into ≤ 2 cm vs > 2 cm, the favorable effects of hepatectomy on long-term survival was seen only in patients with tumors >2 cm (P= 0.0001). The Cox proportional hazards regression model revealed that hepatectomy (P= 0.006) and tumors ≤ 2 cm (P= 0.017) were independently associated with better survival.CONCLUSION: Hepatectomy provides both better local control and better long-term survival for patients with HCC ≤4 cm compared with percutaneous ablation. Of the patients with HCC ≤ 4 cm, those with tumors > 2 cm are good candidates for hepatectomy, provided that the hepatic functional reserve of the patient permits resection.

  16. Tumor ablation with irreversible electroporation.

    Directory of Open Access Journals (Sweden)

    Bassim Al-Sakere

    Full Text Available We report the first successful use of irreversible electroporation for the minimally invasive treatment of aggressive cutaneous tumors implanted in mice. Irreversible electroporation is a newly developed non-thermal tissue ablation technique in which certain short duration electrical fields are used to permanently permeabilize the cell membrane, presumably through the formation of nanoscale defects in the cell membrane. Mathematical models of the electrical and thermal fields that develop during the application of the pulses were used to design an efficient treatment protocol with minimal heating of the tissue. Tumor regression was confirmed by histological studies which also revealed that it occurred as a direct result of irreversible cell membrane permeabilization. Parametric studies show that the successful outcome of the procedure is related to the applied electric field strength, the total pulse duration as well as the temporal mode of delivery of the pulses. Our best results were obtained using plate electrodes to deliver across the tumor 80 pulses of 100 micros at 0.3 Hz with an electrical field magnitude of 2500 V/cm. These conditions induced complete regression in 12 out of 13 treated tumors, (92%, in the absence of tissue heating. Irreversible electroporation is thus a new effective modality for non-thermal tumor ablation.

  17. Femtosecond ablation of ultrahard materials (United States)

    Dumitru, G.; Romano, V.; Weber, H. P.; Sentis, M.; Marine, W.

    Several ultrahard materials and coatings of definite interest for tribological applications were tested with respect to their response when irradiated with fs laser pulses. Results on cemented tungsten carbide and on titanium carbonitride are reported for the first time and compared with outcomes of investigations on diamond and titanium nitride. The experiments were carried out in air, in a regime of 5-8 J/cm2 fluences, using the beam of a commercial Ti:sapphire laser. The changes induced in the surface morphology were analysed with a Nomarski optical microscope, and with SEM and AFM techniques. From the experimental data and from the calculated incident energy density distributions, the damage and ablation threshold values were determined. As expected, the diamond showed the highest threshold, while the cemented tungsten carbide exhibited typical values for metallic surfaces. The ablation rates determined (under the above-mentioned experimental conditions) were in the range 0.1-0.2 μm per pulse for all the materials investigated.

  18. Unintended Thermal Injuries from Radiofrequency Ablation: Organ Protection with an Angioplasty Balloon Catheter in an Animal Model

    Directory of Open Access Journals (Sweden)

    Martha-Grace Knuttinen


    Full Text Available Objectives: The aim of this study was to investigate a novel approach of using a balloon catheter as a protective device to separate liver from the diaphragm or nearby bowel during radiofrequency ablation (RFA of hepatic dome tumors in an animal model. Materials and Methods: All experimental procedures were approved by animal Institutional Review Board. Using a 3 cm RF needle electrode, 70 hepatic ablation zones were created using ultrasound in 7 pigs. 50 lesions were created using balloon interposition between liver and diaphragm; 20 lesions were created using the balloon device interposed posteriorly between liver and bowel. Additional 21 control lesions were performed. Animals were sacrificed immediately; diaphragm and bowel were then visually inspected and sectioned. Diaphragmatic and bowel injury was then classified according to the depth of thickness. Results: Control lesions caused full thickness injury, either to diaphragm or bowel. During ablation of lesions with balloon interposition, there was significantly less diaphragmatic injury, P < 0.001 and less bowel injury, P < 0.01. Conclusion: Using balloon interposition as a protective device has advantages over previous saline infusion or CO 2 insufflation, providing a safe way to expand percutaneous RFA of liver tumors located on the undersurface of the diaphragm. In addition, this method may be used in protection of other organs adjacent to areas being ablated.


    Directory of Open Access Journals (Sweden)

    Uma Devi


    Full Text Available OBJECTIVE: To study incidence age distribution of benign and malignant ovarian tu mours in general population. METHODS AND MATERIAL : To study 120 patients with ovarian tumours in Govt . general hospital during June 2003 and June 2005. RESULTS: Clinical and pathological evaluation of all ovarian tumours was done and incidence, age distrib ution of various benign and malignant ovarian neoplasms were tabulated and compared with other studies. CONCLUSIONS: Most common ovarian tumours are benign tumours and serous cystadenoma is the commonest benign tumour and S erous cystadeno carcinoma is the most common malignant tumour.

  20. Autoimmune pancreatitis mimicking Klatskin tumour on radiology. (United States)

    Hadi, Yousaf Bashir; Sohail, Abdul Malik Amir Humza; Haider, Zishan


    Autoimmune pancreatitis (AIP) is categorised into two distinct types, AIP type 1 and 2. Although there can be multisystem involvement, rarely, the cholangitis associated with AIP can present radiologically in a manner similar to that of Klatskin tumour. We present the case of a 65-year-old man who was almost misdiagnosed with a Klatskin tumour because of the similarity in radiological features of the two aforementioned clinical entities. The patient presented with a history of jaundice, pruritus and abdominal pain, and work up showed deranged liver function tests, elevated cancer antigen 19-9 levels and positive antinuclear antibodies. CT scan of the abdomen showed findings suggestive of Klatskin tumour but due to diffuse enlargement of the pancreas and surrounding low-attenuation halo found on a closer review, a diagnosis of AIP was performed. The patient was started on standard corticosteroid therapy and responded well, with complete resolution of the radiological findings.

  1. MRI of intracranial germ cell tumours

    Energy Technology Data Exchange (ETDEWEB)

    Sumida, M. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Uozumi, T. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Kiya, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Mukada, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Arita, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Kurisu, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Sugiyama, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Onda, J. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Satoh, H. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Ikawa, F. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Migita, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan)


    We reviewed MRI findings in proven intracranial germ cell tumours in 22 cases, 12 of whom received Gd-DTPA. On T1-weighted images, the signal intensity of the tumour parenchyma was moderately low in 19 cases and isointense in 3; on T2-weighted images, it was high in all cases. Regions of different intensity thought to be cysts were found in 17 (77 %): 7 of 12 patients with germinoma (58 %) and in all other cases. Of the 13 patients with pineal lesions T1-weighted sagittal images showed the aqueduct to be obstructed in 5, stenotic in 7 and normal in 1. Strong contrast enhancement was observed in all 12 cases. Of the 14 patients with suprasellar lesions, 5 were found to have an intrasellar extension, and in 3 of these, the normal pituitary gland, which could be distinguished from the tumour, was displaced anteriorly. Ten patients (45 %) had multiple lesions. (orig.)

  2. [Pigmented ciliary body tumours: benign or malignant?]. (United States)

    Vallejo-Vicente, E; Saornil-Álvarez, M A; López-Lara, F; García-Álvarez, C; de Frutos-Baraja, J M; Díez-Andino, P


    We report the cases of 2 women with a pigmented tumour in the ciliary body, one a melanocytoma and the other a melanoma, with different clinical manifestations. The first one presented with decreased visual acuity associated with recent growth of the tumour, as well as sectorial opacities of the lens and subluxation. The second one is asymptomatic and has been kept under observation for more than 30 years. Although the definitive diagnosis of a pigmented tumour of the ciliary body is only achieved by the histopathology study, the group of clinical features is a determining factor when a conservative treatment is indicated. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  3. Risk factors for deterioration of long-term liver function after radiofrequency ablation therapy

    Institute of Scientific and Technical Information of China (English)

    Koichi; Honda; Masataka; Seike; Junya; Oribe; Mizuki; Endo; Mie; Arakawa; Hiroki; Syo; Masao; Iwao; Masanori; Tokoro; Junko; Nishimura; Tetsu; Mori; Tsutomu; Yamashita; Satoshi; Fukuchi; Toyokichi; Muro; Kazunari; Murakami


    AIM:To identify factors that influence long-term liver function following radiofrequency ablation(RFA)in patients with viral hepatitis-related hepatocellular carcinoma.METHODS:A total of 123 patients with hepatitis B virus-or hepatitis C virus-related hepatocellular carcinoma(HCC)(n=12 and n=111,respectively)were enrolled.Cumulative rates of worsening Child-Pugh(CP)scores(defined as a 2-point increase)were examined.RESULTS:CP score worsening was confirmed in 22patients over a mean follow-up period of 43.8±26.3mo.Multivariate analysis identified CP class,platelet count,and aspartate aminotransferase levels as significant predictors of a worsening CP score(P=0.000,P=0.011 and P=0.024,respectively).In contrast,repeated RFA was not identified as a risk factor for liver function deterioration.CONCLUSION:Long-term liver function following RFA was dependent on liver functional reserve,the degreeof fibrosis present,and the activity of the hepatitis condition for this cohort.Therefore,in order to maintain liver function for an extended period following RFA,suppression of viral hepatitis activity is important even after the treatment of HCC.

  4. Uncaria tomentosa exerts extensive anti-neoplastic effects against the Walker-256 tumour by modulating oxidative stress and not by alkaloid activity.

    Directory of Open Access Journals (Sweden)

    Arturo Alejandro Dreifuss

    Full Text Available This study aimed to compare the anti-neoplastic effects of an Uncaria tomentosa (UT brute hydroethanolic (BHE extract with those of two fractions derived from it. These fractions are choroformic (CHCl3 and n-butanolic (BuOH, rich in pentacyclic oxindole alkaloids (POA and antioxidant substances, respectively. The cancer model was the subcutaneous inoculation of Walker-256 tumour cells in the pelvic limb of male Wistar rat. Subsequently to the inoculation, gavage with BHE extract (50 or its fractions (as per the yield of the fractioning process or vehicle (Control was performed during 14 days. Baseline values, corresponding to individuals without tumour or treatment with UT, were also included. After treatment, tumour volume and mass, plasma biochemistry, oxidative stress in liver and tumour, TNF-α level in liver and tumour homogenates, and survival rates were analysed. Both the BHE extract and its BuOH fraction successfully reduced tumour weight and volume, and modulated anti-oxidant systems. The hepatic TNF-α level indicated a greater effect from the BHE extract as compared to its BuOH fraction. Importantly, both the BHE extract and its BuOH fraction increased the survival time of the tumour-bearing animals. Inversely, the CHCl3 fraction was ineffective. These data represent an in vivo demonstration of the importance of the modulation of oxidative stress as part of the anti-neoplastic activity of UT, as well as constitute evidence of the lack of activity of isolated POAs in the primary tumour of this tumour lineage. These effects are possibly resulting from a synergic combination of substances, most of them with antioxidant properties.

  5. Uncaria tomentosa exerts extensive anti-neoplastic effects against the Walker-256 tumour by modulating oxidative stress and not by alkaloid activity. (United States)

    Dreifuss, Arturo Alejandro; Bastos-Pereira, Amanda Leite; Fabossi, Isabella Aviles; Lívero, Francislaine Aparecida Dos Reis; Stolf, Aline Maria; Alves de Souza, Carlos Eduardo; Gomes, Liana de Oliveira; Constantin, Rodrigo Polimeni; Furman, Aline Emmer Ferreira; Strapasson, Regiane Lauriano Batista; Teixeira, Simone; Zampronio, Aleksander Roberto; Muscará, Marcelo Nicolás; Stefanello, Maria Elida Alves; Acco, Alexandra


    This study aimed to compare the anti-neoplastic effects of an Uncaria tomentosa (UT) brute hydroethanolic (BHE) extract with those of two fractions derived from it. These fractions are choroformic (CHCl3) and n-butanolic (BuOH), rich in pentacyclic oxindole alkaloids (POA) and antioxidant substances, respectively. The cancer model was the subcutaneous inoculation of Walker-256 tumour cells in the pelvic limb of male Wistar rat. Subsequently to the inoculation, gavage with BHE extract (50 or its fractions (as per the yield of the fractioning process) or vehicle (Control) was performed during 14 days. Baseline values, corresponding to individuals without tumour or treatment with UT, were also included. After treatment, tumour volume and mass, plasma biochemistry, oxidative stress in liver and tumour, TNF-α level in liver and tumour homogenates, and survival rates were analysed. Both the BHE extract and its BuOH fraction successfully reduced tumour weight and volume, and modulated anti-oxidant systems. The hepatic TNF-α level indicated a greater effect from the BHE extract as compared to its BuOH fraction. Importantly, both the BHE extract and its BuOH fraction increased the survival time of the tumour-bearing animals. Inversely, the CHCl3 fraction was ineffective. These data represent an in vivo demonstration of the importance of the modulation of oxidative stress as part of the anti-neoplastic activity of UT, as well as constitute evidence of the lack of activity of isolated POAs in the primary tumour of this tumour lineage. These effects are possibly resulting from a synergic combination of substances, most of them with antioxidant properties.

  6. Ex-vivo HRMAS of adult brain tumours: metabolite quantification and assignment of tumour biomarkers

    Directory of Open Access Journals (Sweden)

    Wilson M


    Full Text Available Abstract Background High-resolution magic angle spinning (HRMAS NMR spectroscopy allows detailed metabolic analysis of whole biopsy samples for investigating tumour biology and tumour classification. Accurate biochemical assignment of small molecule metabolites that are "NMR visible" will improve our interpretation of HRMAS data and the translation of NMR tumour biomarkers to in-vivo studies. Results 1D and 2D 1H HRMAS NMR was used to determine that 29 small molecule metabolites, along with 8 macromolecule signals, account for the majority of the HRMAS spectrum of the main types of brain tumour (astrocytoma grade II, grade III gliomas, glioblastomas, metastases, meningiomas and also lymphomas. Differences in concentration of 20 of these metabolites were statistically significant between these brain tumour types. During the course of an extended 2D data acquisition the HRMAS technique itself affects sample analysis: glycine, glutathione and glycerophosphocholine all showed small concentration changes; analysis of the sample after HRMAS indicated structural damage that may affect subsequent histopathological analysis. Conclusions A number of small molecule metabolites have been identified as potential biomarkers of tumour type that may enable development of more selective in-vivo 1H NMR acquisition methods for diagnosis and prognosis of brain tumours.

  7. Fusion imaging of real-time ultrasonography with CT or MRI for hepatic intervention

    Directory of Open Access Journals (Sweden)

    Min Woo Lee


    Full Text Available

    With the technical development of ultrasonography (US, electromagnetic tracking-based fusion imaging of real-time US and computed tomography/magnetic resonance (CT/MR images has been used for percutaneous hepatic intervention such as biopsy and radiofrequency ablation (RFA. Because of the fusion imaging technique, the fused CT or MR images show the same plane and move synchronously while performing real-time US. With this information, fusion imaging can enhance lesion detectability and reduce the false positive detection of focal hepatic lesions with poor sonographic conspicuity. Three-dimensional US can also be fused with realtime US for the percutaneous RFA of liver tumors requiring overlapping ablation. When fusion imaging is not sufficient for identifying small focal hepatic lesions, contrast-enhanced US can be added to fusion imaging.

  8. Fusion imaging of real-time ultrasonography with CT or MRI for hepatic intervention

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Woo [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    With the technical development of ultrasonography (US), electromagnetic tracking-based fusion imaging of real-time US and computed tomography/magnetic resonance (CT/MR) images has been used for percutaneous hepatic intervention such as biopsy and radiofrequency ablation (RFA). Because of the fusion imaging technique, the fused CT or MR images show the same plane and move synchronously while performing real-time US. With this information, fusion imaging can enhance lesion detectability and reduce the false positive detection of focal hepatic lesions with poor sonographic conspicuity. Three-dimensional US can also be fused with realtime US for the percutaneous RFA of liver tumors requiring overlapping ablation. When fusion imaging is not sufficient for identifying small focal hepatic lesions, contrast-enhanced US can be added to fusion imaging.

  9. Coordinated regulation of myeloid cells by tumours. (United States)

    Gabrilovich, Dmitry I; Ostrand-Rosenberg, Suzanne; Bronte, Vincenzo


    Myeloid cells are the most abundant nucleated haematopoietic cells in the human body and are a collection of distinct cell populations with many diverse functions. The three groups of terminally differentiated myeloid cells - macrophages, dendritic cells and granulocytes - are essential for the normal function of both the innate and adaptive immune systems. Mounting evidence indicates that the tumour microenvironment alters myeloid cells and can convert them into potent immunosuppressive cells. Here, we consider myeloid cells as an intricately connected, complex, single system and we focus on how tumours manipulate the myeloid system to evade the host immune response.

  10. High dose radiotherapy for pituitary tumours

    Energy Technology Data Exchange (ETDEWEB)

    Mead, K.W. (Queensland Radium Inst., Herston (Australia))


    The results of treatment of 120 pituitary tumours are presented. Based on this experience operable chromophobe adenomas are now treated with 5,000 rads in 4 weeks and inoperable ones receive an additional central dose to 7,500 rads. Pituitary Cushing's tumours are given 10,000 rads in 5 weeks using small fields and acromegalics 5,000 rads to the whole sella and 7,500 to its lower half. The absence of complications at these dose levels is attributed to the use of small fields and the precise application of treatment.

  11. How to express tumours using membrane systems

    Institute of Scientific and Technical Information of China (English)

    Miguel A. Gutiérrez-Naranjo; Mario J. Pérez-Jiménez; Agustín Riscos-Nú(n)ez; Francisco J. Romero-Campero


    In this paper we discuss the potential usefulness of membrane systems as tools for modelling tumours. The approach is followed both from a macroscopic and a microscopic point of view. In the first case, one considers the tumour as a growing mass of cells,focusing on its external shape. In the second case, one descends to the microscopic level, studying molecular signalling pathways that are crucial to determine if a cell is cancerous or not. In each of these approaches we work with appropriate variants of membrane systems.

  12. Stochastic Gompertz model of tumour cell growth. (United States)

    Lo, C F


    In this communication, based upon the deterministic Gompertz law of cell growth, a stochastic model in tumour growth is proposed. This model takes account of both cell fission and mortality too. The corresponding density function of the size of the tumour cells obeys a functional Fokker--Planck equation which can be solved analytically. It is found that the density function exhibits an interesting "multi-peak" structure generated by cell fission as time evolves. Within this framework the action of therapy is also examined by simply incorporating a therapy term into the deterministic cell growth term.

  13. Diabetes and Hepatitis B Vaccination (United States)

    Diabetes and Hepatitis B Vaccination Information for Diabetes Educators What is hepatitis B? Hepatitis B is a contagious liver disease that results from infection with the hepatitis B virus. When first infected, a person can develop ...

  14. Incidence Patterns and Trends of non-Central Nervous System Solid Tumours in Children and Adolescents. A Collaborative Study of the Spanish Population Based Cancer Registries (United States)

    Larrañaga, Nerea; Sanchez, Mª José; Ardanaz, Eva; Felipe, Saray; Marcos-Gragera, Rafael; Ramos, María; Carulla, Marià; Chirlaque, Mª Dolores; Argüelles, Marcial V.; Martos, Carmen; Mateo, Antonio; Peris-Bonet, Rafael


    Objective: To describe incidence patterns and trends in children (0-14 years) and adolescents (15-19 age-range) with solid tumours, except those of central nervous system (CNS), in Spain. Methods: Cases were drawn from eleven Spanish population-based cancer registries. Incidence was estimated for the period 1983-2007 and trends were evaluated using Joinpoint regression analysis. Results: The studied tumour groups accounted for 36% of total childhood cancers and 47.6% of those diagnosed in adolescence with annual rates per million of 53.5 and 89.3 respectively. In children 0 to 14 years of age, Neuroblastoma (NB) was the commonest (7.8%) followed by Soft-tissue sarcomas (STS) (6.3%), bone tumours (BT) (6.2%) and renal tumours (RT) (4.5%). NB was the most frequently diagnosed tumour before the 5th birthday, while STS and BT were the commonest at 5-9 years of age, and BT and Carcinoma and other epithelial tumours (COET) at 10-14. COET presented the highest incidence in adolescents, followed by germ-cell tumours (GCT), BT and STS. These four diagnostic groups accounted for 94% of total non-CNS solid tumours, in adolescents. Overall incidence rates increased significantly in children up to 1996 with an annual percentage change (APC) of 2.6% (95%CI: 1.7; 3.6). NB and COET showed significant time trend (APCs: 1.4% and 3.8% respectively) while other tumour groups such as RT, STS, BT or GCT had no significant changes over time. A significant increase was present in NB under the age of 5 and in BT and STS in children aged 10-14 years. In adolescents there were significant increases for all tumours combined (APC=2.7; 95%CI: 1.8-3.6) and for STS, GCT and COET (APCs: 3.2%, 4.4% and 3.5% respectively), while other tumour groups such as hepatic tumours, BT or thyroid carcinomas showed a decreasing trend or no increase. Conclusions: Overall, the incidence of the studied cancers in children increased along the period 1983-1996 with no posterior significant rise, while the incidence

  15. Sertoliform cystadenoma: a rare benign tumour of the rete testis

    Directory of Open Access Journals (Sweden)

    Bremmer Felix


    Full Text Available Abstract Sertoliform cystadenoma of the rete testis represents an uncommon benign tumour. They appear in patients from 26 to 62 years of age. We describe a case of a 66-year-old man with a tumour in the area of the epididymal head. The tumour markers were not increased. Under the assumption of a malignant testicular tumour an inguinal orchiectomy was performed. The cut surface of this tumour was of grey/white color and showed small cysts. The tumour consisted of two compartments. The epithelial like tumour cells showed a sertoliform growth pattern and cystic dilatations. In between the tumour cells repeatedly actin expressing sclerotic areas could be recognized as the second tumour component. Proliferative activity was not increased. Immunohistochemically the tumour cells were positiv for inhibin, S-100, and CD 99. Alpha feto protein (AFP, human chorionic gonadotropin (ß-HCG and placental alkaline phosphatase (PLAP as well as synaptophysin, epithelial membrane antigene (EMA, and BCL-2 were not expressed. As far as we know this is the sixth reported case of this tumour. Because of the benign nature of this tumour the correct diagnosis is important for the intra- and postoperative management. Here we present a case of this rare tumour and discuss potential differential diagnosis. Virtual Slides The virtual slide(s for this article can be found here:

  16. Coupled modeling of tumour angiogenesis, tumour growth,and blood perfusion

    Institute of Scientific and Technical Information of China (English)


    This paper proposes a more realistic mathematical simulation method to investigate the dynamic process of tumour angio-genesis by fully coupling the vessel growth,tumour growth and associated blood perfusion.The tumour growth and angiogenesis are coupled by the chemical microenvironment and the cell-matrix interaction.The haemodynamic calculation is carried out on the new vasculature,and an estimation of vessel collapse is made according to the wall shear stress criterion.The results are consistent with phy...

  17. Microbiological diagnostics of viral hepatitis


    HASDEMİR, Ufuk


    Viral hepatitis is an infection that primarily affects the liverbut may also have systemic clinical manifestations. The vastmajority of viral hepatitis are caused by one of five hepatotropicviruses: hepatitis A virus (HAV), hepatitis B virus (HBV),hepatitis C virus (HCV), hepatitis D (delta) virus (HDV), andhepatitis E virus (HEV) (Table I) [1]. HBV, HCV, and HDValso cause chronic hepatitis, whereas HAV does not. HEVcauses acute hepatitis in normal hosts but can cause protractedand chronic he...

  18. Microbiological diagnostics of viral hepatitis


    HASDEMİR, Ufuk


    Viral hepatitis is an infection that primarily affects the liverbut may also have systemic clinical manifestations. The vastmajority of viral hepatitis are caused by one of five hepatotropicviruses: hepatitis A virus (HAV), hepatitis B virus (HBV),hepatitis C virus (HCV), hepatitis D (delta) virus (HDV), andhepatitis E virus (HEV) (Table I) [1]. HBV, HCV, and HDValso cause chronic hepatitis, whereas HAV does not. HEVcauses acute hepatitis in normal hosts but can cause protractedand chronic he...

  19. Analysis of infrared laser tissue ablation (United States)

    McKenzie, Gordon P.; Timmerman, Brenda H.; Bryanston-Cross, Peter J.


    The mechanisms involved in infrared laser tissue ablation are studied using a free electron laser (FELIX) in order to clarify whether the increased ablation efficiency reported in literature for certain infrared wavelengths is due to a wavelength effect or to the specific pulse structure of the lasers that are generally used in these studies. Investigations are presented of ablation of vitreous from pigs" eyes using several techniques including protein gel electrophoresis and ablation plume visualization. The ablation effects of three different infrared wavelengths are compared: 3 mm, which is currently in clinical surgical use, and the wavelengths associated with the amide I and amide II bands, i.e. 6.2 mm and 6.45mm, respectively. The results suggest a different ablation mechanism to be in operation for each studied wavelength, thus indicating that the generally reported increased ablation efficiency in the 6-6.5 micron range is due to the wavelength rather than the typical free electron laser pulse structure.

  20. Feline intestinal sclerosing mast cell tumour: 50 cases (1997-2008). (United States)

    Halsey, C H C; Powers, B E; Kamstock, D A


    This case series presents a unique and unreported variant of feline intestinal mast cell tumour recognized at the CSU Veterinary Diagnostic Laboratory. Fifty cases of feline intestinal mast cell tumours described as having a significant stromal component were reviewed. Neoplastic cells formed a trabecular pattern admixed with moderate to abundant dense stromal collagen (sclerosis). Neoplastic cells had poorly discernible intracytoplasmic granules which demonstrated metachromasia with special histochemical stains consistent with mast cell granules. Additionally, a subset of cases stained for mast cell-specific tryptase and c-kit demonstrated positive immunoreactivity. Eosinophilic infiltrates were moderate to marked in almost all cases. Lymph node and hepatic metastases were present in 66% of the cases. Treatment and clinical outcome was available in 25/50 cases. Twenty-three of these patients died or were euthanized within 2 months of initial diagnosis. This is the first case series to characterize a sclerosing variant of intestinal mast cell tumour in the cat which appears to have a high propensity for metastasis and a guarded prognosis.

  1. tumours and cancers in graeco-roman times 1. introduction

    African Journals Online (AJOL)

    In Graeco-Roman times all tumours (Greek: onkoi, abnormal swellings) were consi- dered to be of ... of tumours is a more recent concept, barely two centuries old. In Hippocratic litera- ..... Ancient and medieval chemotherapy for cancer.

  2. Ovarian hilus-cell tumour: a case report. (United States)

    Georgiev, T N; Valkov, I M; Dokumov, S I


    A case of hilus-cell tumour of the ovary, associated with polycystic ovarian disease is reported. The authors discuss the data from hormonal investigations, the morphological picture and the genesis of the tumour.

  3. UV Laser Ablation of Electronically Conductive Polymers (United States)


    deionized water. The polymerization solution for polyaniline was prepared by mixing equal volumes of a solution that was 0.25 M in ammonium persulfate with a...rum2,0 vvcsL) TbeUV.layer ablation of thin polypyrrole and polyaniline films coated on an insulating substrate is described. UV laser ablation is used to...11liiii929. 6 1 2:- A ABSTRACT The UV laser ablation of thin polypyrrole and polyaniline films coated on an insulating substrate is described. UV laser

  4. Hydrodynamic modeling of ns-laser ablation

    Directory of Open Access Journals (Sweden)

    David Autrique


    Full Text Available Laser ablation is a versatile and widespread technique, applied in an increasing number of medical, industrial and analytical applications. A hydrodynamic multiphase model describing nanosecond-laser ablation (ns-LA is outlined. The model accounts for target heating and mass removal mechanisms as well as plume expansion and plasma formation. A copper target is placed in an ambient environment consisting of helium and irradiated by a nanosecond-laser pulse. The effect of variable laser settings on the ablation process is explored in 1-D numerical simulations.

  5. Diamond Ablators for Inertial Confinement Fusion

    Energy Technology Data Exchange (ETDEWEB)

    Biener, J; Mirkarimi, P B; Tringe, J W; Baker, S L; Wang, Y M; Kucheyev, S O; Teslich, N E; Wu, K J; Hamza, A V; Wild, C; Woerner, E; Koidl, P; Bruehne, K; Fecht, H


    Diamond has a unique combination of physical properties for the inertial confinement fusion ablator application, such as appropriate optical properties, high atomic density, high yield strength, and high thermal conductivity. Here, we present a feasible concept to fabricate diamond ablator shells. The fabrication of diamond capsules is a multi-step process, which involves diamond chemical vapor deposition on silicon mandrels followed by polishing, microfabrication of holes, and removing of the silicon mandrel by an etch process. We also discuss the pros and cons of coarse-grained optical quality and nanocrystalline chemical vapor deposition diamond films for the ablator application.

  6. Ablation response testing of aerospace power supplies (United States)

    Lutz, S. A.; Chan, C. C.


    An experimental program was performed to assess the aerothermal ablation response of aerospace power supplies. Full-scale General Purpose Heat Source (GPHS) test articles, Graphite Impact Shell (GIS) test articles, and Lightweight Radioisotope Heater Unit (LWRHU) test articles were all tested without nuclear fuel in simulated reentry environments at the NASA Ames Research Center. Stagnation heating, stagnation pressure, stagnation surface temperature, stagnation surface recession profile, and weight loss measurements were obtained for diffusion-limited and sublimation ablation conditions. The recession profile and weight loss measurements showed an effect of surface features on the stagnation face. The surface features altered the local heating which in turn affected the local ablation.

  7. A case of gouty arthritis following percutaneous radiofrequency ablation for hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Dae; Hee; Choi; Hyo-Suk; Lee


    Percutaneous radiofrequency thermal ablation(RFA) is considered an effective technique for providing local control in the majority of Hepatocellular carcinoma(HCC) patients.Although RFA is generally well tolerated,recent studies have reported complications associated with RFA.We describe a case of acute gouty arthritis in a 71-year-old man with chronic renal failure who was treated with RFA for a HCC lesion and who had hepatitis B-associated cirrhosis and mild renal insufficiency.Regular surveillance of the...

  8. Carcinoid Klatskin tumour: A rare cause of obstructive jaundice. (United States)

    Khuroo, Suhail; Rashid, Arshad; Bali, Rajandeep Singh; Mushtaque, Majid; Khuroo, Farzana


    Carcinoid tumours of the extrahepatic biliary ducts represent an extremely rare cause of bile duct obstruction. We report a case of obstructive jaundice secondary to carcinoid tumour arising at the hilar confluence. Resection of the primary tumour was done and the patient is doing well on follow-up. This case demonstrated that surgery offers the only potential cure for biliary carcinoid and aggressive surgical therapy should be the preferred treatment in cases of potentially resectable biliary tumours.

  9. [Biotherapy of neuroendocrine tumours of the gastrointestinal tract and pancreas

    DEFF Research Database (Denmark)

    Hansen, C.P.; Knigge, U.


    Biotherapy of hormonal symptoms and tumour growth is a mainstay in the therapy of metastatic neuroendocrine tumours of the gastrointestinal tract and pancreas. Symptomatic relief can be achieved by somatostatin analogues and interferon, either alone or in combination. The effect on tumour growth...... is less convincing although a stabilization of disease is recorded in almost 50% of patients. Interferon treatment should mainly be considered for tumours with a low proliferation index Udgivelsesdato: 2008/6/9...


    Directory of Open Access Journals (Sweden)



    Full Text Available Phosphaturic mesenchymal tumour is a tumour that can involve bone or soft tissue. This is a rare tumour and is known to be associated with osteomalasia. This is caused by tumour induced expression of fibroblastic growth factor (FGF23. We present a case of PMT in a 72 year old female patient who was diagnosed with osteomalasia due to nutritional deficiency of vitamin D and was appropriately treated but later presented with a mass in her foot.

  11. Epithelial tumours of the lacrimal gland

    DEFF Research Database (Denmark)

    von Holstein, Sarah Linéa; Coupland, Sarah E; Briscoe, Daniel


    of the lacrimal gland, displacement of the eyeball, reduced eye motility and diplopia. Pain and symptoms of short duration before the first ophthalmic consultation are characteristic of malignant tumours. The histological diagnosis determines the subsequent treatment regimen and provides important clues regarding...

  12. Platinum compounds with anti-tumour activity

    NARCIS (Netherlands)

    Plooy, A.C.M.; Lohman, P.H.M.


    Ten platinum (Pt) coordination complexes with different ligands, comprising both Pt(II) and Pt(IV) complexes of which the cis-compounds all possessed at least some anti-tumour activity and the trans-compounds were inactive, were tested as to their effect on cell survival and the induction and repair

  13. Molecular mechanisms for tumour resistance to chemotherapy. (United States)

    Pan, Shu-Ting; Li, Zhi-Ling; He, Zhi-Xu; Qiu, Jia-Xuan; Zhou, Shu-Feng


    Chemotherapy is one of the prevailing methods used to treat malignant tumours, but the outcome and prognosis of tumour patients are not optimistic. Cancer cells gradually generate resistance to almost all chemotherapeutic drugs via a variety of distinct mechanisms and pathways. Chemotherapeutic resistance, either intrinsic or acquired, is caused and sustained by reduced drug accumulation and increased drug export, alterations in drug targets and signalling transduction molecules, increased repair of drug-induced DNA damage, and evasion of apoptosis. In order to better understand the mechanisms of chemoresistance, this review highlights our current knowledge of the role of altered drug metabolism and transport and deregulation of apoptosis and autophagy in the development of tumour chemoresistance. Reduced intracellular activation of prodrugs (e.g. thiotepa and tegafur) or enhanced drug inactivation by Phase I and II enzymes contributes to the development of chemoresistance. Both primary and acquired resistance can be caused by alterations in the transport of anticancer drugs which is mediated by a variety of drug transporters such as P-glycoprotein (P-gp), multidrug resistance associated proteins, and breast cancer resistance protein. Presently there is a line of evidence indicating that deregulation of programmed cell death including apoptosis and autophagy is also an important mechanism for tumour resistance to anticancer drugs. Reversal of chemoresistance is likely via pharmacological and biological approaches. Further studies are warranted to grasp the full picture of how each type of cancer cells develop resistance to anticancer drugs and to identify novel strategies to overcome it.

  14. Gastrointestinal stromal tumour presenting as gastroduodenal intussusception.

    LENUS (Irish Health Repository)

    Wilson, Mark H


    Gastroduodenal intussusception secondary to gastrointestinal stromal tumour is a very rare cause for intestinal obstruction. The diagnosis of this condition can be challenging, as symptoms are often non-specific and intermittent. This article reports a case where the diagnosis was made preoperatively with abdominal imaging and was treated by a combination of endoscopic reduction and laparoscopic resection.

  15. Childhood ovarian juvenile granulosa cell tumour

    African Journals Online (AJOL)

    Prof Ezechukwu


    May 12, 2012 ... years old of age. We describe a case ... Juvenile granulosa cell tumour a subtype of ovarian stro- mal cell ... A more serious estrogen effects can occur in various end ... usually behave in a benign manner despite having histo-.

  16. Cystic lesions accompanying extra-axial tumours

    NARCIS (Netherlands)

    Lohle, PNM; Wurzer, HAL; Seelen, PJ; Kingma, LM; Go, KG


    We examined the mechanism of cyst formation in extra-axial tumours in the central nervous system (CNS). Cyst fluid, cerebrospinal fluid (CSF) and blood plasma were analysed in eight patients with nine peritumoral cysts: four with meningiomas, two with intracranial and two spinal intradural schwannom

  17. Bone scintigraphy (B S) in testicle tumours

    Energy Technology Data Exchange (ETDEWEB)

    Braga, F.J.H.N.; Arbex, M.A.; Souza, J.F.; Haddad, J. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina


    Full text. Testicle tumours are not very frequent and radiotherapy has an important role in the cure of many patients. The detection of metastases is not an easy task and we do not know any study concerning B S in the search for bone metastases in such cases. We studied 28 patients (8-52 years old) with proven testicle tumours by means of 99 m Tc-M D P (750 MBq intravenously). Images were obtained 2 h after. B S was normal in 21 studies. In 7 evaluations the only abnormality we found was variable but diffuse involvement of the iliac bone on the same side as the affected testicle. Five out of these patients showed important uptake of M D P (4 seminoma and 1 epididymoma) and the 2 others showed moderate uptake of the radio pharmaceutical (2 seminoma). Metastases were confirmed by biopsy. Testicle tumour metastases are known to occur through the lymphatic drainage which goes to the iliac lymph node chain and this makes our findings very logical. The scintigraphic aspect of the affected iliac bone is characteristic and makes it possible to imagine an `iliac sign` for such cases. Early detection of metastases is very important because of radiotherapy efficacy and B S may play an important role in such cases. Testicle tumour metastases should be thought of when this scintigraphic aspect is seen. Differential diagnosis is Paget`s Disease

  18. MR diffusion imaging of human intracranial tumours

    DEFF Research Database (Denmark)

    Krabbe, K; Gideon, P; Wagn, P;


    We used MRI for in vivo measurement of brain water self-diffusion in patients with intracranial tumours. The study included 28 patients (12 with high-grade and 3 with low-grade gliomas, 7 with metastases, 5 with meningiomas and 1 with a cerebral abscess). Apparent diffusion coefficients (ADC) wer...

  19. Giant solitary fibrous tumour of the liver

    NARCIS (Netherlands)

    T. Terkivatan (Türkan); M. Kliffen (Mike); J.H.W. de Wilt (Johannes); A.N. van Geel (Albert); A.M.M. Eggermont (Alexander); C. Verhoef (Kees)


    textabstractBackground: Solitary fibrous tumour (SFT) is an uncommon mesenchymal neoplasm that most frequently affects the pleura, although it has been reported with increasing frequency in various other sites such as in the peritoneum, pericardium and in non-serosal sites such as lung parenchyma,

  20. Analysis of nanoparticle delivery to tumours (United States)

    Wilhelm, Stefan; Tavares, Anthony J.; Dai, Qin; Ohta, Seiichi; Audet, Julie; Dvorak, Harold F.; Chan, Warren C. W.


    Targeting nanoparticles to malignant tissues for improved diagnosis and therapy is a popular concept. However, after surveying the literature from the past 10 years, only 0.7% (median) of the administered nanoparticle dose is found to be delivered to a solid tumour. This has negative consequences on the translation of nanotechnology for human use with respect to manufacturing, cost, toxicity, and imaging and therapeutic efficacy. In this article, we conduct a multivariate analysis on the compiled data to reveal the contributions of nanoparticle physicochemical parameters, tumour models and cancer types on the low delivery efficiency. We explore the potential causes of the poor delivery efficiency from the perspectives of tumour biology (intercellular versus transcellular transport, enhanced permeability and retention effect, and physicochemical-dependent nanoparticle transport through the tumour stroma) as well as competing organs (mononuclear phagocytic and renal systems) and present a 30-year research strategy to overcome this fundamental limitation. Solving the nanoparticle delivery problem will accelerate the clinical translation of nanomedicine.

  1. Solitary fibrous tumour of the vagus nerve. (United States)

    Scholsem, Martin; Scholtes, Felix


    We describe the complete removal of a foramen magnum solitary fibrous tumour in a 36-year-old woman. It originated on a caudal vagus nerve rootlet, classically described as the 'cranial' accessory nerve root. This ninth case of immunohistologically confirmed cranial or spinal nerve SFT is the first of the vagus nerve.

  2. The role of methylation in urological tumours

    NARCIS (Netherlands)

    Heijden, A.G. van der


    Alterations in DNA methylation have been described in human cancer for more than thirty years now. Since the last decade DNA methylation gets more and more important in cancer research. In this review the different alterations of DNA methylation are discussed in testicular germ cell tumours, Wilms't

  3. Imaging biomarkers in primary brain tumours

    Energy Technology Data Exchange (ETDEWEB)

    Lopci, Egesta; Chiti, Arturo [Humanitas Clinical and Research Center, Nuclear Medicine Department, Rozzano, MI (Italy); Franzese, Ciro; Navarria, Pierina; Scorsetti, Marta [Humanitas Clinical and Research Center, Radiosurgery and Radiotherapy, Rozzano, MI (Italy); Grimaldi, Marco [Humanitas Clinical and Research Center, Radiology, Rozzano, MI (Italy); Zucali, Paolo Andrea; Simonelli, Matteo [Humanitas Clinical and Research Center, Medical Oncology, Rozzano, MI (Italy); Bello, Lorenzo [Humanitas Clinical and Research Center, Neurosurgery, Rozzano, MI (Italy)


    We are getting used to referring to instrumentally detectable biological features in medical language as ''imaging biomarkers''. These two terms combined reflect the evolution of medical imaging during recent decades, and conceptually comprise the principle of noninvasive detection of internal processes that can become targets for supplementary therapeutic strategies. These targets in oncology include those biological pathways that are associated with several tumour features including independence from growth and growth-inhibitory signals, avoidance of apoptosis and immune system control, unlimited potential for replication, self-sufficiency in vascular supply and neoangiogenesis, acquired tissue invasiveness and metastatic diffusion. Concerning brain tumours, there have been major improvements in neurosurgical techniques and radiotherapy planning, and developments of novel target drugs, thus increasing the need for reproducible, noninvasive, quantitative imaging biomarkers. However, in this context, conventional radiological criteria may be inappropriate to determine the best therapeutic option and subsequently to assess response to therapy. Integration of molecular imaging for the evaluation of brain tumours has for this reason become necessary, and an important role in this setting is played by imaging biomarkers in PET and MRI. In the current review, we describe most relevant techniques and biomarkers used for imaging primary brain tumours in clinical practice, and discuss potential future developments from the experimental context. (orig.)

  4. Granular cell tumour of the urinary bladder

    Directory of Open Access Journals (Sweden)

    Christoph von Klot


    Full Text Available With only 16 cases reported in the literature, the mostly benign granular cell tumour of the urinary bladder is exceptionally rare. We present the case of a 68-year old patient with one of these lesions demonstrating our histological findings including several immunohistochemical stainings used to differentiate between other more common entities.

  5. Loss of L-FABP, SCP-2/SCP-x, or both induces hepatic lipid accumulation in female mice. (United States)

    Martin, Gregory G; Atshaves, Barbara P; Landrock, Kerstin K; Landrock, Danilo; Schroeder, Friedhelm; Kier, Ann B


    Although roles for both sterol carrier protein-2/sterol carrier protein-x (SCP-2/SCP-x) and liver fatty acid binding protein (L-FABP) have been proposed in hepatic lipid accumulation, individually ablating these genes has been complicated by concomitant alterations in the other gene product(s). For example, ablating SCP2/SCP-x induces upregulation of L-FABP in female mice. Therefore, the impact of ablating SCP-2/SCP-x (DKO) or L-FABP (LKO) individually or both together (TKO) was examined in female mice. Loss of SCP-2/SCP-x (DKO, TKO) more so than loss of L-FABP alone (LKO) increased hepatic total lipid and total cholesterol content, especially cholesteryl ester. Hepatic accumulation of nonesterified long chain fatty acids (LCFA) and phospholipids occurred only in DKO and TKO mice. Loss of SCP-2/SCP-x (DKO, TKO) increased serum total lipid primarily by increasing triglycerides. Altered hepatic level of proteins involved in cholesterol uptake, efflux, and/or secretion was observed, but did not compensate for the loss of L-FABP, SCP-2/SCP-x or both. However, synergistic responses were not seen with the combinatorial knock out animals-suggesting that inhibiting SCP-2/SCP-x is more correlative with hepatic dysfunction than L-FABP. The DKO- and TKO-induced hepatic accumulation of cholesterol and long chain fatty acids shared significant phenotypic similarities with non-alcoholic fatty liver disease (NAFLD).

  6. Tumour and tumour-like lesions of the patella - a multicentre experience

    Energy Technology Data Exchange (ETDEWEB)

    Singh, J.; James, S.L.; Davies, A.M. [The Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Kroon, H.M. [Leiden University Medical Centre, Department of Radiology, C-2-S, P. O Box 9600, Leiden (Netherlands); Woertler, K. [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Anderson, S.E. [Knochentumor- Referenzzentrum der Schweizerischen Gesellschaft fuer Pathologie, Basel (Switzerland)


    Fifty-nine cases of lesions presenting in the patella were identified after review of the databases of four European bone tumour registries. Of the 59 cases, 46% were non neoplastic, 39% were benign and 15% were malignant. The commonest benign neoplasm was giant cell tumour (GCT) (11 cases). Younger patients were more likely to have a benign neoplasm. Lesions in patients less than 40 years of age included giant cell tumour, chondroblastoma, aneurysmal bone cyst (ABC), osteomyelitis, osteoid osteoma and solitary bone cyst. In patients older than 40 years, the following were common lesions: intra-osseous gout, metastasis and intra-osseous ganglion. Expansion of the patella with thinning of cortex was seen more commonly in GCT and brown tumour in hyperparathyroidism. There was associated soft tissue extension in gout and malignant lesions. (orig.)

  7. Hepatitis C FAQs for the Public (United States)

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  8. Hepatitis B Foundation Newsletter: B Informed (United States)

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  9. Use of a circular mapping and ablation catheter for ablation of atypical right ventricular outflow tract arrhythmia. (United States)

    Katritsis, Demosthenes G; Giazitzoglou, Eleftherios; Paxinos, George


    A new technique for ablation of persistent ectopic activity with atypical electrocardiographic characteristics at the vicinity of the right ventricular outflow tract is described. A new circular mapping and ablation catheter initially designed for pulmonary vein ablation was used. Abolition of ectopic activity was achieved with minimal fluoroscopy and ablation times.

  10. Hepatitis B - children (United States)

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  11. Hepatitis Foundation International (United States)

    ... million people globally. admin / 03/17/2015 Viral Hepatitis An estimated 4.4 million Americans from all ... Events section below. EVENTS FULL CALENDAR Loading… VIRAL HEPATITIS DISPARITIES HARD TO REACH, HARD TO TREAT™ AFRICAN ...

  12. Hepatitis B Vaccination Protection (United States)

    Fact Sheet Hepatitis B Vaccination Protection Hepatitis B virus (HBV) is a pathogenic microorganism that can cause potentially life- threatening disease in humans. HBV infection is transmitted through exposure ...

  13. Hepatitis C (image) (United States)

    Hepatitis C is a virus-caused liver inflammation which may cause jaundice, fever and cirrhosis. Persons who are most at risk for contracting and spreading hepatitis C are those who share needles for injecting drugs ...

  14. Hepatitis virus panel (United States)

    ... page: // Hepatitis virus panel To use the sharing features on this page, please enable JavaScript. The hepatitis virus panel is a series of blood tests used ...

  15. The mechanical microenvironment in cancer: How physics affects tumours. (United States)

    Nagelkerke, Anika; Bussink, Johan; Rowan, Alan E; Span, Paul N


    The tumour microenvironment contributes greatly to the response of tumour cells. It consists of chemical gradients, for example of oxygen and nutrients. However, a physical environment is also present. Apart from chemical input, cells also receive physical signals. Tumours display unique mechanical properties: they are a lot stiffer than normal tissue. This may be either a cause or a consequence of cancer, but literature suggests it has a major impact on tumour cells as will be described in this review. The mechanical microenvironment may cause malignant transformation, possibly through activation of oncogenic pathways and inhibition of tumour suppressor genes. In addition, the mechanical microenvironment may promote tumour progression by influencing processes such as epithelial-to-mesenchymal transition, enhancing cell survival through autophagy, but also affects sensitivity of tumour cells to therapeutics. Furthermore, multiple intracellular signalling pathways prove sensitive to the mechanical properties of the microenvironment. It appears the increased stiffness is unlikely to be caused by increased stiffness of the tumour cells themselves. However, there are indications that tumours display a higher cell density, making them more rigid. In addition, increased matrix deposition in the tumour, as well as increased interstitial fluid pressure may account for the increased stiffness of tumours. Overall, tumour mechanics are significantly different from normal tissue. Therefore, this feature should be further explored for use in cancer prevention, detection and treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Relevance of high-dose chemotherapy in solid tumours

    NARCIS (Netherlands)

    Nieboer, P; de Vries, EGE; Mulder, NH; van der Graaf, WTA


    Drug resistance is a major problem in the treatment of solid tumours. Based on a steep dose-response relationship for especially alkylating agents on tumour cell survival, high-dose chemotherapy was considered of interest for the treatment of solid tumours. Results of phase 1 and 2 studies with high

  17. [Malignant germinal tumours of the mediastinum: diagnosis and treatment]. (United States)

    Lemarié, E


    Mediastinal germinal tumours are composed of tissues resembling those that follow one another during embryo development, by differentiation of the primordial and extraembryonic layers. Such practice separates the mature teratomas (benign), seminomas and non-seminomatous germinal tumours (NSGT). Platin-based chemotherapy has shattered the prognosis of such tumours.

  18. Tumour suppressor genes in sporadic epithelial ovarian cancer

    DEFF Research Database (Denmark)

    Liu, Ying; Ganesan, Trivadi S


    of the evolution of tumour progression. A major focus of research has been to identify tumour suppressor genes implicated in sporadic ovarian cancer over the past decade. Several tumour suppressor genes have been identified by strategies such as positional cloning and differential expression display. Further...

  19. Improved classification, diagnosis and prognosis of canine round cell tumours

    NARCIS (Netherlands)

    Cangul, Taci


    As the name suggests, canine round cell tumour (RCTs) are composed of cells with a round morphology. There is some discrepancy amongst authors as to which tumours belong to this category, but most designate lymphomas, melanomas, plasmacytomas, transmissible venereal tumours (TVTs), histiocytomas, an

  20. Accuracy and efficacy of percutaneous biopsy and ablation using robotic assistance under computed tomography guidance: a phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Koethe, Yilun [National Institutes of Health, Center for Interventional Oncology, NIH Clinical Center, Bethesda, MD (United States); National Institutes of Health, Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, MD (United States); Duke University School of Medicine, Durham, NC (United States); Xu, Sheng [National Institutes of Health, Center for Interventional Oncology, NIH Clinical Center, Bethesda, MD (United States); Velusamy, Gnanasekar [Perfint Healthcare Pvt. Ltd., Chennai (India); Wood, Bradford J. [National Institutes of Health, Center for Interventional Oncology, NIH Clinical Center, Bethesda, MD (United States); National Institutes of Health, Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, MD (United States); Venkatesan, Aradhana M. [National Institutes of Health, Center for Interventional Oncology, NIH Clinical Center, Bethesda, MD (United States); National Institutes of Health, Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, MD (United States); National Institutes of Health, Center for Interventional Oncology, Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, MD (United States)


    To compare the accuracy of a robotic interventional radiologist (IR) assistance platform with a standard freehand technique for computed-tomography (CT)-guided biopsy and simulated radiofrequency ablation (RFA). The accuracy of freehand single-pass needle insertions into abdominal phantoms was compared with insertions facilitated with the use of a robotic assistance platform (n = 20 each). Post-procedural CTs were analysed for needle placement error. Percutaneous RFA was simulated by sequentially placing five 17-gauge needle introducers into 5-cm diameter masses (n = 5) embedded within an abdominal phantom. Simulated ablations were planned based on pre-procedural CT, before multi-probe placement was executed freehand. Multi-probe placement was then performed on the same 5-cm mass using the ablation planning software and robotic assistance. Post-procedural CTs were analysed to determine the percentage of untreated residual target. Mean needle tip-to-target errors were reduced with use of the IR assistance platform (both P < 0.0001). Reduced percentage residual tumour was observed with treatment planning (P = 0.02). Improved needle accuracy and optimised probe geometry are observed during simulated CT-guided biopsy and percutaneous ablation with use of a robotic IR assistance platform. This technology may be useful for clinical CT-guided biopsy and RFA, when accuracy may have an impact on outcome. (orig.)

  1. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation.


    Chun, KR; Bestehorn, K; Pocock, SJ; FIRE AND ICE Investigators; , COLLABORATORS; Kuck, KH; Metzner, A; Ouyang, F; Chun, J; Fürnkranz, A; Elvan, A.; Arentz, T.; Kühne, M.; Sticherling, C; Gellér, L


    BACKGROUND: Current guidelines recommend pulmonary-vein isolation by means of catheter ablation as treatment for drug-refractory paroxysmal atrial fibrillation. Radiofrequency ablation is the most common method, and cryoballoon ablation is the second most frequently used technology. METHODS: We conducted a multicenter, randomized trial to determine whether cryoballoon ablation was noninferior to radiofrequency ablation in symptomatic patients with drug-refractory paroxysmal atrial fibrillatio...

  2. Orbital tumours and tumour-like lesions: exploring the armamentarium of multiparametric imaging. (United States)

    Purohit, Bela S; Vargas, Maria Isabel; Ailianou, Angeliki; Merlini, Laura; Poletti, Pierre-Alexandre; Platon, Alexandra; Delattre, Bénédicte M; Rager, Olivier; Burkhardt, Karim; Becker, Minerva


    Although the orbit is a small anatomical space, the wide range of structures present within it are often the site of origin of various tumours and tumour-like conditions, both in adults and children. Cross-sectional imaging is mandatory for the detection, characterization, and mapping of these lesions. This review focuses on multiparametric imaging of orbital tumours. Each tumour is reviewed in relation to its clinical presentation, compartmental location, imaging characteristics, and its histological features. We herein describe orbital tumours as lesions of the globe (retinoblastoma, uveal melanoma), optic nerve sheath complex (meningioma, optic nerve glioma), conal-intraconal compartment (hemangioma), extraconal compartment (dermoid/epidermoid, lacrimal gland tumours, lymphoma, rhabdomysarcoma), and bone and sinus compartment (fibrous dysplasia). Lesions without any typical compartmental localization and those with multi-compartment involvement (veno-lymphatic malformation, plexiform neurofibroma, idiopathic orbital pseudotumour, IgG4 related disease, metastases) are also reviewed. We discuss the role of advanced imaging techniques, such as MR diffusion-weighted imaging (DWI), diffusion tensor imaging, fluoro-2-deoxy-D-glucose positron emission tomography CT (FDG-PET CT), and positron emission tomography MRI (MRI PET) as problem-solving tools in the evaluation of those orbital masses that present with non-specific morphologic imaging findings. Main messages/Teaching points • A compartment-based approach is essential for the diagnosis of orbital tumours. • CT and MRI play a key role in the work-up of orbital tumours. • DWI, PET CT, and MRI PET are complementary tools to solve diagnostic dilemmas. • Awareness of salient imaging pearls and diagnostic pitfalls avoids interpretation errors.

  3. Prophylactic Anticonvulsants in patients with brain tumour

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, P.A. [Depts. of Oncology and Clinical Neurosciences, Univ. of Calgary, Calgary, Alberta (Canada); Tom Baker Cancer Centre, Calgary, Alberta (Canada); Weaver, S. [Depts. of Neurology and Medicine, Albany Medical College, Albany, New York (United States); Fulton, D. [Dept. of Radiation Oncology, Cross Cancer Institute and Dept. of Medicine/Neurology, Univ. of Alberta, Edmonton, Alberta (Canada)


    We conducted a clinical trial to determine if prophylactic anticonvulsants in brain tumour patients (without prior seizures) reduced seizure frequency. We stopped accrual at 100 patients on the basis of the interim analysis. One hundred newly diagnosed brain tumour patients received anticonvulsants (AC Group) or not (No AC Group) in this prospective randomized unblinded study. Sixty patients had metastatic, and 40 had primary brain tumours. Forty-six (46%) patients were randomized to the AC Group and 54 (54%) to the No AC Group. Median follow-up was 5.44 months (range 0.13 -30.1 months). Seizures occurred in 26 (26%) patients, eleven in the AC Group and 15 in the No AC Group. Seizure-free survivals were not different; at three months 87% of the AC Group and 90% of the No AC Group were seizure-free (log rank test, p=0.98). Seventy patients died (unrelated to seizures) and survival rates were equivalent in both groups (median survival = 6.8 months versus 5.6 months, respectively; log rank test, p=0.50). We then terminated accrual at 100 patients because seizure and survival rates were much lower than expected; we would need {>=}900 patients to have a suitably powered study. These data should be used by individuals contemplating a clinical trial to determine if prophylactic anticonvulsants are effective in subsets of brain tumour patients (e.g. only anaplastic astrocytomas). When taken together with the results of a similar randomized trial, prophylactic anticonvulsants are unlikely to be effective or useful in brain tumour patients who have not had a seizure. (author)

  4. Fractionated Radiotherapy with 3 x 8 Gy Induces Systemic Anti-Tumour Responses and Abscopal Tumour Inhibition without Modulating the Humoral Anti-Tumour Response.

    Directory of Open Access Journals (Sweden)

    Thomas H P M Habets

    Full Text Available Accumulating evidence indicates that fractionated radiotherapy (RT can result in distant non-irradiated (abscopal tumour regression. Although preclinical studies indicate the importance of T cells in this infrequent phenomenon, these studies do not preclude that other immune mechanisms exhibit an addition role in the abscopal effect. We therefore addressed the question whether in addition to T cell mediated responses also humoral anti-tumour responses are modulated after fractionated RT and whether systemic dendritic cell (DC stimulation can enhance tumour-specific antibody production. We selected the 67NR mammary carcinoma model since this tumour showed spontaneous antibody production in all tumour-bearing mice. Fractionated RT to the primary tumour was associated with a survival benefit and a delayed growth of a non-irradiated (contralateral secondary tumour. Notably, fractionated RT did not affect anti-tumour antibody titers and the composition of the immunoglobulin (Ig isotypes. Likewise, we demonstrated that treatment of tumour-bearing Balb/C mice with DC stimulating growth factor Flt3-L did neither modulate the magnitude nor the composition of the humoral immune response. Finally, we evaluated the immune infiltrate and Ig isotype content of the tumour tissue using flow cytometry and found no differences between treatment groups that were indicative for local antibody production. In conclusion, we demonstrate that the 67NR mammary carcinoma in Balb/C mice is associated with a pre-existing antibody response. And, we show that in tumour-bearing Balb/C mice with abscopal tumour regression such pre-existing antibody responses are not altered upon fractionated RT and/or DC stimulation with Flt3-L. Our research indicates that evaluating the humoral immune response in the setting of abscopal tumour regression is not invariably associated with therapeutic effects.

  5. RNF43 is a tumour suppressor gene mutated in mucinous tumours of the ovary. (United States)

    Ryland, Georgina L; Hunter, Sally M; Doyle, Maria A; Rowley, Simone M; Christie, Michael; Allan, Prue E; Bowtell, David D L; Gorringe, Kylie L; Campbell, Ian G


    Mucinous carcinomas represent a distinct morphological subtype which can arise from several organ sites, including the ovary, and their genetic characteristics are largely under-described. Exome sequencing of 12 primary mucinous ovarian tumours identified RNF43 as the most frequently somatically mutated novel gene, secondary to KRAS and mutated at a frequency equal to that of TP53 and BRAF. Further screening of RNF43 in a larger cohort of ovarian tumours identified additional mutations, with a total frequency of 2/22 (9%) in mucinous ovarian borderline tumours and 6/29 (21%) in mucinous ovarian carcinomas. Seven mutations were predicted to truncate the protein and one missense mutation was predicted to be deleterious by in silico analysis. Six tumours had allelic imbalance at the RNF43 locus, with loss of the wild-type allele. The mutation spectrum strongly suggests that RNF43 is an important tumour suppressor gene in mucinous ovarian tumours, similar to its reported role in mucinous pancreatic precancerous cysts.

  6. Immunohistochemical detection of tumour cell proliferation and intratumoural microvessel density in canine malignant mammary tumours

    Directory of Open Access Journals (Sweden)

    Sennazli Gulbin


    Full Text Available The objective of this study was to investigate the correlation between different histological types and grades of canine malignant mammary tumours, tumour cell proliferation and their angiogenic activity using immunohistochemical markers. Mammary tissue samples from 47 bitches with mammary cancer were evaluated. The expression of cellular proliferation marker Ki-67 and endothelial marker Von Willebrand’s factor (vWF were immunohistochemically demonstrated. The tumours with the highest Ki-67 and vWF expressions were found to share similar histomorphological features. Simple solid carcinoma had the highest levels of Ki-67, vWF, and higher histological grade while complex carcinomas, osteosarcomas, and carcinosarcomas had the lowest ones. The differences between the expressions of Ki-67 and vWF in different tumour types were considered to be of great importance in determination of biological behaviour and prognosis of these tumours. This study is one of the few studies that evaluate these differences among the subtypes of malignant canine mammary tumours

  7. Hepatitis C and HIV (United States)

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  9. What Is Hepatitis? (United States)

    ... عربي 中文 English Français Русский Español What is hepatitis? Online Q&A Reviewed July 2016 Q: What ... Question and answer archives Submit a question World Hepatitis Day Know hepatitis - Act now Event notice Key ...

  10. Hepatic (Liver) Function Panel (United States)

    ... 1- to 2-Year-Old Blood Test: Hepatic (Liver) Function Panel KidsHealth > For Parents > Blood Test: Hepatic (Liver) Function Panel Print A A A What's in ... Is The hepatic function panel, also known as liver function tests, is a group of seven tests ...

  11. Nanosecond laser ablation of silver nanoparticle film (United States)

    Chung, Jaewon; Han, Sewoon; Lee, Daeho; Ahn, Sanghoon; Grigoropoulos, Costas P.; Moon, Jooho; Ko, Seung H.


    Nanosecond laser ablation of polyvinylpyrrolidone (PVP) protected silver nanoparticle (20 nm diameter) film is studied using a frequency doubled Nd:YAG nanosecond laser (532 nm wavelength, 6 ns full width half maximum pulse width). In the sintered silver nanoparticle film, absorbed light energy conducts well through the sintered porous structure, resulting in ablation craters of a porous dome shape or crown shape depending on the irradiation fluence due to the sudden vaporization of the PVP. In the unsintered silver nanoparticle film, the ablation crater with a clean edge profile is formed and many coalesced nanoparticles of 50 to 100 nm in size are observed inside the ablation crater. These results and an order of magnitude analysis indicate that the absorbed thermal energy is confined within the nanoparticles, causing melting of nanoparticles and their coalescence to larger agglomerates, which are removed following melting and subsequent partial vaporization.

  12. Laser ablation in analytical chemistry - A review

    Energy Technology Data Exchange (ETDEWEB)

    Russo, Richard E.; Mao, Xianglei; Liu, Haichen; Gonzalez, Jhanis; Mao, Samuel S.


    Laser ablation is becoming a dominant technology for direct solid sampling in analytical chemistry. Laser ablation refers to the process in which an intense burst of energy delivered by a short laser pulse is used to sample (remove a portion of) a material. The advantages of laser ablation chemical analysis include direct characterization of solids, no chemical procedures for dissolution, reduced risk of contamination or sample loss, analysis of very small samples not separable for solution analysis, and determination of spatial distributions of elemental composition. This review describes recent research to understand and utilize laser ablation for direct solid sampling, with emphasis on sample introduction to an inductively coupled plasma (ICP). Current research related to contemporary experimental systems, calibration and optimization, and fractionation is discussed, with a summary of applications in several areas.

  13. Nanoscale ablation through optically trapped microspheres (United States)

    Fardel, Romain; McLeod, Euan; Tsai, Yu-Cheng; Arnold, Craig B.


    The ability to directly create patterns with size scales below 100 nm is important for many applications where the production or repair of high resolution and density features is needed. Laser-based direct-write methods have the benefit of being able to quickly and easily modify and create structures on existing devices, but ablation can negatively impact the overall technique. In this paper we show that self-positioning of near-field objectives through the optical trap assisted nanopatterning (OTAN) method allows for ablation without harming the objective elements. Small microbeads are positioned in close proximity to a substrate where ablation is initiated. Upon ablation, these beads are temporarily displaced from the trap but rapidly return to the initial position. We analyze the range of fluence values for which this process occurs and find that there exists a critical threshold beyond which the beads are permanently ejected.

  14. Physical processes of laser tissue ablation (United States)

    Furzikov, Nickolay P.


    The revised ablation model applicable to homogeneous tissues is presented. It is based on the thermal mechanism and involves the instability of the laserinduced evaporation (thermodestruction) front the growth of the surface ripple structure the interference of the laser wave and of the surface wave arising by diffraction on the ripples Beer''s law violation the pulsed thermodestruction of the organic structural component the tissue water boiling and gas dynamic expansion of the resulting products into the surrounding medium which is followed by the shock wave formation. The UV and IR ablation schemes were implemented and compared to the corneal ablation experiments. The initial ablation pressure and temperature are given restored from the timeofflight measurements of the supersonic expansion of the product. 1.

  15. Laser ablation of a polysilane material (United States)

    Hansen, S. G.; Robitaille, T. E.


    The laser ablation properties of a (50%)-isopropyl methyl-(50%)-n-propyl methyl silane copolymer are examined. Both 193- and 248-nm-pulsed excimer laser radiation cleanly and completely remove this material in vacuum above certain energy thresholds (30 and 50 mJ/cm2, respectively). Under these conditions the ablation properties are quite similar to those reported for typical organic polymers. Below threshold, ablation is less efficient and becomes increasingly inefficient as irradiation continues due to spectral bleaching. In the presence of air, material removal is incomplete even for high-energy densities and long exposures. The ablation rate is shown to be independent of substrate material both above and below threshold.

  16. Ablative Ceramic Foam Based TPS Project (United States)

    National Aeronautics and Space Administration — A novel composite material ablative TPS for planetary vehicles that can survive a dual heating exposure is proposed. NextGen's TPS concept is a bi-layer functional...

  17. Duplex/colour Doppler sonography: measurement of changes in hepatic arterial haemodynamics following intra-arterial angiotensin II infusion. (United States)

    Leen, E; Angerson, W J; Warren, H W; Goldberg, J A; Sutherland, G R; Cooke, T G; McArdle, C S


    Angiotensin II (AT-II) has been used to target regionally-administered cytotoxic microspheres in patients with intrahepatic tumours. The optimisation of vasoconstrictor targeting requires a knowledge of the blood flow changes induced by agents such as AT-II. We therefore assessed duplex/colour Doppler sonography (DCDS) as a means of evaluating the effects of AT-II infusion on hepatic arterial blood flow (HABF) and arterial resistance in patients with intrahepatic tumours. HABF was measured continuously in nine patients using DCDS before, during and after an infusion of AT-II (15 micrograms in 3 ml of saline over 90 s) via a hepatic artery catheter. In seven patients with less than 30% hepatic replacement by tumour, the baseline level of HABF was 331 +/- 85 ml min-1 (mean +/- s.d.), and this was reduced by 75-80% within 30 s of the start of AT-II infusion. HABF recovered rapidly from the end of the infusion, and increased by up to 20% above the baseline for approximately 2 min. In two patients with greater than 50% hepatic replacement, HABF showed no reduction but rose continuously from the start of AT-II infusion, increasing by a factor of 2-2.5 after 3-4 min. Arterial resistance showed reciprocal changes in all cases. We conclude that DCDS is effective in assessing the temporal changes in hepatic arterial blood flow caused by AT-II. In order to optimise tumour targeting, the injection of microspheres loaded with cytotoxic drugs should be completed before the end of the AT-II infusion. The targeting advantage of AT-II in patients with a high percentage hepatic replacement by tumour should be re-assessed.

  18. Pulmonary tumours in the Netherlands : focus on temporal trends in histology and stage and on rare tumours

    NARCIS (Netherlands)

    de Jong, W. K.; Schaapveld, M.; Blaauwgeers, J. L. G.; Groen, H. J. M.


    Background: Recent temporal trends in histology and stage of pulmonary tumours in the Netherlands were studied. The incidence of rare pulmonary tumours was determined. Methods: All tumours originating from the trachea, bronchus and lung recorded in the Netherlands Cancer Registry were included. Base

  19. Cytoreductive surgery in disseminated non-seminomatous germ cell tumours of testis. (United States)

    Kulkarni, R P; Reynolds, K W; Newlands, E S; Dawson, P M; Makey, A R; Theodorou, N A; Bradley, J; Begent, R H; Rustin, G J; Bagshawe, K D


    Between 1977 and 1988, 67 patients underwent surgical removal of residual metastatic deposits following an aggressive chemotherapy regimen (cisplatin, vincristine, methotrexate and bleomycin alternating with etoposide, actinomycin D and cyclophosphamide) for disseminated germ cell tumours of the testis (stage IIB or above). Ninety-one surgical procedures were performed. There were 63 (69 per cent) retroperitoneal lymph node dissections, 16 (18 per cent) thoracotomies, three (3 per cent) hepatic resections, three (3 per cent) craniotomies, five (5 per cent) delayed orchidectomies and one anterolateral decompression of the vertebral column. Nine (13 per cent) patients required a repeat retroperitoneal node dissection and one patient needed a repeat thoracotomy to remove recurrent metastatic deposits during the period of follow-up. Multivisceral resections and vascular reconstruction procedures were required in 20 (30 per cent) patients undergoing retroperitoneal node dissection. Fifty-five (82 per cent) patients remain in complete remission with a mean follow-up period of 49.6 months (range 2-121 months). Nine (13 per cent) patients died with metastatic disease between 2 months to 4 years after operation. There were three deaths in the perioperative period (4 per cent). The histology of the resected metastases revealed undifferentiated active tumour in 20 (30 per cent) patients, differentiated mature teratoma in 29 (43 per cent) patients and fibrosis/necrosis in 18 (27 per cent) patients. Twelve (60 per cent) patients with undifferentiated elements and 15 patients (60 per cent) with raised preoperative tumour markers (poor prognostic categories) are in complete remission. Cytoreductive surgery in patients with metastatic germ cell tumours offers the best chance of remission following chemotherapy even in poor prognostic group categories.

  20. Principles of the radiative ablation modeling (United States)

    Saillard, Yves; Arnault, Philippe; Silvert, Virginie


    Indirectly driven inertial confinement fusion (ICF) rests on the setting up of a radiation temperature within a laser cavity and on the optimization of the capsule implosion ablated by this radiation. In both circumstances, the ablation of an optically thick medium is at work. The nonlinear radiation conduction equations that describe this phenomenon admit different kinds of solutions called generically Marshak waves. In this paper, a completely analytic model is proposed to describe the ablation in the subsonic regime relevant to ICF experiments. This model approximates the flow by a deflagrationlike structure where Hugoniot relations are used in the stationary part from the ablation front up to the isothermal sonic Chapman-Jouguet point and where the unstationary expansion from the sonic point up to the external boundary is assumed quasi-isothermal. It uses power law matter properties. It can also accommodate arbitrary boundary conditions provided the ablation wave stays very subsonic and the surface temperature does not vary too quickly. These requirements are often met in realistic situations. Interestingly, the ablated mass rate, the ablation pressure, and the absorbed radiative energy depend on the time history of the surface temperature, not only on the instantaneous temperature values. The results compare very well with self-similar solutions and with numerical simulations obtained by hydrodynamic code. This analytic model gives insight into the physical processes involved in the ablation and is helpful for optimization and sensitivity studies in many situations of interest: radiation temperature within a laser cavity, acceleration of finite size medium, and ICF capsule implosion, for instance.