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Quimioembolización arterial transcatéter

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Predictive Factors of Downstaging of Hepatocellular Carcinoma Beyond the Milan Criteria Treated with Intra-arterial Therapies

Valentina Bova, Roberto Miraglia, Luigi Maruzzelli, Giovanni Battista Vizzini, Angelo Luca

Purpose: This study was designed to analyze the clinical results in patients suitable for liver transplantation with hepatocellular carcinoma (HCC) who exceeded Milan criteria, which underwent intra-arterial therapies (IAT), to determine predictive factors of successful downstaging.

RADIOLOGY. Chemoembolization for Hepatocellular Carcinoma: 1-Month Response Determined with Apparent Diffusion Coefficient Is an Independent Predictor of Outcome

Vincent Vandecaveye, MD, PhD, Katrijn Michielsen, MSc, Frederik De Keyzer, MSc, Wim Laleman, MD, PhD, Mina Komuta, MD, PhD, Katya Op de beeck, MD, Tania Roskams, MD, PhD, Frederik Nevens, MD, PhD, Chris Verslype, MD, PhD, Geert Maleux, MD, PhD

Purpose: To evaluate the predictive utility of apparent diffusion coefficient (ADC) changes at diffusion-weighted (DW) magnetic resonance (MR) imaging 1 month after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) compared with the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, European Association for the Study of the Liver (EASL) criteria, and modified RECIST (mRECIST).

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Safety and Effectiveness of Chemoembolization with Drug-Eluting Beads for Advanced-Stage Hepatocellular Carcinoma

Sanjeeva P. Kalva, Melina Pectasides, Raymond Liu, Niranjan Rachamreddy, Shravani Surakanti, Kalpana Yeddula, Suvranu Ganguli, Stephan Wicky, Lawrence S. Blaszkowsky, Andrew X. Zhu

Background: According to the Barcelona Clinic Liver Cancer (BCLC) algorithm, patients with advanced stage (BCLC-C) hepatocellular carcinoma (HCC) are recommended for systemic treatment or palliative therapy. However, chemoembolization with drug-eluting beads (DEB-TACE) has been shown to be safe in high-risk patients. The purpose of our study was to evaluate the safety and effectiveness of DEB-TACE in patients with an advanced-stage HCC.

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Trends in Utilization of Transarterial Treatments for Hepatocellular Carcinoma: Results of a Survey by the Italian Society of Interventional Radiology

Irene Bargellini, Francesco Florio, Rita Golfieri, Maurizio Grosso, Dario Luca Lauretti, Roberto Cioni

Purpose: This study was designed to provide an overview of the practice of locoregional treatments for HCC by the Italian centers of Interventional Radiology (IR) with particular reference to transarterial modalities.

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Repeated Bland-TAE Using Small Microspheres Injected via an Implantable Port–Catheter System for Liver Metastases: An Initial Experience

Toshihiro Tanaka, Hideyuki Nishiofuku, Shinsaku Maeda, Testuya Masada, Hiroshi Anai, Hiroshi Sakaguchi, Kimihiko Kichikawa

Purpose: The purpose of this pilot study was to assess the effectiveness of repeated bland-TAE using small-size microspheres for liver metastases. To date, there have been no publications as to whether bland-TAE could be effective for nonhypervascular liver tumors.

RADIOLOGY. Hepatocellular Carcinoma: High Hepatitis B Viral Load and Mortality in Patients Treated with Transarterial Chemoembolization

Su Jong Yu, MD, , Jeong-Hoon Lee, MD, , Eun Sun Jang, MD, , Eun Ju Cho, MD, , Min-Sun Kwak, MD, , Jung-Hwan Yoon, MD, , Hyo-Suk Lee, MD, , Chung Yong Kim, MD, and , Yoon Jun Kim, MD

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related morbidity and mortality. HCC is a cancer with rapid progression and the hepatitis B virus (HBV) is associated with 70% of all HCC cases worldwide (1). Despite surveillance programs conducted in high-risk populations, most HCCs are diagnosed at an advanced stage (2), and as a result, only 10%–20% of patients are eligible for curative surgery (3). Therefore, the remaining 80% with an unresectable tumor should be considered for local-regional therapies including transarterial chemoembolization (TACE) (4).

RADIOLOGY. CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part I. Development, Growth, and Spread: Key Pathologic and Imaging Aspects

Jin-Young Choi, MD, Jeong-Min Lee, MD, Claude B. Sirlin, MD

Hepatocellular carcinoma (HCC) is an epithelial tumor originating in the liver and composed of cells with characteristics similar to those of normal hepatocytes (1). It is the fifth most common tumor in the world, and its incidence is increasing, especially in Western nations (2). Cirrhosis is the most important clinical risk factor for HCC, with approximately 80% of cases of HCC developing in patients with a cirrhotic liver (3). In such patients, the annual incidence of HCC ranges from 2% to 8% (4,5). The exact incidence depends on the cause of cirrhosis (highest incidence in those infected with hepatitis C virus or hepatitis B virus), severity of cirrhosis (highest incidence in those with decompensated cirrhosis), geographic region (higher in Japan than in Europe or United States), and sex (higher in men than women). The risk is greater in individuals with multiple risk factors as well as in those coinfected with human immunodeficiency virus (6). Patients without cirrhosis also may develop HCC, especially those with long-standing chronic liver inflammation due to hepatitis B virus or hepatitis C virus infection (7) or nonalcoholic steatohepatitis (8), but at a much lower rate than those with cirrhosis. Other risk factors for HCC include heavy alcohol consumption, tobacco smoking (9), obesity, diabetes, hereditary hemochromatosis, high dietary consumption of aflatoxins, and family history of HCC (6). Importantly, cirrhosis and chronic hepatitis now are recognized as risk factors for intrahepatic cholangiocarcinoma (ICC) as well as HCC (10); thus, many patients at risk for HCC may develop ICC instead.

AMERICAN JOURNAL OF ROENTGENOLOGY. Survival, Efficacy, and Safety of Small Versus Large Doxorubicin Drug-Eluting Beads TACE Chemoembolization in Patients With Unresectable HCC

Hasmukh J. Prajapati, Minzhi Xing, James R. Spivey, Steven I. Hanish, Bassel F. El-Rayes, John S. Kauh, Zhengjia Chen and Hyun S. Kim

OBJECTIVE. The purpose of this study was to investigate the overall survival, efficacy, and safety of small (100–300 µm) versus large (300–500 and 500–700 µm) doxorubicin drug-eluting beads transarterial chemoembolization (DEB TACE) in patients with unresectable hepatocellular carcinoma (HCC).

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Transarterial Chemoembolization for Hepatocellular Carcinoma with a New Generation of Beads: Clinical–Radiological Outcomes and Safety Profile

Carlo Spreafico, Tommaso Cascella, Antonio Facciorusso, Carlo Sposito, Lanocita Rodolfo, Carlo Morosi, Enrico M. Civelli, Marta Vaiani, Sherrie Bhoori, Alessandro Pellegrinelli, Alfonso Marchianò, Vincenzo Mazzaferro

Purpose: To evaluate the short-term safety and efficacy of the new generation of 70–150 µm drug-eluting beads (M1 DEB) in patients with hepatocellular carcinoma undergoing transarterial chemoembolization (TACE) as a primary therapy or as a bridge to liver transplantation (LT).

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