Persistent left-sided SVC: An incidental finding during Port-A-Cath placement.

Port-A-Cath (port), a single-lumen, tunneled catheter, is routinely placed into the superior vena cava (SVC) for cancer patients undergoing chemotherapy. We present a case of a port placement in which variant anatomy was discovered during the fluoroscopy-guided procedure and confirmed by venogram of a persistent left-sided SVC (PLSVC). Upon further investigation into the patient's previous computed tomography (CT) scans, the diagnosis was further confirmed. Patients with PLSVC are typically asymptomatic; however, some are associated with increased congenital heart defects (CHD), which increase the risk for complications during invasive procedures. Diagnosing PLSVCs and knowing the clinical implications/complications can improve patient care; by not removing catheters unnecessarily and being prepared to treat/minimize complications.

Artificial Intelligence and Radiomics: Clinical Applications for Patients with Advanced Melanoma Treated with Immunotherapy.

Immunotherapy has greatly improved the outcomes of patients with metastatic melanoma. However, it has also led to new patterns of response and progression, creating an unmet need for better biomarkers to identify patients likely to achieve a lasting clinical benefit or experience immune-related adverse events. In this study, we performed a focused literature survey covering the application of artificial intelligence (AI; in the form of radiomics, machine learning, and deep learning) to patients diagnosed with melanoma and treated with immunotherapy, reviewing 12 studies relevant to the topic published up to early 2022. The most commonly investigated imaging modality was CT imaging in isolation (n = 9, 75.0%), while patient cohorts were most frequently recruited retrospectively and from single institutions (n = 7, 58.3%). Most studies concerned the development of AI tools to assist in prognostication (n = 5, 41.7%) or the prediction of treatment response (n = 6, 50.0%). Validation methods were disparate, with two studies (16.7%) performing no validation and equal numbers using cross-validation (n = 3, 25%), a validation set (n = 3, 25%), or a test set (n = 3, 25%). Only one study used both validation and test sets (n = 1, 8.3%). Overall, promising results have been observed for the application of AI to immunotherapy-treated melanoma. Further improvement and eventual integration into clinical practice may be achieved through the implementation of rigorous validation using heterogeneous, prospective patient cohorts.