Long-term outcomes of transarterial embolization with lipiodol-bleomycin emulsion plus polyvinyl alcohol particles versus the particles alone for large symptomatic focal nodular hyperplasia: a propensity score-matched analysis.

OBJECTIVES: To compare the efficacy of transarterial embolization (TAE) with polyvinyl alcohol (PVA) particles alone and lipiodol-bleomycin emulsion (LBE) plus PVA particles for patients with unresectable large symptomatic focal nodular hyperplasia (FNH). METHODS: We performed a retrospective analysis of patients who underwent TAE either with PVA particles alone (group A, n = 46) or LBE plus PVA particles (group B, n = 35) for large (≥ 7 cm) symptomatic FNH between January 2002 and February 2019. Propensity score matching (PSM) (1:1) was performed to adjust for potential baseline confounders. Technical success, adverse events (AEs), symptom relief, and changes in the lesion size after TAE were evaluated. Statistical analysis included Wilcoxon rank sum test and χ2 test. RESULTS: After PSM, no significant differences in baseline characteristics were found between the groups (31 in group A and 31 in group B, with a mean age of 31 years). Technical success was achieved in all patients (100%), without major AEs in both groups. Complete resolution of the abdominal symptoms was reported in 77.4% in group A and 100% in group B (p = 0.037) during a mean follow-up period of 72 months; complete resolution (CR) of the FNH rate was significantly higher in group B than in group A (93.6% vs. 67.7%; p = 0.019). CONCLUSION: Compared with the use PVA particles alone, TAE with LBE plus PVA particles in the treatment of patients with large symptomatic FNH had a significantly higher rates of CR of the FNH and complete relief of the symptoms. KEY POINTS: • Transarterial embolization (TAE) with lipiodol-bleomycin emulsion (LBE) plus PVA particles for the large symptomatic FNH yielded better results than with PVA particles alone, in terms of complete resolution of FNH lesions (93.6% vs 67.7%) and complete relief of the abdominal symptoms (100% vs 77.4%) during a mean follow-up period of 72 months (38-170 months). • No major complications were recorded in both groups, and no significant difference in the incidence of postembolization syndrome were observed between the two groups.

Photoinduced free radical-releasing systems and their anticancer properties.

Cancer has been a serious threat and impact on the health and life of human. Phototherapy is considered as a promising therapeutic method to replace the traditional treatment in clinic owing to its noninvasive nature and high efficiency. Photoinitiators have long been used in the field of photopolymerization; however, few studies have been carried out on their potential as anticancer agents under light irradiation. In this study, the effect of a photoinitiator, diphenyl (2, 4, 6-trimethylbenzoyl) phosphine oxide (TPO), on breast cancer is investigated and the related mechanism is elucidated. It is found that TPO has low dark toxicity and significant phototoxicity. TPO can inhibit cell growth and development and promote cell apoptosis through a mitochondrial pathway under light irradiation. Further studies show that cell apoptosis is induced by free radicals produced from the photolysis of TPO to activate JNK phosphorylation. Overall, we identify the antitumor effects of TPO in vitro for the first time, and provides a proof of concept for its application as a novel photolatent therapeutic drug.

Peripheral RAFT Polymerization on a Covalent Organic Polymer with Enhanced Aqueous Compatibility for Controlled Generation of Singlet Oxygen.

A covalent organic polymer (COP) is prepared by crosslinking the photosensitizer 4,4',4'',4'''-(porphyrin-5,10,15,20-tetrayl)tetraaniline (TAPP) with 4,4'-(anthracene-9,10-diyl)dibenzoic acid (ADDA) via 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide/4-dimethylaminopyridine coupling. The COP is further modified with a hydrophilic polymer, poly(poly(ethylene glycol) methyl ether methacrylate) by grafting-from reversible-addition-fragmentation chain transfer (RAFT) polymerization to enhance its solubility in various solvents. The modified COP can bind singlet oxygen through the formation of endoperoxide by ADDA upon the exposure to red light irradiation. Singlet oxygen can be then released via the photodynamic mechanism or the cycloreversion by endoperoxide when heated at 110 °C. These results open new possibilities for simultaneous generation of singlet oxygen by the photodynamic route and singlet oxygen carriers, demonstrating promise for treating hypoxic tumors.

Comparison of Clinical Outcomes of Prostatic Artery Embolization with 50-µm Plus 100-µm Polyvinyl Alcohol (PVA) Particles versus 100-µm PVA Particles Alone: A Prospective Randomized Trial.

PURPOSE: To evaluate the safety and efficacy of prostatic artery embolization (PAE) using the combination of 50-µm and 100-µm polyvinyl alcohol (PVA) particles versus 100-µm PVA particles alone in the treatment of patients with symptomatic benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Over a 5-year period, 120 patients treated with PAE for lower urinary tract symptoms (LUTS) secondary to BPH were randomized to undergo embolization with 50-µm plus 100-µm PVA particles (group A) or 100-µm PVA particles alone (group B). Mean follow-up time was 34 months (range, 12-57 mo). There were no differences between groups regarding baseline data. Primary outcome measurements included change in International Prostate Symptom Score (IPSS) and incidence of adverse events. Secondary outcome measurements included procedure-associated pain, prostate ischemia measured on magnetic resonance (MR) imaging 1 week after PAE, and changes over time in quality of life (QOL) questionnaire, peak urinary flow rate (Qmax), postvoid residual (PVR) volume, prostate volume (PV), prostate-specific antigen (PSA) level, and International Index of Erectile Function (IIEF) were evaluated. Recurrence of LUTS following PAE was defined as relief of LUTS temporally but increased IPSS ≥ 8 or QOL score ≥ 3 or decrease in Qmax to < 7 mL/s. RESULTS: Mean follow-up periods were 35 months ± 22 in group A and 33 months ± 25 in group B (P = .629). No differences between groups regarding procedural details, pain scores, or adverse events were noted (P > .05). At 24 month of follow-up, patients in group A had a greater decrease in mean IPSS (18.7 ± 12.5 vs 14.8 ± 13.5), QOL score (3.7 ± 1.5 vs 2.4 ± 1.8), Qmax (10.5 mL ± 9.5 vs 6.8 mL ± 5.0), PVR (92.0 mL ± 75.0 vs 60.0 mL ± 55.0), and PV (37.0 mL ± 19.5 vs 25.5 mL ± 15.0) compared with patients in group B (P < .05 for all). Mean ratios of prostate ischemic volume at 1 week after PAE were 70% ± 20 in group A and 41% ± 25 in group B (P = .021); mean PSA levels at 24 hour after PAE were 92.5 ng/mL ± 55.0 in group A and 77.5 ng/mL ± 45.0 in group B (P = .031); LUTS recurrence rates were 3.6% in group A and 14.6% in group B (P = .024). The mean IIEF-5 was not significantly different from baseline in either group. CONCLUSIONS: PAE with 50-µm plus 100-µm PVA particles resulted in greater improvement in clinical and imaging outcomes and no significant differences in adverse events compared with 100-µm PVA particles alone.

Benign Prostatic Hyperplasia: Cone-Beam CT in Conjunction with DSA for Identifying Prostatic Arterial Anatomy.

Purpose To describe findings in prostatic arteries (PAs) at digital subtraction angiography (DSA) and cone-beam computed tomography (CT) that allow identification of benign prostatic hyperplasia and to determine the value added with the use of cone-beam CT. Materials and Methods This retrospective single-institution study was approved by the institutional review board, and the requirement for written informed consent was waived. From February 2009 to December 2014, a total of 148 patients (mean age ± standard deviation, 70.5 years ± 14.5) underwent DSA of the internal iliac arteries and cone-beam CT with a flat-detector angiographic system before they underwent prostate artery embolization. Both the DSA and cone-beam CT images were evaluated by two interventional radiologists to determine the number of independent PAs and their origins and anastomoses with adjacent arteries. The exact McNemar test was used to compare the detection rate of the PAs and the anastomoses with DSA and with cone-beam CT. Results The PA anatomy was evaluated successfully by means of cone-beam CT in conjunction with DSA in all patients. Of the 296 pelvic sides, 274 (92.6%) had only one PA. The most frequent PA origin was the common gluteal-pudendal trunk with the superior vesicular artery in 118 (37.1%), followed by the anterior division of the internal iliac artery in 99 (31.1%), and the internal pudendal artery in 77 (24.2%) pelvic sides. In 67 (22.6%) pelvic sides, anastomoses to adjacent arteries were documented. The numbers of PA origins and anastomoses, respectively, that could be identified were significantly higher with cone-beam CT (301 of 318 [94.7%] and 65 of 67 [97.0%]) than with DSA (237 [74.5%] and 39 [58.2%], P < .05). Cone-beam CT provided essential information that was not available with DSA in 90 of 148 (60.8%) patients. Conclusion Cone-beam CT is a useful adjunctive technique to DSA for identification of the PA anatomy and provides information to help treatment planning during prostatic arterial embolization. © RSNA, 2016.

Prostatic arterial embolization for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia: a comparative study of medium- and large-volume prostates.

OBJECTIVES: To compare the outcomes of prostatic arterial embolization (PAE) in treating large (>80 mL) in comparison with medium-sized prostate glands (50-80 mL) to determine whether size affects the outcome of PAE. PATIENTS AND METHODS: A total of 115 patients (mean age 71.5 years) diagnosed with lower urinary tract symptoms (LUTS) attributable to benign prostatic hyperplasia (BPH) refractory to medical treatment underwent PAE. Group A (n = 64) included patients with a mean prostate volume of 129 mL; group B (n = 51) included patients with a mean prostate volume of 64 mL. PAE was performed using 100-µm particles. Follow-up was performed using the International Prostate Symptom Score (IPSS), quality of life (QoL), peak urinary flow rate (Qmax ), post-void residual urine volume (PVR), the International Index of Erectile Function short form (IIEF-5), prostate-specific antigen (PSA) and prostate volume measured by magnetic resonance imaging at 1, 3 and 6 months, and every 6 months thereafter. RESULTS: There were no significant differences between groups in baseline IPSS, QoL, Qmax , PVR, PSA level or IIEF-5 score. The technical success rate was 93.8% in group A and 96.8% in group B (P = 0.7). A total of 101 patients (55 patients in group A and 46 patients in group B) completed the mean (range) follow-up of 17 (12-33) months. Compared with baseline, there were significant improvements in IPSS, QoL, Qmax , prostate volume and PVR in both groups after PAE. The outcomes in group A were significantly better than in group B with regard to mean ± sd IPSS (-14 ± 6.5 vs -10.5 ± 5.5, respectively), Qmax (6.0 ± 1.5 vs 4.5 ± 1.0 mL/s, respectively), PVR (-80.0 ± 25.0 vs -60.0 ± 20.0 mL, respectively), prostate volume (-54.5 ± 18.0 mL [-42.3%] vs -18.5 ± 5.0 mL [-28.9%], respectively), and QoL score (-3.0 ± 1.5 vs -2.0 ± 1.0) with P values <0.05. The mean IIEF-5 score was not significantly different from baseline in both groups. No major complications were noted. CONCLUSIONS: We found that PAE is a safe and effective treatment method for patients with LUTS attributable to BPH. The clinical and imaging outcomes of PAE were better in patients with larger prostate glands than medium-sized ones.

Experimental study on the safety of percutaneous transhepatic portal vein ablation.

BACKGROUND/AIMS: Portal vein tumor thrombus (PVTT) is a common complication of hepatocellular carcinoma (HCC) with poor prognosis. Radiofrequency ablation (RFA) has been used for PVTT, however, its safety remains unclear. In this study, we have evaluated the safety of percutaneous transhepatic RFA of pigs' normal portal vein (PV). METHODOLOGY: RFA was conducted in miniature pigs either by local direct ablation (group A, n=6), or after occlusion by balloon or by thrombus (group B, n=4). The MRI imaging and pathological changes of PV were recorded after operation. RESULTS: RFA was successful in 4 of 6 pigs in group A and 3 of 4 pigs in group B. One pig (P4) died one day after RFA in group A. P1 showed a significantly increased thrombus in peritoneal cavity in contrast to another survived pig (P2) with inflammatory edema, but no obvious abnormalities were observed in the other two pigs (P1 and P3) in Group A. But in Group B, the range of PV lesion was larger than that in Group A with thrombus in lumens, and even inflammatory edema range increased significantly 3 weeks later. CONCLUSION: The percutaneous intravascular RFA using an endovascular bipolar RF device is technically feasible but the safety needs further investigation.

Prostatic arterial embolization for the treatment of lower urinary tract symptoms as a result of large benign prostatic hyperplasia: A prospective single-center investigation.

OBJECTIVE: To evaluate the effectiveness and safety of prostatic arterial embolization as a primary treatment for patients with lower urinary tract symptoms as a result of large benign prostatic hyperplasia. METHODS: A total of 64 patients with prostates >80 mL were included in the study. Prostatic arterial embolization was carried out using a combination of 50-µm and 100-µm particles. Clinical follow up was carried out using the International Prostate Symptom Score, quality of life, peak urinary flow, postvoid residual volume, International Index of Erectile Function Short Form, prostate-specific antigen, and prostatic volume at 1, 3, 6 and every 6 months thereafter. RESULTS: Prostatic arterial embolization was technically successful in 60 of 64 patients (93.8%). Follow-up data were available for 60 patients with a mean of 18 months. A clinical improvement, defined as reduction of International Prostate Symptom Score and increase of peak urinary flow, at 1 month, 3 months, 6 months, 12 months and 24 months, was achieved in 95.0%, 95.0%, 93.3%, 92.6% and 90.5%, respectively. A total of 42 patients had completed the follow up at 24 months after prostatic arterial embolization. There was an improvement in terms of mean International Prostate Symptom Score (pre-prostatic arterial embolization vs post-prostatic arterial embolization 27.0 vs 8.0; P < 0.01), mean quality of life (5.5 vs 2.0; P < 0.01), mean peak urinary flow (7.0 vs 13.0; P < 0.01), mean postvoid residual volume (130 vs 45.0; P < 0.05) and prostatic volume (121.0 vs 71.5, reduction of 40.9%; P < 0.01) were significantly different with respect to baseline. CONCLUSION: Prostatic arterial embolization seems to be a safe and effective treatment method for patients with lower urinary tract symptoms as a result of large benign prostatic hyperplasia, and it might play an important role for patients in whom medical therapy has failed, who are not candidates for surgical treatment.

[Application value of preoperative embolization in primary retroperitoneal tumor].

OBJECTIVE: To evaluate the value of angiography in clarifying the origin of the feeding arteries of primary retroperitoneal tumors and to explore the application of embolization therapy in the treating of primary retroperitoneal tumor. METHODS: 68 patients with primary retroperitoneal tumor were randomized into conventional tumor resection group (n = 35) and the preoperative embolization group (n = 33). Some clinical data were compared between the preoperative embolization group and the routine operation group, including blood loss, blood transfusion, operation time and adverse reactions after embolization. All the diagnoses were pathologically confirmed. The origins of the tumor-feeding arteries were analyzed. The clinical value of embolization in assisting the surgery as well as in making prognosis was assessed. RESULTS: According to their location and size, primary retroperitoneal tumors had feeding arteries from different origins. In this series of cases the tumor blood supply originated from the lumbar artery (81.8%), internal iliac artery (45.5%) and adrenal artery (27.3%). In the preoperative embolization group and conventional surgery group, the blood loss was 912 ml vs. 2 500 ml (P < 0.001), the blood transfusion was 1 000 ml vs. 2 600 ml (P < 0.001), the operation time was 4.1 h vs. 5.9 h (P < 0.001), and the length of hospital stay was 12.5 d vs. 19.8 d (P < 0.001). CONCLUSIONS: The origins of the feeding arteries in primary retroperitoneal tumors are very complex. Preoperative embolization therapy may effectively reduce the intraoperative blood loss, postoperative adverse events, length of hospital stay, and facilitate the patients' recovery.

[Super selective transcatheter arterial embolization for treatment of focal nodular hyperplasia of the liver: report of 21 cases].

OBJECTIVE: To evaluate the efficiency and safety of transcatheter arterial embolization (TAE) for treatment of focal nodular hyperplasia (FNH). METHODS: From January 2005 to December 2010, super selective TAE was performed for 21 patients with FNH. The patients consisted of 16 men and 5 women with age range of 16 to 44 years (mean age, 28 ± 12). Liver contrast enhancement CT and ultrasonography (US) were performed in all patients, dynamic contrast enhancement MRI was performed in 17 patients. All patients underwent percutaneous needle biopsies and the diagnosis of FNH was proven histologically. The indications for TAE were patients with progressive increase in size of FNH, who were not candidates for surgical treatment, or who refused for surgery. Embolic materials used in this series included emulsion of iodized oil and bleomycin and polyvinyl alcohol particle (PVA). Follow-up examinations included the routine blood tests, liver and renal function tests, US, CT or MRI. RESULTS: Eighteen patients (85.7%) had a single solitary focus and 3 (14.3%) had multiple foci. The diameter of the mass varied from 3.5 cm to 9.5 cm with a mean of 5.5 cm (5.5 ± 3.0 cm). All patients presented angiographically with characteristic findings, such as feeding artery that was distributed with a spinning wheel appearance, an extensive hypervascular mass, without arterio-venous shunt or portal vein invasion. A single session of TAE was performed in all patients. Technical success of TAE was achieved in all cases. No major complications were encountered in any of our patients. All patients were regularly followed up ranging from 1 to 6 years (3.5 ± 2.0) and they were healthy without recurrence. Marked reduction in the size of the FNH without arterial blood supply was found in 16 patients, and almost complete resolution of the FNH was observed in 6 patients. CONCLUSION: TAE is a safe and effective therapy for the management of patients with FNH. TAE could control FNH very well and even could be considered as a radical treatment.

[Management of acute massive pulmonary thrombosis embolism with interventional techniques].

OBJECTIVE: To assess the efficacy and safety of interventional techniques in the treatment of deep venous thrombosis (DVT) and its complication of acute massive pulmonary thrombosis embolism (PTE). METHODS: Twenty massive PTE patients received the examinations of Doppler ultrasonography, computed tomography (CT) and venography. After a definite diagnosis, interventional therapy was used for symptomatic controls. The interventional procedures included catheter fragmentation and suction (n = 11), catheter-directed thrombolysis (n = 7), stent placement (n = 4) and inferior vena cava (IVC) filter placement (n = 11). After the above procedures, low doses of urokinase and heparin were prescribed for 1 week. During a follow-up period of 6 - 24 months, the findings of CT, radiography and ultrasound were re-examined. RESULTS: Interventions were successful. The success rates of fragmentation and suction and iliac vein stenting were both 100%. No major complications occurred. Pulmonary embolism involved main trunks and branches of lungs. Both arterial blood pressure and oxygen saturation were below normal values. After interventions, the clinical symptoms and angiographic results improved obviously. CONCLUSION: It is safe and effective to apply catheter-directed mechanical fragmentation, suction and thrombolysis in the treatment of DVT and PTE. IVC filter may be useful for the prevention of PTE.

Prostate artery embolization for the treatment of urinary retention caused by large (>80 ​mL) benign prostatic hyperplasia: Results of 21 patients.

OBJECTIVE: A large prostate size (>80 â€‹mL) of benign prostatic hyperplasia (BPH) is technically challenging to treat surgically. This study aimed to investigate the safety and efficacy of super-selective prostatic artery embolization (PAE) for the treatment of urinary retention caused by large BPH. METHODS: A total of 21 patients with urinary retention, indwelling urinary catheter, or suprapubic cystostomy as a consequence of giant BPH (prostate volume [PV] â€‹> â€‹80 â€‹mL) who sought treatment between January 2013 and December 2017 were enrolled. A microcatheter (1.9-2.7 Fr) and a "two-step embolization" combining 50-µm and 100-µm polyvinyl alcohol embolization particles were used in all patients. International Prostate Symptom Score (IPSS), quality of life (QoL), PV, and prostate-specific antigen (PSA) were evaluated at 3, 6, and 12 months post-PAE. Clinical success was defined as removal of urinary catheter or suprapubic cystostomy and ability to void spontaneously. RESULTS: The clinical success rate was 95.2% (20/21). Compared with pre-procedural values, IPSS, QoL, PV, and PSA showed statistically significant differences at 3, 6, and 12 months post-PAE (P â€‹< â€‹0.05). There were no serious complications after PAE. CONCLUSIONS: PAE was safe and effective for the treatment of urinary retention caused by large BPH in patients without surgical treatment options.

Simultaneous transarterial chemoembolization and radiofrequency ablation for large hepatocellular carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) is a common cancer and a leading cause of tumor-related death. Patients with large HCC (≥ 8 cm) are at an advanced stage and have poor prognosis, and hepatic resection may not be suitable, and the incidence of postoperative recurrence is high. AIM: To evaluate recurrence and mid-term survival of patients with large HCC treated by transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA). METHODS: This was a retrospective study. From 2010 to 2013, 46 consecutive patients with large HCC were treated with simultaneous TACE and RFA. Thirty-five of 46 patients had a single tumor. Progression-free survival (PFS) and overall survival (OS) were analyzed at 2 years and 3 years, respectively. RESULTS: Forty-six patients treated by simultaneous TACE and RFA had no significant complications and treatment was successful. After 3 years, median PFS and OS were 10.21 ± 1.58 mo and 26.44 ± 2.26 mo, retrospectively. The survival rate was 67.5% after 2 years and 55.67% after 3 years. CONCLUSION: These preliminary data show that simultaneous TACE and RFA are safe and effective for large HCC.

Adjuvant trans-arterial chemoembolization after hepatectomy significantly improves the prognosis of low-risk patients with R0-stage hepatocellular carcinoma.

Background: Transcatheter arterial chemoembolization (TACE) is one of the local therapies most commonly used to treat intermediate-stage or advanced-stage hepatocellular carcinoma (HCC). However, the clinical benefits of PA-TACE (postoperative adjuvant TACE) for improving prognosis (progress-free survival [PFS] or overall survival [OS]) of low-risk HCC patients with R0-stage HCC after hepatectomy were not very clear. Methods: From January 2005 to December 2012, 180 patients who underwent hepatectomy for HCC treatment were enrolled in this study, and the follow-up of these patients was ended in December 2017. Among these patients, 102 patients were performed PA-TACE 1 month later after R0 hepatectomy and 78 patients without adjuvant TACE after R0 hepatectomy. Survival analysis was calculated using the Kaplan-Meier statistical method. Differences between survival curves of different groups were tested using the univariate log-rank test. Multivariate Cox model was used to search for independent prognostic factors for progression or death and to acquire the adjusted HR. Results: PA-TACE significantly improved the survival of HCC patients received surgical resection. The PFS (progress-free survival) of PA-TACE group (median PFS 52.0 months; 95% CI: 14.0-90.0) was significantly longer than the control group (median PFS 11.1 months; 95% CI: [7.9-14.3]; log-rank P<0.001); and the OS (in PA-TACE group (median OS 90.7 months; 95% CI: 84.4-97.0 months) was also much longer than that of control group (median OS 54.4 months; 95% CI: 38.2-70.6 months; log-rank p<0.001). Moreover, the benefits of PA-TACE are greater for low-risk patients than high-risk patients. Conclusion: In patients with HCC, PA-TACE can significantly prolong progression-free survival and long-term OS. For low-risk patients, the benefits might be greater.

Early- and intermediate-term outcome of transarterial embolization for symptomatic hepatic focal nodular hyperplasia.

Purpose: To evaluate the early- and intermediate-term outcome in patients with symptomatic hepatic focal nodular hyperplasia (FNH) treated with transarterial embolization using bleomycin-iodinated oil and polyvinyl alcohol (PVA) particles. Materials and methods: In this two-center retrospective study between January 2005 and December 2013, 27 consecutive patients with symptomatic hepatic FNH underwent superselective catheterization by microcatheter techniques and embolization using bleomycin-iodinated oil combined with PVA. Early-term (3-41 months) follow-up of TAE was performed in terms of symptom control, changes in lesion size, and complications. Intermediate-term (45-112 months) follow-up was carried out to assess symptom control and reinterventions for recurrence. Results: Embolization was performed in 27 patients with 31 lesions. Technical success was achieved in all cases. The follow-up period ranged from three to 112 months. At early-term follow-up, mean lesion diameters were decreased significantly from 6.4±2.7 cm pre-intervention to 3.6±1.8 cm at 3-9 months after embolization (P<0.001). A total of 7 lesions had complete resolution during the whole follow-up period. At intermediate-term follow-up, local recurrence was found in 1 treated lesion at 54-months. Contrast-enhanced scans showed complete lack of residual arterial blood supply in the majority of lesions during the follow-up period. There was no major complication associated with the procedure. Conclusion: Transarterial embolization using bleomycin-iodinated oil and PVA is a feasible, safe and effective alternative in both early- and intermediate-terms for the treatment of symptomatic hepatic FNH.

Safety and efficacy of transarterial interventional therapy for treatment of hepatocellular carcinoma with peritoneal metastases.

PURPOSE: The aim of this study was to evaluate the safety and efficacy of transarterial interventional therapy for the treatment of hepatocellular carcinoma (HCC) patient with peritoneal metastases. MATERIALS AND METHODS: A total of 7 HCC patients with peritoneal metastases were treated by interventional therapy. Combined treatment with transarterial chemoembolization for intrahepatic lesions and transarterial embolization for peritoneal metastases was performed through hepatic artery, gastroduodenal artery, and superior mesenteric artery. RESULTS: Treatment resulted in an objective response of 85.7% Modified Response Evaluation Criteria in Solid Tumors. No severe adverse effects were observed. CONCLUSIONS: Transarterial interventional therapy can be performed safely and may improve the prognosis of HCC patients with peritoneal metastases.

The Value of Hybrid Angio-CT in Preoperative Detection and Localization of Insulinomas: A Single-Center Retrospective Study.

OBJECTIVE: To investigate the performance of hybrid angio-CT in preoperative detection and localization for insulinomas. METHODS: Fifty-four postoperative pathology-confirmed patients from April 2015 to March 2017 were retrospectively reviewed; all patients underwent angio-CT with administration of contrast media in SMA, GDA and SA due to negative, inconclusive or controversial findings by several preoperative diagnostic methods including TAUS, CEUS, EUS, ECT, EMRI and DSA. Surgery was used as gold standard for localization of insulinomas; detection sensitivity and localization accuracy of angio-CT were assessed and compared with other preoperative image options. RESULTS: Fifty-six benign insulinomas (mean diameter, 15.8 mm) in 54 patients (18 men and 36 women) were found according to surgical results; the overall detection sensitivity of TAUS, CEUS, EUS, ECT, EMRI and DSA was 21.4, 78.4, 79.2, 70.0, 79.2 and 72.2%, respectively. The overall localization accuracy was 14.3, 58.8, 68.8, 60.0, 75.0 and 44.4%, respectively. A total of 53 tumors were detected by angio-CT, 51 tumors were accurately located, and the overall detection sensitivity and localization accuracy of angio-CT was 94.4 and 90.7%, which was significantly higher than that of all other preoperative diagnostic methods (p < 0.05). No any serious complications occurred during angio-CT. CONCLUSION: Our study indicates the great potential value of angio-CT in the preoperative detection and localization of insulinomas; angio-CT can be used as a preferred invasive diagnostic method.