Interventional Oncology and Immuno-Oncology: Current Challenges and Future Trends.

Personalized cancer treatments help to deliver tailored and biologically driven therapies for cancer patients. Interventional oncology techniques are able to treat malignancies in a locoregional fashion, with a variety of mechanisms of action leading to tumor necrosis. Tumor destruction determines a great availability of tumor antigens that can be recognized by the immune system, potentially triggering an immune response. The advent of immunotherapy in cancer care, with the introduction of specific immune checkpoint inhibitors, has led to the investigation of the synergy of these drugs when used in combination with interventional oncology treatments. The aim of this paper is to review the most recent advances in the field of interventional oncology locoregional treatments and their interactions with immunotherapy.

The Role of the Transjugular Intrahepatic Porto-Systemic Shunt in an Emergency Setting.

Transjugular intrahepatic porto-systemic shunt (TIPSS) is an interventional radiology procedure whose aim is to create artificial communication between the portal and the hepatic blood flow in order to reduce the pressure gradient in portal hypertension. The indications to perform a TIPSS procedure can be framed in an elective or emergency setting: refractory ascites to diuretic therapy and secondary prophylaxis of variceal hemorrhage are the most frequent reasons for executing a TIPSS in an election context, while acute uncontrolled variceal bleeding is the principal indication that a TIPSS needs to be performed in an emergency setting. In recent years, the role of the TIPSS has been redefined for several conditions, such as ectopic varices, portal vein thrombosis, Budd-Chiari syndrome, hepatic veno-occlusive disease, and many others. This review aims to perform a deep analysis of when and why a TIPSS procedure should be carried out in an emergency, pointing out the related most common technical difficulties and complications.

Interventional Radiology in the Treatment of Pancreatic Adenocarcinoma: Present and Future Perspectives.

Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease; patients' long-term survival is strictly linked to the surgical resection of the tumor but only a minority of patients (2-3%) have a resectable disease at diagnosis. In patients with surgically unresectable disease, interventional radiology is taking on an increasing role in treatment with the application of loco-regional percutaneous therapies. The primary purposes of this narrative review are to analyze the safety and efficacy of ablative techniques in the management of borderline resectable and locally advanced diseases and to underline the role of the interventional radiologist in the management of patients with distant metastases. The secondary purpose is to focus on the synergy between immunotherapy and ablative therapies.

Technological Advancements in Interventional Oncology.

Interventional radiology, and particularly interventional oncology, represents one of the medical subspecialties in which technological advancements and innovations play an utterly fundamental role. Artificial intelligence, consisting of big data analysis and feature extrapolation through computational algorithms for disease diagnosis and treatment response evaluation, is nowadays playing an increasingly important role in various healthcare fields and applications, from diagnosis to treatment response prediction. One of the fields which greatly benefits from artificial intelligence is interventional oncology. In addition, digital health, consisting of practical technological applications, can assist healthcare practitioners in their daily activities. This review aims to cover the most useful, established, and interesting artificial intelligence and digital health innovations and updates, to help physicians become more and more involved in their use in clinical practice, particularly in the field of interventional oncology.

Progress in interventional radiology treatment of pulmonary embolism: A brief review.

Pulmonary embolism represents a common life-threatening condition. Prompt identification and treatment of this pathological condition are mandatory. In cases of massive pulmonary embolism and hemodynamic instability or right heart failure, interventional radiology treatment for pulmonary embolism is emerging as an alternative to medical treatment (systemic thrombolysis) and surgical treatment. Interventional radiology techniques include percutaneous endovascular catheter directed therapies as selective thrombolysis and thrombus aspiration, which can prove useful in cases of failure or infeasibility of medical and surgical approaches.

Cell Damage Index as Computational Indicator for Blood Cell Activation and Damage.

Shear-induced hemolysis is a major concern in the design and optimization of blood-contacting devices. Even with a small amount of mechanical stress, inflammatory reactions can be triggered in the cells. Blood damage is typically estimated using continuum fluid dynamics simulations. In this study, we report a novel cell damage index (CDI) obtained by simulations on the single-cell level in a lattice Boltzmann fluid flow. The change of the cell surface area gives important information on mechanical stress of individual cells as well as for whole blood. We are using predefined basic channel designs to analyze and compare the newly developed CDI to the conventional blood damage calculations in very weak shear stress scenarios. The CDI can incorporate both volume fraction and channel geometry information into a single quantitative value for the characterization of flow in artificial chambers.

Young Children's Self-Concepts Include Representations of Abstract Traits and the Global Self.

There is debate about the abstractness of young children's self-concepts-specifically, whether they include representations of (a) general traits and abilities and (b) the global self. Four studies (N = 176 children aged 4-7) suggested these representations are indeed part of early self-concepts. Studies 1 and 2 reexamined prior evidence that young children cannot represent traits and abilities. The results suggested that children's seemingly immature judgments in previous studies were due to peculiarities of the task context not the inadequacy of children's self-concepts. Similarly, Studies 3 and 4 revealed that, contrary to claims of immaturity in reasoning about the global self, young children update their global self-evaluations in flexible, context-sensitive ways. This evidence suggests continuity in the structure of self-concepts across childhood.

Atraumatic Pulsatile Leukocyte Circulation for Long-Term In Vitro Dynamic Culture and Adhesion Assays.

Low flow rate pumping of cell suspensions finds current applications in bioreactors for short-term dynamic cell culture and adhesion assays. The aim of this study was to develop an atraumatic pump and hemodynamically adapted test circuit to allow operating periods of at least several hours. A computer-controlled mini-pump (MP) was constructed based on non-occlusive local compression of an elastic tube with commercial bi-leaflet valves directing the pulsatile flow into a compliant circuit. Cell damage and activation in the system were tested with whole blood in comparison with a set with a conventional peristaltic pump (PP). Activation of circulating THP-1 monocytes was tested by measuring the expression of CD54 (ICAM-1). Additionally, monocyte-endothelial interactions were monitored using a parallel-plate flow chamber with an artificial stenosis. The system required a priming volume of only 20 mL, delivering a peak pulsatile flow of up to 35 mL/min. After 8 h, blood hemolysis was significantly lower for MP with 11 ± 3 mg/dL compared with PP with 100 ± 16 mg/dL. CD142 (tissue factor) expression on blood monocytes was 50% lower for MP. With MP, THP-1 cells could be pumped for extended periods (17 h), with no enhanced expression of CD54 permitting the long-term co-culture of THP-1 with endothelial cells and the analysis of flow pattern effects on cell adhesion. A low-damage assay setup was developed, which allows the pulsatile flow of THP-1 cells and investigation of their interaction with other cells or surfaces for extended periods of time.