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Percutaneous vertebroplasty (PV) of the cervical spine has been traditionally performed with a trans-oral or antero-lateral approach. The posterior trans-pedicular approach (PTPA) has been sporadically reported. Therefore, the aim of this study is to retrospectively assess the technical feasibility, safety, and clinical outcomes of cervical PV performed with a PTPA. All consecutive patients undergoing PV in cervical levels with PTPA (under general anesthesia and computed tomography [CT] guidance) from January 2008 to November 2019 were identified. The following data were collected: patients’ demographics; indication for PV; vertebral level features; procedure-related variables; and clinical outcomes including complications and pain relief. Thirty-two patients (18 females, 14 males; mean age 61.1 ± 13.2 years, range 36–88) were included accounting for 36 vertebrae. Three vertebrae (3/36, 8%) were referred due to an underlying traumatic fracture, the remaining (33/36, 92%) due to a painful lytic tumor. Technical success was 97% (35/36 levels). Mean time required to deploy the trocar was 23 ± 11 min (range 7–60). Extra-vertebral asymptomatic cement leakage was observed in 3/35 (9%) vertebral levels. One patient (1/32, 3%) developed an acute cardiogenic pulmonary edema requiring admission in the intensive care unit; another patient (1/32, 3%) developed localized infection to the skin entry site, which was managed conservatively. At 1-month follow-up, the mean pain in the study population was 1.0 ± 1.1 (range 0–4/10) vs 6.2 ± 1.4 (range 4–9/10) at baseline (p < 0.05). Cervical PV performed via a CT-guided PTPA is technically feasible, safe, and results in effective pain relief. • Percutaneous vertebroplasty (PV) is a well-established technique for the treatment of benign and malignant compression fractures. • Common PV approaches used for cervical vertebrae include the trans-oral, antero-lateral, lateral, and sporadically the posterior trans-pedicular approach. • Retrospective analysis of our 11-year experience with the posterior trans-pedicular approach used for cervical vertebrae proved that such approach was safe and effective.

The purpose of this study is to discuss technical aspects and rationales of magnetic resonance (MR)-guided cryoablation (CA) of Morton's neuroma (MN); preliminary clinical experience is also retrospectively reviewed.Procedures were performed under local anaesthesia on an outpatient basis. Lesion size and location, procedural (technical success, procedural time, complications) and clinical outcomes (patient satisfaction according to a four-point scale, residual pain according to a 0-10 visual analogue scale and instances of "stump neuroma") were assessed via chart review and cross-sectional telephone survey after the 20th case.Twenty patients (15 female, 5 male; mean age 50.3 years) were included; 24 MN (mean size 12.7 mm) were treated. Technical success was 100 %. Mean procedural time was 40.9 +/- A 10.4 min (range 35-60). One minor complication (superficial cellulitis) was reported (4.2 %). Follow-up (mean 19.7 months) was available for 18/24 MN. Patient satisfaction on a per-lesion basis was as follows: "completely satisfied" in 77.7 %, "satisfied with minor reservations" in 16.6 % and "satisfied with major reservations" in 5.7 % of cases. Mean pain score at last follow-up post-CA was 3.0. No instances of "stump neuroma" were reported.MR-guided CA of MN is a novel therapy which appears technically feasible. Clinical advantages of the procedure are high patient satisfaction, reduced risk of "stump neuroma" syndrome and good patient tolerance on an outpatient basis. Further, prospective studies are needed to confirm these encouraging results.

High grade serous ovarian cancer (HGSOC) is the most common and lethal subtype of epithelial ovarian cancer. Prevalence (~96%) of mutant p53 is a hallmark of HGSOC. Estrogen receptor-beta (ERβ) has been reported to be another important player in HGSOC, although the pro-versus anti-tumorigenic role of its different isoforms remains unsettled. However, whether there is functional interaction between ERβ and mutant p53 in HGSOC is unknown. ERβ1 and ERβ2 mRNA and protein analysis in HGSOC cell lines demonstrated that ERβ2 is the predominant isoform in HGSOC. Specificity of ERβ2 antibody was ascertained using cells depleted of ERβ2 and ERβ1 separately with isoform-specific siRNAs. ERβ2-mutant p53 interaction in cell lines was confirmed by co-immunoprecipitation and in situ proximity ligation assay (PLA). Expression levels of ERβ2, ERα, p53, and FOXM1 proteins and ERβ2-mutant p53 interaction in patient tumors were determined by immunohistochemistry (IHC) and PLA, respectively. ERβ2 levels correlate positively with FOXM1 levels and negatively with progression-free survival (PFS) and overall survival (OS). Quantitative chromatin immunoprecipitation (qChIP) and mRNA expression analysis revealed that ERβ2 and mutant p53 co-dependently regulated FOXM1 gene transcription. The combination of ERβ2-specific siRNA and PRIMA-1MET that converts mutant p53 to wild type conformation increased apoptosis. Our work provides the first evidence for a novel ERβ2-mutant p53-FOXM1 axis that can be exploited for new therapeutic strategies against HGSOC.

PurposeThe elimination of abdominal tumors by percutaneous cryoablation has been shown to be an effective and less invasive alternative to open surgery. Cryoablation destroys malignant cells by freezing them with one or more cryoprobes inserted into the tumor through the skin. Alternating cycles of freezing and thawing produce an enveloping iceball that causes the tumor necrosis. Planning such a procedure is difficult and time-consuming, as it is necessary to plan the number and cryoprobe locations and predict the iceball shape which is also influenced by the presence of heating sources, e.g., major blood vessels and warm saline solution, injected to protect surrounding structures from the cold.MethodsThis paper describes a method for fast GPU-based iceball modeling based on the simulation of thermal propagation in the tissue. Our algorithm solves the heat equation within a cube around the cryoprobes tips and accounts for the presence of heating sources around the iceball.ResultsExperimental results of two studies have been obtained: an ex vivo warm gel setup and simulation on five retrospective patient cases of kidney tumors cryoablation with various levels of complexity of the vascular structure and warm saline solution around the tumor tissue. The experiments have been conducted in various conditions of cube size and algorithm implementations. Results show that it is possible to obtain an accurate result within seconds.ConclusionThe promising results indicate that our method yields accurate iceball shape predictions in a short time and is suitable for surgical planning.

International audience; Purpose To retrospectively analyze our interventional radiology outpatient clinics (IROC) for referral patterns, impact on interventional practice, and patient satisfaction. Materials and Methods Consultations performed between 2011 and 2019 were extracted. The two consecutive years with the highest number of consultations (n2018 = 1426; n2019 = 1595) were compared for unattended consultations (i.e., scheduled consultations with patients not showing-up); initial/follow-up consultations; hospital clinician/general practitioner referrals; initial consultations with radiologists not recommending interventions; procedural conversion rate (PCR; i.e., No. initial consultations resulting in interventions over the total number of initial consultations performed for the same clinical indication). A survey was conducted in 159 patients to determine their satisfaction. Results Consultations increased from 2011 to 2019 by 130%. In 2018–2019, the number of unattended consultations was stable (7.0% vs 6.6%; P = .68). The referrals were for back pain (42.2%), interventional oncology (40.5%), and arteriovenous malformations (9.0%). For back pain, in 2019, there were fewer consultations with radiologists not recommending interventions and increased PCR compared to 2018 (11.9% vs. 17.7%; 88.1% vs. 82.3%; respectively; P = .01). For interventional oncology, follow-up consultations and general practitioner referrals increased in 2019 compared to 2018 (43.0% vs 35.3%; P = .01; 24.4% vs. 12.7%; P

International audience; Percutaneous thermal ablation has proven to be safe and effective in the management of patients with spinal tumors. Such treatment is currently proposed following the decision of a multidisciplinary tumor board to patients with small painful benign tumors such as osteoid osteoma or osteoblastoma, as well as carefully selected patients presenting with spinal metastases. In both scenarios, in order to provide a clinically effective procedure, ablation is often tailored to the specific patients' clinical needs and features of the target tumor. In this review, we present the most common clinical contexts in which spine ablation may be proposed. We scrutinize technical aspects and challenges that may be encountered during the procedure, as well as offering insight on follow-up and expected outcomes.

Although rare, unintended thermal injury to organs surrounding the ablation zone can lead to severe complications. Over the past 15 years, different protective methods have been developed to limit risk of complications, and expand indications to include more challenging lesions in various locations including liver, kidney, lung and bone. The most frequently used techniques include hydrodissection, carbodissection, balloon interposition and probe torqueing. In most cases, tumours can be physically separated from sensitive structures, reducing risk of thermal injury. Endoluminal cooling/warming is an alternative option for complex ablations close to the ureter or major bile ducts. Different techniques may be combined to achieve successful protection in locations with complex anatomy. The purpose of this review is to provide an overview of available protective measures and discuss respective advantages/drawbacks.

International audience; Introduction - Percutaneous image-guided cryo- (CA) and radiofrequency- (RFA) ablations have been widely used in the treatment of painful bone metastases (BM). However, paucity of data is available for the performance of these treatments when used with a curative intent. The aim of this study is to investigate the local progression free-survival (LPFS) after radical percutaneous image-guided ablation of BM in oligometastatic patients, and to identify predictive factors associated with local tumor progression. Materials and methods - This is a retrospective review of all patients who underwent percutaneous image-guided CA or RFA of BM with a radical intent between 2007 and 2018. Results - Forty-six patients with a total of forty-nine BM underwent percutaneous image-guided CA (N = 37; 75,5%) or RFA (N = 12; 24,5%). Primary malignancies included thyroid (N = 11, 22.5%), breast (N = 21; 42.9%), lung (N = 8; 16.3%) and other (N = 9; 18,3%) cancers. Additional consolidation was performed after ablation in 20.4% cases (N = 10). Mean follow-up was 34.1 ± 22 months. Local progression at the treated site was observed in 28.5% cases (N = 14); 1- and 2-year LPFS was 76.8% and 71.7%, respectively. Size of BM (>2 cm) predicted local tumor progression (p = .002). Conclusions - Percutaneous image-guided locoregional therapies used in the radical treatment of BM in oligometastatic patients demonstrate significant rates of LPFS providing the size of BM ≤2 cm.

To investigate the shape and the volume of ablation zones obtained with microwave ablation (MWA) performed with multiple antennas in liver tumours. Tumour volume, number of antennas, size (long diameter (Dl), along the antenna axis; short diameter (Ds), perpendicular to the antenna axis; vertical diameter (Dv), vertical to both Dl and Ds) and shape (roundness index (RI); 1 corresponds to a sphere) of the ablation zone, ablation volume, and complications were evaluated. Mean Dl, Ds, and Dv were 4.7 ± 1.4 cm, 3.9 ± 1.4 cm, and 3.8 ± 1.0 cm, respectively. Mean RIs (Ds/Dl, Dv/Dl, and Dv/Ds) were 0.83 ± 0.13, 0.83 ± 0.17, and 1.02 ± 0.23, respectively, without any difference between the mean RI obtained with the double (0.84 ± 0.01) and that with the triple-antenna (0.93 ± 0.13) approach (p = 0.25). Mean ablation volume was 41 ± 32 cm3 (vs. mean tumour volume 13 ± 10 cm3; range 1–40; p

To review our preliminary experience with 6-l-18F-fluorodihydroxyphenylalanine (18F-FDOPA) PET/CT-guided radiofrequency ablation (RFA) of liver metastases from neuroendocrine tumours (NETs).Three patients (mean age 51.3 years; range 43-56) with gastro-entero pancreatic NET (GEP-NET) liver metastases underwent 18F-FDOPA PET/CT-guided RFA. Patients were referred with oligometastatic hepatic-confined disease (1-6 metastases; < 3 cm) on 18F-FDOPA PET/CT; poor lesion visualisation on US, CT, and MR; and ongoing symptoms. Procedures were performed in an interventional PET/CT scanner under general anaesthesia using a split-dose protocol. Lesion characteristics, procedural duration and technical success (accurate probe placement and post-procedural ablation-zone photopaenia), complications, patient and operator dose, and clinical outcomes were evaluated.Thirteen liver metastases (mean size 11.4 mm, range 8-16) were treated in three patients (two presented with "carcinoid syndrome"). Technical success was 100 % with a mean procedural duration of 173.3 min (range 90-210) and no immediate complications. Mean patient dose was 2844 mGy center dot cm (range 2104-3686). Operator and radiographer doses were acceptable other than the operator's right hand in the first case (149 A mu Sv); this normalised in the second case. There was no local tumour or extra-hepatic disease progression at mid-term follow-up (mean 12.6 months; range 6-20); however, two cases progressed with new liver metastases at different sites. There was 100 % clinical success (n = 2) in resolving carcinoid syndrome symptoms.18F-FDOPA PET/CT-guided RFA appears technically feasible, safe, and effective in patients with GEP-NETs and low-burden hepatic metastases. Further prospective studies are required to elucidate its precise role in tailored multimodality management of GEP-NET liver metastases.

Management of musculoskeletal (MSK) tumours has traditionally been delivered by surgeons and medical oncologists. However, in recent years, image-guided interventional oncology (IO) has significantly impacted the clinical management of MSK tumours. With the rapid evolution of relevant technologies and the expanding range of clinical indications, it is likely that the impact of IO will significantly grow and further evolve in the near future.In this narrative review, we describe well-established and new interventional technologies that are currently integrating into the IO armamentarium available to radiologists to treat MSK tumours and illustrate new emerging IO indications for treatment.

International audience; In the last few decades, thermal ablation (TA) techniques have been increasingly applied to treat small localised renal cell carcinomas. Despite this trend, there is still an underuse of TA compared to surgery and a substantial lack of high-quality evidence derived from large, prospective, randomised controlled trials comparing the long-term oncologic outcomes of TA and surgery. Therefore, in this narrative review, we assess published guidelines and recent literature concerning the diagnosis and management of kidney-confined renal cell carcinoma to understand whether percutaneous image-guided TA is ready to be proposed as a first-line treatment.

Percutaneous cryoablation has become a popular alternative to open surgery for the treatment of abdominal tumors. The preoperative planning of such interventions is an essential but complicated task. It consists in predicting the best placement for several cryoprobes to optimize the resulting iceball shape, that has to cover the whole tumor, while preserving healthy tissue and surrounding sensitive structures. In the past few years, methods have been proposed to simulate the propagation of cold within the tissue, in order to anticipate the final coverage. However, all the proposed models considered the source of cold as limited to the active tip of the cryoprobe, thus omitting a residual freezing along the probe’s body. The lack of precision of the resulting models can cause an underestimation of the predicted iceball leading to potential damages to healthy tissue or pain. In this paper, we describe the extension of an existing freezing simulation model to account for this effect. We detail the experimentation of our model on 5 retrospective cases, and demonstrate the improvement of the accuracy and realism of our simulation.

Cross-modal data matching refers to retrieval of data from one modality, when given a query from another modality. In general, supervised algorithms achieve better retrieval performance compared to their unsupervised counterpart, as they can learn better representative features by leveraging the available label information. However, this comes at the cost of requiring huge amount of labeled examples, which may not always be available. In this work, we propose a novel framework in a semi-supervised setting, which can predict the labels of the unlabeled data using complementary information from different modalities. The proposed framework can be used as an add-on with any baseline crossmodal algorithm to give significant performance improvement, even in case of limited labeled data. Finally, we analyze the challenging scenario where the unlabeled examples can even come from classes not in the training data and evaluate the performance of our algorithm under such setting. Extensive evaluation using several baseline algorithms across three different datasets shows the effectiveness of our label prediction framework., Comment: 12 pages, 3 tables, 2 figures, 1 algorithm flowchart

Purpose To test in vivo in an animal model the inherent atraumatic characteristics of the spring loaded blunt tip of a coaxial needle (Gangi-SoftGuard®, Apriomed, Sweden) against a conventional sharp stylet coaxial needle. Material and Methods The study was conducted on a 40 kg male swine that was its own control for a vascular trauma model. The procedure consisted of voluntary attempts to transfix and traverse the artery/aorta under continuous real-time angiogram. Test and control needles were positioned in the region of the intercostal, superior mesenteric and femoral/deep femoral arteries, and in the aorta. Computed tomography (CT) angiogram was performed post trauma to check for bleeding in the form of extravasation of contrast material. One attempt was performed per site and needle, except for the intercostal artery where a second attempt was done with the test needle, resulting in a total of 4 and 5 tests for the control and test needles, respectively. Results With the spring loaded blunt tip, no vascular trauma or bleeding was noted in the intercostal, superior mesenteric and femoral arteries, nor in the aorta. Vascular spasm that recovered with time was noted during the second attempt to transfix the same intercostal artery. There were consistent vascular traumas and bleedings with the control needle in all three tested arteries and the aorta, confirmed on angiogram as well as CT angiogram. Conclusion The atraumatic feature offered by the spring loaded blunt tip prevented vascular trauma during the 5 attempts made to transfix the artery/aorta in a swine.

International audience; An 80-year-old female underwent EVAR 4 years ago. She presented type II endoleak with sac expansion from 68 to 80 mm during 3-year follow-up after EVAR. Although she underwent translumbar percutaneous sac embolization, the AAA sac continued to enlarge, suggesting mixed-type endoleak including type I, II, and III. Transgraft direct sac angiography revealed endoleak cavity without demonstrable feeding vessel. Transgraft sac embolization using n-butyl cyanoacrylate and graft reinforcement was performed concurrently, without complications. The graft reinforcement consisted of graft extension for eliminating occult type I endoleak, and relining for eliminating occult type III endoleak. Six months after the procedure, CT showed no signs of sac expansion. Transgraft sac embolization combined with graft reinforcement is one of the available options for persistent and refractory mixed-type endoleak.

International audience; Objective To report a technique of percutaneous retrohepatic hydrodissection, highlighting its potential to physically separate liver tumours from the inferior vena cava (IVC) and the ostia of the hepatic veins (HV). Materials and Methods Between December 2017 and April 2018, hydrodissection of the retrohepatic IVC was performed in 5 patients (5 females; mean age 64.5 years) undergoing percutaneous ablation of 5 liver metastases (mean size: 3.6 cm) located adjacent to the IVC. Number of hydrodissection needles, volume of hydrodissection, separation of tumour/liver parenchyma from IVC/HV post-hydrodissection; technical success of ablation; and complications were tabulated. Results Two to three 22G spinal needles were required per case for adequate dissection. Mean volume to obtain sufficient hydrodissection was 410 ml on average. Physical separation of the IVC and tumour/hepatic parenchyma was successful in all cases, by 9 mm on average (range 5–12 mm). It also leaded to physical separation of the ostia of the right and middle HV in all cases. There was no early or delayed complication, notably no venous thrombosis in the post-operative period. All lesions but one were completely ablated after one session at 3-month follow-up. The patient with residual tumour was successfully retreated. Conclusion Retrohepatic hydrodissection is a feasible technique to separate a tumour from the IVC and/or ostia of the HV. This could potentially limit the heat-sink effect/reduce the risk of thrombosis. Larger follow-up studies are required to assess efficacy on a long-term basis.

To evaluate the pharmacokinetic profile (PK) and embolization effect of 70-150-μm doxorubicin eluting beads (DEBs) following intra-arterial injection (i.a.) in the rabbit liver VX2 tumour model.In this ACUC-approved study, 25 white New Zealand rabbits were randomly assigned into a small DEB group (SDB, n = 7, 70-150-μm DEBs), large DEB group (LDB, n = 7, 100-300-μm DEBs), untreated controls (n = 7), and doxorubicin controls (n = 4, without tumour, received i.a. 12.5 mg doxorubicin). Plasma PK was assessed up to 180 min post-injection. Drug tissue and liver enzyme levels, radiologic tumor response and histopathologic tumour necrosis were assessed at 7 days.Mean tumour doxorubicin concentrations were 922.83 nM (SD = 722.05) and 361.48 nM (SD = 473.23) for the SDB and LDB, respectively (p = 0.005). There was no statistically significant difference in tumour doxorubicinol, plasma doxorubicin and doxorubicinol PK values. More beads were observed in the SDB tumours (p = 0.01). Liver enzymes increased and gradually declined over the observation period, with significantly higher values in the SDB.In this preclinical study, plasma PK of i.a.-injected 70-150-μm DEBs was not different than that of 100-300-μm DEBs. More beads and higher tissue doxorubicin levels were observed in the SDB tumours.• Small and large doxorubicin-eluting beads show similar plasma pharmacokinetic profiles. • Higher tissue doxorubicin levels were observed in the small bead group. • Liver enzymes were overall significantly higher in the small bead group.

Sir,Knee osteoarthritis (OA) is a leading cause of disability; it has been estimated that in the United States nearly one-tenth of the adults are affected by such condition with an expected radiogr...

International audience; Aim: To investigate the analgesic properties and the safety of low power bipolar radiofrequency ablation (RFA) performed with internally cooled electrodes and vertebral augmentation for the treatment of painful spinal malignancies. Materials and methods: Consent was waived for retrospective study participation. Review of electronic records identified 11 consecutive patients (6 females; 5 males; mean age 61.3 ± 11.6 years) with one-index painful spinal tumour, who were treated between June 2016 and October 2017 with bipolar RFA and vertebral augmentation. Patients were treated if they presented with focal pain (≥4/10 on a 0–10 visual analogic scale in the 24-h period) corresponding to a metastatic vertebral level on cross sectional imaging. The Wilcoxon test was used to evaluate the significance of the post-operative pain. Results: Lumbar levels were treated in 72.7% cases; metastatic epidural involvement was noted in 81.8% cases; 54.5% patients received associated treatments in addition to RFA, which was coupled to vertebral augmentation in all cases. Two (18.2%) complications were noted. Mean pain score measured at last clinical follow-up available (mean 1.9 ± 1.4 months) was 3.5 ± 2 (versus 7.8 ± 1.1 at baseline; p

International audience; Purpose: Radiofrequency ablation (RFA) is the most common percutaneous technique applied to treat painful spinal metastasis; however, experience in this field is somehow still limited. A systematic literature research was performed to understand the effects of RFA in terms of analgesia and safety. Materials and methods: Inclusion criteria for the studies were as follows: (1) randomised controlled or non-randomised studies with a prospective or retrospective design; (2) population made up of adults with spinal metastasis; (3) spinal metastasis treated with RFA alone or in combination/comparison with other treatments; (4) studies reporting about patients’ pain before and at least one time-point following RFA; and (5) English-language studies. Results: Seven hundred and thirty-three articles were screened and 8 (4 prospective, 4 retrospective) matched the inclusion criteria. Study population ranged between 10 and 92 patients across studies. Five out of eight studies reported a highly effective pain management (≥4 points of pain reduction between baseline and the last time-point available); 2/8 studies reported moderate results (≥2 points of pain reduction between baseline and the last time-point available). All studies combined RFA with cement augmentation in the vast majority of patients (40–100%) or metastasis (94–95.8%). Grade I–IIIa neural complications were reported in up to 16% of the cases and were always managed conservatively or with steroids. Conclusions: RFA, combined with vertebral augmentation in most of the cases, is effective and safe in achieving short- to mid-term (from 1 week to 6 months) analgesia in patients affected by painful spinal metastasis.

Due to abundance of data from multiple modalities, cross-modal retrieval tasks with image-text, audio-image, etc. are gaining increasing importance. Of the different approaches proposed, supervised methods usually give significant improvement over their unsupervised counterparts at the additional cost of labeling or annotation of the training data. Semi-supervised methods are recently becoming popular as they provide an elegant framework to balance the conflicting requirement of labeling cost and accuracy. In this work, we propose a novel deep semi-supervised framework which can seamlessly handle both labeled as well as unlabeled data. The network has two important components: (a) the label prediction component predicts the labels for the unlabeled portion of the data and then (b) a common modality-invariant representation is learned for cross-modal retrieval. The two parts of the network are trained sequentially one after the other. Extensive experiments on three standard benchmark datasets, Wiki, Pascal VOC and NUS-WIDE demonstrate that the proposed framework outperforms the state-of-the-art for both supervised and semi-supervised settings., Comment: Updated Version of the Paper has been accepted in IEEE Transactions on Multimedia {https://ieeexplore.ieee.org/document/8907496/}

Percutaneous cryoablation is a minimally invasive procedure of hypothermia for the treatment of tumors. Several needles are inserted in the tumor through the skin, to create an iceball and kill the malignant cells. The procedure consists of several cycles alternating extreme freezing and thawing. This procedure is very complex to plan, as the iceball is formed from multiple needles and influenced by major blood vessels nearby, making its final shape very difficult to anticipate. For computer assistance to cryoablation planning, it is essential to predict accurately the final volume of necrosis. In this paper, a fast GPU implementation of 3D thermal propagation is presented based on heat transfer equation. Our approach accounts for the presence of major blood vessels in the vicinity of the iceball. The method is validated first in gel conditions, then on an actual retrospective patient case of renal cryoablation with complex vascular structure close to the tumor. The results show that the accuracy of our simulated iceball can help surgeons in surgical planning.

This study presents a simplified framework for the quantification of the probability of seismically induced subaerial and submarine mass movements, an essential input for assessment of tsunami risk. The study incorporates the probability of seismically-induced ground motions developed from a Probabilistic Seismic Hazard Analysis (PSHA) and the probability of landslide triggering given an input ground motion, to calculate the joint probability of seismically-induced mass movement. Potential subaerial and submarine sliding masses of sufficient size to trigger a tsunami were identified through a geomorphological analysis of seafloor bathymetry and topographic relief coupled with available regional geological studies of the area. Typical slide volumes were in the range of 107 and 108 m3, consistent with the volumes noted during historical events. In this study, the probability of triggering a mass movement was defined as the probability of exceeding a threshold seismically-induced displacement value along a defined sliding surface beyond which uncontrolled movement of the slide mass was assumed to occur, leading to the potential development of a tsunami wave. The probability of exceeding the threshold displacement was calculated using the Bray and Travasarou (2007) method for estimating earthquake-induced slope displacements. The study treated uncertainty in the input parameters through the use of probability density functions developed using slope stability back analyses and engineering judgement. Material strength parameters were subsequently updated using Bayes theorem. The results of the study indicated that seismically-induced mass movements with potential for triggering a tsunami wave would have an annual probability lower than 1·10−3. Some of the slide scenarios selected in the study were used by others as input into hydrodynamic analyses for tsunami wave generation and propagation, and subsequently to define design inundation levels and design wave events for marine facilities.

A vibration exciter is a machine which produces mechanical vibratory motion to which the test object is subjected. This article presents design, construction, performance and testing of mechanical vibrations exciter, which have unbalanced mass to generate uniaxial vibrations. The exciter is designed to produce a given range of harmonic or time dependent excitation force and displacement through a given range of frequencies. The mechanical vibration exciter produces vibrations due to centrifugal force of rotating eccentric mass. The vibrations produced lie in the low frequency range. The construction of working device and its important parts are described here. The most important part of exciter is unbalanced mass attached with rotating disc of motor. Exciter has unbalanced mass at one end of disc, base frame, top plate as platform, springs and motor. This exciter is used for testing of welded parts, consolidation of concrete, concrete filling in mould. The obtained experimental results are in line with theoretical results.

Introduction: C-Arm CT (CACT) is a new imaging modality in liver oncology therapy that allows for the acquisition of 3D images intra-procedurally. CACT has been used to enhance intra-arterial therapies for the liver by improving lesion detection, avoiding non-target embolization, and allowing for more selective delivery of agents. However, one of the limitations of this technology is image artifacts created by respiratory motion. Purpose: To determine in this preliminary study improvements in image acquisition, motion compensation, and high resolution 3D reconstruction that can improve CACT image quality (IQ). Material and methods: Three adult male New Zealand white rabbits were used for this study. First, a control rabbit was used to select the best x-ray acquisition imaging protocol and then two rabbits were implanted with liver tumor to further develop 3D image reconstruction and motion compensation algorithms. Results: The best IQ was obtained using the low 80 kVp protocol with motion compensated reconstruction with high resolution and fast acquisition speed (60 fps, 5 s/scan, and 312 images). Conclusion: IQ improved by: (1) decreasing acquisition time, (2) applying motioncompensated reconstruction, and (3) high resolution 3D reconstruction. The findings of this study can be applied to future animal studies and eventually could be translated into the clinical environment.

In the recent times, due to the high depletion rates of availability of fossil fuels, solar energy is substituting as one of the excellent options for power grid evolution. Any system under operation is susceptible to faults due to internal and external factors. The identification of certain faults not only consumes more time but also leads to wastage of resources due to unwanted maintenance strategies employed. This paper presents a proposal to provide an intelligent approach towards fault diagnostics of a solar micro grid with battery back-up for a reliability centered maintenance approach to supersede and improve upon preventive maintenance strategy. The paper presents an analysis of the comprehensive list of faults that may occur in a PV microgrid, the parameters needed to correctly diagnose and classify the faults and finally select a minimum number of sensors and data acquisition required for Reliability Centered Maintenance of a PV based micro grid.

Purpose To show that hepatic tumor volume and enhancement pattern measurements can be obtained in a time-efficient and reproducible manner on a voxel-by-voxel basis to provide a true three-dimensional (3D) volumetric assessment. Materials and Methods Magnetic resonance (MR) imaging data obtained from 20 patients recruited for a single-institution prospective study were retrospectively evaluated. All patients had a diagnosis of hepatocellular carcinoma (HCC) and underwent drug-eluting beads (DEB) transcatheter arterial chemoembolization for the first time. All patients had undergone contrast-enhanced MR imaging before and after DEB transcatheter arterial chemoembolization; poor image quality excluded 3 patients, resulting in a final count of 17 patients. Volumetric RECIST (vRECIST) and quantitative EASL (qEASL) were measured, and segmentation and processing times were recorded. Results There were 34 scans analyzed. The time for semiautomatic segmentation was 65 seconds±33 (range, 40–200 seconds). vRECIST and qEASL of each tumor were computed Conclusions Semiautomatic quantitative tumor enhancement (qEASL) and volume (vRECIST) assessment is feasible in a workflow-efficient time frame. Clinical correlation is necessary, but vRECIST and qEASL could become part of the assessment of intraarterial therapy for interventional radiologists.

The purpose of this study was to study the pharmacokinetics of irinotecan injected intravenously, intra-arterially, or loaded onto a delivery platform.Fifty-four New Zealand White rabbits with VX2 liver tumor, divided in 3 groups of 17 rabbits, each received irinotecan either by intravenous (IV) route, intra-arterial hepatic (IA) route, or loaded on drug-eluting beads (DEBIRI). Animals were killed at 1, 6, and 24 h. Irinotecan and SN-38 concentrations were measured at different time points in serum, tumor, and normal liver.Twelve milligrams of irinotecan were injected IV and IA, whereas 6-16.5 mg were injected loaded onto DEBIRI. Normalized serum irinotecan reached a peak of 333 ng/ml (range 198.8-502.5) for IV, 327.1 ng/ml (range 277.1-495.6) for IA, and 189.7 ng/ml (range 111.1-261.9) for DEBIRI (P 0.001) delivery. The area-under-the-curve value from 10 to 60 min of serum irinotecan concentration was significantly lower for DEBIRI (P = 0.0009). Tumor irinotecan levels for IV, IA, and DEBIRI (in ng/200 mg of tissue followed by ranges in parentheses) were, respectively, 23.6 (0.3-24.9), 36.5 (7.7-1914.1), and 20.2 (2.9-319) at 1 h; 4.2 (1-27.9), 99.3 (46.6-159.5), and 42.1 (11.3-189) at 6 h; and 2.7 (2.5-6.9), 18.3 (1.5-369.1), and 174.4 (3.4-5147.3) at 24 h (P = 0.02). At 24 h, tumor necrosis was 25% (10-30), 60% (40-91.25), and 95% (76.25-95) for IV, IA, and DEBIRI, respectively (P = 0.03).Compared with IV or IA, DEBIRI induces lower early serum levels of irinotecan, a high and prolonged intratumoral level of irinotecan, and a greater rate of tumor necrosis at 24 h. Further evaluation of the clinical benefit of DEBIRI is warranted.

Background Although some authors have advocated the practice of arterial embolization for angiographically negative acute hemorrhage from gastroduodenal ulcers, this technique remains controversial. Purpose To compare the results of arterial embolization for bleeding (BU) and non-bleeding (NBU) gastroduodenal ulcers. Material and Methods Transcatheter embolization was performed in 57 patients (39 men, 18 women, mean age 69.8 years) who experienced acute bleeding from gastroduodenal ulcers. At the time of embolization active contrast extravasation was seen in 36 of 57 patients, while in the remaining 21 patients embolization was based on endoscopic findings. Patient demographics, clinical success, need for re-intervention secondary to re-bleeding, and 30-day complication and mortality rates were reviewed and compared between the two groups by using statistical analyses. Results In the BU group, the gastroduodenal artery (GDA) was embolized in 31 patients (86.1%), the left gastric artery (LGA) in three patients (8.3%), and the left gastroepiploic artery (LGEA) in two patients (5.6%). In the NBU group, the GDA was embolized in 18 patients (85.7%), and the LGA in three patients (14.3%). Clinical success (61.9 vs. 75.0%, P = 0.30), need for re-intervention (38.1 vs. 27.8%, P = 0.42), and 30-day complication (9.5 vs. 5.6%, P = 0.57), and mortality (28.6 vs. 25%, P = 0.77) rates were not statistically different between the two groups. Embolization in patients in NBU group did not have impact on clinical success (OR, 0.54; 95%CI, 0.17–1.72; P = 0.30). Conclusion Arterial embolization in patients with angiographically NBU is as safe and effective as embolization in patients with BU.

To compare fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with computed tomography (PET/CT) and chest CT in the evaluation of the effectiveness of lung radiofrequency (RF) ablation.Institutional review board approved the study, and all patients gave written informed consent. Thirty-four patients (22 men and 12 women; mean age, 64 years) planned to undergo lung RF ablation were prospectively included and underwent FDG PET/CT and chest CT before (pre-RF ablation PET) and 24 hours, 1 month, and 3 months after RF ablation. Persistent equivocal findings up to 3 months were followed up.Pre-RF ablation PET led to changes in the treatment strategy in nine patients (26%) by depicting unexpected metastases. Two patients without FDG uptake in lesions to be treated were excluded. Overall, 28 patients (46 lesions: five primary cancer, 41 metastases) were treated and followed up. Within 3 months after RF ablation, incomplete treatment was diagnosed in four of 28 patients (14%, three at 1 month and one at 3 months). Findings of FDG PET/CT were true-positive in four, false-positive in one, and true-negative in 23 patients. Findings of chest CT were true-positive in one, false-positive in one, false-negative in three, and true-negative in 23 patients. Inflammatory FDG uptake in mediastinal lymph nodes and at the needle path puncture site used for RF ablation was observed in 15%, 21%, and 15% of patients and in 19%, 11%, and 15% of patients at 24 hours, 1 month, and 3 months, respectively.FDG PET/CT can be used for the evaluation of the effectiveness of lung RF ablation. Inflammatory FDG uptake in mediastinal lymph nodes or at the needle path site used for RF ablation may occur.

The purpose is to evaluate the feasibility of imaging mouse brain with high resolution ultrasound (HiRes US), and generation of mouse brain tumor (glioma) model under HiRes US guided implantation of glioma cells. Normal mouse brain was imaged with 30 MHz HiRes US in six pups and ten adult nude mice. Glioma model was developed by injecting human glioma cells (5 × 105), U-87MG-luc, under HiRes US guidance, in three pups and five adult mice. Bioluminescence imaging, magnetic resonance imaging, and HiRes US were used for in vivo tumor imaging. In addition, brain imaging ex vivo with HiRes US were also performed in three tumor bearing and five normal brains. The brain parenchyma was seen as a homogeneous low echo on HiRes US without locoregional echo differences. An inverted U shaped linear echo structure (fissure) differentiated the telencephalon from the diencephalon. Bilaterally budding structure at the base of the skull represented the trigeminal nerve. The inserted needle, used to implant the glioma cells, was seen as a high linear echogenic reflection. Brain tumor on ex vivo HiRes US was well demarcated, homogeneous and hyperechoic compared to the surrounding healthy brain. In conclusion, imaging the brain with HiRes US in small animal model like mouse is possible and convenient. Real-time guiding is possible to perform any intervention from tumor implantation to percutaneous therapeutic procedures. Ex vivo, HiRes US is extremely useful to study the detailed anatomical features.

3-Bromopyruvate (3BrPA) is a pyruvate analog known for its alkylating property. Recently, several reports have documented the antiglycolytic and anticancer effects of 3BrPA and its potential for therapeutic applications. 3BrPA-mediated cytotoxicity has been evaluated in vitro by various methods including tetrazolium salt (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide)-based assays such as MTT, MTS, and so on. However, growing body of evidences has shown that tetrazolium reagent may interfere with the test compounds. In this study, we investigated whether the tetrazolium reagent interferes with the assessment of 3BrPA cytotoxicity. The results of the tetrazolium-based MTS assay were compared with 3 distinct cell viability detection methods, that is, Trypan Blue staining, ATP depletion, and Annexin V staining in 2 different cell lines, Vx-2 and HepG2. The MTS assay data showed false positive results by indicating increased cell viability at 1 mM and 2 mM 3BrPA whereas the other cell viability assays demonstrated that both Vx-2 and HepG2 cells are not viable at the same treatment conditions. In order to validate the direct interaction of 3BrPA with MTS reagent, we tested cell-free media incubated with different concentrations of 3BrPA. The results of cell-free media showed an increase in absorbance in a dose-dependent manner confirming the interaction of MTS with 3BrPA. Thus, our data clearly demonstrate that 3BrPA interferes with the accuracy of MTS-based cytotoxicity evaluation. Hence, we suggest that employing multiple methods of biochemical as well as morphological cytotoxicity assays is critical to evaluate 3BrPA-mediated cell death.

The current review provides an overview on the palliative, combined, neoadjuvant, bridging, and symptomatic indications of transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). It is based on an analysis of the current literature and the experience of the authors on the topic. Chemoembolization combines the infusion of chemotherapeutic drugs with particle embolization. Tumor ischemia raises the drug concentration compared to infusion alone, extends the retention of the chemotherapeutic agent and reduces systemic toxicity. Palliatively, TACE is performed to control symptoms and prolong survival in HCC patients; in some indications TACE allows a local tumor control of 18-63%. For combined indications, excellent results were achieved by combined therapies, such as percutaneous ethanol injection (PEI)/TACE, radiofrequency ablation (RF)/TACE, and laser-induced thermotherapy (LITT)/TACE. As a neoadjuvant therapy prior to liver resection TACE showed 70% tumor control. Though debatable, TACE still plays a role as a bridging tool before liver transplantation. Symptomatic indication of TACE in ruptured HCC showed 83-100% control of bleeding but survival was poor. Thus, TACE represents an important therapeutic tool against HCC in general in addition to its special role in cases of unresectable HCC.

Life-threatening intra-abdominal hemorrhage following ultrasonographically guided percutaneous renal biopsy is extremely rare and, most of the time, is due to renal vascular injury. Injury of other abdominal arteries during percutaneous renal biopsy is exceedingly rare. We report herein a case of left superior colonic artery injury during ultrasonographically guided percutaneous renal biopsy, which was responsible for pseudoaneurysm formation and subsequent intra-abdominal hemorrhage and gastrointestinal bleeding. Arterial pseudoaneurysm was rapidly and successfully treated with minimally invasive endovascular treatment using microcoils. Superselective embolization stopped the bleeding and preserved colonic vascularization, thus preventing ischemia of the involved colonic segment.