Efficacy of transarterial chemoembolization on lesion reduction in colorectal liver metastases

Following failure of systemic chemotherapy, transarterial chemoembolization [TACE] is an available method to control unresectable liver metastases from colorectal carcinoma [CRC]. The aim of present study was to evaluate the efficacy of chemoembolization for inoperable metastatic liver lesions from CRC. Forty-five CRC patients with liver metastases resistant to systemic chemotherapy were enrolled in our study. For each patient, three session of TACE were conducted with 45 days interval. A combination of mitomycin, doxorubicin, and lipiodol were used for TACE. A tri-phasic computed tomography scan and biochemical laboratory tests were performed for all patients at baseline and 30 days after each TACE. Image analysis included measurement of lesion diameters as well as contrast enhancement. Eleven patients deceased before completing three session and the final analyses were performed on the remaining 34 patients. Evaluation of a total 93 lesions in all patients after chemoembolization sessions revealed a 25.88% reduction in anteroposterior [AP] diameter, 33.92% transverse [T] diameter, and 42.22% in product of APxT diameter of lesions [P<0.001 for all instances]. CT scan showed a total disappearance of 33% of lesions and evident reduction in contrast enhancement in 16% of them. There were no changes in contrast enhancement in 51% of lesions. Evaluation of single largest lesion in each patient revealed 57.32% reduction in AP diameter, 59.66% in T diameter, and 62.17% in product of APxT diameters [P<0.001 for all diameters]. TACE offers a viable option for CRC patients with unresectable liver metastases by significantly reducing lesion size and contrast enhancement.

Uterine segmentation and volume measurement in uterine fibroid patients' MRI using fuzzy C-mean algorithm and morphological operations

Uterine fibroids are common benign tumors of the female pelvis. Uterine artery embolization [UAE] is an effective treatment of symptomatic uterine fibroids by shrinkage of the size of these tumors. Segmentation of the uterine region is essential for an accurate treatment strategy. In this paper, we will introduce a new method for uterine segmentation in T1W and enhanced T1W magnetic resonance [MR] images in a group of fibroid patients candidated for UAE in order to make a reliable tool for uterine volumetry. Uterine was initially segmented using Fuzzy C-Mean [FCM] method in T1W-enhanced images and some morphological operations were then applied to refine the initial segmentation. Finally redundant parts were removed by masking the segmented region in T1W-enhanced image over the registered T1W image and using histogram thresholding. This method was evaluated using a dataset with ten patients' images [sagittal, axial and coronal views]. We compared manually segmented images with the output of our system and obtained a mean similarity of 80%, mean sensitivity of 75.32% and a mean specificity of 89.5%. The Pearson correlation coefficient between the areas measured by the manual method and the automated method was 0.99. The quantitative results illustrate good performance of this method. By uterine segmentation, fibroids in the uterine may be segmented and their properties may be analyzed

Hydatid cyst of the knee: a case report

Hydatid disease is a parasitic infection which occurs in specific geographical areas such as the Mediterranean region. We report a case of hydatid cyst of the knee in a 34-year-old man who was admitted with inability to walk and a painful knee. He had a past history of liver infection nine years ago. Laboratory findings were negative. According to the high prevalence of hydatid disease in Iran, it should be considered as a differential diagnosis of Baker's cyst, synovial cyst and lipoma