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BACKGROUND: Ingestion of gastrointestinal foreign bodies (FB) is a common clinical problem worldwide. Approximately 10-20% of FBs require an endoscopic procedure for removal, and < 1% require surgery. CASE DESCRIPTION: An 89-year-old male with Alzheimer's disease was hospitalized because of abdominal pain, abdominal distention, vomiting for three days, and cessation of bowel movements for six days. Abdominal computed tomography (CT) scan showed a small intestinal obstruction and an atypical FB in the small intestine. A pill and remaining plastic casing were removed from the small intestine during surgery. FB is a square with four sharp acute angles at its edge. The patient was discharged after two weeks of treatment, and no recurrence or complications were observed during the 6- month follow-up. CONCLUSION: Atypical intestinal FBs may cause misdiagnosis and easily lead to serious complications. Therefore, an appropriate radiological examination, such as CT, is necessary for unexplained intestinal obstruction. Symptomatic intestinal FBs should be actively removed to avoid serious complications.
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Nephrostomy catheter misplacement into the inferior vena cava after percutaneous nephrolithotomy is an extremely rare complication, and subsequent catheter-related thrombosis has been more rarely reported. Here, we report a rare case of nephrostomy catheter misplacement after percutaneous nephrolithotomy. During the procedure, due to bleeding upon establishing the puncture channel, a renal fistula catheter with a balloon was inserted to facilitate hemostasis. However, the catheter inadvertently migrated into the inferior vena cava, with the inflated balloon obstructing venous return, resulting in thrombosis formation within the inferior vena cava. The patient was urgently transferred to our hospital for intervention. Upon administering anticoagulation and antimicrobial therapy, we first placed a filter in the patient's inferior vena cava to prevent thrombus embolism to the pulmonary arteries during catheter removal. Under fluoroscopy, the catheter was withdrawn into the renal vein, followed by catheter-directed thrombolysis and thrombus aspiration. Eventually, the renal fistula catheter was gradually removed in stages without any bleeding and pulmonary embolism occurring throughout the treatment process. Through a review of relevant literatures, we analyzed the reasons for catheter misplacement and summarized the associated treatment experience.
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The rapid advancement of artificial intelligence (AI) and robotics has led to significant progress in various medical fields including interventional radiology (IR). This review focuses on the research progress and applications of AI and robotics in IR, including deep learning (DL), machine learning (ML), and convolutional neural networks (CNNs) across specialties such as oncology, neurology, and cardiology, aiming to explore potential directions in future interventional treatments. To ensure the breadth and depth of this review, we implemented a systematic literature search strategy, selecting research published within the last five years. We conducted searches in databases such as PubMed and Google Scholar to find relevant literature. Special emphasis was placed on selecting large-scale studies to ensure the comprehensiveness and reliability of the results. This review summarizes the latest research directions and developments, ultimately analyzing their corresponding potential and limitations. It furnishes essential information and insights for researchers, clinicians, and policymakers, potentially propelling advancements and innovations within the domains of AI and IR. Finally, our findings indicate that although AI and robotics technologies are not yet widely applied in clinical settings, they are evolving across multiple aspects and are expected to significantly improve the processes and efficacy of interventional treatments.
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To evaluate the treatment efficacy of uterine artery embolization (UAE) using 8Spheres conformal microspheres for symptomatic uterine leiomyoma. In this prospective observational study, 15 patients were enrolled and underwent UAE by 2 experienced interventionalists from September 1, 2018, to September 1, 2019. All patients underwent menstrual bleeding scores, the symptom severity domain of the Uterine Fibroid Symptom and Quality of Life questionnaire scores (with lower scores indicating mild symptoms), pelvic contrast-enhanced magnetic resonance imaging, ovarian reserve tests (estradiol, prolactin, testosterone, follicle-stimulating, luteinizing, and progesterone), and other appropriate preoperative examinations within 1 week before UAE. During follow-up, menstrual bleeding scores and the symptom severity domain of the Uterine Fibroid Symptom and Quality of Life questionnaire scores were recorded at 1, 3, 6, and 12 months after UAE to assess the efficacy of symptomatic uterine leiomyoma. Pelvic contrast-enhanced magnetic resonance imaging was performed 6 months after the interventional therapy. Biomarkers of ovarian reserve function were reviewed at 6 and 12 months after treatment. All 15 patients successfully underwent UAE, without severe adverse effects. Six patients experienced abdominal pain, nausea, or vomiting, all of which improved significantly after symptomatic treatment. The menstrual bleeding scores declined from baseline (350.2 ± 61.9 mL) to (131.8 ± 42.7 mL), (140.3 ± 42.4 mL), (68.0 ± 22.8 mL), and (64.43 ± 17.0 mL) at 1, 3, 6, and 12 months, respectively. The symptom severity domain scores at 1, 3, 6, and 12 months postoperatively were significantly lower and statistically significant compared to the preoperative scores. The uterus and dominant leiomyoma volumes decreased from baseline (340.0 ± 35.8 cm3), (100.6 ± 24.3 cm3) to (266.6 ± 30.9 cm3), (56.1 ± 17.3 cm3) at 6 months after UAE, respectively. Moreover, the ratio of leiomyoma volumes and uterus decreased from (27.4 ± 4.5%) to (18.7 ± 3.9%). At the same time, there was no significant effect on changes in the biomarkers of ovarian reserve levels. Only the changes in testosterone levels before and after UAE were statistically significant (P < .05). 8Spheres conformal microspheres are ideal embolic agents for UAE therapy. This study showed that 8Spheres conformal microsphere embolization for symptomatic uterine leiomyoma could effectively relieve heavy menstrual bleeding, improve the symptom severity of patients, reduce the volume of leiomyoma, and have no significant effect on ovarian reserve function.
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Leiomioma , Embolización de la Arteria Uterina , Femenino , Humanos , Microesferas , Estudios Prospectivos , Calidad de Vida , Leiomioma/diagnóstico por imagen , Leiomioma/terapiaRESUMEN
Hepatocellular carcinoma (HCC) has the sixth-highest new incidence and fourth-highest mortality worldwide. Transarterial chemoembolization (TACE) is one of the primary treatment strategies for unresectable HCC. However, the therapeutic effect is still unsatisfactory due to the insufficient distribution of antineoplastic drugs in tumor tissues and the worsened post-embolization tumor microenvironment (TME, e.g., hypoxia and reduced pH). Recently, using nanomaterials as a drug delivery platform for TACE therapy of HCC has been a research hotspot. With the development of nanotechnology, multifunctional nanoplatforms have been developed to embolize the tumor vasculature, creating conditions for improving the distribution and bioavailability of drugs in tumor tissues. Currently, the researchers are focusing on functionalizing nanomaterials to achieve high drug loading efficacy, thorough vascular embolization, tumor targeting, controlled sustained release of drugs, and real-time imaging in the TACE process to facilitate precise embolization and enable therapeutic procedures follow-up imaging of tumor lesions. Herein, we summarized the recent advances and applications of functionalized nanomaterials based on TACE against HCC, believing that developing these functionalized nanoplatforms may be a promising approach for improving the TACE therapeutic effect of HCC.
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Carcinoma Hepatocelular , Quimioembolización Terapéutica , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/terapia , Disponibilidad Biológica , Sistemas de Liberación de Medicamentos , Microambiente TumoralRESUMEN
Transarterial chemoembolization (TACE) is commonly used for treating advanced hepatocellular carcinoma (HCC). However, the instability of lipiodol-drug emulsion and the altered tumor microenvironment (TME, such as hypoxia-induced autophagy) postembolization are responsible for the unsatisfactory therapeutic outcomes. Herein, pH-responsive poly(acrylic acid)/calcium phosphate nanoparticles (PAA/CaP NPs) were synthesized and used as the carrier of epirubicin (EPI) to enhance the efficacy of TACE therapy through autophagy inhibition. PAA/CaP NPs have a high loading capacity of EPI and a sensitive drug release behavior under acidic conditions. Moreover, PAA/CaP NPs block autophagy through the dramatic increase of intracellular Ca2+ content, which synergistically enhances the toxicity of EPI. TACE with EPI-loaded PAA/CaP NPs dispersed in lipiodol shows an obvious enhanced therapeutic outcome compared to the treatment with EPI-lipiodol emulsion in an orthotopic rabbit liver cancer model. This study not only develops a new delivery system for TACE but also provides a promising strategy targeting autophagy inhibition to improve the therapeutic effect of TACE for the HCC treatment.
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Carcinoma Hepatocelular , Quimioembolización Terapéutica , Neoplasias Hepáticas , Nanopartículas , Animales , Conejos , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/patología , Aceite Etiodizado/farmacología , Emulsiones , Epirrubicina , Fosfatos de Calcio/farmacología , Microambiente TumoralRESUMEN
RATIONALE: Primary intracranial malignant melanoma (PIMM) is a rare malignant tumor that lacks specific clinical manifestations. Preoperative diagnosis is difficult to differentiate from meningiomas on computed tomography (CT) scans. Magnetic resonance imaging (MRI) usually shows typical characteristics with high signal intensity on T1WI and low signal intensity on T2WI. PIMM is highly invasive, insensitive to chemoradiotherapy, and has a poor prognosis. PATIENT CONCERNS: A 27-year-old woman was admitted to the hospital with a headache for 10 days. She did not experience nausea, vomiting, dizziness, or any other discomfort. A computerized tomography (CT) scan demonstrated a high-density mass in the left cerebellum with patchy calcification at the posterior edge, and heterogeneous enhancement was observed on a contrast-enhanced scan. MRI revealed typical characteristics of high signal intensity on T1WI and low signal intensity on T2WI. The signal characteristics of FLAIR were similar to those of T2WI, and diffusion-weighted imaging (DWI) sequence showed limited diffusion of the tumor. Magnetic resonance spectroscopy revealed increased choline (Cho) and decreased creatine (Cr) and N-acetyl aspartate (Naa) in the tumor. INTERVENTIONS: The patient underwent tumor resection and postoperative chemoradiotherapy and immunotherapy. PATHOLOGICAL DIAGNOSIS: Histological and Immunohistochemistry (IHC) tests confirmed the diagnosis of PIMM. In addition, genetic testing revealed GNAQ gene variation. OUTCOMES: No recurrence or complications were observed during the follow-up for 6 months. LESSONS: PIMM is rare, and its pathological diagnosis should be closely combined with clinical and medical history. GNAQ is a common variant of PIMM and is expected to be a therapeutic target.
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Neoplasias Encefálicas , Melanoma , Neoplasias Meníngeas , Femenino , Humanos , Adulto , Imagen por Resonancia Magnética/métodos , Imagen de Difusión por Resonancia Magnética/métodos , Neoplasias Encefálicas/cirugía , Melanoma/cirugíaRESUMEN
RATIONALE: Traumatic carotid-cavernous sinus fistula (TCCF) is a pathological shunt between the carotid arteries and cavernous sinus due to trauma. Imaging-guided (e.g., ultrasonic image and fluoroscopic roadmap image) direct puncture of the superior ophthalmic vein (SOV) for embolization of TCCF has been previously described in other studies. PATIENT CONCERNS AND DIAGNOSIS: We report a case of TCCF in a 58-years-old male patient who was admitted to our hospital with a sustained head injury after falling from a high platform, resulting in rapidly progressive swelling, pain, diminishing vision for more than 6 months, and blindness in his left eye for 1 month. INTERVENTIONS AND OUTCOMES: The patient underwent digital subtraction angiography and endovascular embolization. After the failure of super-selection of the left cavernous sinus, an alternative approach to obliterating the TCCF by puncturing the SOV is directly guided by Dyna-CT. After embolization, the patient's clinical symptoms gradually disappeared and discharged from the hospital 5 days later. No recurrence or complications occurred during follow-up for 1 year. CONCLUSION: This case illustrates that direct puncture of the SOV guided by Dyna-CT as an alternative approach to embolization of TCCF is safe, effective, and feasible.
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Fístula del Seno Cavernoso de la Carótida , Seno Cavernoso , Embolización Terapéutica , Masculino , Humanos , Persona de Mediana Edad , Fístula del Seno Cavernoso de la Carótida/diagnóstico por imagen , Fístula del Seno Cavernoso de la Carótida/etiología , Fístula del Seno Cavernoso de la Carótida/terapia , Seno Cavernoso/diagnóstico por imagen , Embolización Terapéutica/métodos , Punciones/métodos , Tomografía Computarizada por Rayos X/efectos adversosRESUMEN
The design of nanomedicine for cancer therapy, especially the treatment of tumor metastasis has received great attention. Proteasome inhibition is accepted as a new strategy for cancer therapy. Despite being a big breakthrough in multiple myeloma therapy, carfilzomib (CFZ), a second-in-class proteasome inhibitor is still unsatisfactory for solid tumor and metastasis therapy. In this study, hollow titanium nitride (TiN) nanoshells are synthesized as a drug carrier of CFZ. The TiN nanoshells have a high loading capacity of CFZ, and their intrinsic inhibitory effect on autophagy synergistically enhances the activity of CFZ. Due to an excellent photothermal conversion efficiency in the second near-infrared (NIR-II) region, TiN nanoshell-based photothermal therapy further induces a synergistic anticancer effect. In vivo study demonstrates that TiN nanoshells readily drain into the lymph nodes, which are responsible for tumor lymphatic metastasis. The CFZ-loaded TiN nanoshell-based chemo-photothermal therapy combined with surgery offers a remarkable therapeutic outcome in greatly inhibiting further metastatic spread of cancer cells. These findings suggest that TiN nanoshells act as an efficient carrier of CFZ for realizing enhanced outcomes for proteasome inhibitor-based cancer therapy, and this work also presents a "combined chemo-phototherapy assisted surgery" strategy, promising for future cancer treatment.
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Nanocáscaras , Neoplasias , Fotoquimioterapia , Humanos , Línea Celular Tumoral , Oro , Metástasis Linfática , Neoplasias/tratamiento farmacológico , Oligopéptidos , Inhibidores de Proteasoma/farmacología , TitanioRESUMEN
Cancer has emerged as one of the world's most concerning health problems. The progression and metastasis mechanisms of cancer are complex, including metabolic disorders, oxidative stress, inflammation, apoptosis, and intestinal microflora disorders. These pose significant challenges to our efforts to prevent and treat cancer and its metastasis. Natural drugs have a long history of use in the prevention and treatment of cancer. Many effective anti-tumor drugs, such as Paclitaxel, Vincristine, and Camptothecin, have been widely prescribed for the prevention and treatment of cancer. In recent years, a trend in the field of antitumor drug development has been to screen the active antitumor ingredients from natural drugs and conduct in-depth studies on the mechanisms of their antitumor activity. In this review, high-frequency keywords included in the literature of several common Chinese and English databases were analyzed. The results showed that five Chinese herbal medicines (Radix Salviae, Panax Ginseng C. A. Mey, Hedysarum Multijugum Maxim, Ganoderma, and Curcumaelongae Rhizoma) and three natural compounds (quercetin, luteolin, and kaempferol) were most commonly used for the prevention and treatment of cancer and cancer metastasis. The main mechanisms of action of these active compounds in tumor-related research were summarized. Finally, we found that four natural compounds (dihydrotanshinone, sclareol, isoimperatorin, and girinimbin) have recently attracted the most attention in the field of anti-cancer research. Our findings provide some inspiration for future research on natural compounds against tumors and new insights into the role and mechanisms of natural compounds in the prevention and treatment of cancer and cancer metastasis.
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Medicamentos Herbarios Chinos , Neoplasias , Apoptosis , Medicamentos Herbarios Chinos/farmacología , Medicina Tradicional China , Neoplasias/tratamiento farmacológico , Neoplasias/prevención & control , RizomaRESUMEN
Context: The hepatic VX2 carcinoma model in rabbits has been widely used in interventional diagnosis and treatment research for hepatocellular carcinoma (HCC). However, traditional methods for developing this model all have their shortcomings. Aims: To develop an improved method to construct an animal model of hepatic VX2 carcinoma. Settings and Design: The puncture technique was used to obtain the VX2 tumor tissue. A tumor puncture-inoculation kit was designed and modified to implant the tumor tissue into the recipient rabbit's liver. Methods and Material: 18 New Zealand white rabbits were implanted with VX2 tumor tissue using the improved tumor puncture-inoculation kit under ultrasound guidance. Ultrasonography, contrast-enhanced computerized tomography, magnetic resonance imaging, and digital subtraction angiography were performed to evaluate tumor formation and imaging characteristics. Statistical Analysis: Statistical analysis was performed using SPSS software. Two groups were compared using Student's t-test analysis. Results: All rabbits tolerated VX2 tumor tissue implantation successfully. 17 out of the 18 experimental rabbits developed liver tumors, and one rabbit had abdominal tumor metastasis. The average volume of tumors was 39.47 mm3 and 460.1 mm3 (P < 0.001) on the 7th and 14th days after modeling, respectively. Imageological diagnosis showed that all tumors had abundant blood supply and typical imaging characteristics. Conclusions: This improved modeling method is easy to operate and less traumatic, with a high tumor formation rate, low metastasis rate, prominent tumor imaging characteristics, and high detection rate, which is expected to become a promising method for constructing rabbit liver tumor model.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Conejos , Animales , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/patología , Angiografía de Substracción Digital , Ultrasonografía , Modelos Animales de EnfermedadRESUMEN
PURPOSE: To evaluate the method and effectiveness of transcatheter arterial chemoembolization (TACE) combined with simultaneous DynaCT-guided Microwave ablation (MWA) for the treatment of small hepatocellular carcinoma (SHCC). MATERIALS AND METHODS: From June 2015 to May 2017, a total of 28 consecutive patients with SHCC received single treatment of TACE and 23 subjects received a combination treatment of TACE with simultaneous DynaCT-guided MWA. Following 1 month of treatment, the tumor response was assessed using the mRECIST criteria and the outcomes were analyzed including intervention-associated complications, changes in liver function, imaging response, and progression-free survival (PFS). RESULTS: The technical success rate was 100%. The rates of CR (65%) in the combined TACE and MWA group were higher than those of the TACE group (46%). The rate of common adverse events, such as liver abscess, spontaneous bacterial peritonitis and liver dysfunction, in the combined TACE and MWA group (56%) was comparable to the corresponding rate of the TACE group (P > 0.411). The median and mean PFS of the TACE group were significantly lower than those of the combined TACE and MWA group (19.00 months vs. 29.00 months, 21.076 months vs. 24.693 months, p = 0.019, log-rank test). CONCLUSION: Stereotactic DynaCT-guided MWA is a safe and effective method for the treatment of SHCC, which usually provides an effective tumor puncture path, notably for lesions that cannot be detected following TACE. Overall, the data suggested that this treatment method could improve the clinical outcome of patients with SHCC.