• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1649-1654
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• 2013

Objective: This work aimed to evaluate the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with c-arm cone-beam CT guided synchronous radiofrequency ablation (RFA) in treatment of large hepatocellular carcinoma (HCC). Methods: 21 patients with large HCC were studied from January 2010 to March 2012. TACE combined with synchronous C-arm cone-beam CT guided RFA were performed on a total of 25 lesions. Conventional imaging examination (CEUS, enhanced CT or MRI) and AFP detection were regularly conducted to evaluate the technical success rate of combined treatment, complications, treatment response, time without disease recurrence and survival rate. Results: The technical success rate of combined treatment was 100%, without any significant complication. After 1 month, there were 19 cases with complete response and 2 cases with partial response, with an complete response rate of 90.4% (19/21) and a clinical effective rate of 100% (21/21). The complete response rates of single nodular lesions (100%, 17/17) was significantly higher than that of multiple nodular lesions (50%, 2/4) (P<0. 05). During 2 to 28 months of follow-up, in 19 cases with complete response, the average time without disease recurrence was $10.8{\pm}6$ months. The total survival rates of 6, 12 and 18 months in 21 patients were 100%, respectively. Conclusion: TACE combined with synchronous C-arm CT guided RFA is safe and effective for treatment of large HCC. The treatment efficacy for single nodular lesion is better than that for multiple nodular lesions.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.737-742
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• 2012

To evaluate efficacy of microwave ablation in a primary clinical study, sixty patients (44 men, 16 women; mean age 53 years) with 96, 1-8 cm (mean $3.20{\pm}0.17$ cm) liver cancers were treated with 2,450-MHz internally cooled-shaft antenna. Complete ablation (CA) and local tumor progression (LTP) rates as well as complications were determined. CA rates in small (< 3.0 cm), intermediate (3.1-5.0 cm) and large (5.1-8.0 cm) liver cancers were 96.4% (54/56), 92.3% (24/26) and 78.6% (11/14), respectively. During a mean follow-up period of $17.17{\pm}6.52$ months, LTP occurred in five (5.21%) treated cases. There was no significant difference in the CA and LTP rates between the HCC and liver metastasis patient subgroups (P<0.05). Microwave ablation provides a reliable, efficient, and safe technique to perform hepatic tumor ablation.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2681-2684
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• 2014

Aim: To compare drainage alone or combined with anti-tumor therapy for treatment of obstructive jaundice caused by recurrence and metastasis after primary tumor resection. Materials and Methods: We collect 42 patients with obstructive jaundice caused by recurrence and metastasis after tumor resection from January 2008 - August 2012, for which percutaneous transhepatic catheter drainage (pTCD)/percutaneous transhepatic biliary stenting (pTBS) were performed. In 25 patients drainage was combined with anti-tumor treatment, antineoplastic therapy including intra/postprodure local treatment and postoperative systemic chemotherapy, the other 17 undergoing drainage only. We assessed the two kinds of treatment with regard to patient prognosis. Results: Both treatments demonstrated good effects in reducing bilirubin levels in the short term and promoting liver function. The time to reobstruction was 125 days in the combined group and 89 days in the drainage only group; the mean survival times were 185 and 128 days, the differences being significant. Conclusions: Interventional drainage in the treatment of the obstructive jaundice caused by recurrence and metastasis after tumor resection can decrease bilirubin level quickly in a short term and promote the liver function recovery. Combined treatment prolongs the survival time and period before reobstruction as compared to drainage only.

• Journal of Radiation Protection and Research
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• v.39 no.4
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• pp.213-217
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• 2014

Medical operations and diagnosis using interventional radiology techniques have been increased. The management and monitoring of occupational radiation exposure to the staff of interventional radiology become important, specially because they stand in close proximity to the patient. The operational radiation protection quantity, Hp(10) which can be obtained from personal dosimeter do not always represent the effective dose to the staff. So, in this study, to estimate the critical organ doses to the staff of interventional radiology, Monte Carlo calculations with mathematical human phantom and dose measurements with personal dosimeters were carried out for the major interventional radiology procedures using C-arm. Results showed that the values of Hp(10) measured by personal dosimeters were higher than critical organ doses which were calculated. And the calculated dose to thyroids was much higher than those of other critical organ doses. For the proper radiation protection of the medical staff of interventional radiology, additional radiation protection for thyroids as well as for whole body shielding like wearing a lead apron should be considered.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7897-7903
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• 2015

Background: To explored the value of 3D C-arm CT (CACT) guidance system in performing radiofrequency ablation (RFA) following transarterial chemoembolizationon (TACE) for hepatocellular carcinomas. Materials and Methods: RFA of hepatocellular carcinomas (HCC) were performed on 15 patients (21 lesions) with the assistance of CACT guidance system. Technical success, procedure time, complications and patient radiation exposure were investigated. The puncture performance level was evaluated on a five-point scale (5-1: excellent-poor). Complete ablation rate was evaluated after two months follow-up using enhanced CT scans. Results: The technical success rate of RFA procedure under CACT navigation system was 100 %. Mean total procedure time was $24.24{\pm}6.53min$, resulting in a mean effective exposure dose of $15.4{\pm}5.1mSv$. The mean puncture performance level rated for CACT guided RFA procedure was $4.87{\pm}0.35$. Complete ablation (CA) was achieved in 20 (95.2%) of the treated 21 tumors after the first RFA session. None of patients developed intra-procedural complications. Conclusions: 3D CACT guidance system enables reliable and efficient needle positioning by providing real-time intraoperative guidance for performing RFA on HCCs.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.433-435
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• 2021

Pleural adhesions are a major challenge in standard and nonintubated video-assisted thoracic surgery. The currently available imaging techniques help to assess the presence and extent of pleural adhesions, but do not provide information on tissue deformability, which is crucial for intraoperative management. In this report, we describe the utilization of real-time elastography mapping of pleural adhesions. This technique enabled us to detect areas with softer adhesions, and helped establish the surgical plan in a difficult case of a patient scheduled for nonintubated video-assisted thoracic surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.6135-6140
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• 2015

Background: The aim of this meta-analysis was to assess the efficacy of the apparent diffusion coefficient (ADC) value of diffusion-weighted MRI (DWI) for differentiating biliary tract cancer (BTC) from benign biliary tract diseases in Asians. Materials and Methods: We systematically searched Embase and PubMed prior to December 2014. Eight studies conducted in Asians met our predetermined inclusion criteria. Results: Our meta-analysis results showed that ADC values in BTC tissues were significantly lower than in benign biliary tract tissues (SMD = -1.54, 95%CI: -1.75~-1.33, P<0.001). Subgroup analysis based on the MRI machine type showed that the ADC values were consistent, accurate and reliable in the diagnosis of BTC when comparing cancer tissue vs. benign tissue under the Siemens 1.5 T/3.0 T, Philips 1.5 T/3.0 T, GE 1.5 T, and Toshiba 1.5 T types, respectively (all P<0.05). Further, ADC values were still consistent and accurate in the differential diagnosis of BTC under the b value of 800 and $1000s/mm^2$ (all P<0.05). Conclusions: Our findings supported potential clinical applications of DWI ADC values in differentiating BTC from benign biliary tract diseases in Asians.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.703-706
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• 2014

Objective: To evaluate the safety and efficacy of sequential transcatheter arterial chemoembolization (TACE) and portal vein embolization (PVE) before major hepatectomy for patients with hepatocellur carcinoma (HCC). Methods: In this retrospective case-control study, data were collected from patients who underwent sequential TACE and PVE prior to major hemihepactectomy. Liver volumes were measured by computed tomography volumetry before TACE, and preoperation to assess degree of future remnant liver (FRL) hypertrophy and to check whether intro- or extrohepatic metastasis existed. Liver function was monitored by biochemistry after TACE, prior to and after major hepatectomy. Results: Mean average FRL volume increased 32.3-71.4% (mean 55.4%) compared with preoperative FRL volume. After TACE, liver enzymes were elevated, but returned to normal in four weeks. During PVE and resection, no patient had intro- or extrohepatic metastasis. Conclusion: Sequential TACE and PVE is an effective method to improve resection opportunity, expand the scope of surgical resection, and greatly reduce postoperative intra- and extrahepatic metastasis.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.523-530
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• 2022

Objective : To evaluate the safety and efficacy of an overlapped stenting-assisted coiling technique in treating vertebral artery dissecting aneurysm (VADA) via Low-profile Visualized Intraluminal Support (LVIS) stent-within-Neuroform EZ stent. Methods : From January 2017 to June 2019, 18 consecutive patients with VADAs (ruptured : unruptured=5 : 13) were treated with the overlapping stents assisted-coiling technique in our center. The overlapping manner was a Neuroform EZ stent being deployed first, followed by LVIS stents placement using the 'shelf' technique. The patients' clinical characteristics, technical feasibility and safety, and immediate and follow-up angiographic results were retrospectively reviewed. Results : Seventeen (94.4%) procedures were technically successful with an exact deployment of the stents and patent parent or perforator arteries. The immediate angiographies after procedure confirmed Raymond class I, II, and III occlusion of VADAs were in 12 (66.7%), two (11.1%), and four cases (22.2%), respectively. Post-procedural complications developed in one patient (5.6%) with minor brainstem infarctions, which resulted from an in-stent thrombosis during the procedure. Angiographic follow-up at 5.7 months (range 3 to 9 months) demonstrated Raymond class I and II occlusion were in all cases (100%). The modified Rankin Scale scores at 21.3 months (range 15 to 42 months) 0-2 in 17 cases (94.4%) and three in one case (5.6%). Conclusion : Overlapping stents via LVIS stent-within-Neuroform EZ stent combined with coiling is safe and effective for patients with VADA in the midterm results.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5527-5531
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• 2013

Background and Aim: Increasing evidence correlates the presence of systemic inflammation with poor survival in patients with hepatocellular carcinoma (HCC). The aim of this study was to investigate the prognostic significance of the blood neutrophil-to-lymphocyte ratio (NLR) in patients with advanced HCC who received sorafenib monotherapy. Methods: A total of sixty-five patients with advanced HCC, not eligible for locoregional therapy, treated with sorafenib were enrolled. Potential prognostic factors such as age, gender, tumoral characteristics, performance status and NLR were analyzed. Results: Median OS and TTP for the entire cohort were 10.0 months (95%CI, 7.6-12.3 months) and 4.5 months (95% CI, 4.0-4.9 months). The mean NLR at baseline was 2.89. The median OS of patients with a high NLR (>4) was 6.5 months (95%CI, 5.2-7.7 months) compared with 12.5 months (95%CI, 9.9-15.0) for patients with a normal NLR (${\leq}4$) (P=0.01). Age ${\leq}65$, NLR>4, extrahepatic metastases and vascular invasion were all predictors of poorer overall survival. Multivariate analysis showed that NLR > 4, vascular invasion and extrahepatic metastases were independent predictors of poorer overall survival. The median TTP of patients with a high NLR was 2.5 months (95%CI, 1.4-3.6 months) compared with 4.5 months (95%CI, 3.9-5.1 months) for patients with a normal NLR (P=0.012). Conclusions: High baseline NLR was associated with worse OS and TTP for patients with advanced HCC treated with sorafenib.