Transarterial chemoembolization versus sorafenib in patients with hepatocellular carcinoma and extrahepatic disease

BackgroundSorafenib is the recommended treatment for advanced hepatocellular carcinoma (HCC), but transarterial chemoembolization (TACE) is performed in individual cases with limited extrahepatic spread. The aim of this study was to compare the outcome of patients with HCC and extrahepatic disease (EHD) treated with sorafenib and TACE.MethodsA total of 172 patients with HCC and EHD treated with sorafenib (n = 98) or TACE (n = 74) at three German referral centers (Hannover, Mainz and Hamburg) were included in this study. In order to reduce selection bias, patients were matched for significant demographic differences using a propensity score analysis.ResultsPatients with liver cirrhosis, high…

Two-dimensional parametric parenchymal blood flow in transarterial chemoembolisation for hepatocellular carcinoma: perfusion change quantification and tumour response prediction at 3 months post-intervention.

Aim To evaluate the feasibility and potential value of two-dimensional (2D) parametric parenchymal blood flow (2D-PPBF) for the assessment of perfusion changes during transarterial chemoembolisation with drug-eluting beads (DEB-TACE) and to analyse correlations of 2D-PPBF parameters and tumour response. Materials and methods Thirty-two patients (six women, 26 men, mean age: 67±8.9 years) with unresectable hepatocellular carcinoma (HCC) who underwent their first DEB-TACE were included in this study. To quantify perfusion changes using 2D-PPBF, the acquired digital subtraction angiography (DSA) series were post-processed. Ratios were calculated between the reference region of interest (ROI) a…

Vollautomatische, lappenbasierte Segmentierung von MR-Pefusionsmessungen in COPD Patienten mit Methoden des maschinellen Lernens

Coil embolisation for massive haemoptysis in cystic fibrosis.

IntroductionMassive haemoptysis is a life-threatening event in advanced cystic fibrosis (CF) lung disease with bronchial artery embolisation (BAE) as standard of care treatment. The aim of our study was to scrutinise short-term and long-term outcomes of patients with CF and haemoptysis after BAE using coils.MethodsWe carried out a retrospective cohort study of 34 adult patients treated for massive haemoptysis with super selective bronchial artery coil embolisation (ssBACE) between January 2008 and February 2015. Embolisation protocol was restricted to the culprit vessel(s) and three lobes maximum. Demographic data, functional end-expiratory volume in 1 s in % predicted (FEV1% pred.) and bod…

A 3D Deep Neural Network for Liver Volumetry in 3T Contrast-Enhanced MRI.

 To create a fully automated, reliable, and fast segmentation tool for Gd-EOB-DTPA-enhanced MRI scans using deep learning. Datasets of Gd-EOB-DTPA-enhanced liver MR images of 100 patients were assembled. Ground truth segmentation of the hepatobiliary phase images was performed manually. Automatic image segmentation was achieved with a deep convolutional neural network. Our neural network achieves an intraclass correlation coefficient (ICC) of 0.987, a Sørensen-Dice coefficient of 96.7 ± 1.9 % (mean ± std), an overlap of 92 ± 3.5 %, and a Hausdorff distance of 24.9 ± 14.7 mm compared with two expert readers who corresponded to an ICC of 0.973, a Sørensen-Dice coefficient of 95.2 ± 2.8 %, and…

Deep semantic lung segmentation for tracking potential pulmonary perfusion biomarkers in chronic obstructive pulmonary disease (COPD): The multi‐ethnic study of atherosclerosis COPD study

Background Chronic obstructive pulmonary disease (COPD) is associated with high morbidity and mortality. Identification of imaging biomarkers for phenotyping is necessary for future treatment and therapy monitoring. However, translation of visual analytic pipelines into clinics or their use in large-scale studies is significantly slowed by time-consuming postprocessing steps. Purpose To implement an automated tool chain for regional quantification of pulmonary microvascular blood flow in order to reduce analysis time and user variability. Study type Prospective. Population In all, 90 MRI scans of 63 patients, of which 31 had a COPD with a mean Global Initiative for Chronic Obstructive Lung …