Caspase-Cleaved Cytokeratin 18 Fragment M30 as a Potential Biomarker of Macrovascular Invasion in Hepatocellular Carcinoma

Background and Aim

Extremely poor prognosis in hepatocellular carcinoma (HCC) patients with progressing disease was denoted by vascular invasion. Cytokeratin 18 (CK18) has been shown to be overexpressed in hepatocellular carcinoma so it is a valuable tumor marker; however, its role in vascular invasion is still unclear. This study aimed to predict CK18 as a predictive marker for macrovascular malignant invasion.

Methods

The present study was conducted on three groups of patients: group I included 91 HCC patients without macrovascular invasion, group II included 34 HCC patients with radiological evidence of vascular invasion, and group III included 110 control individuals subdivided into IIIA as healthy blood donors and IIIB as post-HCV cirrhotic patients without HCC.

Results

ROC curve of M30 fragments of CK18 was constructed for discrimination between HCC with and without macrovascular invasion. Optimum cutoff value was 304.5 ng/mL (AUC = 0.997, P < 0.001), sensitivity (100%) and specificity (98.8%). Regression analysis was conducted for prediction of macrovascular invasion within HCC patients. The following variables: higher levels of AST, M30, bilirubin, and AFP, lower levels of serum albumin, larger tumor size, child B score, and multiple lesions were associated with vascular invasion in univariate analysis. While in multivariate analysis, higher levels of AST and bilirubin and elevated levels of M30 and AFP serum were considered independent predictors for macrovascular invasion in HCC patients.

Conclusion

The present study suggests that increased M30 fragments of CK18 levels may be useful as a possible marker of early tumor invasiveness.

     

Safety of Carotid Canal during Transtympanic Dilatation of the Eustachian Tube: A Cadaver Pilot Study

To assess the safety of Transtympanic balloon dilatation of the cartilaginous proximal Eustachian tube under endoscopic guidance as it relates to the integrity of the carotid canal in cadaver model. Endoscopic guided Transtympanic dilatations of the cartilaginous proximal end of the Eustachian tube were performed in 15 ears of 8 fresh frozen cadaver heads. CT scans were done before and after dilatation. Images were reviewed by two otologists and one radiologist. Balloon catheter placement and dilatation of the proximal Eustachian tube was feasible in all specimens. Endoscopic examination post dilatation showed a consistent increase in the aperture of the proximal cartilaginous tube in all ears. Review of CT images after dilatation showed no evidence of trauma to the carotid canal in all ears instrumented. Endoscopically guided Transtympanic dilatation of the proximal Eustachian tube is not associated with damage to the carotid canal in cadaver model. Level of Evidence: 4.     

Fast-Track Registration: A Way to Increase Efficiency in the IR Division

Purpose

To evaluate changes in patient registration process at an academic 2-suite IR Division to determine if moving registration from the waiting room to the vascular holding area decreased amount of time patients spent in the Radiology Department and improved start times.

Radioprotective efficacy of Ginkgo biloba and Angelica archangelica extract against technetium-99m-sestamibi induced oxidative stress and lens injury in rats

Purpose: Technetium-99m is a radioactive tracer that emits gamma rays. Its half-life time is 6?h. Similar to other ionizing radiations, the main mechanism of radiation-induced effects is initiated through the production of reactive oxygen species (ROS). This study was designed to determine the possible protective effects of Ginkgo biloba and Angelica archangelica against oxidative organ damage that was induced by ^99mTc-sestamibi.

Materials and methods: The experiments were performed on thirty-six Wistar-rats which were subdivided into control groups and groups exposed to ^99mTc-sestamibi. The irradiated groups were either untreated or pre-treated with G. biloba or A. archangelica. For all groups, the levels and/or activities of Catalase (CAT), Glutathione (GSH), Malondialdehyde (MDA) and Superoxide-dismutase (SOD) were measured in blood and lenses. The soluble/insoluble protein ratio was determined and lens-protein profiles were obtained via Sodium-Dodecyl-Sulfate Polyacrylamide Gel-Electrophoresis (SDS-PAGE).

Results: There were no significant difference between the pre-treated and irradiated G. biloba group and control group, while both groups were significantly different (p?A. archangelica did not confer any significant protection against ^99mTc-sestamibi induced toxicity.

Conclusions: This study demonstrated that G. biloba, through its free radical scavenging and antioxidant properties, successfully attenuated ^99mTc-sestamibi radiation-induced oxidative organ injury. The latter is a crucial factor of cataractogenesis in rats, suggesting that G. biloba may have a potential benefit in the protection against radiopharmaceuticals.     

MRI is it complementary or mandatory to ultrasound in classification of different congenital anomalies of female reproductive tract?

Aim of work

To assess the added value of MRI compared to US in diagnosis of Mullerian duct anomalies and its subtypes thus guiding proper management plans.

MR diffusion imaging and ADC measurement in solid and cystic mediastinal masses for differentiating benign from malignant lesions

Purpose

The purpose of this study is to evaluate the role of MR diffusion imaging (DWI) and apparent diffusion coefficient (ADC) measurement of solid and cystic mediastinal masses to differentiate benign from malignant lesions.

Role of diffusion tensor imaging in carpal tunnel syndrome: A case control comparative study to electrophysiological tests and clinical assessment

Purpose

To study the efficacy of diffusion tensor imaging (DTI) in the diagnosis of carpal tunnel syndrome (CTS).