Four-dimensional transcatheter intraarterial perfusion MRI monitoring of radiofrequency ablation of rabbit VX2 liver tumors

Purpose:

To investigate the hypothesis that four‐dimensional (4D) transcatheter intraarterial perfusion (TRIP) magnetic resonance imaging (MRI) can quantify immediate perfusion changes after radiofrequency (RF) ablation in rabbit VX2 liver tumors.

Materials and Methods:

Nine New Zealand White rabbits were used to surgically implant VX2 liver tumors. During ultrasound‐guided RF ablation, tumors received either a true or sham ablation. After selective catheterization of the left hepatic artery under x‐ray fluoroscopy, we acquired pre‐ and post‐RF ablation 4D TRIP MR images using 3 mL of 2.5% intraarterial gadopentetate dimeglumine. Two regions‐of‐interest were drawn upon each tumor to generate signal‐intensity time curves. Area under the curve (AUC) was calculated to provide semiquantitative perfusion measurements that were compared using a paired t‐test (α = 0.05). Ablated tissue was visually confirmed on pathology using Evans blue dye.

Results:

Mean AUC perfusion of VX2 tumors for the true ablation group decreased by 92.0% (95% confidence interval [CI]: 83.3%–100%), from 1913 (95% CI: 1557, 2269) before RF ablation to 76.6 (95% CI: 18.4, 134.8) after RF ablation (a.u., P < 0.001). Sham‐ablated tumors demonstrated no significant perfusion changes.

Conclusion:

4D TRIP MRI can quantify liver tumor perfusion reductions in VX2 rabbits after RF ablation. This MRI technique can potentially be used to improve tumor response assessment at the time of RF ablation. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.     

Arm posture score and arm movement during walking: a comprehensive assessment in spastic hemiplegic cerebral palsy

Patients with hemiplegic cerebral palsy often have noticeably deviant arm posture and decreased arm movement. Here we develop a comprehensive assessment method for the upper extremity during walking. Arm posture score (APS), deviation of shoulder flexion/extension, shoulder abduction/adduction, elbow flexion/extension and wrist flexion/extension were calculated from three-dimensional gait analysis. The APS is the root mean square deviation from normal, similar to Baker's Gait Profile Score (GPS) [1]. The total range of motion (ROM) was defined as the difference between the maximum and minimum position in the gait cycle for each variable. The arm symmetry, arm posture index (API) was calculated by dividing the APS on the hemiplegic side by that on the non-involved side, and the range of motion index (ROMI) by dividing the ROM on the hemiplegic side by that on the non-involved side. Using the APS, two groups were defined. Group 1 had minor deviations, with an APS under 9.0 and a mean of 6.0 (95% CI 5.0-7.0). Group 2 had more pronounced deviations, with an APS over 9.0 and a mean of 13.1 (CI 10.8-15.5) (p=0.000). Total ROM was 60.6 in group 1 and 46.2 in group 2 (p=0.031). API was 0.89 in group 1 and 1.70 in group 2 (p<0.001). ROMI was 1.15 in group 1 and 0.69 in group 2 (p=0.003). APS describes the amount of deviation, ROM provides additional information on movement pattern and the indices the symmetry. These comprehensive objective and dynamic measurements of upper extremity abnormality can be useful in following natural progression, evaluating treatment and making prognoses in several categories of patients.     

Iatrogenic left pulmonary artery to left atrium fistula

Trans‐catheter balloon angioplasty is a well‐established treatment modality for pulmonary artery (PA) stenosis in children with congenital heart disease. We report a case of an unusual complication where a fistula developed between the left PA and the left atrium during balloon angioplasty in a patient with history of tetralogy of Fallot. This was successfully treated with placement of a covered stent. © 2014 Wiley Periodicals, Inc.     

Photodynamic therapy of colorectal cancer using a new light source

PURPOSE: Photodynamic therapy (PDT) is a relatively new alternative modality for palliation of rectal cancer. Current source of light for PDT are laser systems that are expensive and not necessarily needed for PDT. We evaluated a new nonlaser light source for PDT, Versa-Light ^® .METHODS AND RESULTS: In vitro PDT—CT26 murine colon carcinoma cells were incubated with aluminum phthalocyanine (AlPcS ₄ ) for 48 hours and subjected to photoradiation using Versa-Light ^® ,and viability was assessed. There was a significant decrease in viability of treated cells compared with controls. In vivo PDT—BALB/c mice were injected either subcutaneously or intrarectally with CT26 cancer cells. IP AlPcS ₄ (2.5 mg/kg) was injected when tumors were visible. After 24 hours, mice were subjected to photoradiation. Massive tumor necrosis in response to PDT was observed. PDT also prolonged survival of treated mice. Patient treatment—A 70-year-old woman with recurrent local rectal carcinoma received intravenous Photofrin II ^® (2 mg/kg). After 48 and 96 hours, she was subjected to direct photoradiation. After the first light session, there was complete macroscopic disappearance of the tumor. Biopsies up to 10 weeks after the treatment showed no cancer cells in the treated area. Sixteen weeks later, a randomized biopsy from previous tumor site showed carcinoma cells. CONCLUSIONS: We believe that Versa-Light ^® ,is a good light source for PDT. It was effective in both in vitro and animal studies. It can also be safely used for clinical PDT.Supported by the Roni Udassin Memorial Fund of the Israel Cancer Society.     

Efficacy of cross-sectional imaging guided sympathetic neurolysis in abdoiniuopelvic tumors

Aim of work

To study the efficacy of visceral neurolytic blocks in the abdominopelvic cancer when guided by ultrasound/CT.

The cardiovascular influence of interleukin-1 beta on the expression of bradykinin B1 and B2 receptors

The cytokine interleukin 1ss (IL-1ss) and the bradykinin receptors 1 (B1R) and 2 (B2R) are known to be upregulated in the ischemic heart. In the present study we investigated whether or not there is a causal link between these entities. Further we investigated whether or not pharmacological inhibition of IL-1ss release affects B1R and B2R regulation as well as left ventricular (LV) function in an in vivo rat model of myocardial infarction (MI). B1R and B2R mRNA levels were determined in cultured rat cardiomyocytes, aortic smooth muscle cells and cardiac fibroblasts (n=6 per group) under basal conditions, and after incubation of IL-1ss (40, 400 and 4000 pg/ml). Also, MI was induced in male Sprague-Dawley rats by ligation of the left descending coronary artery. Rats were treated with the interleukin converting enzyme inhibitor (ICEI) pralnacasan (50 mg/kg/day), or with a placebo. Three weeks after induction of MI, LV function was assessed using a 1.4 Millar TIP-catheter. Cardiac expressions of B1R and B2R mRNA were measured using ribonuclease-protection assays. Under basal conditions, both B1R and B2R were expressed in cardiomyocytes and smooth muscle cells, but not in cardiac fibroblasts. IL-1ss cultivation led only in cardiomyocytes to a significant upregulation of B1R mRNA. To a significant upregulation of B2R mRNA, it did not. In addition, ICEI treatment led in vivo to a significant downregulation of cardiac B1R mRNA, but not of B2R mRNA expression three weeks after induction of MI. Our data suggest that a causal link exists between cardiac IL-1ss content and B1R regulation after MI.