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Kunikowska J, Korzeniowski K, Pełka K, Lamparski K, Patkowski W. [ 68 Ga]Ga-PSMA-11 in diagnosis and follow-up after transarterial chemoembolization in hepatocellular carcinoma. Eur J Nucl Med Mol Imaging 2023; 51:314-315. [PMID: 37542658 PMCID: PMC10684657 DOI: 10.1007/s00259-023-06372-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/28/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Jolanta Kunikowska
- Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | - Kacper Pełka
- Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland.
- Department of Methodology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland.
| | - Krzysztof Lamparski
- 2Nd Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Waldemar Patkowski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
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Masior Ł, Krasnodębski M, Kuncewicz M, Karaban K, Jaszczyszyn I, Kruk E, Małecka-Giełdowska M, Korzeniowski K, Figiel W, Krawczyk M, Wróblewski T, Grąt M. Alpha-Fetoprotein Response after First Transarterial Chemoembolization (TACE) and Complete Pathologic Response in Patients with Hepatocellular Cancer. Cancers (Basel) 2023; 15:3962. [PMID: 37568778 PMCID: PMC10417598 DOI: 10.3390/cancers15153962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Transarterial chemoembolization (TACE) is used as a bridging treatment in liver transplant candidates with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the main tumor marker used for HCC surveillance. The aim of this study was to assess the potential of using the AFP change after the first TACE in the prediction of complete tumor necrosis. The study comprised 101 patients with HCC who underwent liver transplantation (LT) after TACE in the period between January 2011 and December 2020. The ΔAFP was defined as the difference between the AFP value before the first TACE and AFP either before the second TACE or the LT. The receiver operator characteristics (ROC) curves were used to identify an optimal cut-off value. Complete tumor necrosis was found in 26.1% (18 of 69) and 6.3% (2 of 32) of patients with an initial AFP level under and over 100 ng/mL, respectively (p = 0.020). The optimal cut-off value of ΔAFP for the prediction of complete necrosis was a decline of ≥10.2 ng/mL and ≥340.5 ng/mL in the corresponding subgroups. Complete tumor necrosis rates were: 62.5% (5 of 8) in patients with an initial AFP < 100 ng/mL and decline of ≥10.2 ng/mL; 21.3% (13 of 61) in patients with an initial AFP < 100 ng/mL and decline of <10.2 ng/mL; 16.7% (2 of 12) in patients with an initial AFP > 100 ng/mL and decline of ≥340.5 ng/mL; and null in 20 patients with an initial AFP > 100 ng/mL and decline of <340.5 ng/mL, respectively (p = 0.003). The simple scoring system, based on the initial AFP and AFP decline after the first treatment, distinguished between a high, intermediate and low probability of complete necrosis, with an area under the ROC curve of 0.699 (95% confidence intervals 0.577 to 0.821, p = 0.001). Combining the initial AFP with its change after the first treatment enables early identification of the efficacy of TACE.
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Affiliation(s)
- Łukasz Masior
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Maciej Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Mikołaj Kuncewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Kacper Karaban
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Igor Jaszczyszyn
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Emilia Kruk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | | | | | - Wojciech Figiel
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Tadeusz Wróblewski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
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Lamparski K, Procyk G, Bartnik K, Korzeniowski K, Maciąg R, Matsibora V, Sajdek M, Dryjańska A, Wnuk E, Rosiak G, Maj E, Januszewicz M, Gąsecka A, Ostrowski T, Kaszczewski P, Gałązka Z, Wojtaszek M. Can Color Doppler Ultrasound Be Effectively Used as the Follow-Up Modality in Patients Undergoing Splenic Artery Aneurysm Embolization? A Correlational Study between Doppler Ultrasound, Magnetic Resonance Angiography and Digital Subtraction Angiography. J Clin Med 2023; 12:jcm12030792. [PMID: 36769441 PMCID: PMC9917602 DOI: 10.3390/jcm12030792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
Splenic artery aneurysm (SAAs) rupture is associated with a high mortality rate. Regular surveillance with imaging before and after intervention is crucial to guide best evidence treatment. The following study aimed to determine the efficacy of color Doppler ultrasound imaging (DUS) compared to digital subtraction angiography (DSA) and magnetic resonance angiography (MRA) as a follow-up modality after selective coil embolization of true SAAs. We analyzed data from 20 patients, 15 females (48.1 ± 16.1 years) undergoing selective SAA coil embolization using detachable fibered embolization coils. Imaging using DUS, MRA, and DSA was performed 3 months after the initial embolization or the consequent re-embolization procedure. Primary clinical success, defined as Class I aneurysm occlusion, on 3-month follow-up was seen in 16 (80.0%) patients. DUS had a sensitivity of 94.4% and a specificity of 42.9% when compared to DSA and 92.3% and 30%, respectively, when compared to MRA in identifying Class I aneurysm occlusion. The positive predictive value (PPV) of DUS in identifying the need for re-embolization was 75.0%, while the NPV of DUS in these terms was 90.5%. DUS showed a high sensitivity in detecting aneurysm occlusion and clinical success, simultaneously exhibiting poor specificity. Still, with caution, this follow-up modality could be used for monitoring select low-risk patients after selective embolization of SAAs. DUS could provide a higher cost-to-benefit ratio, enabling more systematic post-procedural follow-up, as it is far more commonly used compared to MRA and non-invasive compared to DSA.
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Affiliation(s)
- Krzysztof Lamparski
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
- Correspondence: ; Tel.: +48-606-607-512
| | - Grzegorz Procyk
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Krzysztof Bartnik
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Krzysztof Korzeniowski
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Rafał Maciąg
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Vadym Matsibora
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Michał Sajdek
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Alicja Dryjańska
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Emilia Wnuk
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Grzegorz Rosiak
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Edyta Maj
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Magdalena Januszewicz
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Aleksandra Gąsecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Tomasz Ostrowski
- Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Piotr Kaszczewski
- Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Zbigniew Gałązka
- Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
| | - Mikołaj Wojtaszek
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
- Everlight Radiology, 350 Euston Rd, London NW1 3AX, UK
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4
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Zugaj P, Karpiński G, Daniluk F, Pietrasik A, Lamparski K, Korzeniowski K, Szarpak Ł, Filipiak KJ, Gąsecka A. Successful percutaneous transluminal angioplasty to treat superior vena cava syndrome. Kardiol Pol 2023; 81:72-74. [PMID: 36136035 DOI: 10.33963/kp.a2022.0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Paweł Zugaj
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Grzegorz Karpiński
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Fryderyk Daniluk
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Arkadiusz Pietrasik
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | | | | | - Łukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, United States
| | - Krzysztof J Filipiak
- Department of Clinical Sciences, Maria Sklodowska-Curie Medical Academy, Warszawa, Poland
| | - Aleksandra Gąsecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland.
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Beumer BR, van Vugt JLA, Sapisochin G, Yoon P, Bongini M, Lu D, Xu X, De Simone P, Pintore L, Golse N, Nowosad M, Bennet W, Tsochatzis E, Koutli E, Abbassi F, Claasen MPAW, Merli M, O'Rourke J, Gambato M, Benito A, Majumdar A, Tan EK, Ebadi M, Montano-Loza AJ, Berenguer M, Metselaar HJ, Polak WG, Mazzaferro V, IJzermans JNM, Salinas‐Miranda E, Bhoori S, Rossi P, Remiszewski P, Korzeniowski K, Arico F, Toso C, Ferri F, Shah T, Puchades L, Herreras J, De Man RA, Van Klaveren D. Impact of muscle mass on survival of patients with hepatocellular carcinoma after liver transplantation beyond the Milan criteria. J Cachexia Sarcopenia Muscle 2022; 13:2373-2382. [PMID: 36622940 PMCID: PMC9530497 DOI: 10.1002/jcsm.13053] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/31/2022] [Accepted: 06/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Access to the liver transplant waitlist for patients with hepatocellular carcinoma (HCC) depends on tumour presentation, biology, and response to treatments. The Milan Criteria (MC) represent the benchmark for expanded criteria that incorporate additional prognostic factors. The purpose of this study was to determine the added value of skeletal muscle index (SMI) in HCC patients beyond the MC. METHOD Patients with HCC that were transplanted beyond the MC were included in this retrospective multicentre study. SMI was quantified using the Computed Tomography (CT) within 3 months prior to transplantation. Cox regression models were used to identify predictors of overall survival (OS). The discriminative performance of SMI extended Metroticket 2.0 and AFP models was also assessed. RESULTS Out of 889 patients transplanted outside the MC, 528 had a CT scan within 3 months prior to liver transplantation (LT), of whom 176 (33%) were classified as sarcopenic. The median time between assessment of the SMI and LT was 1.8 months (IQR: 0.77-2.67). The median follow-up period was 5.1 95% CI [4.7-5.5] years, with a total of 177 recorded deaths from any cause. In a linear regression model with SMI as the dependent variable, only male gender (8.55 95% CI [6.51-10.59], P < 0.001) and body mass index (0.74 95% CI [0.59-0.89], P < 0.001) were significant. Univariable survival analysis of patients with sarcopenia versus patients without sarcopenia showed a significant difference in OS (HR 1.44 95% CI [1.07 - 1.94], P = 0.018). Also the SMI was significant (HR 0.98 95% CI [0.96-0.99], P = 0.014). The survival difference between the lowest SMI quartile versus the highest SMI quartile was significant (log-rank: P = 0.005) with 5 year OS of 57% and 71%, respectively. Data from 423 patients, describing 139 deaths, was used for multivariate analysis. Both sarcopenia (HR 1.45 95% CI [1.02 - 2.05], P = 0.036) and SMI were (HR 0.98 95% CI [0.95-0.99], P = 0.035) significant. On the survival scale this translates to a 5 year OS difference of 11% between sarcopenia and no sarcopenia. Whereas for SMI, this translates to a survival difference of 8% between first and third quartiles for both genders. CONCLUSIONS Overall, we can conclude that higher muscle mass contributes to a better long-term survival. However, for individual patients, low muscle mass should not be considered an absolute contra-indication for LT as its discriminatory performance was limited.
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Affiliation(s)
- Berend R Beumer
- Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jeroen L A van Vugt
- Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Gonzalo Sapisochin
- Multi Organ Transplant Program, University Health Network, University of Toronto, Toronto, Canada
| | - Peter Yoon
- Multi Organ Transplant Program, University Health Network, University of Toronto, Toronto, Canada.,Department of Surgery, Westmead Hospital, Sydney, Australia
| | - Marco Bongini
- Gastrointestinal Surgery and Liver Transplantation, National Cancer Institute of Milan, Department of Oncology, University of Milan, Milan, Italy
| | - Di Lu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Xu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Paolo De Simone
- Hepatobiliary Surgery and Liver Transplantation, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Lorenzo Pintore
- Hepatobiliary Surgery and Liver Transplantation, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Nicolas Golse
- Centre Hépato-Biliaire, Hôpital Paul Brousse, Université Paris-Sud, Villejuif, France
| | - Malgorzata Nowosad
- Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - William Bennet
- Transplant Institute, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg, Sweden
| | - Emmanouil Tsochatzis
- Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital and UCL Institute of Liver and Digestive Health, London, UK
| | - Evangelia Koutli
- Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital and UCL Institute of Liver and Digestive Health, London, UK
| | - Fariba Abbassi
- Division of Digestive Surgery, University Hospitals of Geneva, Genève, Switzerland
| | - Marco P A W Claasen
- Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Multi Organ Transplant Program, University Health Network, University of Toronto, Toronto, Canada
| | - Manuela Merli
- Section of Gastroenterology, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Joanne O'Rourke
- The Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Martina Gambato
- Section of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Alberto Benito
- Section of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Avik Majumdar
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, Australia
| | - Ek Khoon Tan
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore
| | - Maryam Ebadi
- Division of Gastroenterology and Liver Unit, Zeidler Ledcor Centre, University of Alberta, Edmonton, Canada
| | - Aldo J Montano-Loza
- Division of Gastroenterology and Liver Unit, Zeidler Ledcor Centre, University of Alberta, Edmonton, Canada
| | - Marina Berenguer
- Hepatology & Liver Transplantation Unit and Ciberehd and ISS La Fe, Hospital Universitario y Politécnico La Fe, University of Valencia, Valencia, Spain
| | - Herold J Metselaar
- Erasmus MC Transplant Institute, Department of Gastroenterology and Hepatology, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Wojciech G Polak
- Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Vincenzo Mazzaferro
- Gastrointestinal Surgery and Liver Transplantation, National Cancer Institute of Milan, Department of Oncology, University of Milan, Milan, Italy
| | - Jan N M IJzermans
- Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | - Emmanuel Salinas‐Miranda
- Joint Department of Medical Imaging, University Health Network Sinai Health System and University of Toronto Toronto Canada
| | - Sherrie Bhoori
- Gastrointestinal Surgery and Liver Transplantation, National Cancer Institute of Milan, Department of Oncology University of Milan Milan Italy
| | - Piercarlo Rossi
- Department of Radiology Azienda Ospedaliero‐Universitaria Pisana Pisa Italy
| | - Piotr Remiszewski
- Department of General, Endocrine and Transplant Surgery Medical University of Gdansk Gdansk Poland
| | - Krzysztof Korzeniowski
- Department of General Transplant and Liver Surgery Medical University of Warsaw Warsaw Poland
| | - Francesco Arico
- Royal Free Sheila Sherlock Liver Centre Royal Free Hospital and UCL Institute of Liver and Digestive Health London UK
| | - Christian Toso
- Division of Digestive Surgery University Hospitals of Geneva Genève Switzerland
| | - Flaminia Ferri
- Division of Digestive Surgery University Hospitals of Geneva Genève Switzerland
| | - Tahir Shah
- The Liver Unit Queen Elizabeth Hospital Birmingham Birmingham UK
| | - Lorena Puchades
- Hepatology & Liver Transplantation Unit and Ciberehd and ISS La Fe, Hospital Universitario y Politécnico La Fe University of Valencia Valencia Spain
| | - Julia Herreras
- Hepatology & Liver Transplantation Unit and Ciberehd and ISS La Fe, Hospital Universitario y Politécnico La Fe University of Valencia Valencia Spain
| | - Rob A. De Man
- Erasmus MC Transplant Institute, Department of Gastroenterology and Hepatology University Medical Centre Rotterdam Rotterdam The Netherlands
| | - David Van Klaveren
- Department of Public Health University Medical Centre Rotterdam Rotterdam The Netherlands
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Bartnik K, Podgórska J, Rosiak G, Korzeniowski K, Giziński J, Sajdek M, Wróblewski T, Zieniewicz K, Nyckowski P, Rowiński O. Performance of initial LI-RADS 2018 treatment response in predicting survival of patients with hepatocellular carcinoma following TACE: a retrospective, single-center cohort study. J Cancer Res Clin Oncol 2021; 147:3673-3683. [PMID: 33778924 PMCID: PMC8557150 DOI: 10.1007/s00432-021-03603-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/16/2021] [Indexed: 12/17/2022]
Abstract
Purpose Treatment response following transarterial chemoembolization (TACE) is frequently evaluated with Liver Imaging Reporting and Data System Treatment Response (LR-TR) algorithm, but its association with patients’ outcomes is not supported in the literature. The purpose of this study was to provide such data. Methods A retrospective analysis of 99 TACE patients with stage A/B hepatocellular carcinoma according to Barcelona-Clinic Liver Cancer staging system was performed. Two radiologists assessed LR-TR, while a third radiologist re-assessed divergent results. Overall survival (OS) and time to disease progression (TTP) were the primary endpoints of the study, while the Cox proportional hazard model was used for outcome analyses. Results Interobserver agreement was substantial between the two readers with κ = 0.69 (95% CI 0.58–0.81). The median OS in viable, equivocal, and non-viable groups were 27, 27, and 73 months, respectively (p < 0.001). However, after adjustment for confounding factors, there was no significant association between initial viable response and OS (HR 0.98 [95% CI 0.37–2.63], p = 0.97), while equivocal response remained statistically significant (HR 3.52. [95% CI 1.27–9.71], p = 0.015). No significant association was noted when viable and equivocal groups were analyzed in aggregate (HR 1.03 [95% CI 0.4–2.4], p = 0.96). The median TTP did not differ between non-viable and viable groups (23 vs 18 months, respectively; p = 0.98). None of the analyzed predictors was associated with TTP. Conclusion Initial LR-TR response was not an independent predictor for OS nor TTP. The preliminary results suggest the necessity for more aggressive management of equivocal patients.
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Affiliation(s)
- Krzysztof Bartnik
- Doctoral School, Medical University of Warsaw, Warsaw, Poland.,Second Department of Radiology, Medical University of Warsaw, Ul. Banacha 1a, 02-097, Warsaw, Poland
| | - Joanna Podgórska
- Second Department of Radiology, Medical University of Warsaw, Ul. Banacha 1a, 02-097, Warsaw, Poland.
| | - Grzegorz Rosiak
- Second Department of Radiology, Medical University of Warsaw, Ul. Banacha 1a, 02-097, Warsaw, Poland
| | - Krzysztof Korzeniowski
- Second Department of Radiology, Medical University of Warsaw, Ul. Banacha 1a, 02-097, Warsaw, Poland
| | - Jakub Giziński
- Second Department of Radiology, Medical University of Warsaw, Ul. Banacha 1a, 02-097, Warsaw, Poland
| | - Michał Sajdek
- Second Department of Radiology, Medical University of Warsaw, Ul. Banacha 1a, 02-097, Warsaw, Poland
| | - Tadeusz Wróblewski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Nyckowski
- Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Olgierd Rowiński
- Second Department of Radiology, Medical University of Warsaw, Ul. Banacha 1a, 02-097, Warsaw, Poland
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7
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Wojtaszek M, Lamparski K, Wnuk E, Ostrowski T, Maciąg R, Rix T, Maj E, Milczarek K, Korzeniowski K, Rowiński O. Selective occlusion of splenic artery aneurysms with the coil packing technique: the impact of packing density on aneurysm reperfusion correlated between contrast-enhanced MR angiography and digital subtraction angiography. Radiol Med 2019; 124:450-459. [PMID: 30712163 DOI: 10.1007/s11547-019-00993-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 01/23/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim was to evaluate the relationship between coil packing densities after splenic artery aneurysm (SAA) treatment using detachable microcoils and rates of SAA reperfusion and to suggest a post-treatment surveillance protocol using contrast-enhanced MRA. MATERIALS AND METHODS Evaluated were 16 patients (4 men; mean age 46.7), who underwent true SAA embolization using detachable microcoils (Concerto, Medtronic). SAAs were treated by selective coil packing (CP) or stent-assisted coil exclusion (SAC). Contrast-enhanced magnetic resonance angiography (CE-MRA) and digital subtraction angiography (DSA) were performed at 3 months post-procedure and correlated. RESULTS Primary CP was used in 13 patients, while SAC was used in three patients. On follow-up, complete aneurysm occlusion was seen in seven patients (43.8%). Sac reperfusion occurred in nine patients (56.2%) and was demonstrated in all CE-MRA and six DSA studies. Mean aneurysm packing density was 20.10 ± 8.05% for the CP group and 32.90 ± 11.95% for the SAC group (p = 0.038). There was a significant difference in the incidence of aneurysm sac reperfusion on CE-MRA study between CP and SAC (9 vs. 0). No sac reperfusion was seen in aneurysms with packing densities ≥ 29%, irrespective of either embolization method. CONCLUSION Favorable midterm results for coil packing of SAAs seem to depend on the coil packing density with a coil volume approximately a quarter of the aneurysm volume being most effective. Follow-up should involve the use of CE-MRA as this modality has been shown to be superior over DSA in detecting aneurysm reperfusion and coil compaction. LEVEL OF EVIDENCE Level IV, therapeutic study.
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Affiliation(s)
- Mikołaj Wojtaszek
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland. .,Vascular Unit, Kent & Canterbury Hospital, East Kent Hospital University NHS Trust, Canterbury, Kent, CT1 3NG, UK.
| | - Krzysztof Lamparski
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland
| | - Emilia Wnuk
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland
| | - Tomasz Ostrowski
- Department of General and Endocrine Surgery, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland
| | - Rafał Maciąg
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland
| | - Thomas Rix
- Vascular Unit, Kent & Canterbury Hospital, East Kent Hospital University NHS Trust, Canterbury, Kent, CT1 3NG, UK
| | - Edyta Maj
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland
| | - Krzysztof Milczarek
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland
| | - Krzysztof Korzeniowski
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland
| | - Olgierd Rowiński
- 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland
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Radkiewicz P, Korzeniowski K. Justification and Indifference: Diverse Permissive Attitudes Toward Witnessed Violence Against the Elderly and Disabled. J Interpers Violence 2017; 32:3797-3821. [PMID: 26354499 DOI: 10.1177/0886260515603974] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The violence against the elderly and disabled is widespread. This means that many people who witness acts of violence against elders and the disabled do not react. Instead, they are rather inclined to develop permissive attitudes. The presented article distinguishes two permissive attitudes toward witnessed violence against the elderly and disabled: justification and indifference. The rationale for such differentiation is justified with reference to differences concerning (a) the strength of their relationship, (b) their frequency distribution in the population, and (c) the disparate influence of the underlying predictors. A survey study carried out on a nationwide representative sample of 1,000 adult Poles was the empirical basis for answering research questions. The study showed that domestic violence against elders and the disabled is a noticeable phenomenon in the population of Poland. Around 50% of respondents claimed that they came in touch with physical, economic, or psychological violence against the elderly. More than 30% reported the same in the case of disabled persons. Based on this study, it was found that justification of and indifference to violence were actually unrelated phenomena. Moreover, justification was much less widespread in the population than indifference. It seems easier to accept excuses for passivity in the face of violence than to find justifications for violence. Both permissive attitudes turned out to have a disparate pattern of predictors: Justification turned out to be mainly a function of environmental exposure to violence, whereas indifference was mainly a matter of worldview based on materialism and the imperative of self-interest.
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Affiliation(s)
- Piotr Radkiewicz
- 1 Polish Academy of Sciences, Institute of Psychology, Warsaw, Poland
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Wojtaszek M, Wnuk E, Maciag R, Lamparski K, Korzeniowski K, Rowinski O. Promoting False-Lumen Thrombosis after Thoracic Endovascular Aneurysm Repair in Type B Aortic Dissection by Selectively Excluding False-Lumen Distal Entry Tears. J Vasc Interv Radiol 2016; 28:168-175. [PMID: 27645464 DOI: 10.1016/j.jvir.2016.07.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 06/29/2016] [Accepted: 07/08/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To evaluate the efficacy and clinical outcomes of ancillary endovascular procedures in promoting false-lumen (FL) thrombosis (FLT) and preventing aortic expansion in patients after thoracic endografting for type B dissections. MATERIALS AND METHODS This retrospective review included 15 patients (12 men and 3 women; mean age, 59.6 y). Mean aortic diameter at the time of ancillary treatment was 47.4 mm. Different techniques were used as single procedures or sequentially: covered stent occlusion of detached visceral artery entry tears, occlusion of single entry tears with vascular plugs, or aortic endograft occlusion of multiple FL entry tears. FL embolization with ethylene vinyl alcohol copolymer was performed when selective occlusion was considered insufficient to close distal entry tears. Apart from endovascular aneurysm repair, all procedures were performed percutaneously under local anesthesia. If FL diameter increase persisted after 6-month follow-up computed tomographic (CT) angiography, another intervention was planned; otherwise, yearly follow-up was performed. RESULTS Mean clinical follow-up duration was 43.8 months (range, 8 d to 86.8 mo), with no in-hospital mortality. Estimated overall survival rates were 93.3%, 86.6%, and 77% at 12, 24, and 48 months, respectively. Three late deaths occurred, one of which was dissection-related at 40 months. Eight surviving patients (53%) had total FLT and 3 had partial FLT with stable aortic diameter on follow-up CT angiography. FL diameter increased in one patient, requiring further intervention. CONCLUSIONS Selective exclusion of new distal entry tears remaining after thoracic endovascular aneurysm repair can stabilize abdominal aortic expansion and promote FLT.
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Affiliation(s)
- Mikolaj Wojtaszek
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw 02-097, Poland.
| | - Emilia Wnuk
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw 02-097, Poland
| | - Rafal Maciag
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw 02-097, Poland
| | - Krzysztof Lamparski
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw 02-097, Poland
| | - Krzysztof Korzeniowski
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw 02-097, Poland
| | - Olgierd Rowinski
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw 02-097, Poland
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Wojtaszek M, Maciąg R, Korzeniowski K, Nawrot I, Rowiński O. Bridging therapy: coil and polymer embolisation of a ruptured penetrating aortic ulceration of the visceral aorta. Kardiol Pol 2015; 73:569. [PMID: 26189471 DOI: 10.5603/kp.2015.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 02/04/2015] [Indexed: 11/25/2022]
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11
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Wojtaszek M, Antoniak R, Maciag R, Korzeniowski K, Rowinski O. Kidney salvage by catheter guided thrombolysis in acute renal artery thromboembolic occlusions. Chin Med J (Engl) 2014; 127:4147-4149. [PMID: 25430466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- Mikolaj Wojtaszek
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw, Poland.
| | - Robert Antoniak
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw, Poland
| | - Rafal Maciag
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw, Poland
| | - Krzysztof Korzeniowski
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw, Poland
| | - Olgierd Rowinski
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, Warsaw, Poland
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Korzeniowski K, Kierznikowicz B, Olszanski R. Sexually transmitted diseases among Polish soldiers serving in the U.N. peace missions in Lebanon and Cambodia. Int Marit Health 2003; 54:101-7. [PMID: 14974783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
The results are presented of a survey conducted on the incidence of sexually transmitted diseases (STD) among Polish military personnel of the United Nations Forces in Lebanon (UNIFIL) in 1993-2000, and Cambodia (UNTAC) in 1992-1993. The analysis was based on the medical documentation of the patients treated in the UNIFIL Hospital in years 1993-2000. The most frequently recorded cases of sexually transmitted diseases in Cambodia were those of gonorrhoea. The results showed that sexually transmitted diseases did not present a serious health problem among soldiers in Lebanon, but were a problem in Cambodia. Specific living conditions and social norms characteristic for these countries were taken into consideration in presenting the results of the survey.
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Affiliation(s)
- Krzysztof Korzeniowski
- The Institute of Military Medicine, Maritime and Tropical Medicine Department, Gdynia, Poland
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Falkel JE, Hagerman FC, Murray IF, Green K, Korzeniowski K, O??Leary L. 291. Med Sci Sports Exerc 1987. [DOI: 10.1249/00005768-198704001-00291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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Hagerman FC, Falkel JE, Murray TF, Korzeniowski K, O??Leary L, Proctor D. 292. Med Sci Sports Exerc 1987. [DOI: 10.1249/00005768-198704001-00292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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