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Percutaneous Imaging-Guided Techniques in Interventional Oncology

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 31860

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Dr. Dimitrios Filippiadis

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2nd Department of Radiology, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Athens, Greece
Interests: interventional oncology; ablation; vertebral augmentation; MSK interventions
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Special Issue Information

Dear Colleagues,

In recent years, image-guided techniques constitute the 4th pillar of oncology along with systemic, surgical, and radiation therapies. Percutaneous or intra-arterial imaging-guided techniques improve local tumor control and survival rates without systemic side effects, and, in addition, offer pain relief and reduction of the administered analgesic medication. Interventional oncology techniques can be either solely performed or in combination with other therapies including immunotherapy. The combination of percutaneous ablation with immunotherapy results in a synergistic effect due to the enhancement of the immune-stimulating response.

This Special Issue welcomes original articles on innovations in image-guided oncologic interventions focusing upon personalized therapies in cancer patients as well as review articles describing the current state of the art.

Potential topics include but are not limited to the following:

Pre- and intra-procedural imaging for planning and guidance
Fusion imaging or navigation systems and its application in interventional oncology therapies
Percutaneous ablation techniques and products (alcohol, laser, radiofrequency, microwaves, cryoablation, irreversible electroporation, HIFU)
Ablation zone verification software and procedural efficacy
Endovascular therapies in interventional oncology, including trans-arterial bland embolization and chemo- and radio-embolization
Degradable and permanent microspheres for embolization
Imaging predictors of response or recurrence after locoregional therapies
Percutaneous neurolysis or neuromodulation
Vertebral or osseous augmentation with cement and/or cannulated screws/implants

Dr. Dimitrios Filippiadis
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Biopsy
Ablation
Trans-arterial therapies
Immunotherapy
Neurolysis
Osseous augmentation

Published Papers (12 papers)

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13 pages, 11518 KiB

Open AccessArticle

CT-Guided Drainage of Fluid Collections Following Liver Resection: Technical and Clinical Outcome of 143 Patients during a 14-Year Period

by Katharina S. Winter, Veronika Greif, Alexander Crispin, Caroline Burgard, Robert Forbrig, Thomas Liebig, Christoph G. Trumm and Robert Stahl

Diagnostics 2021, 11(5), 826; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11050826 - 02 May 2021

Cited by 5 | Viewed by 2236

Abstract

Purpose: To retrospectively evaluate the technical and clinical outcome of patients with symptomatic postoperative fluid collections following liver resection treated with CT-guided drainage (CTD). Methods: 143 suitable patients were examined between 2004 and 2017. Technical success was defined as (a) sufficient drainage of the fluid collection and (b) the non-occurrence of peri-interventional complications requiring surgical treatment with minor or prolonged hospitalization. Clinical success was defined as (a) decreasing or normalization of specific blood parameters within 30 days after intervention and (b) no surgical revision in addition to intervention required. C-reactive protein (CRP), leukocytes and Total Serum Bilirubin (TSB) were assessed. Dose length product (DLP) for the intervention parts was determined. Results: Technical success was achieved in 99.5% of 189 performed interventions. Clinical success was reached in 74% for CRP, in 86.7% for Leukocytes and in 62.1% for TSB. The median of successful decrease was 6.0 days for CRP, 3.5 days for Leukocytes and 5.5 days for TSB. In 90.2%, no surgical revision was necessary. Total DLP was significantly lower in the second half of the observation period (median 536.0 mGy*cm between years 2011 and 2017 vs. median 745.5 mGy*cm between years 2004 and 2010). Conclusions: Technical success rate of CTD was very high, and clinical success rate was fair to good. Reduction of the radiation dose reflects developments of CT technology and increased experience of the interventional radiologists. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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12 pages, 17709 KiB

Open AccessArticle

Percutaneous CT Fluoroscopy-Guided Core Needle Biopsy of Mediastinal Masses: Technical Outcome and Complications of 155 Procedures during a 10-Year Period

by Caroline Burgard, Robert Stahl, Giovanna Negrao de Figueiredo, Julien Dinkel, Thomas Liebig, Dania Cioni, Emanuele Neri and Christoph G. Trumm

Diagnostics 2021, 11(5), 781; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11050781 - 26 Apr 2021

Cited by 7 | Viewed by 3479

Abstract

Purpose: To evaluate technical outcome, diagnostic yield and safety of computed tomographic fluoroscopy-guided percutaneous core needle biopsies in patients with mediastinal masses. Methods: Overall, 155 CT fluoroscopy-guided mediastinal core needle biopsies, performed from March 2010 to June 2020 were included. Size of lesion, size of needle, access path, number of success, number of biopsies per session, diagnostic yield, patient’s position, effective dose, rate of complications, tumor localization, size of tumor and histopathological diagnosis were considered. Post-interventional CT was performed, and patients observed for any complications. Complications were classified per the Society of Interventional Radiology (SIR). Results: 148 patients (age, 54.7 ± 18.2) underwent 155 CT-fluoroscopy-guided percutaneous biopsies with tumors in the anterior (114; 73.5%), middle (17; 11%) and posterior (24; 15.5%) mediastinum, of which 152 (98%) were technically successful. For placement of the biopsy needle, in 82 (52.9%) procedures a parasternal trajectory was chosen, in 36 (23.3%) a paravertebral access, in 20 (12.9%) through the lateral intercostal space and in 17 (11%) the thoracic anterior midline, respectively. A total of 136 (89.5%) of the biopsies were considered adequate for a specific histopathologic analysis. Total DLP (dose-length product) was 575.7 ± 488.8 mGy*cm. Mean lesion size was 6.0 ± 3.3 cm. Neoplastic pathology was diagnosed in 115 (75.7%) biopsies and 35 (23%) biopsy samples showed no evidence of malignancy. Minor complications were observed in 18 (11.6%) procedures and major pneumothorax requiring drainage insertion in 3 interventions (1.9%). Conclusion: CT fluoroscopy-guided percutaneous core needle biopsy of mediastinal masses is an effective and safe procedure for the initial assessment of patients with mediastinal tumors. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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10 pages, 4632 KiB

Open AccessArticle

Percutaneous Microwave Ablation of Liver Lesions: Differences on the Sphericity Index of the Ablation Zone between Cirrhotic and Healthy Liver Parenchyma

by Athanasios Tsochatzis, Argyro Mazioti, Georgios Iliadis, Georgios Velonakis, Evgenia Efthymiou, Alexis Kelekis, Nikolaos Kelekis and Dimitrios Filippiadis

Diagnostics 2021, 11(4), 655; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11040655 - 05 Apr 2021

Cited by 4 | Viewed by 2030

Abstract

To compare different parameters of the sphericity index of the ablation zone following microwave ablation (MWA) on cirrhotic- and healthy-liver parenchyma in a series of patients treated with the same MWA system. Institutional database research identified 46 patients (77 lesions) who underwent MWA. “Cirrhotic liver group” (CLG) included 35 hepatocellular carcinoma lesions; “healthy liver group” (HLG) included 42 metastatic lesions. The long axis (LAD), short axis 1 (SAD-1) and 2 (SAD-2), the mean SAD-1 and SAD-2 (mSAD) diameter (in mm) and the mean sphericity (mSPH) index of the ablation zones were evaluated for each treated lesion in both groups from baseline to follow-up. A mixed model analysis of variance reported significant main effect of group on SAD-1 (p = 0.023), SAD-2 (p = 0.010) and mSAD (p = 0.010), with HLG showing lower values compared to CLG. No differences were detected on the LAD (p_FDR = 0.089; d = 0.45), and mSPH (p_FDR = 0.148, d = 0.40) between the two groups. However, a significant main effect of time was found on LAD (p < 0.001), SAD-1 (p < 0.001), SAD-2 (p < 0.001) and mSAD (p < 0.001), with decreased values in all indices at follow-up compared to baseline. A significant group by time interaction was observed on mSPH (p = 0.044); HLG had significantly lower mSPH at follow-up where CLG did not show any significant change. Our findings indicate that although in cirrhotic liver short axis diameter of the MWA zone seems to be significantly longer, this has no effect on the sphericity index which showed no significant difference between cirrhotic vs. healthy liver lesions. On the contrary, on one month follow-up ablation zones tend to become significant more ellipsoid in healthy whilst remains stable in cirrhotic liver. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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13 pages, 4244 KiB

Open AccessArticle

Percutaneous Implantation of a Microcatheter-Port System for Hepatic Arterial Infusion Chemotherapy of Unresectable Liver Tumors: Technical Feasibility, Functionality, and Complications

by Olivier Chevallier, Ségolène Mvouama, Julie Pellegrinelli, Kévin Guillen, Sylvain Manfredi, François Ghiringhelli, Nicolas Falvo, Marco Midulla and Romaric Loffroy

Diagnostics 2021, 11(3), 399; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030399 - 26 Feb 2021

Cited by 3 | Viewed by 2021

Abstract

To evaluate the feasibility and safety of percutaneously implanted arterial port catheter systems for hepatic arterial infusion of chemotherapy (HAI) in patients with unresectable liver malignancies. From October 2010 to August 2018, arterial port catheters for HAI were percutaneously implanted in 43 patients with unresectable liver malignancies. Three different catheter placement techniques were compared: a conventional end-hole catheter placed in the common hepatic artery (technique 1, n = 16), a side-hole catheter with the tip fixed in the gastroduodenal artery (technique 2, n = 18), and a long-tapered side-hole catheter with the tip inserted distally in a segmental hepatic artery (technique 3, n = 6). Catheter implantation was successful in 40 (93%) of the 43 patients. Complications related to catheter placement were observed in 10 (23%) patients; 5 (83%) of the 6 major complications were resolved, as well as all 4 minor complications. Catheter migration and occlusion occurred in 9 (22.5%) patients. Catheter migration was more frequent with technique 1 (n = 6) than with technique 2 (n = 1), although the difference was not significant (p = 0.066). Percutaneous arterial port catheter implantation for HAI is highly feasible and carries a low risk of complications. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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8 pages, 996 KiB

Open AccessArticle

Computed Tomography-Guided Percutaneous Radiofrequency Ablation of the Splanchnic Nerves as a Single Treatment for Pain Reduction in Patients with Pancreatic Cancer

by Stavros Grigoriadis, Maria Tsitskari, Maria Ioannidi, Periklis Zavridis, Ioannis Kotsantis, Alexis Kelekis and Dimitrios Filippiadis

Diagnostics 2021, 11(2), 303; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11020303 - 13 Feb 2021

Cited by 5 | Viewed by 1715

Abstract

The aim of this paper is to prospectively evaluate the efficacy and safety of percutaneous computed tomography (CT)-guided radiofrequency (RF) neurolysis of splanchnic nerves as a single treatment for pain reduction in patients with pancreatic cancer. Patients with pancreatic ductal adenocarcinoma suffering from abdominal pain refractory to conservative medication who underwent CT-guided neurolysis of splanchnic nerves by means of continuous radiofrequency were prospectively evaluated for pain and analgesics reduction as well as for survival. In all patients, percutaneous neurolysis was performed with a bilateral retrocrural paravertebral approach at T12 level using a 20 Gauge RF blunt curved cannula with a 1cm active tip electrode. Self-reported pain scores were assessed before and at the last follow-up using a pain inventory with numeric visual scale (NVS) units. The mean patient age was 65.4 ± 10.8 years (male-female: 19-11). The mean pain score prior to RF neurolysis of splanchnic nerves was 9.0 NVS units; this score was reduced to 2.9, 3.1, 3.6, 3.8, and 3.9 NVS units at 1 week, 1, 3, 6, and 12 months respectively (p < 0.001). Significantly reduced analgesic usage was reported in 28/30 patients. Two grade I complications were reported according to the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification system. According to the results of the present study, solely performed computed tomography-guided radiofrequency neurolysis of splanchnic nerves can be considered a safe and efficacious single-session technique for pain palliation in patients with pancreatic ductal adenocarcinoma suffering from abdominal pain refractory to conservative medication. Although effective in pain reduction the technique seems to have no effect upon survival improvement. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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13 pages, 1497 KiB

Open AccessArticle

Transarterial Radioembolization of Hepatocellular Carcinoma, Liver-Dominant Hepatic Colorectal Cancer Metastases, and Cholangiocarcinoma Using Yttrium90 Microspheres: Eight-Year Single-Center Real-Life Experience

by Julie Pellegrinelli, Olivier Chevallier, Sylvain Manfredi, Inna Dygai-Cochet, Claire Tabouret-Viaud, Guillaume Nodari, François Ghiringhelli, Jean-Marc Riedinger, Romain Popoff, Jean-Marc Vrigneaud, Alexandre Cochet, Serge Aho, Marianne Latournerie and Romaric Loffroy

Diagnostics 2021, 11(1), 122; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11010122 - 14 Jan 2021

Cited by 9 | Viewed by 2373

Abstract

Liver tumors are common and may be unamenable to surgery or ablative treatments. Consequently, other treatments have been devised. To assess the safety and efficacy of transarterial radioembolization (TARE) with Yttrium-90 for hepatocellular carcinoma (HCC), liver-dominant hepatic colorectal cancer metastases (mCRC), and cholangiocarcinoma (CCA), performed according to current recommendations, we conducted a single-center retrospective study in 70 patients treated with TARE (HCC, n = 44; mCRC, n = 20; CCA, n = 6). Safety and toxicity were assessed using the National Cancer Institute Common Terminology Criteria. Treatment response was evaluated every 3 months on imaging studies using Response Evaluation Criteria in Solid Tumors (RECIST) or mRECIST criteria. Overall survival and progression-free survival were estimated using the Kaplan-Meier method. The median delivered dose was 1.6 GBq, with SIR-Spheres^® or TheraSphere^® microspheres. TARE-related grade 3 adverse events affected 17.1% of patients. Median follow-up was 32.1 months. Median progression-free survival was 5.6 months and median overall time from TARE to death was 16.1 months and was significantly shorter in men. Progression-free survival was significantly longer in women (HR, 0.49; 95%CI, 0.26–0.90; p = 0.031). Risk of death or progression increased with the number of systemic chemotherapy lines. TARE can be safe and effective in patients with intermediate- or advanced-stage HCC, CCA, or mCRC refractory or intolerant to appropriate treatments. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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13 pages, 5754 KiB

Open AccessArticle

Cone-Beam CT-Guided Lung Biopsies: Results in 94 Patients

by Daniel Gulias-Soidan, Nilfa Milena Crus-Sanchez, Daniel Fraga-Manteiga, Juan Ignacio Cao-González, Vanesa Balboa-Barreiro and Cristina González-Martín

Diagnostics 2020, 10(12), 1068; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10121068 - 10 Dec 2020

Cited by 6 | Viewed by 1715

Abstract

Background: The aim of this study was to evaluate the diagnostic capacity of Cone-Beam computed tomography (CT)-guided transthoracic percutaneous biopsies on lung lesions in our setting and to detect risk factors for possible complications. Methods: Retrospective study of 98 biopsies in 94 patients, performed between May 2017 and January 2020. To obtain them, a 17G coaxial puncture system and a Siemens Artis Zee Floor vc21 archwire were used. Descriptive data of the patients, their position at the time of puncture, location and size of the lesions, number of cylinders extracted, and complications were recorded. Additionally, the fluoroscopy time used in each case, the doses/area and the estimated total doses received by the patients were recorded. Results: Technical success was 96.8%. A total of 87 (92.5%) malignant lesions and 3 (3.1%) benign lesions were diagnosed. The sensitivity was 91.5% and the specificity was 100%. We registered three technical failures and three false negatives initially. Complications included 38 (38.8%) pneumothorax and 2 (2%) hemoptysis cases. Fluoroscopy time used in each case was 4.99 min and the product of the dose area is 11,722.4 microGy/m². Conclusion: The transthoracic biopsy performed with Cone-Beam CT is accurate and safe in expert hands for the diagnosis of lung lesions. Complications are rare and the radiation dose used was not excessive. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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12 pages, 2341 KiB

Open AccessArticle

Cryoablation of Extra-Abdominal Desmoid Tumors: A Single-Center Experience with Literature Review

by Sarah Saltiel, Pierre E. Bize, Patrick Goetti, Nicolas Gallusser, Stéphane Cherix, Alban Denys, Fabio Becce and Georgia Tsoumakidou

Diagnostics 2020, 10(8), 556; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10080556 - 04 Aug 2020

Cited by 18 | Viewed by 3503

Abstract

Cryoablation (CA) has gained popularity in the treatment of benign and malignant musculoskeletal tumors. While extra-abdominal desmoid (EAD) tumors are not malignant, they remain challenging to treat because of their high local recurrence rate. We reviewed all EAD tumors treated with CA at our institution between November 2012 and March 2020. Fourteen procedures were performed on nine females and one male (mean age, 33 ± 18 years) as either first-line (n = 4) or salvage therapy (n = 6) with curative intent (n = 8) or tumor debulking (n = 2). Mean tumor size was 63.6 cm³ (range, 3.4–169 cm³). Contrast-enhanced MRI was performed before treatment and at 3-, 6-, and 12-month follow-up. Treatment outcome was based on the change in enhanced tumor volume (ET-V). For curatively treated patients, the mean ET-V change was −97 ± 7%, −44 ± 143%, and +103 ± 312% at 3, 6, and 12 months, respectively. For debulking patients, the mean ET-V change was −98 ± 4%, +149 ± 364%, and +192 ± 353% at 3, 6, and 12 months, respectively. During a mean follow-up of 53.7 months (range, 12–83 months), one grade III and one grade IV complication were noted. We found CA to be safe and well tolerated in patients with EAD. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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Review

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18 pages, 3327 KiB

Open AccessReview

Advanced Techniques in the Percutaneous Ablation of Liver Tumours

by Terrence CH Hui, Justin Kwan and Uei Pua

Diagnostics 2021, 11(4), 585; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11040585 - 24 Mar 2021

Cited by 16 | Viewed by 4148

Abstract

Percutaneous ablation is an accepted treatment modality for primary hepatocellular carcinoma (HCC) and liver metastases. The goal of curative ablation is to cause the necrosis of all tumour cells with an adequate margin, akin to surgical resection, while minimising local damage to non-target tissue. Aside from the ablative modality, the proceduralist must decide the most appropriate imaging modality for visualising the tumour and monitoring the ablation zone. The proceduralist may also employ protective measures to minimise injury to non-target organs. This review article discusses the important considerations an interventionalist needs to consider when performing the percutaneous ablation of liver tumours. It covers the different ablative modalities, image guidance, and protective techniques, with an emphasis on new and advanced ablative modalities and adjunctive techniques to optimise results and achieve satisfactory ablation margins. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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12 pages, 11938 KiB

Open AccessReview

Role of Fusion Imaging in Image-Guided Thermal Ablations

by Serena Carriero, Gianmarco Della Pepa, Lorenzo Monfardini, Renato Vitale, Duccio Rossi, Andrea Masperi and Giovanni Mauri

Diagnostics 2021, 11(3), 549; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030549 - 19 Mar 2021

Cited by 19 | Viewed by 3374

Abstract

Thermal ablation (TA) procedures are effective treatments for several kinds of cancers. In the recent years, several medical imaging advancements have improved the use of image-guided TA. Imaging technique plays a pivotal role in improving the ablation success, maximizing pre-procedure planning efficacy, intraprocedural targeting, post-procedure monitoring and assessing the achieved result. Fusion imaging (FI) techniques allow for information integration of different imaging modalities, improving all the ablation procedure steps. FI concedes exploitation of all imaging modalities’ strengths concurrently, eliminating or minimizing every single modality’s weaknesses. Our work aims to give an overview of FI, explain and analyze FI technical aspects and its clinical applications in ablation therapy and interventional oncology. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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13 pages, 3151 KiB

Open AccessReview

The Role of Percutaneous Ablation in the Management of Colorectal Cancer Liver Metastatic Disease

by Dimitrios K. Filippiadis, Georgios Velonakis, Alexis Kelekis and Constantinos T. Sofocleous

Diagnostics 2021, 11(2), 308; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11020308 - 14 Feb 2021

Cited by 12 | Viewed by 2594

Abstract

Approximately 50% of colorectal cancer patients will develop metastases during the course of the disease. Local or locoregional therapies for the treatment of liver metastases are used in the management of oligometastatic colorectal liver disease, especially in nonsurgical candidates. Thermal ablation (TA) is recommended in the treatment of limited liver metastases as free-standing therapy or in combination with surgery as long as all visible disease can be eradicated. Percutaneous TA has been proven as a safe and efficacious therapy offering sustained local tumor control and improved patient survival. Continuous technological advances in diagnostic imaging and guidance tools, the evolution of devices allowing for optimization of ablation parameters, as well as the ability to perform margin assessment have improved the efficacy of ablation. This allows resectable small volume diseases to be cured with percutaneous ablation. The ongoing detailed information and increasing understanding of tumor biology, genetics, and tissue biomarkers that impact oncologic outcomes as well as their implications on the results of ablation have further allowed for treatment customization and improved oncologic outcomes even in those with more aggressive tumor biology. The purpose of this review is to present the most common indications for image-guided percutaneous ablation in colorectal cancer liver metastases, to describe technical considerations, and to discuss relevant peer-reviewed evidence on this topic. The growing role of imaging and image-guidance as well as controversies regarding several devices are addressed. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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Other

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5 pages, 1794 KiB

Open AccessCase Report

Diagnostic and Management Difficulty of Bleeding Aorto-Duodenal Fistula Associated with Hodgkin’s Lymphoma

by Boaz Nachmias, Allan I. Bloom and Alexander Gural

Diagnostics 2021, 11(3), 389; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030389 - 25 Feb 2021

Cited by 1 | Viewed by 1443

Abstract

Primary aorto-enteric fistula (AEF) resulting from abdominal malignancy is a rare and often fatal complication. The few reports to date are mostly secondary to solid tumors. We present a case of a patient with refractory Hodgkin’s lymphoma who developed life-threatening AEF. We describe the diagnostic and therapeutic efforts, requiring a multi-disciplinary team of interventional radiology, gastroenterology, and transfusion medicine, resulting in a favorable outcome. Importantly, we offer several insights regarding the identification and management of high-risk patients, with an emphasis on pre-treatment considerations and urgent diagnosis and intervention. Full article

(This article belongs to the Special Issue Percutaneous Imaging-Guided Techniques in Interventional Oncology)

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