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Article: Microballoon Interventions for Liver Tumors: Review of Literature and Future Perspectives.

Lucatelli, Pierleone / Rocco, Bianca / Ciaglia, Simone / Damato, Elio / Mosconi, Cristina / Argirò, Renato / Catalano, Carlo

Journal of clinical medicine

2022 Volume 11, Issue 18

Abstract: Background: Microballoon interventions (MBIs) have been proposed as useful tools to improve the efficacy of locoregional liver treatments. The aim of this systematic review was to summarize the existing evidence on procedural characteristics, safety, ... ...

Abstract	Background: Microballoon interventions (MBIs) have been proposed as useful tools to improve the efficacy of locoregional liver treatments. The aim of this systematic review was to summarize the existing evidence on procedural characteristics, safety, and efficacy of MBIs. Methods: PubMed and Cochrane Central Register of Controlled Trials were queried for original research articles evaluating MBIs in patients with liver malignancies from 2012 to August 2022. Search terms employed were liver malignancies, hepatocellular carcinoma, cholangiocarcinoma, liver metastases, microballoon transarterial chemoembolization, balloon-occluded trans-arterial chemoembolization, balloon-occluded selective internal radiation therapies, balloon-occluded TACE and ablation, and safety or oncological results or efficacy. Merely technical studies and animal studies were excluded. Results: Thirty-four original research studies and one abstract involving 744 patients treated with MBIs were included; 76% of the studies were retrospective, with low risk of bias and moderate-to-poor levels of evidence. Heterogeneity precluded meta-analysis. All studies proved MBI safety, which was not inferior to non-occlusive procedures. Balloon employment ameliorates oncological results, improving time to recurrence, objective response rate, and lowers need for retreatment. Conclusions: MBIs appear to be potential game changers in the treatment of liver malignancies. Multicentric, prospective and randomized studies are necessary to confirm these findings.
Language	English
Publishing date	2022-09-11
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11185334
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Article ; Online: Two-dimensional perfusion angiography permits direct visualization of redistribution of flow in hepatocellular carcinoma during b-TACE.

Lucatelli, Pierleone / Ciaglia, Simone / Rocco, Bianca / De Rubeis, Gianluca / Bolognesi, Guido / Damato, Elio / Corona, Mario / Nardis, Pier Giorgio / Cannavale, Alessandro / Ricci, Paolo / Catalano, Carlo

La Radiologia medica

2024

Abstract: Objectives: To demonstrate in vivo redistribution of the blood flow towards HCC's lesions by utilizing two-dimensional perfusion angiography in b-TACE procedures.: Material and methods: In total, 30 patients with 35 HCC nodules treated in the period ... ...

Abstract	Objectives: To demonstrate in vivo redistribution of the blood flow towards HCC's lesions by utilizing two-dimensional perfusion angiography in b-TACE procedures. Material and methods: In total, 30 patients with 35 HCC nodules treated in the period between January 2019 and November 2021. For each patient, a post-processing software leading to a two-dimensional perfusion angiography was applied on each angiography performed via balloon microcatheter, before and after inflation. On the colour map obtained, reflecting the evolution of contrast intensity change over time, five regions of interests (ROIs) were assessed: one on the tumour (ROI-t), two in the immediate peritumoural healthy liver parenchyma (ROI-ihl) and two in the peripheral healthy liver parenchyma (ROI-phl). The results have been interpreted with a novel in silico model that simulates the hemodynamics of the hepatic arterial system. Results: Among the ROIs drawn inside the same segment of target lesion, the time-to-peak of the ROI-t and of the ROI-ihl have a significantly higher mean value when the balloon was inflated compared with the ROIs obtained with deflated balloon (10.33 ± 3.66 s vs 8.87 ± 2.60 s (p = 0.015) for ROI-t; 10.50 ± 3.65 s vs 9.23 ± 2.70 s (p = 0.047) for ROI-ihl). The in silico model prediction time-to-peak delays when balloon was inflated, match with those observed in vivo. The numerical flow analysis shows how time-to-peak delays are caused by the obstruction of the balloon-occluded artery and the opening of intra-hepatic collateral. Conclusion: The measurements identify predictively the flow redistribution in the hepatic arteries during b-TACE, supporting a proper positioning of the balloon microcatheter.
Language	English
Publishing date	2024-04-18
Publishing country	Italy
Document type	Journal Article
ZDB-ID	205751-7
ISSN	1826-6983 ; 0033-8362
ISSN (online)	1826-6983
ISSN	0033-8362
DOI	10.1007/s11547-024-01816-9
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Article ; Online: Percutaneous Thermal Segmentectomy: Proof of Concept.

Lucatelli, Pierleone / Argirò, Renato / Crocetti, Laura / Rocco, Bianca / Bozzi, Elena / Gasparrini, Fulvio / Tanzilli, Alessandro / Catalano, Carlo / Iezzi, Roberto

Cardiovascular and interventional radiology

2022 Volume 45, Issue 5, Page(s) 665–676

Abstract: Aim: To report the multicenter retrospective experience on combination of balloon-occluded MWA(b-MWA) followed by balloon-occluded TACE(b-TACE) in patients with liver malignancies > 3 cm, focusing on appearance and volume of necrotic area, safety ... ...

Abstract	Aim: To report the multicenter retrospective experience on combination of balloon-occluded MWA(b-MWA) followed by balloon-occluded TACE(b-TACE) in patients with liver malignancies > 3 cm, focusing on appearance and volume of necrotic area, safety profile and oncological results. Materials and methods: Twenty-three patients with liver primary malignancies (hepatocellular carcinoma,HCC = 18; intrahepatic cholangiocarcinoma,iCC = 2) and metastasis (colorectal cancer metastasis = 1;sarcoma metastasis = 1;breast metastasis = 1) were treated. Maximum mean diameter of lesions was 4.4 cm (± 1 cm). Treatments were performed using a single-step approach:b-MWA was performed after balloon-microcatheter inflation, followed by b-TACE (with epirubicin or irinotecan). Necrotic area shape and discrepancy with the expected volume of necrosis suggested by vendor's ablation chart were assessed at post-procedural CT. Complications were categorized according to CIRSE classification. Oncological results at 1 and 3-6 months were evaluated using m-RECIST(HCC) and RECISTv1.1(metastasis/iCC). Results: Mean volume of necrotic area was 75 cm Conclusion: b-MWA followed by b-TACE in a single-step procedure led to larger necrotic areas than the proposed by vendors ablation chart, non-spherical in shape and corresponded to the vascular segment occluded during ablation. This permitted to safely achieve promising oncological results in patients with > 3 cm tumors.
MeSH term(s)	Carcinoma, Hepatocellular/therapy ; Chemoembolization, Therapeutic/methods ; Humans ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/pathology ; Liver Neoplasms/therapy ; Pneumonectomy ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2022-03-30
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	603082-8
ISSN	1432-086X ; 0342-7196 ; 0174-1551
ISSN (online)	1432-086X
ISSN	0342-7196 ; 0174-1551
DOI	10.1007/s00270-022-03117-y
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Article ; Online: Are Radiopaque Beads a Real Advantage?

Lucatelli, Pierleone / De Rubeis, Gianluca / Rocco, Bianca / Bezzi, Mario

Radiology

2019 Volume 290, Issue 3, Page(s) 852–853

MeSH term(s)	Animals ; Carcinoma, Hepatocellular ; Chemoembolization, Therapeutic ; Doxorubicin ; Liver Neoplasms ; Rabbits ; Tomography, X-Ray Computed
Chemical Substances	Doxorubicin (80168379AG)
Language	English
Publishing date	2019-02-05
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.2019182655
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Article ; Online: Bleeding in COVID Patients: What We Have Understood So Far.

Lucatelli, Pierleone / Rocco, Bianca / Nardis, Pier Giorgio / Cannavale, Alessandro / Bezzi, Mario / Catalano, Carlo / Corona, Mario

Cardiovascular and interventional radiology

2021 Volume 44, Issue 4, Page(s) 666–668

Language	English
Publishing date	2021-01-28
Publishing country	United States
Document type	Letter
ZDB-ID	603082-8
ISSN	1432-086X ; 0342-7196 ; 0174-1551
ISSN (online)	1432-086X
ISSN	0342-7196 ; 0174-1551
DOI	10.1007/s00270-021-02775-8
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Article ; Online: A Low Daily Intake of Simple Sugars in the Diet Is Associated with Improved Liver Function in Cirrhotic Liver Transplant Candidates.

Parisse, Simona / Carnevale, Sara / Di Bartolomeo, Francesca / Poli, Edoardo / Miceli, Francesca / Ferri, Flaminia / Mischitelli, Monica / Rocco, Bianca / Lai, Quirino / Lucatelli, Pierleone / Corona, Mario / Mennini, Gianluca / De Santis, Adriano / Rossi, Massimo / Muscaritoli, Maurizio / Cantafora, Alfredo / Ginanni Corradini, Stefano

Nutrients

2023 Volume 15, Issue 7

Abstract: 1) Background: We investigated, for the first time, whether dietary simple sugar intake affects MELD score changes over time in a cohort of cirrhotic liver transplant candidates. (2) Methods: the MELD score, dietary habits using a 3-day food diary, and ... ...

Abstract	(1) Background: We investigated, for the first time, whether dietary simple sugar intake affects MELD score changes over time in a cohort of cirrhotic liver transplant candidates. (2) Methods: the MELD score, dietary habits using a 3-day food diary, and visceral adipose tissue index (VATI) measured with CT scan were assessed in 80 consecutive outpatient cirrhotic patients at baseline, after counseling to follow current nutritional guidelines. The MELD score was reassessed after six months and the DELTA-MELD was calculated as the MELD at the second assessment minus the MELD at baseline. (3) Results: Compared with the baseline, the MELD score of cirrhotic patients at the end of the study was decreased, stable, or increased in 36%, 8% and 56% of patients, respectively. In separate multiple linear regression models, DELTA-MELD was positively and independently correlated with the daily intake of simple sugars expressed in g/kg body weight (
MeSH term(s)	Humans ; Liver Transplantation ; Liver Cirrhosis/complications ; Monosaccharides ; Diet ; Severity of Illness Index ; Prognosis
Chemical Substances	Monosaccharides
Language	English
Publishing date	2023-03-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15071575
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Article ; Online: Possible use of Digital Variance Angiography in Liver Transarterial Chemoembolization: A Retrospective Observational Study.

Lucatelli, Pierleone / Rocco, Bianca / Ciaglia, Simone / Teodoli, Leonardo / Argirò, Renato / Guiu, Boris / Saba, Luca / Vallati, Giulio / Spiliopoulos, Stavros / Patrone, Lorenzo / Gyánó, Marcell / Góg, István / Osváth, Szabolcs / Szigeti, Krisztian / Kiss, János P / Catalano, Carlo

Cardiovascular and interventional radiology

2023 Volume 46, Issue 5, Page(s) 635–642

Abstract: Purpose: Digital variance angiography (DVA), a recently developed image processing technology, provided higher contrast-to-noise ratio (CNR) and better image quality (IQ) during lower limb interventions than digital subtraction angiography (DSA). Our ... ...

Abstract	Purpose: Digital variance angiography (DVA), a recently developed image processing technology, provided higher contrast-to-noise ratio (CNR) and better image quality (IQ) during lower limb interventions than digital subtraction angiography (DSA). Our aim was to investigate whether this quality improvement can be observed also during liver transarterial chemoembolization (TACE). Materials and methods: We retrospectively compared the CNR and IQ parameters of DSA and DVA images from 25 patients (65% male, mean ± SD age: 67.5 ± 11.2 years) underwent TACE intervention at our institute. CNR was calculated on 50 images. IQ of every image set was evaluated by 5 experts using 4-grade Likert scales. Both single image evaluation and paired image comparison were performed in a blinded and randomized manner. The diagnostic value was evaluated based on the possibility to identify lesions and feeding arteries. Results: DVA provided significantly higher CNR (mean CNR Conclusion: In our study, DVA provided higher quality images and better diagnostic insight than DSA; therefore, DVA could represent a useful tool in liver TACE interventions. Level of evidence: III Non-consecutive study.
MeSH term(s)	Humans ; Male ; Middle Aged ; Aged ; Female ; Carcinoma, Hepatocellular/therapy ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/therapy ; Liver Neoplasms/blood supply ; Retrospective Studies ; Chemoembolization, Therapeutic/methods ; Angiography, Digital Subtraction/methods
Language	English
Publishing date	2023-04-19
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	603082-8
ISSN	1432-086X ; 0342-7196 ; 0174-1551
ISSN (online)	1432-086X
ISSN	0342-7196 ; 0174-1551
DOI	10.1007/s00270-023-03420-2
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Article ; Online: In Vivo Comparison of Micro-Balloon Interventions (MBI) Advantage: A Retrospective Cohort Study of DEB-TACE Versus b-TACE and of SIRT Versus b-SIRT.

Lucatelli, Pierleone / De Rubeis, Gianluca / Trobiani, Claudio / Ungania, Sara / Rocco, Bianca / De Gyurgyokai, Simone Zilahi / Masi, Marica / Pecorella, Irene / Cappelli, Federico / Lai, Quirino / Catalano, Carlo / Vallati, Giulio

Cardiovascular and interventional radiology

2022 Volume 45, Issue 3, Page(s) 306–314

Abstract: Purpose: The purpose of this study was to evaluate in vivo the role of the micro-balloon by comparing trans-arterial chemoembolization (DEB-TACE) and selective internal radiotherapy (SIRT) procedures performed with and without balloon micro-catheter (b- ... ...

Abstract	Purpose: The purpose of this study was to evaluate in vivo the role of the micro-balloon by comparing trans-arterial chemoembolization (DEB-TACE) and selective internal radiotherapy (SIRT) procedures performed with and without balloon micro-catheter (b-DEB-TACE and DEB-TACE/SIRT and b-SIRT) for the treatment of hepatocellular carcinoma (HCC). Methods: The impact of a balloon micro-catheter on trans-arterial loco-regional treatment was analyzed using non-enhanced post-procedural cone-beam CT (Ne-CBCT) by comparing the attenuation values in the embolized area and the surrounding liver tissue before and after DEB-TACE versus b-DEB-TACE and by comparing 2D/3D dosimetry in single-photon emission computed tomography after SIRT versus b-SIRT, and by comparing the histological count of the beads following orthotopic liver transplantation in the DEB-TACE versus b-DEB-TACE subgroup. Results: We treated 84 HCC patients using trans-arterial loco-regional therapy. Fifty-three patients (26 DEB-TACE and 27 b-DEB-TACE) were analyzed in the TACE group. Contrast, signal-to-noise ratio, and contrast-to-noise ratio were all significantly higher in b-DEB-TACE subgroup than DEB-TACE (182.33 HU [CI95% 160.3-273.5] vs. 124 HU [CI95% 80.6-163.6]; 8.3 [CI95% 5.7-10.1] vs. 4.5 [CI95% 3.7-6.0]; 6.9 [CI95% 4.3-7.8] vs. 3.1 [CI95% 2.2-5.0] p < 0.05). Thirty-one patients (24 SIRT and 7 b-SIRT) were analyzed in the SIRT group. 2D dosimetry profile evaluation showed an activity intensity peak significantly higher in the b-SIRT than in the SIRT subgroup (987.5 ± 393.8 vs. 567.7 ± 302.2, p = 0.005). Regarding 3D dose analysis, the mean dose administered to the treated lesions was significantly higher in the b-SIRT than in the SIRT group (151.6 Gy ± 53.2 vs. 100.1 Gy ± 43.4, p = 0.01). In histological explanted liver analysis, there was a trend for higher intra-tumoral localization of embolic microspheres for b-DEB-TACE in comparison with DEB-TACE. Conclusions: Due to the use of three different methods, the results of this study demonstrate in vivo, a better embolization profile of oncological intra-arterial interventions performed with balloon micro-catheter regardless of the embolic agent employed.
MeSH term(s)	Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/therapy ; Chemoembolization, Therapeutic/methods ; Humans ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/pathology ; Liver Neoplasms/therapy ; Retrospective Studies ; Sirtuins ; Treatment Outcome
Chemical Substances	Sirtuins (EC 3.5.1.-)
Language	English
Publishing date	2022-01-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	603082-8
ISSN	1432-086X ; 0342-7196 ; 0174-1551
ISSN (online)	1432-086X
ISSN	0342-7196 ; 0174-1551
DOI	10.1007/s00270-021-03035-5
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Article ; Online: Cone-Beam CT-Guided Transarterial Tagging of Endophytic Renal Tumors with Indocyanine Green for Robot-Assisted Partial Nephrectomy.

Nardis, Pier Giorgio / Cipollari, Stefano / Lucatelli, Pierleone / Basilico, Fabrizio / Rocco, Bianca / Corona, Mario / Cannavale, Alessandro / Leonardo, Costantino / Flammia, Rocco Simone / Proietti, Flavia / Vallati, Giulio / Gallucci, Michele / Catalano, Carlo

Journal of vascular and interventional radiology : JVIR

2022 Volume 33, Issue 8, Page(s) 934–941

Abstract: Purpose: To evaluate the safety, efficacy, and clinical impact of preoperative cone-beam computed tomography (CT)-guided selective embolization of endophytic renal tumors with the fluorescent dye indocyanine green (ICG) and ethiodized oil in patients ... ...

Abstract	Purpose: To evaluate the safety, efficacy, and clinical impact of preoperative cone-beam computed tomography (CT)-guided selective embolization of endophytic renal tumors with the fluorescent dye indocyanine green (ICG) and ethiodized oil in patients undergoing robot-assisted partial nephrectomy (RAPN) using near-infrared fluorescence imaging (NIR-FI). Materials and methods: Patients with renal endophytic tumors eligible for RAPN and transarterial embolization with ICG and ethiodized oil were prospectively enrolled. Technical success was defined as the completion of the embolization procedure. Radiographic success, defined as ethiodized oil accumulation in the nodule, was classified as poor, moderate, good, or optimal on the basis of postembolization cone-beam CT. Surgical visibility of the tumors during RAPN with the use of NIR-FI was classified as follows: (a) not visible, (b) visible with poorly defined margins, and (c) visible with well-defined margins. Results: Forty-one patients underwent preoperative selective embolization. Technical success was 100%. Ethiodized oil accumulation on cone-beam CT was poor in 2 (4.9%), moderate in 6 (14.6%), good in 25 (61.0%), and optimal in 8 (19.5%) of 41 patients. During RAPN with NIR-FI, tumors were visible with well-defined margins in 26 (63.4%), visible with blurred margins in 14 (34.1%), and not visible in 1 (2.4%) of 41 cases. There were no adverse events following endovascular embolization. Conclusions: Preoperative transarterial superselective embolization of endophytic renal tumors with ICG and ethodized oil in patients undergoing RAPN is safe and effective, allowing accurate intraoperative visualization and resection of endophytic tumors.
MeSH term(s)	Cone-Beam Computed Tomography ; Ethiodized Oil ; Humans ; Indocyanine Green ; Kidney Neoplasms/diagnostic imaging ; Kidney Neoplasms/pathology ; Kidney Neoplasms/surgery ; Margins of Excision ; Nephrectomy/adverse effects ; Nephrectomy/methods ; Robotic Surgical Procedures/adverse effects ; Robotic Surgical Procedures/methods ; Robotics ; Treatment Outcome
Chemical Substances	Ethiodized Oil (8008-53-5) ; Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2022-04-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	1137756-2
ISSN	1535-7732 ; 1051-0443
ISSN (online)	1535-7732
ISSN	1051-0443
DOI	10.1016/j.jvir.2022.04.016
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Article: Surgical Resection Is Superior to TACE in the Treatment of HCC in a Well Selected Cohort of BCLC-B Elderly Patients-A Retrospective Observational Study.

Brozzetti, Stefania / D'Alterio, Chiara / Bini, Simone / Antimi, Jessica / Rocco, Bianca / Fassari, Alessia / Lucatelli, Pierleone / Nardis, Piergiorgio / Di Martino, Michele / De Sanctis, Giuseppe Maria / Corona, Mario / Bagni, Oreste / Cortesi, Enrico / Bezzi, Mario / Catalano, Carlo

Cancers

2022 Volume 14, Issue 18

Abstract: Hepatocellular carcinoma (HCC) usually develops in cirrhotic liver, with high recurrence rates. However, considering its increasing detection in non-cirrhotic liver, the choice of treatment assumes particular relevance. This study aimed to investigate ... ...

Abstract	Hepatocellular carcinoma (HCC) usually develops in cirrhotic liver, with high recurrence rates. However, considering its increasing detection in non-cirrhotic liver, the choice of treatment assumes particular relevance. This study aimed to investigate outcomes of patients among BCLC stages and enrolled for surgical resection (SR) according to a more complex evaluation, to establish its safety and efficacy. A total of 186 selected HCC patients (median age 73.2 yrs), submitted to SR between January 2005 and January 2021, were retrospectively analyzed. Of which, 166 were staged 0, A, B according to the BCLC system, while 20 with a single large tumor (>5 cm) were classified as stage AB. No perioperative mortality was recorded; complications occurred in 48 (25.80%) patients, and all but two were Clavien−Dindo grade I−II. Median follow-up was 9.2 years. Subsequently, 162 recurrent patients (87,1%) were selected for new treatments. Comparable overall survival rates (OS) were observed at 1, 3, 5, and 10 years in 0, A, B and AB stages (p = 0.2). Eventually, the BCLC-B group was matched to 40 BCLC-B patients treated (2015-2021) with TACE. Significant differences in baseline characteristics (p <0.0001) and in OS were observed at 1 and 3 years (p <0.0001); a significant difference was also observed in oncological outcomes, in terms of the absence, residual, or relapse of disease (p <0.05). Surgery might be a valid treatment in HCC for patients affected by chronic liver disease in a condition of compensation, up to BCLC-B stage. Surgical indication for liver resection in case of HCC should be extensively revised.
Language	English
Publishing date	2022-09-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers14184422
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