Advanced Interventional Radiology: Innovation Driving Personalized Medicine

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (20 June 2024) | Viewed by 7415

Special Issue Editor


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Guest Editor
Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Nimes, France
Interests: interventional radiology
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Special Issue Information

Dear Colleagues,

We are delighted to announce the launch of a new Special Issue in Journal of Personalized Medicine titled “Advanced Interventional Radiology: Innovation Driving Personalized Medicine”. This Special Issue aims to showcase the latest advancements and breakthroughs in interventional radiology, with a particular focus on driving personalized and patient-centric approaches to healthcare.

Interventional radiology has revolutionized the field of medicine by offering minimally invasive alternatives to conventional treatments. Over the years, remarkable progress has been made in interventional techniques, allowing for precise and targeted interventions across a wide range of medical conditions. From vascular interventions to percutaneous procedures, interventional radiology has opened up new frontiers in personalized therapy.

In this Special Issue, we aim to highlight the innovative aspects of interventional radiology that are shaping the future of personalized medicine. We invite researchers, clinicians, and experts in the field to contribute their original research articles, reviews, and perspectives on novel interventional techniques, emerging technologies, and cutting-edge approaches.

One key area of focus for this Special Issue is interventional radiology in oncology. Cancer treatment has witnessed tremendous advancements through interventional radiology, enabling the delivery of targeted therapies directly to tumors while minimizing damage to healthy tissues. We encourage authors to share their experiences and findings in developing and refining interventional radiology techniques for oncological interventions.

Furthermore, we seek articles that explore the integration of imaging modalities, artificial intelligence, and data-driven approaches in interventional radiology. As technology continues to evolve, leveraging these advancements can enhance procedural planning, optimize patient selection, and enable personalized treatment strategies.

By bringing together the latest research and advancements in interventional radiology, we aim to foster collaborations, inspire further innovations, and contribute to the ongoing development of personalized medicine. We believe that this Special Issue will serve as a platform for disseminating groundbreaking research, facilitating knowledge exchange, and ultimately improving patient outcomes.

We invite all researchers and clinicians working in the field of interventional radiology to submit their valuable original research articles and reviews for this Special Issue. Together, let us advance the frontiers of interventional radiology and drive the paradigm shift towards personalized medicine.

We look forward to your submissions and to sharing the exciting developments in advanced interventional radiology.

Prof. Dr. Julien Frandon
Guest Editor

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Keywords

  • interventional radiology
  • endovascular
  • embolization
  • neovessel
  • ischemia
  • preconditioning
  • personalized therapy
  • dose optimization

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Published Papers (6 papers)

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Research

19 pages, 8398 KiB  
Article
Clinical, Technical, and MRI Features Associated with Patients’ Outcome at 3 Months and 2 Years following Prostate Artery Embolization: Is There an Added Value of Radiomics?
by Antoine Martin, Clément Marcelin, François Petitpierre, Eva Jambon, Rim Maaloum, Nicolas Grenier, Yann Le Bras and Amandine Crombé
J. Pers. Med. 2024, 14(1), 67; https://doi.org/10.3390/jpm14010067 - 4 Jan 2024
Cited by 2 | Viewed by 1215
Abstract
Our aim was to investigate which features were associated with clinical successes at short- and mid-terms following prostate artery embolization (PAE) for symptomatic benign prostate hypertrophy (BPH). All adults treated by PAE for BPH at our referral center between January 2017 and March [...] Read more.
Our aim was to investigate which features were associated with clinical successes at short- and mid-terms following prostate artery embolization (PAE) for symptomatic benign prostate hypertrophy (BPH). All adults treated by PAE for BPH at our referral center between January 2017 and March 2021, with pre-treatment MRI, technical success, and follow-up at 3 months and 2 years were included in this single-center retrospective study. Radiologists reviewed the prostatic protrusion index (PPI), adenomatous dominant BPH (adBPH), and Wasserman classification on pre-treatment MRI. Radiomics analysis was achieved on the transitional zone on pre-treatment T2-weighted imaging (WI) and ADC, and comprised reproducibility assessment, unsupervised classifications, and supervised radiomics scores obtained with cross-validated Elasticnet regressions. Eighty-eight patients were included (median age: 65 years), with 81.8% clinical successes at 3 months and 60.2% at 2 years. No feature was associated with success at 3 months, except the radiomics score trained on T2-WI and ADC (AUROC = 0.694). Regarding success at 2 years, no radiomics approaches provided significant performances; however, Wasserman type-1 and change in international prostate symptom score (IPSS) at 3 months ≤ −35% were associated with success in multivariable analysis (OR = 5.82, p = 0.0296, and OR = 9.04, p = 0.0002). Thus, while radiomics provided limited interest, Wasserman classification and early IPSS changes appeared predictive of mid-term outcomes. Full article
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18 pages, 6322 KiB  
Article
Pulmonary Artery Embolization in the Management of Hemoptysis Related to Lung Tumors
by Amandine Claudinot, Frédéric Douane, Olivier Morla, Christophe Perret, Marine Neveu, Francine Thouveny, Antoine Bouvier, José Hureaux, Arnaud Le Guen, Jérémy Jouan, Jean-François Heautot, Antoine Larralde, Damiano Cerasuolo, Emmanuel Bergot, Audrey Fohlen and Jean-Pierre Pelage
J. Pers. Med. 2023, 13(11), 1597; https://doi.org/10.3390/jpm13111597 - 12 Nov 2023
Cited by 2 | Viewed by 1308
Abstract
(1) Background: Bronchial artery embolization has been shown to be effective in the management of neoplastic hemoptysis. However, knowledge of pulmonary artery embolization is lacking. The aim of this study was to evaluate the safety and efficacy of pulmonary artery embolization in patients [...] Read more.
(1) Background: Bronchial artery embolization has been shown to be effective in the management of neoplastic hemoptysis. However, knowledge of pulmonary artery embolization is lacking. The aim of this study was to evaluate the safety and efficacy of pulmonary artery embolization in patients presenting with hemoptysis related to lung tumors. (2) Methods: This retrospective study reviewed all consecutive patients with cancer and at least one episode of hemoptysis that required pulmonary artery embolization from December 2008 to December 2020. The endpoints of the study were technical success, clinical success, recurrence of hemoptysis and complications. (3) Results: A total of 92 patients were treated with pulmonary artery embolization (63.1 years ± 9.9; 70 men). Most patients had stage III or IV advanced disease. Pulmonary artery embolization was technically successful in 82 (89%) patients and clinically successful in 77 (84%) patients. Recurrence occurred in 49% of patients. Infectious complications occurred in 15 patients (16%). The 30-day mortality rate was 31%. At 3 years, the survival rate was 3.6%. Tumor size, tumor cavitation and necrosis and pulmonary artery pseudoaneurysm were significantly associated with recurrence and higher mortality. (4) Conclusions: Pulmonary artery embolization is an effective treatment to initially control hemoptysis in patients with lung carcinoma, but the recurrence rate remains high and overall survival remains poor. Full article
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15 pages, 7477 KiB  
Article
Selective Arterial Embolization of Ruptured Hepatocellular Carcinoma with N-Butyl Cyanoacrylate and Lipiodol: Safety, Efficacy, and Short-Term Outcomes
by Jory Cali, Olivier Chevallier, Kévin Guillen, Marianne Latournerie, Amin Mazit, Ludwig Serge Aho-Glélé and Romaric Loffroy
J. Pers. Med. 2023, 13(11), 1581; https://doi.org/10.3390/jpm13111581 - 7 Nov 2023
Viewed by 1132
Abstract
The rupture of hepatocellular carcinoma (rHCC) is uncommon but causes sudden life-threatening bleeding. Selective transarterial embolization (STAE) is an effective bleeding-control option. The optimal embolic agent is unknown, and data on the use of cyanoacrylate glue are lacking. The objective of this study [...] Read more.
The rupture of hepatocellular carcinoma (rHCC) is uncommon but causes sudden life-threatening bleeding. Selective transarterial embolization (STAE) is an effective bleeding-control option. The optimal embolic agent is unknown, and data on the use of cyanoacrylate glue are lacking. The objective of this study was to report the outcomes of cyanoacrylate-lipiodol embolization for rHCC. We retrospectively reviewed the files of the 16 patients (14 males; mean age, 72 years) who underwent emergency cyanoacrylate-lipiodol STAE at a single center in 2012–2023 for spontaneous rHCC. All 16 patients had subcapsular HCC and abundant hemoperitoneum. The technical success rate was 94% (15/16). Day 30 mortality was 19%; the three patients who died had severe hemodynamic instability at admission; one death was due to rebleeding. Liver enzyme levels returned to baseline by day 30. No rebleeding was recorded during the median follow-up of 454 days in the 10 patients who were alive with available data after day 30. Larger prospective studies with the collection of longer-term outcomes are needed to assess our results supporting the safety and effectiveness of cyanoacrylate-lipiodol STAE for rHCC. Randomized trials comparing this mixture to other embolic agents should be performed. Full article
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12 pages, 2857 KiB  
Article
A Feasibility Study of CT-Guided Osteosynthesis under Local Anesthesia
by Joris Lavigne, Nicolas Stacoffe, Damien Heidelberg, Philippe Wagner and Jean-Baptiste Pialat
J. Pers. Med. 2023, 13(10), 1493; https://doi.org/10.3390/jpm13101493 - 14 Oct 2023
Viewed by 902
Abstract
Background: Evaluation of local anesthesia for perioperative pain control in patients undergoing CT-guided percutaneous osteosynthesis. Methods: A total of 12 patients underwent percutaneous osteosynthesis under local anesthesia. Intraoperative pain was assessed after the procedure using numerical rating scale (NRS). Patients were also asked [...] Read more.
Background: Evaluation of local anesthesia for perioperative pain control in patients undergoing CT-guided percutaneous osteosynthesis. Methods: A total of 12 patients underwent percutaneous osteosynthesis under local anesthesia. Intraoperative pain was assessed after the procedure using numerical rating scale (NRS). Patients were also asked to rate their overall experience of the operation using the following scale: “highly comfortable, comfortable, hardly comfortable, uncomfortable” and, finally, “Would you be willing to repeat this intervention again under the same conditions if necessary?” Patients were also clinically followed up at 1 month, 3 months, and 6 months using the EQ5D5L scale to assess their pain and quality of life. Results: Patients underwent percutaneous osteosynthesis for osteoporotic (n = 9), pathological (n = 2), or traumatic fractures (n = 1), including the thoraco-lumbar spine (n = 8) or the pelvis (n = 4). The mean of NRS value experienced during the procedure was 3.4/10 (0–8). The overall feeling was highly comfortable (42%), comfortable (50%), hardly comfortable (8%), and uncomfortable (0%). Finally, 75% of patients answered “YES” to the question of repeating the operation under the same conditions if necessary. At follow-up, a significant reduction in pain was observed postoperatively. According to the EQ5D5L scale, there was a significant improvement in pain, mobility, self-activities, autonomy, and perceived quality of life at 3 and 6 months. Conclusion: Radiological percutaneous osteosynthesis is an effective technique that can be performed under local anesthesia with a comfortable experience for most of the patients. Full article
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11 pages, 485 KiB  
Article
Safety and Efficacy of Prestige Coils for Embolization of Vascular Abnormalities: The Embo-Prestige Study
by Julien Frandon, Romaric Loffroy, Clement Marcelin, Hélène Vernhet-Kovacsik, Joel Greffier, Djamel Dabli, Skander Sammoud, Pierre Marek, Olivier Chevallier, Jean-Paul Beregi and Hervé Rousseau
J. Pers. Med. 2023, 13(10), 1464; https://doi.org/10.3390/jpm13101464 - 5 Oct 2023
Cited by 1 | Viewed by 1108
Abstract
A wide variety of coils are available for vascular embolization. This study aimed to evaluate the safety and efficacy of a new Prestige coil. We carried out retrospective analysis of a multicenter’s registry data collected between February 2022 and November 2022. The choice [...] Read more.
A wide variety of coils are available for vascular embolization. This study aimed to evaluate the safety and efficacy of a new Prestige coil. We carried out retrospective analysis of a multicenter’s registry data collected between February 2022 and November 2022. The choice of embolization agent used to treat peripheral vascular anomalies was left to the investigator’s discretion. Patients for whom at least one Prestige coil was used were included in Series 1. All other patients were included in Series 2. Efficacy and safety were evaluated. Patients were followed up for one month. In total, 220 patients were included, 110 in each series. Patients included 149 men (67.7%) and 71 women (32.3%), with a median age of 62.5 years (IQR: 35.8–73). Patient ages were similar in the two series. Complete occlusion of the targeted vessel was reported in 96.4% (n = 106/110) of patients in Series 1 and in 99.7% (n = 109/110) in Series 2. Four patients experienced non-serious adverse events (1.8%, n = 4/220): one experienced back pain and one vomiting in Series 1; one patient had off-target embolization and one a puncture site hematoma in Series 2. Sixteen patients (7.2%, n = 16/220) were lost to follow up. Improvement in the patient’s general state at one month was reported in 79.0% (n = 83/105) of patients in Series 1 and in 74.7% (n = 74/99) in Series 2. Ten deaths occurred, five in Series 1 (4.8%, n = 5/105) and five in Series 2 (5.1%, n = 5/99). These deaths all concerned critically ill patients embolized for emergent arterial bleeding. In conclusion, the 1-month follow-up showed that Prestige coils, alone or in combination, are efficient and safe. Full article
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14 pages, 2866 KiB  
Article
Differentiation of Small Clear Renal Cell Carcinoma and Oncocytoma through Magnetic Resonance Imaging-Based Radiomics Analysis: Toward the End of Percutaneous Biopsy
by Thibault Toffoli, Olivier Saut, Christele Etchegaray, Eva Jambon, Yann Le Bras, Nicolas Grenier and Clément Marcelin
J. Pers. Med. 2023, 13(10), 1444; https://doi.org/10.3390/jpm13101444 - 28 Sep 2023
Cited by 2 | Viewed by 1006
Abstract
Purpose: The aim of this study was to ascertain whether radiomics data can assist in differentiating small (<4 cm) clear cell renal cell carcinomas (ccRCCs) from small oncocytomas using T2-weighted magnetic resonance imaging (MRI). Material and Methods: This retrospective study incorporated 48 tumors, [...] Read more.
Purpose: The aim of this study was to ascertain whether radiomics data can assist in differentiating small (<4 cm) clear cell renal cell carcinomas (ccRCCs) from small oncocytomas using T2-weighted magnetic resonance imaging (MRI). Material and Methods: This retrospective study incorporated 48 tumors, 28 of which were ccRCCs and 20 were oncocytomas. All tumors were less than 4 cm in size and had undergone pre-biopsy or pre-surgery MRI. Following image pre-processing, 102 radiomics features were evaluated. A univariate analysis was performed using the Wilcoxon rank-sum test with Bonferroni correction. We compared multiple radiomics pipelines of normalization, feature selection, and machine learning (ML) algorithms, including random forest (RF), logistic regression (LR), AdaBoost, K-nearest neighbor, and support vector machine, using a supervised ML approach. Results: No statistically significant features were identified via the univariate analysis with Bonferroni correction. The most effective algorithm was identified using a pipeline incorporating standard normalization, RF-based feature selection, and LR, which achieved an area under the curve (AUC) of 83%, accuracy of 73%, sensitivity of 79%, and specificity of 65%. Subsequently, the most significant features were identified from this algorithm, and two groups of uncorrelated features were established based on Pearson correlation scores. Using these features, an algorithm was established after a pipeline of standard normalization and LR, achieving an AUC of 90%, an accuracy of 77%, sensitivity of 83%, and specificity of 69% for distinguishing ccRCCs from oncocytomas. Conclusions: Radiomics analysis based on T2-weighted MRI can aid in distinguishing small ccRCCs from small oncocytomas. However, it is not superior to standard multiparameter renal MRI and does not yet allow us to dispense with percutaneous biopsy. Full article
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