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The aim of focal treatments (FTs) in prostate cancer (PCa) is to treat lesions while preserving surrounding benign tissue and anatomic structures. Irreversible electroporation (IRE) is a nonthermal technique that uses high-voltage electric pulses to increase membrane permeability and induce membrane disruption in cells, which potentially causes less damage to the surrounding tissue in comparison to other ablative techniques. We summarize the study protocol for the Prostate Cancer IRE Study (PRIS), which involves two parallel randomized controlled trials comparing IRE with (1) robot-assisted radical prostatectomy (RARP) or (2) radiotherapy in men with newly diagnosed intermediate-risk PCa (NCT05513443). To reduce the number of patients for inclusion and the study duration, the primary outcomes are functional outcomes: urinary incontinence in study 1 and irritative urinary symptoms in study 2. Providing evidence of the lower impact of IRE on functional outcomes will lay a foundation for the design of future multicenter studies with an oncological outcome as the primary endpoint. Erectile function, quality of life, treatment failure, adverse events, and cost effectiveness will be evaluated as secondary objectives. Patients diagnosed with Gleason score 3 + 4 or 4 + 3 PCa from a single lesion visible on magnetic resonance imaging (MRI) without any Gleason grade 4 or higher in systematic biopsies outside of the target (unifocal significant disease), aged ≥40 yr, with no established extraprostatic extension on multiparametric MRI, a lesion volume of

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Sialadenosis is a rare entity characterized by bilateral diffuse, painless swelling of the parotid glands. Its etiology is not clear; however, it may occur due to adverse effects of some drugs. To our knowledge, sialadenosis due to valproic acid has not been reported in the literature up to date in any child. In this article, the authors presented a child who developed sialadenosis due to valproic acid, and improved after stopping use of the drug.

WOS:000379846300009, PubMed ID: 27306661, PURPOSE Splenic artery embolization is a minimally invasive therapeutic procedure utilized in a number of disorders. Ankaferd blood stopper (ABS) is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We aimed to investigate the safety and efficiency of ABS for splenic artery embolization in a sheep model. METHODS Seven adult female sheep were included in the study. Selective celiac angiography was performed using a 5F diagnostic catheter and then a 2.7F hydrophilic coating microcatheter was advanced coaxially to the distal part of the main splenic artery. Under fluoroscopic guidance, 6 mL mixture composed of half-and-half ABS and contrast agent was slowly injected. Fluoroscopy was used to observe the deceleration and stagnation of the flow. Control celiac angiograms were obtained immediately after the embolization. After the procedure, the animals were observed for one day and then sacrificed with intravenous sodium thiopental. RESULTS Technical success rate was 100%. None of the animals died or experienced a major systemic adverse event during the procedure. All of the spleens appeared dark on macroscopic examination due to excessive thrombosis. Microscopically, the majority of the splenic sinusoids (90%-95%) were necrotic. CONCLUSION In our study, splenic artery embolization by ABS was found to be safe and effective in the shortterm. Further studies are needed to better understand the embolizing potential of this novel hemostatic agent.

Objectives: The aim of this study was to emphasize the feasibility and cost effectiveness of trocar type catheter in percutaneous abscess drainage under imaging guidance and to determine the clinical efficacy of the method.Materials and methods: From June 2008 to December 2010, 48 patients who were referred to interventional radiology unit, in order to undergo percutaneous abscess drainage. All was data including age, the organ or the part of the body where the abscess was localized and size of abscess were recorded. Forty-two (87%) patients underwent drainage with ultrasonographic guidance, while 6 (13%) underwent with computed tomography guidance. One pediatric patient underwent systemic sedation anesthesia (with remiphentanyl and midazolam) and the rest of the patient with local anesthesia (with prilocain hydrochlorid). Catheterization procedure with which abscess drainage was done accepted as technically successful.Results: Imaging guided percutaneous abscess drainage procedures were performed with trocar type catheter to localized abscesses in different organs or systems in 48 patients (25 men, 23 women, mean age 52 years, range 2-82 years). Technical success was 100% in all cases. No patient had a complication during the procedure. Time to extraction of percutaneous catheter after drainage procedure was 5-28 days (mean 11.2 days). There was no recurrence except for a case, in which an abscess at the splenectomy site was successfully drained.Conclusion: Percutaneous drainage with imaging guidance using the trocar type catheter should be preferred because of its feasibility, cost-effectiveness, and reduced rate of complications in treating abscesses, which localized at different organ systems.

Objectives: The objective of our research was to determine the accuracy and precision of the Cavalieri principle with images obtained from magnetic resonance imaging (MRI) in estimation of the actual testicular volume in humans. Methods: We performed volume measurements of 42 testes from 21 patients scheduled for bilateral orchiectomy for prostate cancer. We performed volume estimation measurements with ultrasonography (US), Prader's orchidometer (PrOM), and Cavalieri principle MRI (we used views in axial sagittal and planes) before orchiectomy. We measured actual testes volume with the fluid displacement technique after orchiectomy. Differences and correlations between estimated and actual volumes were evaluated. For all patients, we compared right and left testicular volumes independently with these measurements. Results: Mean ± SD actual testicular volume and estimated testicular volumes with US, PrOM, and Cavalieri principle using MRI axial and sagittal images were 15.3 ± 3.3 and 17.7 ± 3.0 cm3, 20.0 ± 3.5 cm3, and 16.0 ± 3.7 and 16.0 ± 3.6 cm3, respectively. Estimated and measured volumes were not different from each other. US and PrOM measured volumes were correlated with the actual volume. However, r-values with Pearson correlation test for estimated volumes measured with the Cavalieri principle with MRI were higher than US and PrOM (r-values were 0.934 and 0.961 vs 0.919 and 0.757, respectively). Conclusions: The results of this study demonstrate that testicular volume measurements with the Cavalieri principle using images obtained from MRI may be considered a complementary method to traditional techniques to estimate the actual testicular volume. © 2009 Elsevier Inc. All rights reserved.

UNLABELLED Positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) has evolved as a useful imaging modality in the assessment of a variety of cancers, especially for tumor staging and post treatment monitoring. It provides metabolic information. Although, when used alone, relative lack of anatomic landmarks, is a major limitation of PET imaging, this limitation of PET imaging is overcome by the availability of integrated PET/CT imaging. PET and CT images are acquired in one procedure, yielding fused anatomical and functional data sets. Studies with integrated PET/CT imaging have shown promising results. In this case, we present an interesting integrated PET/CT imaging in a lung cancer patient with rare, diaphragm and thyroid cartilage metastases. CONFLICT OF INTEREST None declared.

Basilic vein aneurysms are rare clinical entities. A 21-year-old woman with basilic vein aneurysms and multiple hemangiomas in the right upper extremity is presented. The case is discussed in light of the relevant literature with emphasis on the use of Doppler ultra-sonography and magnetic resonance venography. © 2008 Pulsus Group Inc. All rights reserved.

There are two well-known indications for first-pass perfusion in the literature. First is the evaluation of myocardial ischemia, and the other is the evaluation of tumor vascularity. Our aim was to assess the value of a first-pass contrast bolus tracking sequence (FPCBTS) for cases unrelated to these pathologies.A total of 35 patients (age range, 1 day to 66 years; mean age, 10.4±19.2 years; median age, 4.5 months) with suspected congenital (n=31) and acquired (n=4) heart and great vessel disease were included in the study. All the patients underwent cardiac magnetic resonance imaging (MRI) and FPCBTS, and 20 patients underwent contrast enhanced magnetic resonance angiography (CE-MRA). We used cardiac MRI and CEMRA for anatomic evaluation and FPCBTS for dynamic flow evaluation.Truncus arteriosus, double outlet right ventricle, tetralogy of Fallot, corrected transposition of great arteries, atrial and ventricular septal defect, aortic rupture, cardiac hydatid cyst, tricuspid atresia, anomalous pulmonary venous return, and interrupted aorta were detected using the technique described here. Septal defects in six patients and atrial aneurysm in two patients were excluded. The shunt gap and flow direction of the septal defects, a ruptured wall in a dissected aorta, a hydatid cyst, and the atrial relationship in two cases with paracardiac masses were diagnosed easily using this dynamic evaluation technique.FPCBTS can be performed in addition to cardiac MRI and CEMRA to reveal flow dynamics and morphology.

Kronik hepatit C nedeniyle interferon içeren tedavi rejimleri uygulanan hastalarda ilaçlara bağlı yan etkilerle sıklıkla karşılaşılmaktadır. Bu yan etkiler bazen ilaçların suboptimal dozlarda verilmesine hatta tedavinin kesilmesine neden olabilmektedir. İnterferon alan hastalarda trombositopeni sık görülür ve tedaviyi zorlaştırır. Biz burada Pegile interferonribavirintelaprevir üçlü tedavisi alan ve tedaviyi etkileyen trombositopeni tedavisi için splenik embolizasyon uygulanılan hepatit C virüs (HCV) () sirotik bir hastayı sunmayı amaçladık. Kırk yedi yaşında kadın hasta kliniğimizde HCV() siroz nedeniyle 6 yıldır takip edilmekteydi. Altı yıl önce 48 hafta pegylated interferon (PEGIFN)ribavirin tedavisi almış ve tedavi sonrası relaps saptanmıştı. Proteaz inhibitörü içeren 3'lü tedavi protokollerinin genotip 1b hastalarda ülkemizde de onaylanmasından sonra hastaya telaprevir içeren 3'lü tedavi protokolü planlandı. Hastanın tedavi öncesi laboratuvar tetkikleri Child A sirozla uyumluydu. Abdominal ultrasonografide kronik karaciğer hastalığı bulguları ve splenomegali saptandı. Tedavi öncesi HCV RNA 756000 copy/ml, Hb: 11,8 g/dL, WBC: 4600/?L, Trombosit: 64000/?L idi. Hastaya Peg IFN ?-2a 135 mcg/hafta, ribavirin 1000 mg/gün ve telaprevir 3x750 mg/gün başlandı. İki hafta içerisinde trombosit sayımı önce 42000 /?L ve ardından 14000 /?L'ye kadar düştü. PEG-IFN dozu kademeli olarak 67,5 mcg/haftaya kadar azaltıldı. Trombositopeni nedeniyle hastaya parsiyel splenik embolizasyon uygulandı. Bir hafta içerisinde trombosit sayısı 45000/?L'ye yükseldi ve PEG-IFN dozu tekrar 135 mcg/haftaya arttırıldı. Tedavinin geri kalan kısmında trombosit sayısı yaklaşık 60000/?L civarında seyretti ve hasta 48 haftalık tedaviyi başarıyla tamamladı. Hastaya tedavi sonu ve tedavi bitiminden 12 hafta sonra bakılan HCV RNA (-) olarak saptandı. PEG-IFN içeren üçlü tedavi tedavi protokolleri uygulanacak olan sirotik hastalarda trombositopeni tedavisinde splenik embolizasyon minimal invaziv bir seçenek olarak kullanılabilir., Various drug-related side effects are frequently encountered in patients receiving interferon-containing treatment regimens for chronic hepatitis C. Such side effects sometimes necessitate drugs be given in suboptimal doses or even discontinuation of the treatment. Thrombocytopenia is frequent in patients receiving interferon and complicates treatment course. Here, we present a case of hepatitis C virus (HCV) () cirrhotic patient in whom splenic embolization was successfully performed in order to overcome thrombocytopenia associated with pegylated interferon (PEG-IFN)ribavirintelaprevir triple therapy. A 47-year-of woman was being followed in our clinic due to HCV-related cirrhosis for 6 years. She was given PEG-IFNribavirin treatment for 48 weeks 6 years ago and HCV infection relapsed. After the approval of protease inhibitorcontaining triple therapy regimens in genotype 1b HCV () patients in our country, such treatment was planned. Laboratory investigations were consistent with Child class A cirrhosis. Abdominal ultrasound showed the presence of cirrhosis and splenomegaly. HCV RNA was 756000 copy/ml. Pretreatment hematologic parameters were as follows; Hb: 11.8 g/dL, WBC: 4600/?L and platelet count: 64000/?L. Treatment was started with PEG IFN ?-2a 135 mcg/week, ribavirin 1000 mg/day and telaprevir 3x750 mg/day. Platelet count dropped gradually to 42000 /?L and than to 14000 /?L in two weeks. PEG-IFN dose was progressively reduced up to 67.5 mcg/week. To overcome thrombocytopenia, partial splenic embolization was performed. Platelet count increased to 45000 /?L in 1 week and PEG-IFN dose was increased back to 135 mcg/week. Throughout the rest of the treatment, platelet count remained around 60.000 /?L and she successfully completed a 48-week treatment course. Both end-treatment and 12th week post-treatment HCV RNA were negative. Treatment of severe thrombocytopenia with splenic embolization may be an effective minimally invasive option in HCV () cirrhotic patients in whom PEG-IFN-containing triple treatment regimens are given.

Subklaviyan arter anevrizması nedeniyle opere edilen bir Behcet olgusunda anevrizmaya açılan vertebral arter ve sağ internal mamaryan arterin, anevrizma kesesi içerisinde bırakılması sonucu, post operatif dönemde iatrojenik olarak ortaya çıkan sağ internal mamaryan arter çalma sendromunun görüntüleme bulgularını sunmak istedik. Bizim bilgilerimize göre bugüne kadar, sağ internal mamaryan arterin sorumlu olduğu çalma sendromu literatürde tariflenmemiştir. Kesitsel noninvaziv radyolojik görüntüleme yöntemleri, bu olguda anatomik detayın gösterilmesi, cerrahi sonrası değişen ve yeni ortaya çıkan anatominin ortaya konmasında oldukça başarılı olmuştur., We are presenting a case of right internal mammary artery steal syndrome in a patient with Behcet disease. At the surgical treatment of a subclavian artery aneurysm, leaving the origins of both vertebral artery and right internal mammary artery within the aneurysm sac has led this situation. To the best of our knowledge, a similar case has never been described. Non-invasive cross sectional radiological imaging techniques were very successful in demonstrating the anatomical details and provided valuable informations in understanding postsurgical anatomy.