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Background and Aims Methods Results Conclusion Holmium‐166 (166Ho) radioembolization could offer a more individualized approach in terms of imaging and dosimetry. We aim to evaluate the feasibility and safety of 166Ho selective internal radiation therapy (SIRT) using a higher tumour dose than previously administered determined by 166Ho‐scout as a surrogate marker in HCC patients.This is an open‐label, prospective, non‐randomized, single‐centre pilot study that included patients with HCC that received 166Ho‐SIRT if the work‐up using 166Ho‐scout showed a tumour‐absorbed dose ≥150 Gy, a non‐tumoural liver absorbed dose less than 60 Gy and a lung absorbed dose less than 30 Gy. Primary endpoints were feasibility and safety–toxicity profiles at 24–48 h and 1 month. Overall response rates (ORR) at 3 months (mRECIST, RECIST 1.1 and metabolic response by FDG and choline PET CT) and time to progression (TTP) represented the secondary endpoints.Fifteen patients with large tumours (mean diameter 55.67 ± 28.42 mm) received 17 166Ho‐SIRT treatments between July 2020 and June 2022. All the attempted treatments were accomplished. Mean administered tumour dose was 183.18 ± 71.71 Gy, while non‐tumour liver dose was 30.29 ± 14.56 Gy. Median time of follow‐up was 12 months (IQR 9–16). Only grade 1–2 clinical and biological AEs were observed. There were no liver decompensations. At 3 months, objective response was achieved for all target lesions (CR 78.57%, PR 21.43% according to mRECIST). Median TTP was 18.8 (range 2.9; n.e.) months.Personalized 166Ho‐SIRT with a tumour delivered dose ≥150 Gy was feasible and safe for HCC patients with promising response rates. [ABSTRACT FROM AUTHOR]

Background and purpose: Cerebral vasospasm (CV) following aneurysmal subarachnoid hemorrhage (aSAH) may lead to morbidity and mortality. Endovascular mechanical angioplasty may be performed if symptomatic CV is refractory to noninvasive medical management. Compliant and noncompliant balloons and manually adjustable mesh may be used in this indication. We describe our initial experience with the Comaneci (Rapid Medical, Yokneam, Israel) in cerebral vasospasm treatment following aSAH. Methods: All patients included in the prospective observational SAVEBRAIN PWI (NCT05276934 on clinicaltrial.gov) study who underwent cerebral angioplasty using the Comaneci device for the treatment of medically refractory and symptomatic CV after aSAH were identified. Patient demographic information, procedural details, and outcomes were obtained from electronic medical records. Results: Between February 2022 and June 2023, seven consecutive patients underwent CV treatment with the Comaneci. Angioplasty of 37 arterial segments (supraclinoid internal carotid artery, A1, A2, and A3 segments of the anterior cerebral artery and M1 and M2 segments of the middle cerebral artery) was attempted, and 35/37 (95%) were performed. The vessel diameter improved significantly following angioplasty (+64%), while brain hypoperfusion decreased (-45% of the mean T Max ). There was no long-term clinical complication, and 6% per-procedural complications occurred. Conclusions: The Comaneci is effective in the treatment of cerebral vasospasm following aSAH, bringing a new device in the armamentarium of the neurointerventionalist to perform intracranial angioplasty., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

We present the case of a 17-year-old patient known to have an asymptomatic ectopic spleen, who presented with an acute abdomen. Clinical symptoms and ultrasound led to suspect an acute appendicitis, confirmed later on by pathology. Twenty-four hours after the appendectomy, the patient complained of an abdominal pain of acute onset. Torsion of the pedicle of the ectopic spleen was suspected. Imaging studies supported this diagnosis, and an urgent splenectomy was performed. Did the torsion happen by simple coincidence 24 hours after appendectomy, knowing that the spleen has been asymptomatic for 17 years, or was it precipitated by the surgical intervention? Should we have removed the ectopic spleen during the appendectomy? This is the first report of a case of torsion of a wandering spleen after a laparotomy; a review of the literature is done in order to explain the physiopathology of the disease, and to propose its management.

Goal: We compare our results of a prospective study, on 120 totally implantable venous access ports (TIVAP) inserted at angiographic unit, under ultrasound and fluoroscopic guidance, with those of the literature., Materials and Methods: The 120 AP data, placed under ultrasound and fluoroscopic control for chemotherapy treatment, were prospectively analyzed. The detailed technique of insertion is noted. Data related to the technical success rate and to complications were classified into major, minor, early or late, according to the recommendations of the interventional radiology society., Results: The technical success rate is 100% with no major complication noted. Eight (6.6%) TIVAP were withdrawn because of infection in 4 cases (33%), and end of treatment in the other four. The withdrawals took place in chemotherapy clinics. Three (25%) are classified as early infections, within two months of the procedure, two of which were associated to wound non-healing. Four patients (33%) presented early minor complications (hematoma surrounding TIVAP insertion site)., Conclusion: Our results correspond to previously published data. The insertion of AP at the angiographic unit under ultrasound and fluoroscopic control has lower risk of complications and a success rate higher than that being inserted following anatomical location. Collaboration with a specialized care nurses team is of paramount importance.

Objective: Contrast-enhanced MR imaging has great clinical value as a means of characterizing myocardial tissue in patients with ischemic heart disease. The purpose of our study was to evaluate use of this technique in the assessment of patients with hypertrophic cardiomyopathy., Conclusion: On late-enhancement MR imaging, the various types or patterns of enhancement found in patients with hypertrophic cardiomyopathy are related to differences in morphology and regional function. Enhancement in hypertrophied areas likely reflects the presence of abundant connective tissue, foci of myocardial necrosis, or a combination of both.