Liver fat quantification on contrast-enhanced photon-counting CT scans was accurate compared with the reference standard MRI proton density fat fraction.

Uterine fibroids are the most common benign tumors of the uterus. Approximately 20–50% of women with myomas experience a variety of symptoms such as vaginal bleeding, abdominal pain, pelvic pain and pressure, and urological problems, possibly interfering with fertility and pregnancy. Although surgery remains the standard treatment option for fibroids, non-invasive therapeutic options, such as high-intensity focused ultrasound (HIFU), have emerged over the last dec ade. During HIFU, ultrasound is focused on the target tissue causing coagulation necrosis. HIFU has, meanwhile, become an established method for treating uterine fibroids in many countries. Clinical data have shown that it effectively alleviates fibroid-related symptoms and reduces fibroid size with a very low rate of side effects. However, there is a lack of data on how this treatment affects laboratory parameters and structural features of uterine tissue. As our center is the only one in German-speaking countries where ultrasound-guided HIFU technology is currently established, the aim of this prospective, monocentric, single-arm trial is not only to evaluate the safety and efficacy of local US-guided HIFU in symptomatic uterine fibroid patients according to GCP standards but also to explore its effects on blood parameters and the structural integrity of uterine tissue using elastographic methods.

Purpose: To investigate and compare the physical properties of the new generation Gore VIATORR-Controlled Expansion Endoprosthesis (VCX) to those of the predecessor VIATORR stent in an in vitro experimental setup.Materials and Methods: A total of 12 stents (8 VCX; 4 VIATORR; GORE, USA) were examined. Radial resistive force (RRF) and chronic outward force (COF) were assessed using a radial force testing machine (RX-650, Machine Solutions Inc., USA). To assess the radial forces of the VCX above 8 mm, balloon expansion was performed between cycles.Results: All VCX stents show an abrupt decrease in COF at an external diameter of 8.3 mm; RRF decreases likewise at an external diameter of 8.5 mm. The predecessor VIATORR stent without the “controlled expansion” feature shows linear radial force reduction until full expansion at a diameter of 10 mm.The physical properties of the VCX can be altered by balloon modulation. Point of COF (RRF) reduction shifts to 8.5 mm (8.6 mm), 8.6 mm (8.8 mm) and 9.3 mm (9.6 mm) following modulation with a 8 mm, 9 mm and 10 mm balloon.Conclusions: The VCX shows an abrupt and disproportionate decrease in COF and RRF at an external diameter of 8.3 mm, thus passive expansion to its nominal diameter of 10 mm is not to be expected. By means of balloon dilatation the physical properties of the stent can be altered, enabling customized TIPS creation. The previous VIATORR stent shows continuous COF and RRF until total expansion.

Purpose: This study investigates how endovascular interventionalists adapt to using a robotic platform, specifically the CorPath GRX Robotic System, and examines the influence of prior manual catheterization experience. Materials and methods: An in-vitro trial was conducted to assess the adaptation to robot-assisted catheter-guided interventions in comparison to manual catheterization using a neurovascular phantom. Three interventional radiologists (beginner: no manual experience; intermediate: 3 years; expert: 10 years) with varying experience levels performed three corresponding robotic and manual guided superselective catherization tasks with three attempts per position with both approaches. Procedure time and total radiation dose was recorded. Results: For the beginner reduced intervention times were noted using the robot-assisted approach (mean: 123 s) in comparison to manual catheterization (mean: 257 s; p = 0.008), whilst no differences were seen in between procedure durations for the intermediate (mean: 71 s for manual versus 102 s for robotic; p = 0.388) and expert interventionalist (mean: 30 s for manual versus 42 s for robotic; p = 0.479). The beginner also benefited significantly from robot-assisted procedures with lower emitted total radiation doses (mean: 0.007 Gy for manual versus 0.003 Gy for robotic; p = 0.007), while no significant differences are observed for intermediate (mean: 0.002 Gy for manual versus 0.003 Gy for robotic; p = 0.137) and expert practitioners (mean: 0.0008 Gy for manual versus 0.001 Gy for robotic; p = 0.459). Conclusion: Robot-assisted platforms accelerate skill acquisition for beginners while maintaining efficiency for experienced practitioners. However, addressing costs and training requirements is essential for wider adoption and optimized outcomes.

Lower rates of hepatic encephalopathy (HE) following left-sided transjugular intrahepatic portosystemic shunt (TIPS) placement have been hypothesized to stem from a distinct ammonia distribution within the portal venous system. This prospective study investigated ammonia concentrations at five portal and splanchnic venous sites in 50 fasting cirrhotic patients (20 female [40%]; mean age: 60.4 years) prior to TIPS implantation for ascites (33/50, 66%) or variceal bleeding (17/50, 34%). While ammonia levels were significantly higher in the superior mesenteric vein (mean: 143 µg/dl) compared to the splenic vein (mean: 66 µg/dl; p < 0.001), mean ammonia concentrations in the right (104 µg/dl) and left (107 µg/dl) portal vein branches were found to be equivalent (p = 0.008 for equivalence). No systematic differences between right and left portal vein ammonia were observed. These findings suggest that in fasting cirrhotic patients, local ammonia levels in the main portal vein branches do not differ significantly. Therefore, other factors likely contribute to any observed differences in HE rates related to TIPS placement site, warranting further investigation into alternative mechanisms.

To evaluate the embolic properties of different acrylic adhesive/iodized oil mixtures for lymphatic interventions. Polymerization of histoacryl (HA) (Bayer Healthcare) and glubran 2 (GL) (GEM) mixed with iodized oil (ratios 1:0–1:7) were investigated in lymphatic fluids with low and high triglyceride (low TG & high TG) contents. Static polymerization time and dynamic polymerization experiments with different volumes of glucose flush (1, 2 and 5 mL) were performed to simulate thoracic duct embolization. For both glues, static polymerization times were longer when the iodized oil content was increased and when performed in high TG lymphatic fluid. In the dynamic experiments, the prolongation of polymerization due to the oil content and TG levels was less pronounced for both glue types. Increased lymphatic flow rates decreased embolization times for low glue/oil ratios while preventing embolization for high glue/oil ratios. Higher glucose flush volumes increased occlusion times. Polymerization times of acrylic glue in a lymphatic fluid are prolonged by increasing the iodized oil concentration and triglyceride concentration as well as by using larger volumes of glucose flush. Increased lymphatic flow rates decrease embolization times for low glue/oil ratios and may prevent embolization for high glue/oil ratios.