Background and Objectives: This study aimed to evaluate the added value of cone-beam computed tomography (CBCT) for detecting hepatocellular carcinomas (HCC) and feeding arteries during transcatheter arterial chemoembolization (TACE). Material and methods: Seventy-six patients underwent TACE and CBCT. We subcategorized patients into groups I (61 patients: possible superselection of tumor/feeding arteries) and II (15 patients: limited superselection of tumor/feeding arteries). We evaluated fluoroscopy time and radiation dose during TACE. Two blinded radiologists independently performed an interval reading based on digital subtraction angiography (DSA) imaging only and DSA combined with CBCT in group I. Result: The mean total fluoroscopy time was 1456.3 ± 605.6 s. The mean dose–area product (DAP), mean DAP of CBCT, and mean ratio of DAP of CBCT to total DAP was 137.1 ± 69.2 Gy cm², 18.3 ± 7.1 Gy cm², and 13.3%, respectively. The sensitivity for detecting HCC increased after the additional CBCT reading, from 69.6% to 97.3% and 69.6% to 96.4% for readers 1 and 2, respectively. The sensitivity for detecting feeding arteries increased from 60.3% to 96.6% and 63.8% to 97.4% for readers 1 and 2, respectively. Conclusions: CBCT can increase sensitivity for detecting HCCs and feeding arteries without significantly increasing the radiation exposure.

Lee MS, et al. Pediatr Gastroenterol Hepatol Nutr. 2021 Nov;24(6):555-563. https://doi.org/10.5223/pghn.2021.24.6.555

강경식, et al. J Korean Soc Radiol. 2020 Dec;82:e33. https://doi.org/10.3348/jksr.2020.0099

A pseudoaneurysm of the subclavian artery following central venous catheter placement is a rare but potentially fatal complication that often requires surgical intervention. However, surgical repair of the subclavian artery remains challenging. Herein, we report the case of a male patient undergoing hemodialysis who developed a pseudoaneurysm of the subclavian artery after a bedside central vein catheter placement. Hemostasis was successfully achieved by selecting the pseudoaneurysm using a microcatheter. At the 10-month follow-up, the pseudoaneurysm was completely excluded, and the patient was in a stable condition. The patient underwent native arteriovenous fistula creation and hemodialysis. Endovascular treatment could be an effective nonsurgical treatment for subclavian artery pseudoaneurysms and has been attempted as a first-line treatment option.

Purpose: To evaluate the prognostic significance of venographic findings and procedural factors for long-term venous patency after thrombectomy in patients with May-Thurner syndrome (MTS)-associated deep vein thrombosis (DVT). Materials and Methods: This retrospective cohort study included 75 patients with iliofemoral DVT secondary to MTS, who underwent thrombectomy between January 2011 and April 2023. Key venographic findings—venous stenosis (≥50%), venous spur, and persistent collaterals—along with stent placement and diameter were analyzed. The primary outcome was 24-month venous patency, assessed using univariate tests, Kaplan–Meier survival analysis, and multivariate Cox proportional hazards modeling. Results: At 24 months, 58 patients (77.3%) maintained venous patency, whereas 17 (22.7%) experienced reocclusion. Univariate and Kaplan–Meier analyses showed that stenosis ≥50%, venous spur, persistent collaterals, and absence of stent placement were significantly associated with reduced patency (all p < 0.05). However, in the multivariate Cox model, only venous stenosis ≥50% remained a statistically significant independent predictor of reocclusion (hazard ratio [HR]=5.04; 95% Confidence Interval: 1.28–19.82; p = 0.021). Stent placement (HR = 1.78; p = 0.337) and diameter ( p = 0.349) were not independently associated with patency. Conclusion: Residual venous stenosis ≥50% following thrombectomy is an independent predictor of reduced long-term patency in patients with MTS. While stent placement was associated with better outcomes in the univariate analysis, it did not independently predict patency after adjustment, likely due to treatment-related confounding factors. Effective anatomical resolution of stenosis may be more critical than stent deployment. Prospective studies are warranted to clarify the prognostic impact of venographic findings and interventional strategies.

Purpose: This study aimed to develop an algorithm for the automatic detecting chest percutaneous catheter drainage (PCD) and evaluating catheter positions on chest radiographs using deep learning. Methods: This retrospective study included 1,217 chest radiographs (proper positioned: 937; malpositioned: 280) from a total of 960 patients underwent chest PCD from October 2017 to February 2023. The tip location of the chest PCD was annotated using bounding boxes and classified as proper positioned and malpositioned. The radiographs were randomly allocated into the training, validation sets (total: 1,094 radiographs; proper positioned: 853 radiographs; malpositioned: 241 radiographs), and test datasets (total: 123 radiographs; proper positioned: 84 radiographs; malpositioned: 39 radiographs). The selected AI model was used to detect the catheter tip of chest PCD and evaluate the catheter’s position using the test dataset to distinguish between properly positioned and malpositioned cases. Its performance in detecting the catheter and assessing its position on chest radiographs was evaluated by per radiographs and per instances. The association between the position and function of the catheter during chest PCD was evaluated. Results: In per chest radiographs, the selected model’s accuracy was 0.88. The sensitivity and specificity were 0.86 and 0.92, respectively. In per instance, the selected model’s the mean Average Precision 50 (mAP50) was 0.86. The precision and recall were 0.90 and 0.79 respectively. Regarding the association between the position and function of the catheter during chest PCD, its sensitivity and specificity were 0.93 and 0.95, respectively. Conclusion: The artificial intelligence model for the automatic detection and evaluation of catheter position during chest PCD on chest radiographs demonstrated acceptable diagnostic performance and could assist radiologists and clinicians in the early detection of catheter malposition and malfunction during chest percutaneous catheter drainage.