Purpose The aim of the study was to determine how many times iodine-125 (125I) seed brachytherapy (ISB) for recurrent pulmonary metastases (RPM) can be done, and the clinical efficacy and complications of repeated ISB in RPM treatment. Material and methods Between September 2013 and August...

Purpose: To evaluate the clinical efficacy and safety of computed tomography (CT)-guided iodine-125 (I-125) seed implantation (ISI) for hepatocellular carcinoma (HCC) or cholangiocellular carcinoma (CCC) lesions in challenging locations after transcatheter arterial chemoembolization (TACE). Material and methods: A retrospective single-center review of 24 patients with HCC or CCC tumors in challenging locations (hepatic dome or close to the heart/diaphragm/hepatic hilum) was conducted. Patients who underwent CT-guided I-125 implantation from May 2014 to January 2019 were recruited. Patients' demographics and details including technical success, treatment response, patient survival, and complication rate were also evaluated. Results: Treated tumors were located in the hepatic dome (n = 10; 41.7%), subcapsularly (n = 6; 25%), close to the heart (n = 3; 12.5%), and in the liver hilum (n = 5; 20.8%). The mean maximum diameter of tumors in challenging locations was 40.08 +/- 11.34 mm (range, 25-68 mm). TACE (2 +/- 1, 1-4 times) was applied before ISI. There were 27 ISI treatments administered (3 patients also received supplemental ISI). The total number of implanted seeds was 1,160, with mean 48 +/- 16 seed per patient (range, 30-90 seeds). The mean D-90 value for ISI was 125 Gy. Technical success rate was 100%, while a complete response + partial response (CR + PR) was documented in 70.83%, 79.17%, 83.33%, and 79.17% of patients at 3, 6, 12, and 24 months post-ISI, respectively. There were no major complications, although 2 cases experienced I-125 seed transfer to the diaphragm, and 1 case experienced transfer to the heart cavity. Conclusions: CT-guided ISI for HCC or CCC lesions in challenging locations after TACE is both highly effective and safe.

Purpose Small lung metastases change their location with respiration, making difficult to localize, therefore, increasing the number of punctures. Accurate puncture can reduce trauma to lung tissue and accelerate patient’s recovery. The aim of the study was to present our experience with the...

Background: The prognostic value of systemic inflammatory biomarkers in intrahepatic cholangiocarcinoma (iCCA) remains uncertain. This study aimed to compare their predictive performance and identify the most effective indicator. Methods: We retrospectively analyzed 312 iCCA patients who underwent curative resection at three medical centers (2014– 2022). Twelve systemic inflammatory biomarkers, derived from routine blood parameters (neutrophils, lymphocytes, monocytes, platelets, albumin), were assessed for overall survival (OS) and disease-free survival (DFS). Prognostic accuracy was evaluated using the concordance index (C-index), time-dependent area under the ROC curve (time-AUC), and Brier score. Independent predictors identified by multivariate Cox regression were incorporated into nomograms to estimate survival. Results: The median patient age was 63 years, 71.8% were male, 38.8% had stage III disease, and 37.5% had poorly differentiated tumors. Median follow-up was 24 months. Among the twelve biomarkers, the pan-immune-inflammation value (PIV) demonstrated the strongest prognostic performance. For OS, PIV achieved a C-index of 0.682, time-AUC of 0.695, and Brier score of 0.180; for DFS, C-index was 0.679, time-AUC 0.681, and Brier score 0.192. Unlike single-ratio indices, PIV integrates neutrophil, monocyte, platelet, and lymphocyte counts, providing a multidimensional view of systemic inflammation and immunity. Multivariate analysis confirmed high PIV as an independent predictor of poor OS (HR = 2.488; 95% CI: 1.745– 3.546; P < 0.001) and DFS (HR = 2.353; 95% CI: 1.701– 3.247; P < 0.001). Nomograms combining PIV with clinicopathological factors (CEA, CA19-9, perineural invasion, TNM stage) demonstrated improved discrimination and calibration at 12, 36, and 60 months. Conclusion: PIV provides superior prognostic value compared with traditional inflammatory indices, offering a cost-effective and readily available biomarker for iCCA. While promising, these results are based on a retrospective multicenter cohort without independent validation, and should be confirmed in prospective external studies.