조재성, et al. J Korean Soc Radiol. 2021 Nov;82:e155. https://doi.org/10.3348/jksr.2021.0091

This study aimed to evaluate the feasibility, safety, and oncologic outcomes of irreversible electroporation (IRE) using a clustered electrode in patients with locally advanced pancreatic cancer (LAPC). In this single-center prospective cohort study, 13 patients with LAPC (median age, 60 years; range, 48–78 years) underwent clustered electrode IRE between September 2022 and September 2024. Patient characteristics, procedural details, and clinical outcomes were recorded. Endpoints included technical success, procedure-related complications, overall survival (OS), and progression-free survival (PFS). Tumors were located in the pancreatic head in four patients (30.8%) and in the body/tail in nine (69.2%). The median tumor size was 2.4 cm (1.5–4.0 cm), and vascular invasion was present in all patients. Technical success was achieved in all patients. Intraoperative IRE was performed in 11 (84.6%) patients, and 2 (15.4%) patients underwent percutaneous IRE. Gastrointestinal bleeding events as major complications occurred in two patients (15.4%) and, both were successfully controlled by embolization. No 60-day mortality was observed. At a median follow-up of 24.5 months (range, 9.9–33.4 months) after IRE, median OS and PFS from IRE were 20.1 and 14.5 months, respectively. IRE using clustered electrodes for LAPC appears to be a feasible therapeutic approach, offering reliable technical success and acceptable safety. Survival outcomes are encouraging; however, larger, controlled studies are required.

Objective: To evaluate the role of noncontrast cone-beam computed tomography (CBCT) in pulmonary arteriovenous malformation (PAVM) embolization. Materials and Methods: This retrospective single-center study included 63 patients (mean age, 51.3 ± 12.1 years; 8 males, 55 females) who underwent PAVM embolization between January 2018 and June 2024. Patients were categorized into a CBCT-assisted group (n = 13) and a digital subtraction angiography (DSA)-only group (n = 50). The use of CBCT was determined selectively at the discretion of the performing interventional radiologists. Patient demographics, PAVM characteristics, radiation exposure, fluoroscopy time, procedure time, and the number of DSA acquisitions were compared between the two groups. Technical and clinical success were evaluated. Results: CBCT guidance significantly reduced the number of DSA acquisitions (2.4 ± 1.0 vs. 4.9 ± 2.6, p = 0.001), procedure time (54.6 ± 24.3 min vs. 75.1 ± 34.5 min, p = 0.021), and fluoroscopy time (14.9 ± 12.0 min vs. 25.5 ± 18.2 min, p = 0.017) compared with DSA-only group. Dose-area product (87.7 ± 111.4 Gy·cm² vs. 86.0 ± 58.7 Gy·cm²; p = 0.959) and cumulative air-kerma (387.2 ± 464.2 mGy vs. 354.5 ± 305.7 mGy; p = 0.811) did not differ significantly between the groups. Technical success was achieved in all cases (100%). Clinical success rates were 98% in the DSA-only group and 100% in the CBCT group, with no significant difference (p = 1.000). No procedure-related complications were observed. Conclusions: Noncontrast CBCT may improve procedural efficiency in PAVM embolization by reducing DSA acquisitions and procedure time without significantly increasing radiation dose. This technique provides valuable anatomical guidance, particularly in complex scenarios such as obscured or multiple lesions.