Purpose: The aim of this pooled analysis was to evaluate the clinical efficacy and safety of transarterial radioembolization (TARE) with yttrium-90 ( 90 Y) microspheres for the treatment of unresectable intrahepatic cholangiocarcinoma (ICC). Methods: We searched the Cochrane Library, Embase, PubMed, SCI with the English language from inception to October 2018. A pooled analysis was conducted using Stata software. Results: There were 16 eligible studies included in this pooled analysis. The pooled median overall survival (OS) from 12 studies was 14.3 (95% CI: 11.9–17.1) months. Based on Response Evaluation Criteria in Solid Tumors (RECIST), no complete response was reported, and the median of partial response, stable disease and progressive disease were 11.5% (range: 4.8–35.3%), 61.5% (range: 42.9–81.3%) and 22.7% (range: 12.5–52.4%) respectively. The pooled disease control rate (DCR) from nine studies was 77.2% (95% CI: 70.2–84.2%). According to the type of microspheres, subgroup analysis was performed, the median OS in the glass microspheres group was 14.0 (95% CI: 9.1–21.4) months, and 14.3 (95% CI: 11.5–17.8) months in the resin microspheres group. The DCR was 77.3% (95% CI: 63.5–91.1%) and 77.4% (95% CI: 66.8–87.9%) in the glass and resin microspheres groups respectively. Most of the side effects reported in the included studies were mild and did not require intervention. Conclusion: TARE with 90 Y microspheres is safe and effective for patients with unresectable ICC with acceptable side effects. And it seems that the type of microsphere has no influence on therapeutic efficacy.

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Background:The aim of the present study was to assess the feasibility of applying low-dose contrast media (CM), and to explore the optimal virtual monoenergetic images (VMIs) in run-off computed tomography (CT) angiography (CTA) on dual-layer spectral detector CT (SDCT).Methods: Forty patients were randomly assigned into a control group using routine volume CM (group A) and an experimental group using half-volume CM (group B). In groups A and B, 120 kVp polychromatic conventional images were generated via hybrid iterative reconstruction algorithm defined as A1 and B1, respectively. Additionally, in group B, VMIs (range, 40-120 keV) were reconstructed via a spectral reconstruction algorithm defined as B2-B10. Vascular attenuation, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and radiation dose were evaluated. Subjective evaluation was performed using a 5-point scale.Results: The patient demographics and radiation dose demonstrated no significant difference between

Objective The aims of this study were to evaluate image quality of virtual monoenergetic images (VMIs) compared with conventional images (CIs) from spectral detector CT (SDCT) and to explore the optimal energy level in run-off computed tomography angiography (CTA). Methods The data sets of 35 patients who received run-off CTA on the SDCT were collected in this retrospective study. Conventional images were generated via iterative reconstruction algorithm and VMI series from 40 to 120 keV were generated via spectral reconstruction algorithm. The objective indices including vascular attenuation, noise, signal-to-noise ratio, and contrast-to-noise ratio were compared. Two readers performed subjective evaluation using a 5-point scale. Results The attenuation showed higher values compared with CIs at 40 to 60 keV ( P < 0.001). The noise was similar in 60- to 80-keV VMIs and significantly decreased in 90- to 120-keV VMIs ( P < 0.001) in comparison with CIs. The signal-to-noise ratio and contrast-to-noise ratio were improved in 40- to 60-keV VMIs compared with CIs ( P < 0.05). The score of subjective assessment was higher than that of CIs in 50- to 70-keV VMIs ( P < 0.001). Conclusions Virtual monoenergetic images can provide improved image quality compared with CIs from SDCT in run-off CTA, and VMIs at 60 keV may be the best choice in evaluating lower extremity arteries.