T1ρ MRI demonstrates enhanced lesion contrast compared with T2 , and in some cases may provide complementary information. T1ρ may provide a useful measure of demyelinating processes in MS.

Aim To retrospectively compare the initial response, local recurrence, and complication rates of radiofrequency ablation (RFA) vs microwave ablation (MWA) when combined with neoadjuvant bland transarterial embolization (TAE) or drug eluting microsphere chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). Methods A total of 35 subjects with BCLC very early and early stage HCC (range 1.2 – 4.1 cm) underwent TAE (23) or TACE (12) with RFA (15) or MWA (20) from 1/2009–6/2015 as either definitive therapy or a bridge to transplant. TAE and TACE were performed with 40–400 μm particles and 30–100 μm plus either Doxorubicin or Epirubicin eluting microspheres respectively. Initial response and local progression were evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST). Complications were graded using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Results Complete response (CR) rates were 80% (12/15) for RFA + TAE/TACE and 95% (19/20) for MWA + TAE/TACE (p value 0.29). Local recurrence (LR) was 30% (4/12) for RFA + TAE/TACE and 0% (0/19) for MWA + TAE/TACE. Durability of response (DR), defined as local disease control for duration of the study, demonstrated a significant difference in favor of MWA (p value 0.0091). There was no statistical difference in complication rates (3 vs 2). Conclusions MWA and RFA when combined with neoadjuvant TAE or TACE have similar safety and efficacy in the treatment of early stage HCC. MWA provided more durable disease control in this study, however, prospective data remains necessary to evaluate superiority of either modality.

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transarterial chemoembolization (cTACE) vs. yttrium-90 radioembolization (Y90) for Hepatocellular Carcinoma (HCC). Materials: With IRB approval, 45 patients with unresectable HCC were prospectively randomized to cTACE vs. Y90 [PREMIERE TRIAL (1)]. From this cohort, the fluoroscopy times and doses were recorded for all of these patients' procedures. Statistical comparison between both cohorts was conducted using independent sample t-test assuming unequal variances. Statistical significance was set at po0.05. Results: Twenty-one patients received cTACE (32 treatment sessions) and 24 patients received Y90 (29 treatment sessions) with glass microspheres. All Y90 patients had a separate planning angiogram prior to radioembolization. Mean fluoroscopic time (95%CI) for the planning angiography prior to Y90 was 11.6 minutes (9.3-14) and mean fluoroscopic dose was 1611 mGy (969-2253). Mean fluoroscopy time (95%CI) for Y90 treatment procedures was 13.3 minutes (10-16.5) and 18.3 minutes (15.5-21) for cTACE procedures (P ¼ 0.021). Mean fluoroscopic dose (95%CI) for Y90 treatment was 1154 mGy (712-1596) and 1834 mGy (1356-2312) for cTACE (P ¼ 0.035). Mean accumulative fluoroscopic time/dose for Y90 included the dose administered on planning angiography and on treatment day. Mean accumulative fluoroscopy time (95%CI) for cTACE patients after multiple treatments was 29 minutes (21-38) and 28 minutes for Y90 patients (24-33) (P ¼ 0.8213). Mean fluoroscopic dose (95%CI) for Y90 patients was 2978 mGy and 3941 mGy (1830-6053) for cTACE patients (P ¼ 0.4). Conclusions: Y90 radioembolization exposes patients to significantly less fluoroscopy time and dose compared to cTACE per treatment session. When combined with planning angiography, there is no statistically significant difference in fluoroscopy time and dose between Y90 and cTACE.

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The purpose of this work was to evaluate the effect of new fluoroscopic imaging hardware and software on patient skin entrance exposure during common IR procedures. Materials and Methods: A retrospective review of patient entrance reference point (PERP) using an automated dose database Imalogix (Bryn Mawr, PA) was performed from January 1, 2020, to September 20, 2020. The data was sorted by imaging equipment used (Siemens Healthineers, Forchheim, GR) and procedure description according to the Radlex playbook. Cases from three Artis Q units were pooled, as were cases from two Pheno units that employ advanced new imaging chain hardware and software. Statistics from thirteen most common procedures (N > 9) were evaluated using box and whisker plots. Results: There were 1134 cases for the Artis Q platform, and 759 cases for the Pheno platform. The thirteen most common procedures ranged from tunnel central line placement (308), down to IVC filter placement (19). The maximum median PERP for the Atris Q systems was 1484 mGy (arterial embolization) and the minimum median PERP was 3 mGy (peripherally inserted central catheter placement). The maximum median PERP for the Pheno systems was 769 mGy (arterial embolization) and the minimum median PERP was 1 mGy (peripherally inserted central catheter placement). Median PERP on the Pheno platform was less than Artis Q for 11/13 (85%) procedures. Interquartile range for PERP was less on the Pheno platform than Artis Q for 12/13 (92%) procedures. The average decrease in PERP on the Pheno platform was 46% for all procedures lower than Artis Q. Conclusions: Use of improved imaging hardware and software can reduce patient PERP by 46% for a range of common procedures. Future work needs to be performed to understand patient habitus, platform default dose rates and image quality to understand the dose reduction.