David M Liu

Vancouver General Hospital · Department of Radiology

A large variety of different imaging guided interventions have become available to treat pain secondary to knee osteoarthritis. Radiologists may now play an important role in treating patients - not just in making imaging based diagnosis.

Aim This study examined treatment patterns, survival outcomes and healthcare costs related to hepatocellular carcinoma (HCC) in British Columbia. Methods The study utilized data from two physician databases (HCC and MOTION) and the provincial British Columbia transplant database. Results The analysis revealed diverse treatment approaches and iden...

e16111 Background: Hepatocellular carcinoma (HCC) is a complex disease with treatments that may include locoregional therapy (LRT), systemic therapy and liver transplant. Using retrospective real-world data from a tertiary care hospital in British Columbia (BC). We examined characteristics, treatment pathways, survival and relevant healthcare costs...

Purpose To determine whether hepatic hilar nerve block techniques reduce analgesic and sedation requirements during percutaneous image-guided thermal ablation of hepatic tumors. Materials and Methods A single-center retrospective cohort analysis was performed of 177 patients (median age 67; range 33 – 86) who underwent percutaneous image-guided th...

Purpose To perform precision dosimetry in yttrium-90 radioembolization through CT imaging of radiopaque microspheres in a rabbit liver model and to compare extracted dose metrics to those produced from conventional PET-based dosimetry. Materials and methods A CT calibration phantom was designed containing posts with nominal microsphere concentrati...

Purpose To perform precision dosimetry in yttrium-90 radioembolization through CT imaging of radiopaque microspheres in a rabbit liver model, and to compare extracted dose metrics to those produced from conventional PET-based dosimetry. Materials and Methods A CT calibration phantom was designed to contain posts having nominal microsphere concentr...

Background: Yttrium-90 (Y-90) can be an effective liver-directed therapy for patients with metastatic neuroendocrine tumors (NETs), but population-based data are limited. We characterized the use of Y-90 in NET patients and identified factors associated with response. Methods: We identified 49 patients with metastatic liver-dominant NETs across...

Locoregional therapies (LRT) play an important role in the treatment of hepatocellular carcinoma (HCC), with the aim of increasing overall survival while preserving liver function. Different forms of LRT are available and choosing which one is best will depend on technical aspects, liver morphology, tumor biology, and patient’s symptoms. The purpos...

Percutaneous image guided thermal ablation has become a cornerstone of therapy for patients with oligometastatic disease and primary liver malignancies. Evolving from percutaneous ethanol injection (PEI), thermal ablation utilizing radiofrequency ablation (RFA) and microwave ablation (MWA) have become the standard approach in the treatment of isola...

Purpose To assess safety and efficacy of a modified rapid hemostasis protocol for distal transradial access (TRA). Materials and Methods A single-center retrospective study of patients undergoing percutaneous image-guided procedures from a distal TRA with rapid deflation hemostasis protocol was performed. Between March 2017 and August 2019, 593 pr...

PurposeTo assess left radial artery size, technical feasibility and safety of ldTRA in the anatomical snuffbox for percutaneous image-guided procedures.Materials and MethodsA retrospective single-center study was performed from November 2016 to June 2018 on all patients undergoing ldTRA for interventional radiology procedures.ResultsA total of 287...

Purpose: Patients with hepatocellular carcinoma and portal vein tumor thrombus have a poor prognosis and limited therapeutic options. We sought to compare survival, tolerability, and safety in such patients treated with conventional yttrium-90 transarterial radioembolization dosimetric techniques or ablative transarterial radioembolization. Mater...

Introduction: The inability to having comprehensive access to all pertinent imaging data related to an endovascular procedure in the sterile field is an unmet need, and its absence may have deleterious effects on decision-making, outcomes and workflow. Current image navigation solutions rely on traditional personal computing interfaces which are di...

Purpose To examine the feasibility of a novel technology platform that enables real-time touchless interaction with radiology images in both a simulated and an actual clinical setting. Materials and Methods This platform offers three different modes for image interaction. The gesture recognition mode uses a depth camera to detect the user’s hand g...

Transarterial radioembolization (TARE)with beta particle emitting microspheres via Yttrium-90 decay has become a fundamental component of the contemporary Interventional Oncology practice. TARE continues to advance as a result of increased utilization, clinical study, technological improvements, and evolving applications. To maximize TARE safety an...

The frequency of transradial access in interventional radiology has been steadily increasing, including for yttrium-90 (Y-90)selective internal radiation therapy to treat hepatic malignancies. The aim of this article is to detail an optimized approach to transradial Y-90 (TRY-90), showing it to be a safe and feasible first-line approach to hepatic...

Purpose To conduct a retrospective review and quality assurance study of inferior vena cava (IVC) filter retrieval over a two-year period at a tertiary care centre. Methods Patients who underwent IVC filter placement or retrieval over a two-year period were identified. Medical records were reviewed for patient characteristics, filter indication, t...

Purpose Comparing total fluoroscopy time (FT) to perform uterine artery embolization (UAE) with transradial approach (TRA) versus transfemoral approach (TFA). Our hypothesis was that there would be no significant procedural time penalty incurred, despite the learning curve associated with adopting a new approach. Materials and Methods A cohort stu...

Purpose To evaluate the safety and efficacy of a modified rapid hemostasis protocol (left distal Percutaneous Radial hEmostasis using a Truncated dEflation Algorithm) ldPROTEA in patients undergoing left distal radial access (ldTRA). Material and methods A prospective single-center observational study from June of 2017 to January of 2018. All pa...

Purpose Evaluate thoracic aortic remodeling in complicated acute or subacute type B dissection treated with TEVAR using the PETTICOAT technique. Material and methods Single-centre retrospective study from November 2012 – December 2017. Complicated acute or subacute type B dissection treated with a single covered graft and uncovered dissection st...

The 19th annual Western Canadian Gastrointestinal Cancer Consensus Conference (wcgccc) was held in Winnipeg, Manitoba, 29-30 September 2017. The wcgccc is an interactive multidisciplinary conference attended by health care professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) who are involved in the care o...

In patients with liver-limited oligometastatic disease, the goal of treatment can be curative intent. Historically, this was accomplished in patients presenting with upfront resectable disease. The availability of increasingly efficacious chemotherapy and biologic combinations with encouraging response rates led to the potential to convert unresect...

Purpose To determine the frequency of hepatobiliary infections after transarterial radioembolization (TARE) with yttrium 90 (90Y) in patients with liver malignancy and a history of biliary intervention. Materials and Methods For this retrospective study, records of all consecutive patients with liver malignancy and history of biliary intervention t...

Purpose: To evaluate cone-beam parenchymal blood volume (PBV) before and after embolization as a predictor of radiographic response to transarterial chemoembolization in unresectable hepatocellular carcinoma (HCC). Materials and methods: A phase IIa prospective clinical trial was conducted in patients with HCCs > 1.5 cm undergoing chemoembolizat...

Considerable efforts have been placed on the development of degradable microspheres for use in transarterial embolization indications. Using the guidance of the U.S. Food and Drug Administration (FDA) special controls document for the preclinical evaluation of vascular embolization devices, this review consolidates all relevant data pertaining to n...

Purpose Radiopaque microspheres may provide intraprocedural and postprocedural feedback during transarterial radioembolization (TARE). Furthermore, the potential to use higher resolution x‐ray imaging techniques as opposed to nuclear medicine imaging suggests that significant improvements in the accuracy and precision of radiation dosimetry calcula...

Investigating dosimetric characteristics of novel Y90 microsphere for HCC treatment.

Primary liver cancer, mainly hepatocellular carcinoma, is one of the most common malignancies worldwide. Surgical management, either resection or transplantation, is considered definitive treatment, however, less than 20% of patients are ultimately candidates. Thermal ablation modalities such as radiofrequency ablation and microwave ablation have e...

Over the past two decades there have been significant advances in the use of magnetic resonance imaging (MRI) to assess the vascular system. New imaging sequences and improvements in magnet design have enabled the creation of higher spatial resolution images. MRI is now a viable alternative imaging modality when compared to both invasive angiograph...

Purpose: The study sought to describe a single centre's technical approach to transradial intervention and report on clinical outcomes and safety. Methods: A total of 749 transradial access (TRA) procedures were performed at a single hospital in 562 patients (174 women and 388 men). Procedures included 445 bland embolizations or chemoembolizatio...

A practical understanding and approach to radioembolization. The majority o hepatic arterial therapies that utilize carrier-based delivery mechanisms (eg, chemoembolization and drug-eluting beads) rely on the embolic phenomena to contribute to radiographic and clinical response. Transarterial radioembolization (TARE) operates on a completely dieren...

Selective internal radiation therapy (SIRT) has emerged as a well-accepted therapeutic for primary and metastatic hepatic malignancies. This therapeutic modality requires the combined efforts of multiple medical disciplines to ensure the safe delivery of yttrium-90 (90Y)-labeled microspheres. The development of this therapy followed decades of clin...

The yeast strain Y isolated from acidic tofu whey was identified as Pichia amenthionina Y by morphological examination, 26S ribosomal DNA sequence analysis, and by means of the Biolog microbial identification system. Further analyses indicated that this strain can grow in a wide temperature range (26℃~42℃), and that its optimal temperature is 36℃....

Aim: We assessed the effects of flexing and massage on human skin penetration and toxicity of topically applied coated and uncoated zinc oxide nanoparticles (˜75 nm) in vivo. Materials & methods: Noninvasive multiphoton tomography with fluorescence lifetime imaging was used to evaluate the penetration of nanoparticles through the skin barrier an...

Embolotherapies used in the treatment of hepatocellular carcinoma (HCC) include bland embolization, conventional transarterial chemoembolization (cTACE) using ethiodol as a carrier, TACE with drug-eluting beads and super absorbent polymer microspheres (DEB-TACE), and selective internal radiation therapy (SIRT). Successfully treated HCC lesions unde...

An unstable patient presented with an enlarging splenic hematoma, for whom splenectomy was contraindicated. The decision was made to treat this patient with subtotal splenic embolization. Initial attempts at embolotherapy using a conventional end-hole catheter resulted in a false angiographic end point with reflux into short gastric arteries, likel...

Objectives: This study was conducted in order to compare a high resolution, non-contrast-enhanced MRA (NATIVE SPACE, NE-MRA) of the pedal vasculature with contrast-enhanced MRA (CE-MRA) and digital subtraction angiography (DSA) in patients with peripheral arterial occlusive disease (PAOD). Methods: The prospective study consists of 20 PAOD patie...

The nitrate reductase gene (nir), encoding the nitrite reductase enzyme (NiR) in Lactobacillus plantarum DMDL 9010, was cloned, and the expressed product was purified. The nir fragment was amplified by polymerase chain reaction (PCR) using L. plantarum DMDL 9010 DNA as template. Sequencing studies revealed that the nir fragment was 1638 bp in size....

A strain LJ01 with strong nitrite degradation ability was isolated from fermented bean paste and was identified as Bacillus cereus. Then, the primary cell localization of this nitrite reductase was examined by measuring the enzyme activity of different cellular components from LJ01 cell. After LJ01 was induced by 100 mg/L sodium nitrite solution an...

To perform a meta-analysis of randomized controlled trials (RCTs) of drug-eluting balloon (DEB) angioplasty and drug-eluting stents (DESs) for infrainguinal peripheral arterial disease. Systematic searches were performed for all relevant RCTs. Eight RCTs for DEB angioplasty and 12 RCTs for a DES in peripheral arterial disease were identified. Meta-...

Nanodermatology is a rapidly emerging field of study receiving significant interest because of its potential application in the prevention and treatment of skin diseases. However, nanoparticulate penetration into and through the skin is not feasible through topical application alone. Many physical and chemical approaches have been developed to enha...

The objective of the study was to determine the efficacy of contrast-enhanced ultrasound (CEUS) using ultrasound (US)-specific microbubbles in guiding radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). A retrospective analysis of 50 patients with HCC treated with CEUS guided RFA using perflutren at our institution was performed. CEUS...

ABSTRACT The management of colorectal liver metastasis has undergone a significant change since the development of novel ablation and embolization. Drug-eluting microsphere platforms, designed to deliver targeted concentrations of systemic therapy directly into the tumor via its arterial vasculature, have garnered interest and gained in popularity...

Context: Traumatic pancreatic injury with pancreatic duct disruption is surgically managed with at least a partial pancreatectomy, often leading to poor blood glucose control and the subsequent development of diabetes mellitus. Autologous β-islet cell transplantation may therefore help to preserve pancreatic endocrine function. Case description:...

Background: In our institution, a retrospective analysis of inferior vena cava (IVC) filter usage demonstrated attempted removal in only 60% of patients. We performed a prospective cohort study to determine if an IVC filter management program (IVCFP) will improve retrieval rates. Methods: Consecutive patients receiving a retrievable IVC filter were...

Primary liver malignancies and liver metastases are affecting millions of individuals worldwide. Because of their late and advanced stage presentation, only 10% of patients can receive curative surgical treatment, including transplant or resection. Alternative treatments, such as systemic chemotherapy, ablative therapy, and chemoembolization, have...

We used β-lactam antibiotic residues in milk as the target to develop a rapid detection kit. Based on sensitivity of Bacillus stearothermophilus 10208 to acid and β-lactam antibiotics, growth conditions were optimized and a test kit that could show a color reaction within 2.5 h was developed. The results of the single-factor experiment showed that...

Aim: The dose-response relationship between doxorubicin and superabsorbent drug-eluting microspheres has not been established. In this study, we investigated the relationships between dose and delivery parameters as they pertain to toxicity and response in surgically resectable hepatocellular carcinoma (HCC). Patients and methods: Twenty-five pa...

Rationale and Objectives To measure the impact of 1-year interventional fellowship training on fluoroscopic time and contrast media utilization in uterine artery embolization (UAE). Materials and Methods Retrospective single institution analysis of 323 consecutive UAEs performed by 12 interventional fellows using a standardized protocol. Fluorosco...

Magnetic resonance angiography is a technique used to image both central and peripheral arteries using contrast and noncontrast techniques. These techniques are similar in that a bright signal, which appears white within blood vessels, is generated and the background tissues, veins and stationary tissues, are dark. This allows for assessment of ana...

Objective: The purpose of this study was to investigate the safety and efficacy of CT-guided percutaneous cryoablation for the treatment of osteoid osteoma in adults. Materials and methods: A retrospective case series over a 30-month period involved 10 consecutive adult patients (nine male and one female patients; mean age, 27.9 years; age range...

Transarterial Radioembolization (TARE) with 90-Yttrium (90Y) microspheres has been established in the management paradigm of a number of primary and metastatic liver neoplasms. Prior to treatment, angiographic assessment and 99mTc-macroaggregated albumin (Tc-MAA) hepatic arterial perfusion should be performed to detect extrahepatic shunting to the...

Purpose To determine whether Trellis pharmacomechanical thrombectomy (PMT) followed by catheter directed thrombolysis (CDT) results in improved short term outcomes compared to CDT alone, in patients with acute upper extremity deep vein thrombosis (DVT). Materials and Methods Following ethics committee approval, an institutional database search fro...

Lactobacillus sp. DMDL 9010 was isolated from fermented vegetables and was used for the degradation of nitrites in MRS broth, and the results are compared with those of other four lactic acid bacteria including LCR 719, LB 1.83, ST 1.204 and LP 8140, with the best nitrite degradation effect of DMDL 9010 after 24-h fermentation (P≤0.001) being revea...

Lower gastrointestinal hemorrhage presents a common indication for hospitalization and account for over 300000 admissions per year in the United States. Multimodality imaging is often required to aid in localization of the hemorrhage prior to therapeutic intervention if endoscopic treatment fails. Imaging includes computer tomography angiography, r...