Scott C Goodwin

• Doctor of Medicine
• Chair at University of California, Irvine

Aim: To evaluate the utility of the portal venous phase on multiphasic computed tomography (CT) after treatment of hepatocellular carcinoma (HCC) with trans-arterial chemoembolisation (TACE). Materials and methods: This was a retrospective review of patients who underwent TACE for HCC between 1 April 2012 and 21 December 2014, with appropriate m...

Non-contrast CT (NCCT) imaging plays an important role in the diagnosis and prognosis of acute stroke. Tissue plasminogen activator (tPA) is the only FDA approved treatment for ischemic strokes. . Determining whether or not to administer tPA based on NCCT within a short time frame is a challenging task. We have developed a computer-assisted ASPECTS...

Nephrotoxicity is a common adverse effect of many chemotherapeutic agents. The agents most commonly associated with chemotherapy-associated nephrotoxicity are methotrexate, semustine, streptozocin, mithramycin, and cisplatin. Certain chemotherapeutic agents have adverse effects on the kidneys and urothelium that can be visualized radiographically,...

Arteriovenous fistulae and grafts for hemodialysis access are a lifeline in patients with end-stage renal disease. A significant cause of morbidity and mortality in this population is dialysis access dysfunction. Duplex ultrasound imaging is an excellent modality to evaluate arteriovenous fistulae and grafts, the 2 main types of long-term hemodialy...

Doppler ultrasonography of the hepatic vasculature is an integral part of evaluating precirrhotic and cirrhotic patients. While the reversal of the portal venous flow is a well-recognized phenomenon, other flow patterns, although not as easily understood, may play an important role in assessing the disease status. This article discusses the differe...

Given the changing climate of health care and the imperative to add value, radiologists must join forces with the rest of medicine to deliver better patient care in a more cost-effective, evidence-based manner. For several decades, interventional radiology has added value to the health care system through innovation and the provision of alternative...

Recently, we reported that cancer cells that recover from a potentially lethal damage gain new phenotypic features comprised of mitochondrial structural remodeling associated with increased glycolytic dependency and drug resistance. Here, we demonstrate that a subset of cancer cells, upon recovery from a potentially lethal damage, undergo dediffere...

We recently demonstrated that cancer cells that recover from damage exhibit increased aerobic glycolysis, however, the molecular mechanism by which cancer cells survive the damage and show increased aerobic glycolysis remains unknown. Here, we demonstrate that diverse cancer cells that survive hypoxic or oxidative damage show rapid cell proliferati...

New and improved techniques have been continuously introduced into CT and MR imaging modalities for the diagnosis and therapy planning of acute stroke. Nevertheless, non-contrast CT (NCCT) is almost always used by every institution as the front line diagnostic imaging modality due to its high affordability and availability. Consequently, the potent...

Healthcare expenditure in many developed countries has reached such an unprecedented level that it cannot be sustainable unless some change in medical practice is implemented. In this paper, we examine a computer-in-the-loop model for the transaction between care-providers and care-receivers by identifying tasks that can be offloaded from physician...

Uterine fibroids are a common problem in women. Statistics showing 20-50% of fibroids produce symptoms and consequently patients seek surgical intervention to improve their quality of life. Treatments for fibroids are typically successful in controlling the fibroid disease, yet sexual function following invasive surgical treatments for fibroids can...

Lower-extremity endovascular interventions are increasingly being performed by vascular surgeons (VSs) and interventional cardiologists (ICs) in addition to interventional radiologists (IRs). Regardless of specialty, well trained, experienced, and dedicated operators are expected to offer the best outcomes. To examine specialty-specific trends, out...

Cholecystectomy remains one of the most commonly performed procedures in general surgery. Although the incidence, diagnosis, and treatment of bile duct (BD) injuries have been well described, studies characterizing associated vascular injuries are limited. The objective of this study was to analyze the frequency and management of associated vascula...

A 45-year-old, premenopausal black woman (gravida 3, para 2, with a history of one spontaneous abortion) presents with menorrhagia and dysmenorrhea that has worsened progressively over a period of 10 years. She does not wish to have any more children. On physical examination, she has a firm, nontender, enlarged uterus. The ovaries are not palpable....

Summary We evaluated the efficacy of transcatheter embolisation of the uterine arteries for the control of haemorrhage associated with myomata. Clinical follow-up, size of uterus and individual myomata on ultrasound, chart review for readmission and questionnaire administered by telephone formed the data-base for 25 embolisation patients. All patie...

Summary Arterial embolisation has been used for >20 years to control acute haemorrhage secondary to obstetric and gynaecologic disease The use of this technique to specifically address pelvic haemorrhage in three major categories has increased in recent years. Embolisation is used to control acute pelvic haemorrhage in post-partum bleeding, postope...

To assess long-term clinical outcomes of uterine artery embolization across a wide variety of practice settings in a large patient cohort. The Fibroid Registry for Outcomes Data (FIBROID) for Uterine Embolization was a 3-year, single-arm, prospective, multi-center longitudinal study of the short- and long-term outcomes of uterine artery embolizatio...

A multidisciplinary UAE RCP was convened to develop a prioritized research agenda for uterine embolization and related topics. The panel recommended the development of a protocol tentatively entitled "Impact of Uterine Embolization and Myomectomy on Ovarian and Endometrial Function." Accordingly, this prioritized research project will be the subjec...

To prospectively evaluate the safety and effectiveness of polyvinyl alcohol (PVA) microspheres in patients undergoing uterine artery embolization (UAE) to treat uterine fibroid tumors and to compare the long-term changes in health-related quality of life (QOL) after UAE with the changes seen after myomectomy. One hundred forty-six patients with ute...

To determine whether there is significant quality of life score improvement after uterine artery embolization (UAE) and to compare UAE and myomectomy outcomes. Prospective cohort controlled study. Sixteen medical centers in the United States. One hundred forty-nine UAE patients and 60 myomectomy patients. Patients were assigned to myomectomy or UAE...

As compared with hysterectomy and myomectomy, uterine artery embolization is a safe and efficacious therapy. It should be offered as a legitimate alternative for the treatment of symptomatic fibroids.

To investigate the change in symptom severity and health-related quality of life among patients treated with uterine artery embolization for leiomyomata. Using the Fibroid Registry for Outcomes Data (FIBROID), a multicenter, prospective, voluntary registry of patients undergoing uterine embolization for leiomyomata, we studied changes in symptom st...

DISCLOSURE D.W.P.: is on the advisory board for Siemens.S.C.G.: receives grant support from B.S.C. and is a consultant to Biosphere. Sub-Events

To describe registry methods and baseline patient demographics from a national sample of women undergoing uterine artery embolization for uterine leiomyomata. Interventional radiology practices were recruited to submit data by a secure Web site on women undergoing uterine artery embolization for symptomatic leiomyomata. Baseline data included patie...

To investigate the short-term safety of uterine embolization for leiomyomata in a large cohort of patients treated in a variety of clinical settings. Examining the FIBROID Registry, a multicenter prospective voluntary registry of patients undergoing uterine embolization for leiomyomata, we studied the frequency of adverse events and predictors of a...

Scott C. Goodwin, MD, Sheila C. Bonilla, MD, David Sacks, MD, Richard A. Reed, MD, James B. Spies, MD,Wendy J. Landow, MPH, Robert L. Worthington-Kirsch, MD, the Members of the Reporting Standards forUterine Artery Embolization (UAE) Subcommittee, the Members of the UAE Task Force StandardsSubcommittee, and the Members of the Society of Interventio...

The feasibility of using magnetic targeted carriers (MTC) to deliver doxorubicin intravesically was studied in normal swine bladder. MTCs are microparticles consisting of metallic iron and activated carbon. Doxorubicin is adsorbed to the activated carbon component of the MTCs (MTC-DOX) while the iron component provides magnetic susceptibility. This...

The objective of this study was to evaluate the efficacy of heparin-polymer-coated intravascular stents in the reduction of vessel stenosis. Three types of coatings for Palmaz stents were tested: 1) heparin covalently bound to a polyethylene oxide (Hp-PEO) tether; 2) heparin copolymerized with ethylene vinyl acetate (Hp-Elvax) and 3) Elvax alone. P...

OBJECTIVE:To compare long-term outcomes of uterine artery embolization and abdominal myomectomy in patients with symptomatic uterine myomas.METHODS:At a single institution in an 18-month time, 59 patients had bilateral uterine artery embolization and 38 patients had abdominal myomectomy to treat symptomatic uterine myomas. We reviewed medical recor...

To compare long-term outcomes of uterine artery embolization and abdominal myomectomy in patients with symptomatic uterine myomas. At a single institution in an 18-month time, 59 patients had bilateral uterine artery embolization and 38 patients had abdominal myomectomy to treat symptomatic uterine myomas. We reviewed medical records and surveyed p...

In this article, two successful embolizations of large pelvic arteriovenous malformations (AVMs) with use of ethylene vinyl alcohol, a radiopaque, nonadhesive liquid casting agent, are reported. Both patients presented with large symptomatic pelvic AVMs requiring therapy. Coaxial microcatheter techniques were used to achieve complete success in one...

Increasing clinical experience with uterine fibroid embolization (UFE) has improved the ability of interventionalist radiologists to discern who is and who is not an appropriate candidate for this procedure. Initial evaluation should be directed at obtaining answers to the following key questions: (1) Does the patient have uterine fibroids that acc...

Successful superselective catheterization of the uterine artery requires familiarity with female pelvic arterial anatomy, knowledge of effective catheter and guidewire combinations, and a few tricks. A learning curve can be expected for each of these elements, although it is assumed that the operator will already have experience in basic catheter t...

Conscious sedation and analgesia are integral components of successful uterine fibroid embolization (UFE), both in providing comfort to the anxious patient undergoing an elective procedure and for providing relief of the severe pelvic pain, cramps, and nausea that may result from acute uterine ischemia and the postembolization syndrome that may fol...

Patients generally notice some relief of both menorrhagia and mass-effect symptoms during the first few weeks after uterine fibroid embolization (UFE). Shrinkage of the fibroids continues to take place over several months, peaking somewhere between 3 and 6 months, with measurable shrinkage sometimes noted for up to 1 year. The timing of follow-up v...

Fortunately, the number of complications reported after uterine fibroid embolization (UFE) is extremely low. Angiographic mishap or drug reaction are probably more common than purely UFE-related complications. However, the possibility of infection or necrosis of the uterus, with their significant attendant morbidity, is a sobering reminder that emb...

Building a uterine fibroid embolization (UFE) practice can be a complex process. Choices must be made regarding whether to align oneself with a gynecologist or to accept direct referrals. For the interventional radiologist, the responsibilities of evaluation and patient care pose unique and time-consuming administrative and clinical challenges. Phy...

Uterine artery embolisation has been described as successful only when both arteries are embolised. However, results in patients with one congenitally absent or previously ligated artery are unknown. Women suffering from symptomatic uterine myomata were treated at a university teaching hospital, a community hospital and an outpatient surgery centre...

To determine whether Doppler flow measurements are useful in predicting variables associated with uterine fibroid embolization, including shrinkage of the uterus and myomas, adenomyosis, and uterine fibroid embolization failure. A group of 227 patients with menorrhagia or postmenopausal bleeding secondary to uterine myomas were evaluated with uteri...

This paper seeks to evaluate the ability to deliver term pregnancies following uterine fibroid embolization, and to identify impediments to pregnancy in the embolization procedure. Four physicians performed embolization procedures at various facilities. Patients were asked if fertility was an issue prior to embolization. We measured follicle-stimul...

This article analyzes the early experience with alteplase (rt-PA) and reteplase (r-PA) to identify noteworthy differences in bleeding and to determine correlations with dosage, concomitant anticoagulation, and duration of infusion. A retrospective review of the medical records was unavailable for the initial 82 patients who were treated with either...

The toxicity of a single hepatic intra-arterial administration of doxorubicin (DOX) coupled to a magnetically targeted drug carrier (MTC) was evaluated in a swine model. MTC is a microparticle composite of elemental iron and activated carbon. MTC-DOX is a new formulation of doxorubicin absorbed to the MTC and is designed for site-specific delivery...

To evaluate the safety and efficacy of a hydrodynamic thrombectomy system in a prospective, multicenter randomized comparison with pulse-spray thrombolysis in hemodialysis grafts. Nine centers enrolled 120 adult patients with recently (</=14 days) thrombosed hemodialysis grafts. Graft venography was used to confirm occlusion in 62 patients randomly...

Asymptomatic uterine leiomyoma can be detected on routine computed tomography (CT) of the pelvis. Leiomyomas have been described as low attenuation masses that can disrupt the smooth contour of a normal uterus. Four women underwent uterine artery embolization for the treatment of uterine leiomyoma. CT findings include initial retention of contrast...

During insertion of a central venous sheath an inferior vena cava stainless steel Greenfield filter was dislodged to the right brachiocephalic vein without a free end. Successful retrieval was achieved by using a combination of a guidewire and a snare. Percutaneous retrieval of this vena cava filter is feasible with minimal risk using this method.

To develop collagen stent-grafts impregnated with heparin to improve the biocompatibility of endovascular stents and to design a percutaneous delivery system for graft deployment in a swine model. Heparin-impregnated collagen stent-grafts were deployed, and follow-up angiograms were obtained every 15 minutes for 90 minutes to assess acute thrombose...

Uterine artery embolization (UAE) as a primary therapy for symptomatic fibroids was first used in France in 1991. Currently, there are at least 250 centers in the United States, as well as centers in Canada and England, with experience in this technique. Initial published results worldwide indicate that after UAE, uterine fibroids shrink at least 5...

To develop a research agenda for uterine artery embolization (UAE) for the treatment of symptomatic leiomyomata. An expert panel was convened to examine data and develop a consensus for UAE research. Panelists reviewed data from articles about UAE and data on hysterectomy and myomectomy, which were abstracted into evidence tables. A modified Delphi...

This article offers an overview of fibroid embolization, including the history, technique, indications, complications, and results.

This artilce outlines aspects of patient recruitment periprocedural and postprocedural care. Important aspects of business management, preprocedure evaluations, indications, and postprocedure management are discussed.

Introduction: The authors review their midterm experience with uterine artery embolization for the treatment of uterine fibroids. Materials and methods: Sixty patients were referred for permanent polyvinyl alcohol (PVA) foam particle uterine artery embolization during an 18-month period. Detailed clinical follow-up and ultrasound follow-up were...

MTCs were magnetically targeted and retained at a region of interest in a swine model after intra-arterial infusion. MTCs did not redistribute after removal of the magnetic field. Histopathology results demonstrated high particle density in the area of the magnetic field. Particles were observed in the interstitium and occasionally intra-arterially...

The purpose of this work was to evaluate the incidence of bile peritonitis following T-tube removal in liver transplant patients as a function of the method of T-tube removal. Removal at the bedside was compared to removal in the interventional radiology department with subsequent placement of a temporary drainage catheter. From June 1987 through J...

The first reported cases of uterine artery embolization in obstetric and gynaecological practice were carried out in the late 1970s. Recently, bilateral uterine artery embolization was used as a primary treatment for fibroids. Meticulous preoperative assessment is essential. The technique of uterine artery embolization involves the catheterization...

Embolisation of the uterine arteries, used for many types of pelvic haemorrhage, recently has been successfully applied to women suffering from myomata uterus. As a side effect of embolisation, myomata shrink more than 50% of their pre-embolisation size, measured by ultrasound. The embolised uterus has not been described elsewhere. Various clinical...

Purpose: To compare pulse-spray to continuous-infusion thrombolysis with high-dose urokinase in thrombosed dialysis access grafts. Methods: A prospective randomized controlled trial was performed. From August 1992 to September 1993, 30 thrombosed polytetrafluoroethylene (PTFE) grafts in 24 patients were included, 15 grafts in each group. The succes...

Transcatheter bilateral uterine artery embolization holds promise as a treatment for the chronic symptoms related to uterine leiomyomata. As an alternative to hysterectomy or myomectomy, embolization has the fewest procedural risks, the shortest recovery time, and the least possibility of infection and formation of post-surgical adhesions. Initial...

Purpose: The authors evaluated a technique for the prevention of hemobilia when placing transhepatic biliary drainage catheters (THBDCs). Materials and methods: Initially, 20 patients were randomized into two groups. In the control group, a THBDC was placed after blind needle passage without contrast material opacification of the needle tract. I...

Purpose: To evaluate the potential usefulness of transcatheter uterine artery embolization as a treatment for fibroid-related vaginal bleeding and pelvic pain refractory to hormonal therapy and myomectomy. Materials and methods: Eleven patients (aged 27-55 years; mean, 44.2 years; none desiring future pregnancy) with refractory vaginal bleeding...

Transcatheter arterial embolization has recently emerged as a highly effective percutaneous technique for controlling acute and chronic genital bleeding in a wide variety of obstetric and gynecologic disorders. Benefits for the patient and health care system have included low complication rates, avoidance of surgical risks, fertility preservation,...

Two patients of an initial pilot study are reported. Both suffered from menorrhagia associated with uterine myomata. In each case bilateral uterine artery embolization under digital subtraction angiography was performed using polyvinyl alcohol particles. Patients' anaemia improved; follow-up ultrasound showed a reduction of both uterine volumes and...

Purpose: To create a simple and reproducible model of chromic thrombosis for the evaluation of thrombolytic agents and devices. Materials and methods: A stenosis was created in the superficial femoral artery of domestic swine, and autologous blood clot was deposited above the stenosis. Follow-up last for up to 3 months. Degree of clot organizati...