Radiofrequency ablation (RFA) has become an important tool in the armamentarium of interventional... more Radiofrequency ablation (RFA) has become an important tool in the armamentarium of interventional oncology, particularly in the treatment of primary hepatocellular carcinoma and metastatic tumors. This procedure has proven to be an effective adjunct in treating hepatic tumors as a bridge to liver transplantation, and has a low complication profile. Although adverse events are rare and usually minor, a notable negative outcome is dissemination and implantation of viable tumor cells into the route of applicator entry, or tract seeding. Counter to the goal of treating a patient's cancer, this results in metastatic disease. In this report, the authors present 2 cases of tract seeding after RFA, methods of detection, and means of reducing the incidence of this relatively rare, but significant, complication.
Journal of Vascular and Interventional Radiology, 2013
Purpose-To test the feasibility of targeted intra-arterial administration of the tyrosine kinase ... more Purpose-To test the feasibility of targeted intra-arterial administration of the tyrosine kinase inhibitor chemotherapeutic agent sorafenib to inhibit embolotherapy-induced tumor angiogenesis and reduce systemic drug side effects. Materials and Methods-The left hepatic lobes of five New Zealand White rabbits (mean weight 2.7 ± 0.2 kg) were treated with chemoembolization using sorafenib and ethiodized oil emulsion, followed by immediate euthanasia. Post-procedure noncontrast computed tomography (CT) was used to evaluate intrahepatic chemotherapy mixture distribution. Liquid chromatography/tandem mass spectrometry (LC-MS/MS) was then used to directly measure sorafenib concentration in the treated liver tissue. Histopathological assessment of treated left lobes was performed to identify any immediate toxic effects of the sorafenib solution. Results-Lobar sorafenib chemoembolization was successfully performed in all cases via the left hepatic artery. Sorafenib and ethiodized oil (mean 6.4 mg ± 3.8 and 0.95 mL ± 0.7 mL, respectively) were injected, and CT confirmed targeted left hepatic lobe sorafenib emulsion delivery in all cases. Corresponding LC-MS/MS analysis yielded a mean sorafenib concentration of 94.2 μg/mL ± 48.3 in treated left lobe samples (n = 5), significantly greater than typical therapeutic drug levels (2-10 μg/mL) achieved with oral sorafenib systemic therapy. Histopathological assessment showed only mild or moderate non-specific ballooning degeneration in zone 3 hepatocytes, without tissue necrosis. Conclusions-Targeted transarterial sorafenib delivery is feasible and results in higher tissue drug levels than that reported for systemic sorafenib therapy, without immediate histopathological tissue toxicity. Future studies should aim to determine the utility of sorafenib chemoembolization in reducing hypoxia-induced vasculogenesis in liver tumors.
An organized approach is presented here to test the seismic data bright spots for hydrocarbon ind... more An organized approach is presented here to test the seismic data bright spots for hydrocarbon indications. The test presents the most basic analysis to be done while inferring bright spots for hydrocarbon presence. The simplicity of the approach doesn’t undermine its importance. Application of two simple techniques Polarity and AVO is utilized. The paper also explains what various types of hydrocarbon bright spots are and why we see them the way they are. It also shortens our analysis time and effort window by eliminating cases with absence of hydrocarbon indication or presence upfront. The case marked with certain degree of possibility from here can be further subjected to detailed test. The approach is helpful in mitigating exploration risks and minimizing failures for wells.
Radiofrequency ablation (RFA) has become an important tool in the armamentarium of interventional... more Radiofrequency ablation (RFA) has become an important tool in the armamentarium of interventional oncology, particularly in the treatment of primary hepatocellular carcinoma and metastatic tumors. This procedure has proven to be an effective adjunct in treating hepatic tumors as a bridge to liver transplantation, and has a low complication profile. Although adverse events are rare and usually minor, a notable negative outcome is dissemination and implantation of viable tumor cells into the route of applicator entry, or tract seeding. Counter to the goal of treating a patient's cancer, this results in metastatic disease. In this report, the authors present 2 cases of tract seeding after RFA, methods of detection, and means of reducing the incidence of this relatively rare, but significant, complication.
Journal of Vascular and Interventional Radiology, 2013
Purpose-To test the feasibility of targeted intra-arterial administration of the tyrosine kinase ... more Purpose-To test the feasibility of targeted intra-arterial administration of the tyrosine kinase inhibitor chemotherapeutic agent sorafenib to inhibit embolotherapy-induced tumor angiogenesis and reduce systemic drug side effects. Materials and Methods-The left hepatic lobes of five New Zealand White rabbits (mean weight 2.7 ± 0.2 kg) were treated with chemoembolization using sorafenib and ethiodized oil emulsion, followed by immediate euthanasia. Post-procedure noncontrast computed tomography (CT) was used to evaluate intrahepatic chemotherapy mixture distribution. Liquid chromatography/tandem mass spectrometry (LC-MS/MS) was then used to directly measure sorafenib concentration in the treated liver tissue. Histopathological assessment of treated left lobes was performed to identify any immediate toxic effects of the sorafenib solution. Results-Lobar sorafenib chemoembolization was successfully performed in all cases via the left hepatic artery. Sorafenib and ethiodized oil (mean 6.4 mg ± 3.8 and 0.95 mL ± 0.7 mL, respectively) were injected, and CT confirmed targeted left hepatic lobe sorafenib emulsion delivery in all cases. Corresponding LC-MS/MS analysis yielded a mean sorafenib concentration of 94.2 μg/mL ± 48.3 in treated left lobe samples (n = 5), significantly greater than typical therapeutic drug levels (2-10 μg/mL) achieved with oral sorafenib systemic therapy. Histopathological assessment showed only mild or moderate non-specific ballooning degeneration in zone 3 hepatocytes, without tissue necrosis. Conclusions-Targeted transarterial sorafenib delivery is feasible and results in higher tissue drug levels than that reported for systemic sorafenib therapy, without immediate histopathological tissue toxicity. Future studies should aim to determine the utility of sorafenib chemoembolization in reducing hypoxia-induced vasculogenesis in liver tumors.
An organized approach is presented here to test the seismic data bright spots for hydrocarbon ind... more An organized approach is presented here to test the seismic data bright spots for hydrocarbon indications. The test presents the most basic analysis to be done while inferring bright spots for hydrocarbon presence. The simplicity of the approach doesn’t undermine its importance. Application of two simple techniques Polarity and AVO is utilized. The paper also explains what various types of hydrocarbon bright spots are and why we see them the way they are. It also shortens our analysis time and effort window by eliminating cases with absence of hydrocarbon indication or presence upfront. The case marked with certain degree of possibility from here can be further subjected to detailed test. The approach is helpful in mitigating exploration risks and minimizing failures for wells.
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Papers by nishant kumar