TARE is considered as a palliative treatment for large HCC, especially in cases with PV tumour thrombus. After initial evaluation of the lung shunt fraction, the Yttrium90 embedded glass microspheres(beta emitting particles with mean tissue penetration length of 2.5mm -making it effective against PV tumour thrombus) are selectively injected into the feeding artery. This gentleman with bilobar HCC and PV tumour thrombus -BCLC stage C disease was down-staged to BCLC stage A post TARE. Repeat CECT showed complete resolution of the lesions and he can now be reconsidered for Liver transplantation.
Non-invasive radiology imaging techniques can be used to identify pregnant women at risk for adverse fetal and maternal events. The FetRADS-India categories have been developed, using content validation, for the risk stratification of pregnancy to help initiate appropriate early management for high risk pregnant women including referral to advanced care or tertiary care units. The FetRADS-India score has six levels with increasing scores for higher risk of adverse fetal events and subset scores based on fetal structure, growth and environment. Read at: http://bit.ly/FetRADS-India
Samrakshan, a nationwide IRIA program, aims to reduce perinatal mortality in India. The program standardizes protocols for pre eclampsia & fetal growth restriction including Doppler studies, image quality & interpretations & use of a Bayesian model based algorithm for risk estimation of individuals. This is done through an internet platform hosting content including audio visuals, library, discussion forums, journal club, assignments, quizzes and image audits. 270 radiologists in India are currently being trained using this mobile learning platform.
A pregnant woman was identified as high risk for PE in the first trimester scan at GA 12 weeks. She started low dose Aspirin 150 mg OD after counselling but did not return for follow up USG advised at 22,26 and 30 weeks. She came for a repeat USG at 32 weeks and Doppler showed Grade 1 FGR with EFW 1 centile, MCA 1 centile, CPR 1 centile, Umbilical artery 96th centile and AC 11 centile. Advised weekly followup and had grade 1 FGR at 34 weeks. At 35 weeks, Doppler showed Umbilical Artery AEDV and DV 99th centile; Grade 3 FGR. An LSCS was done. She delivered a live born baby weighing 1700 gms.