RESUMEN
90Y radioembolization is a safe and efficacious treatment option for many patients with unresectable hepatocellular carcinoma. Potential candidates for radioembolization, based on clinical criteria, undergo 99mTc-labeled macroaggregated albumin imaging to determine the extent of hepatopulmonary shunting. Dose selection is based on results from shunt imaging and can exclude patients from radioembolization therapy. We present a case of miscalculated lung shunt fraction and the circumstances that led to the critical error.
Asunto(s)
Embolización Terapéutica , Pulmón/efectos de la radiación , Errores Médicos , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/terapia , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/terapia , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Agregado de Albúmina Marcado con Tecnecio Tc 99m , Radioisótopos de Itrio/uso terapéuticoRESUMEN
Zebrafish have emerged as a powerful biological system for drug development against hearing loss. Zebrafish hair cells, contained within neuromasts along the lateral line, can be damaged with exposure to ototoxins, and therefore, pre-exposure to potentially otoprotective compounds can be a means of identifying promising new drug candidates. Unfortunately, anatomical assays of hair cell damage are typically low-throughput and labor intensive, requiring trained experts to manually score hair cell damage in fluorescence or confocal images. To enhance throughput and consistency, our group has developed an automated damage-scoring algorithm based on machine-learning techniques that produce accurate damage scores, eliminate potential operator bias, provide more fidelity in determining damage scores that are between two levels, and deliver consistent results in a fraction of the time required for manual analysis. The system has been validated against trained experts using linear regression, hypothesis testing, and the Pearson's correlation coefficient. Furthermore, performance has been quantified by measuring mean absolute error for each image and the time taken to automatically compute damage scores. Coupling automated analysis of zebrafish hair cell damage to behavioral assays for ototoxicity produces a novel drug discovery platform for rapid translation of candidate drugs into preclinical mammalian models of hearing loss.