To characterize the learning curve of implementing intracardiac echo (ICE) to guide portal vein (PV) access during transjugular intrahepatic portosystemic shunt (TIPS) creation. An institutional review board–approved retrospective review of all TIPS creations performed between 7/2016 and 10/2022 was performed. ICE was incorporated into the practice in 11/2018. Cases were divided into two groups: ICE or conventional. Cases were reviewed for time between hepatic (HV) and portal vein (PV) access (calculated by time from hepatic venogram to wire access into the PV) and categorized by operator and use of ICE. Differences in PV access time were compared using a Mann-Whitney U test. A total of 176 cases were reviewed; 89/176 (51%) used ICE. PV access times were significantly shorter when using ICE compared to when ICE was not used (33 vs 51 min, p = 0.002). Comparing the access times for cases without ICE and the first 5 cases with ICE for each provider, there was a significant reduction in time (38.5 vs 64 min, p = 0.009). PV access times using ICE did not significantly decrease over time following ICE adoption (p = 0.056). There appears to be a short learning curve for utilization of ICE for TIPS creation, with significant time savings in PV access seen within the first few instances of ICE use. Recognition of this short learning curve may make ICE-guidance during TIPS creation more attractive to interventional radiologists or institutions considering adoption of this technique.

To evaluate the impact of a change in discharge opioid prescription protocol after conventional transarterial chemoembolization (cTACE). An institutional review board–approved retrospective review of patients undergoing cTACE between 5/2021 and 5/2023 was performed. Patients were divided into pre-protocol and post-protocol groups. The protocol change in 5/2022 was a transition from prescribing 3 days of opioids for all cTACE patients to providing an opioid prescription only if a subcapsular tumor was treated or prior need for opioids after liver-directed therapy was documented. Patients were excluded for non-hepatic cTACE, incompletely documented pain/opioid prescriptions, or follow-up less than 30d. Patient demographics, relevant oncologic history, intra-procedural details, concurrent procedures, pain scores, complications, and opioid prescriptions for 30d post-procedure were recorded. Chi-squared, Fischer's exact, Mann-Whitney U, and linear regression analyses were performed to evaluate factors impacting post-discharge opioid use. 102 patients undergoing first cTACE were reviewed (pre-protocol, n=68 and post-protocol, n=34). The majority of procedures were for hepatocellular carcinoma (HCC) (n=75, 74%). The protocol change resulted in significantly fewer post-procedure opioid prescriptions (17/34 (50%) vs 56/68 (82.4%), p< 0.001) and median morphine milligram equivalents (MME) (90 (range: 0-480) vs 15 (0-195), p =0.003). There was no significant difference between groups in reported post-procedure pain after discharge (35/68 (51.5%) vs 19/34 (55.9%), p=0.67). The change in protocol did not delay opioid prescription for pain after discharge. Opioid prescriptions by interventional radiology were significantly lower in patients with concurrent opioid prescriptions from other providers (B=-39.6, p=0.02). A revised discharge opioid prescribing practice for cTACE patients results in significantly fewer opioid prescriptions and total MME by interventional radiology without increased rates of reported post-procedure pain or delayed opioid prescriptions for pain.

The purpose of this study was to review outcomes in treatment of iliocaval/iliofemoral venous disease using stents with and without a specific venous indication and identify factors that may impact patency. An institutional review board–approved retrospective review of patients with iliocaval/iliofemoral venous stent placement for both acute and chronic thrombosis between 2011 and 2022 was performed. Cases of stents placed only in the IVC or in the upper extremity/chest were excluded. Demographics, laboratory values, imaging findings, procedural details, prescription medication, stent patency, clinical symptoms, and re-intervention data were obtained. Baseline descriptive statistics were performed. Primary patency was evaluated using regression analyses. 74 patients (21 M) with median age 45 years (range: 18-82 years) underwent iliocaval/iliofemoral venous reconstruction with stenting. 66/74 (89.1%) patients were treated for chronic post-thrombotic disease. Comorbid etiologies included May-Thurner Syndrome (42/74, 56.8%), hormone use (18/74, 24.3%), and pro-thrombotic conditions (18/74, 24.3%). The median length of follow-up was 502 days (range: 4-4051 days). Stents with a specific venous indication were used in 18/74 (24.3%). Median primary patency for stents with a specific venous indication was 162.5 days (2-617 days). Median primary patency for stents without a specific venous indication was 341 days (range 1-4051 days). Rate of failure was not significantly different between stents with and without specific venous indication (6/18 (33.3%) vs. 13/56 (23.2%), p=0.39). Female patients were at a significantly higher risk of venous stent thrombosis (HR: 6.05, 95% CI: 1.35-27.10, p=0.02). Anticoagulation was associated with significantly less stent thrombosis while controlling for antiplatelet medication use (HR: 0.24, 95% CI 0.07-0.82, p=0.02). Anticoagulation regimen and female gender appear to be significantly associated with stent patency. Stent patency between FDA-approved venous stents and stents without a specific venous indication does not appear significantly different, although long-term follow-up is needed.

Purpose/Objective(s) In people with hepatocellular carcinomas (HCC), reported median progression-free survival (PFS) following locoregional therapy (LRT; TACE or TARE) is less than one year, highlighting a need for additional treatment options. The Phase 3 EMERALD-1 study (NCT03778957) has shown a statistically significant improvement in PFS with durvalumab + bevacizumab + TACE versus TACE alone in participants (pts) with unresectable HCC (uHCC) eligible for embolization. However, an unmet need still exists for evidence to support additional treatment options in settings where TARE is the preferred treatment modality. The EMERALD-Y90 study evaluates the efficacy and safety of TARE with durvalumab monotherapy (one cycle), followed by durvalumab + bevacizumab in pts with uHCC eligible for embolization; the hypothesis is that this regimen will prolong PFS. Materials/Methods EMERALD-Y90 (NCT06040099) is a Phase 2, single-arm study that will enroll approximately 100 pts aged ≥18 years with uHCC (Child-Pugh class A with ECOG PS 0–1) amenable to embolization who are ineligible for, or who have declined treatment with, resection and/or ablation, or liver transplant. Exclusion criteria include having received prior LRT (previous TACE, TARE, or SBRT associated with the curative setting more than 6 months prior to study is permitted, and radiofrequency ablation is permitted if the target lesion was not treated or had subsequently progressed), prior systemic therapy, or having evidence of extrahepatic spread or major portal vein invasion (Vp3/Vp4). Eligible pts will receive partition-based dosing of TARE using Y-90 glass microspheres. Following TARE, pts will receive a single dose of durvalumab 1500 mg followed by durvalumab 1120 mg + bevacizumab 15 mg/kg every three weeks until study completion, disease progression, unacceptable toxicity, or another discontinuation criterion is met. The primary endpoint is PFS (time from day of TARE until the date of disease progression as assessed by the investigator per mRECIST, or death due to any cause). Key secondary endpoints include safety and tolerability in terms of adverse events; and 6-, 12-, and 24-month PFS, objective response rate (proportion of pts with a confirmed complete response or partial response as assessed by the investigator per mRECIST), overall survival (time from start of TARE until death due to any cause), and duration of response (time from date of first documented response until date of progression as determined by the investigator per mRECIST, or death due to any cause). An early safety review is planned when at least 30 pts complete at least two cycles of durvalumab + bevacizumab. Study enrollment will take place at approximately 20 sites across the United States. Results TBD. Conclusion TBD.

Chemotherapy (CTx) is essential to prevent the growth of tumors and has increased patient survival significantly. However, CTx agents have cardiotoxic side effects that can ultimately lead to heart failure. As a result, cardiovascular (CV) death is now the second leading cause of death in cancer patients. It has been accepted that adverse CV events are driven by a dysfunctional microcirculation, therefore CTx-induced endothelial dysfunction may play a key role in development of myocardial pathologies.Many CTx agents induce mitochondrial DNA (mtDNA) damage as many drugs intercalate into double stranded DNA, promoting the release of cell-free mtDNA (cf-mtDNA) into the circulation. Toll-like receptor 9 (TLR9) on the vascular endothelium detects cf-mtDNA and results in an inflammatory response. Prolonged exposure to CTx agents may enhance the mtDNA damage and stimulate the release of additional cf-mtDNA. To determine whether increased drug exposure exacerbates mtDNA damage, two forms of clinically used CTx were utilized: doxorubicin (Dox) and a lysosomal-derived nanoparticle with encapsulated Dox (Dox-NP), which targets tumor cells more specifically. With the ability of tumor-targeted delivery via Dox-NP, we hypothesize that Dox-NP augments mtDNA damage and the inflammatory response.Male Sprague Dawley rats received rat hepatoma-derived tumor cells into the liver twelve days prior to treatment start. Rats were treated with one weekly Dox or Dox-NP injection (7.5mg/kg·BW) for two weeks (cumulative dose 15mg/kg·BW). Cardiac function was evaluated before and six weeks after the initial dose of CTx. Vessel function was evaluated following euthaniasia six weeks after the initial dose. Plasma was obtained upon euthanasia, and cf-mtDNA levels were quantified via qPCR. NF-kB expression, downstream of TLR9 was determined via western blot.Rat microvessels from both treatment groups showed reduced endothelial-mediated vasodilation. Quantification of cf-mtDNA showed a trend toward increased cf-mtDNA levels in response to both Dox and Dox-NP. Likewise, NF-kB expression was elevated three-fold in comparison to Dox. To confirm whether endothelial dysfunction was the result of the inflammatory TLR9 signaling in vivo, isolated human microvessels were treated with 100nM Dox-NP. Vasodilation was not impaired, suggesting that Dox-NP is not directly harmful to the endothelium.Together, these data indicate that tumor-targeted Dox-NP have little to non-direct impact on the endothelium. Thus, endothelial dysfunction in animals treated with Dox-NP is secondary to its effects on a tumor and may be mediated by tumor-derived cf-mtDNA and TLR9 signaling. Moreover, the present data shows that direct effects of standard Dox on ECs may be only partially responsible for impaired dilator function. Conclusively, this work supports the concepts of a new mechanism of Dox-induced endothelial dysfunction. This work was supported by the NIH, 5 R01 HL133029-0 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The purpose of this study was to evaluate the effect of microwave ablation (MWA) probe tip and orientation relative to the central renal collecting system on the incidence of collecting system injury. A single MWA probe (NeuWave PR 15, Madison, WI) was placed under ultrasound guidance into the lower pole of each kidney in 6 pigs (female, ∼50kg). Perpendicular and parallel orientation relative to the collecting system was alternated and distance of tip to collecting system was varied. All ablations were performed at 65W for 5 minutes. Non-contrast CT was obtained to document probe position followed by contrast-enhanced CT to evaluate ablation zone and any complications. Kidneys with proximal ureter were fixed in formalin. Histologic assessment was made for damage to the collecting system and ureter and graded using a standard system. The median distance of probe tip to collecting system was 1.75 (0.1-3.2) cm in the parallel group and 0.85 (0.1-1.3) cm in the perpendicular group. Mean maximum probe temperature in the parallel group was 118.7°C (± 8.5°C) and in the perpendicular group was 109.5°C (± 6.8°C). Ablation zones abutted the collecting system in 67% of the parallel group and 83% of the perpendicular group. Four of 12 (33%) ablations resulted in injury to the collecting system/ureter. One was in the parallel group with injury to the renal pelvis identified as mucosal epithelium attenuation and ulceration. Three were in the perpendicular group demonstrating acute injury to the ureter with ureter muscularis hemorrhage and necrosis. All injuries were seen when ablation zones abutted the collecting system/ureter. There were no findings on CT that appeared to be predictive of histological evidence of ureteral injury. A hematoma with contrast extravasation confirmed on pathology was seen in 1/12 ablations. There were no urine leaks on CT or histopathology. Ablation zones that contact the collecting system/ureter, regardless of orientation of probe placement, appear to cause acute damage. However, transmural injury causing urine leak was not seen in any case. Survival studies are needed to fully elucidate the long-term significance of the findings of acute injury.

Recent studies, both clinical and experimental, indicate that many neurodegenerative disorders including Alzheimer’s disease (AD) often display coexisting metabolic dysfunctions, which may exacerbate neurological symptoms. The hypothalamus is a brain region highly involved in maintaining metabolic and other homeostatic processes and is known to be involved in the etiology of AD, although the role of hypothalamic dysfunction in the onset, progression, and severity of AD is poorly understood. In this study, we demonstrate that our new model of genetic diversity in AD, the AD-BXDs, exhibits non-cognitive symptoms consistent with hypothalamic dysfunction and examined hypothalamic bulk RNA sequencing data in the AD-BXD panel to investigate how the AD transgene impacts gene expression profiles in the hypothalamus. Mostly notably, we identified strong neuroinflammatory signatures from the hypothalamus in the AD-BXDs as early as six months of age. A functionally unknown WGCNA module showed correlation to female body weight and contextual fear acquisition. Eigengene expression of microglial/macrophagic modules and their hub gene expressions were correlated to cognitive phenotypes. From these analyses, we nominated Plek and Laptm5 as new targets to attenuate neuroinflammation in AD.

To evaluate the safety and performance of the Caterpillar Arterial Embolization Device when used for arterial embolization

Osseous breast cancer metastases significantly contribute to patient pain and disability, especially in cases of pathologic fractures. The purpose of this study is to evaluate the use of ablation with or without osteoplasty for pain palliation.

To compare fibered vs. non-fibered coils for embolization in an ovine venous model.

Introduction: TheraSphere® microspheres containing yttrium 90Y are among many radioembolization agents used clinically to reduce liver tumor burden, and their effects on cancer volume reduction are well-established. At the same time, concerns about off target tissue injury often limit their use. Deeper investigation into tissue distribution and long-term impact of these microspheres could inform us about additional ways to use them in practice. Methods: Healthy rat liver and rabbit liver tumor samples from animals treated with TheraSpheres were sectioned and their elemental maps were generated by X-ray fluorescence microscopy (XFM) at the Advanced Photon Source (APS) synchrotron at Argonne National Laboratory (ANL). Results: Elemental imaging allowed us to identify the presence and distribution of TheraSpheres in animal tissues without the need for additional sample manipulation or staining. Ionizing radiation produced by 90Y radioactive contaminants present in these microspheres makes processing TheraSphere treated samples complex. Accumulation of microspheres in macrophages was observed. Conclusions: This is the first study that used XFM to evaluate the location of microspheres and radionuclides in animal liver and tumor samples introduced through radioembolization. XFM has shown promise in expanding our understanding of radioembolization and could be used for investigation of human patient samples in the future.

The purpose of this study was to understand the role of antiplatelet therapy in maintaining arteriovenous graft (AVG) patency after successful percutaneous thrombectomy. This was an IRB-approved, retrospective review of all dialysis access circuit evaluation orders placed over a 1-year period with a narrative keyword search of "declot." A total of 152 encounters were found, 32 of which were excluded as the intervention performed was not a thrombectomy. The remaining 120 encounters were reviewed for patient demographics, details of procedure, and use of antiplatelet therapy prior to and after percutaneous thrombectomy. AVG failure was defined as re-thrombosis, graft abandonment, or surgical revision. The time to AVG failure was calculated from the date of declot to AVG failure. Technical success was defined as patency on angiography and palpable thrill at completion of the procedure. 65% (n = 78) of declots were performed on upper arm grafts, 3% forearm (n = 3), 8% leg (n = 9), 23% HeRO (n = 27), and 3% ax-ax/ax-fem (n = 3). Technical success was seen in 111 of 120 declots. Of the successful declots, 73 (65.8%) were already on antiplatelet therapy. 6 of 9 (67%) unsuccessful declots were not on antiplatelet therapy at the time of procedure. 24.3% of successful AVG declots (n = 27) were subsequently started on new or additional/increased antiplatelet therapy. Aspirin and clopidogrel were the most commonly used agents. Ticagrelor accounted for 18 of 61 cases of existing antiplatelet therapy and 5 of 27 cases of additional/increased therapy. The median time to AVG failure without prior or subsequent antiplatelet therapy was 49 days (range 1-412 days) compared to 90 days (range 1-427 days) for those previously on antiplatelets without a subsequent change in therapy. For those cases that were started on new/additional antiplatelet therapy, the median time to graft failure was 94 days (range 2-407 days). Antiplatelet therapy may provide additional patency gains for patients with AVG as evidenced by trends toward longer time to AVG failure and increased ability to successfully declot the AVG.

To assess the value of obtaining routine next-day radiographic contrast tube study following placement of percutaneous push-type gastrostomy tubes From January 2015 to February 2020, all primary percutaneous push-type gastrostomy tube placement procedures have been identified. Demographic data, purpose of procedure (feeding versus venting), periprocedural (one month) complications, and results of next-day radiographic contrast tube studies (performed prior to initiation of tube feeding) were recorded. Retrospective review of procedural and next-day radiographic images of patients with abnormal tube studies was performed. A total of 267 procedures were identified. 261 patients received next-day radiographic contrast tube studies. 7 patients (2.6%) of those had abnormal studies with only 3 patients (1.2%) requiring surgical/interventional management. Tube studies revealed tube dislodgement in 3 patients, deflated balloon in one patient, false positive interpretation of extraluminal contrast in one study (ruled out by CT scan), and two cases of benign pneumoperitoneum. Retrospective review of the 3 patients with tube dislodgment revealed extraluminal tube placement evident on last archived fluoroscopic procedural images, not recognized during the procedure. 254 patients had normal post procedure tube study and of those; 3 cases were complicated by tube dislodgment (2 in day-2 and 1 in day-12 post procedure). Subsequent imaging for non–tube-related indications showed transhepatic tube placement in one patient and pneumoperitoneum in 12 patients (one with pneumatosis of the colon leading to negative surgical exploration). 6 patients did not receive next-day tube study; however, no periprocedural complications were encountered in this group. Routine use of radiographic contrast tube studies following primary placement of push-type gastrostomy tubes revealed tube mis-placement in few cases, all of which could have been detected intra-procedurally.

Changes in the microenvironment coupled with extracellular matrix remodeling is essential for solid tumors to survive and metastasize. Unraveling the causal mechanisms allows for identification of novel targets and determination of efficacy of targeted treatments. The upregulation of uPAR and MMP-9 are known to be associated with tumor invasiveness, angiogenesis and tumor growth. The purpose of this study is to evaluate whether uPAR and MMP-9 expression is coupled to HIF-1α and whether suppression decreases the aggressiveness of HCC and CRLM tumors. Hepatocellular carcinoma (MCA-RH777), colorectal liver metastasis (CC-531) and immortalized liver (Clone 9) cell lines, grown in DMEM medium at 37°C in a humidified atmosphere with 5% CO2 in normoxic and < 1% O2 hypoxic conditions, were assessed for the expression of HIF-1α, uPAR and MMP-9 by immunocytochemistry. Cells cultured in matrigel-coated transwell were assessed for invasiveness under normoxic and hypoxic conditions. Cells were treated with a HIF-1α inhibitor (R59949) and doxorubicin, and matrigel invasion assays were performed in vitro. Further, tumor sections explanted from rabbit and rat models of HCC and CRLM were stained for the expression of uPAR, MMP-9 and HIF-1α, and compared to normal liver sections after treatment with doxorubicin, R59949 or in combination. HCC and CRLM cells presented striking increases in HIF-1α, uPAR and MMP-9 expression under hypoxic conditions. Percentage of hypoxia induced invasive cells were higher among CRLM cells compared to HCC cells at 12h in Matrigel invasion assays. R59949 significantly reduced the invasion of both CRLM and HCC cells under hypoxic conditions. Immunohistochemistry revealed that rat and rabbit HCC tumors and rat CRLM tumors have abundant levels of HIF-1α, uPAR and MMP-9 compared to the respective normal liver sections. Increase of CRLM and HCC cell invasion under hypoxic conditions is coupled with uPAR and MMP-9 expression.

To compare the safety and efficacy of Angio-Seal to manual compression in achieving hemostasis following direct percutaneous access of polyethylene terephthalate (PTFE) vascular bypass grafts This was an IRB-approved single institution, retrospective review of all patients undergoing endovascular evaluation and/or intervention performed on a peripheral bypass graft from June 2013 to July 2020. Cases in which the percutaneous access was not gained directly into the bypass graft, the bypass graft was not composed of PTFE, or in which closure was not obtained with either Angio-Seal or manual compression (e.g., planned primary surgical closure in collaborative hybrid cases) were excluded. Demographic data including patient age, sex, and co-morbidities, as well as procedural data including the type of procedure, type of graft accessed (femoral-femoral, axillary-femoral, femoral-popliteal or femoral-distal), method of access closure, peri-procedural anticoagulation and antibiotic use, and data regarding 30-day post-procedural complications were collected. For the purposes of this study, an ‘angiogram with intervention’ broadly includes all variety of angioplasty and stenting. A total of 373 cases involving lower extremity bypass interventions were reviewed. Of these, 119 unique cases resulted in 154 direct punctures of a PTFE bypass which met criteria for analysis. This included diagnostic angiograms (n = 18 (12%)), angiography with intervention (n = 66 (43%)) and utilization of catheter-directed thrombolysis (n = 70 (45%)). 116 accesses were closed with Angio-Seal and hemostasis was achieved with manual compression in the remaining 38. Overall, the access complication rate of direct PTFE puncture was 5.2%, with a major complication rate of 2.6%. A total of 4 (3.4%) complications were reported in PTFE accesses closed with Angio-Seal. Of these, 2 (1.7%) were considered major complications, including an abscess requiring surgical drainage and post-deployment stenosis requiring repair. A total of 4 (10.5%) complications were reported following manual compression, of which 2 (5.3%) developed pseudoaneurysms necessitating repair, which were considered major complications. Of the 8 total reported complications, 6 (75%) arose after catheter-directed thrombolysis, and the remaining 2 following an intervention. No complications were reported following diagnostic angiography alone. Angio-Seal is safe and effective in achieving hemostasis following PTFE puncture and has a lower rate of overall and major complications.

Patients with hepatic malignancy have an increased incidence of venous thromboembolic disease (VTE). This risk is further increased with surgical resection, and hepatectomy patients receive prophylactic anticoagulation peri-procedurally. As liver-directed therapy (LDT) becomes increasingly utilized, understanding VTE incidence and prevalence could help provide the necessary information to develop anticoagulation protocols following LDT. The purpose of this study was to identify the incidence of VTE in patients who have undergone LDT and define independent risk factors for developing VTE following LDT. A single-institution (Froedtert Health, Milwaukee, WI) retrospective chart review was conducted to evaluate patients who underwent LDT and had VTE between June 1, 2010, and August 1, 2019. Independent risk factors that were collected included patient demographics, diagnosis, type of LDT, extent of malignancy, ECOG status, comorbidities, and laboratory values. Risk factors were compared between patients that had VTE following LDT and patients that did not develop VTE. 967 patients underwent either TARE or TACE. 65 (6.7%) patients had a VTE event following LDT. 24 (2.5%) of these VTE events were within 90 days of LDT, and 8 (0.8%) were within 30 days. The following risk factors were independently associated with developing VTE following LDT: TARE (compared to TACE, OR 2.64, P = 0.021), other surgery within 1 year prior to LDT (OR 2.21, P = 0.032), and presence of extrahepatic disease (OR 3.89, P = 0.001). Cholangiocarcinoma (OR 3.5, P = 0.075) and metastatic cancer (OR 5.04, P = 0.00004), when compared to HCC, were also found to be associated with VTE. The following factors were found to be protective for VTE following LDT: African American race (OR 0.36, P = 0.025), chronic anticoagulation (OR 0.52, P = 0.091), cirrhosis (OR 0.416, P = 0.015), and increased INR (OR 0.05, P = 0.032). The risk for VTE is multifactorial, with several factors contributing to increased risk and others a decreased risk. A multifactorial model can be developed to categorize patients by risk for VTE, and prophylactic anticoagulation can be considered for individuals at high risk for VTE.

Pancreatic cancer is the fourth leading cause of cancer-related mortality with less than 8% 5-year survival rates. Knowledge on pathogenesis and tumor microenvironment of pancreatic cancer has advanced largely because of mice models; however, a mouse model is unsuitable for site selective delivery. The purpose of this study was to develop an orthotopic rat model of pancreatic cancer suitable to evaluate localized delivery of therapeutics 10 immune compromised Dahl/Salt Sensitive rats were implanted with luciferase expressing Panc-1 cells into the tail of the pancreas. Tumor growth was monitored by weekly bioluminescence and dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging. Quantitative R2* (1/T2*) MR maps were obtained from the multi-echo T2* images. Differences between normal and cancerous pancreas were determined to design treatment parameters using MR-guided focused ultrasound. Rats were euthanized at 3 weeks, the pancreas explanted and gross and histological analyses were performed. All the 10 rats developed tumors within 1 week with tumor size ranging from 2 to 4 mm3, and by the third week, the sizes were 8 to 12 mm3. Bioluminescence imaging showed a strong signal with a 4-fold increase in counts by week 3. DCE MR imaging revealed tumor growth pattern in the pancreas. Voxel wise analysis showed a steep increase in R2* for tumor voxels. T2 mapping at third week showed tumors that can be targeted by focused ultrasound. At necropsy all the organs and tissues were normal for gross observation and pancreas tail demonstrated fibrotic regions. H&E sections from implanted rats when compared with normal rat pancreas tissues confirmed the histological growth of tumor with several micro metastases. Our model allows the growth of human pancreatic cancers and provide a treatment window for the interventional strategies.