Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty patients [15 men, 5 women, 19-71 years old (mean 52 years)] highly suspected of having tumoral liver pathology were prospectively studied with motion compensated T2-weighted spin echo (SE) [repetition time (TR) 2,200 ms, echo time (TE) 90 ms] and Gd-DOTA enhanced gradient echo fast low angle shot [TR 60 ms, TE 10 ms, angle 30 degrees) sequences. The final diagnoses were hemangioma (five), hepatocellular carcinoma (four), focal nodular hyperplasia (one), adenoma (one), metastasis (two), abscess (two), echinococcal cyst (one), tumor of unknown origin (three), cirrhosis (one). Contrast enhanced images were obtained during the early vascular phases after intravenous bolus injection of Gd-DOTA at a dose of 0.1 mmol/kg (0.2 ml/kg). After Gd-DOTA, positive contrast enhancement was seen in 11 cases, negative enhancement in 4, and nonenhancement in 6. Contrast patterns were similar to contrast enhanced CT. In terms of visibility of lesions, the unenhanced motion-compensated T2 SE sequences were superior to the nonenhanced gradient echo sequences in 12 patients and equal in 8. After gadolinium enhancement, T2-weighted SE images were superior to the postcontrast gradient echo images in eight cases, equal in eight and inferior in four cases.
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PMID:Gadolinium-DOTA enhanced fast imaging of liver tumors at 1.5 T. 231 49

For assessment of the value of delayed hepatobiliary imaging with technetium 99m (99mTc)-(Sn)-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) for specific diagnosis of hepatocellular carcinoma, 88 patients with various malignant and benign liver diseases (49 with hepatocellular carcinoma, 4 with cholangiocellular carcinoma, 10 with metastatic liver carcinoma, 2 with liver cysts, 2 with liver hemangioma, 1 with liver abscess, 2 with intrahepatic lithiasis, 12 with liver cirrhosis, and 6 with chronic hepatitis) were studied. In 20 (41%) of the 49 patients with hepatocellular carcinoma, greater uptake of 99mTc-PMT by the tumor than by the surrounding liver tissue was seen in delayed hepatobiliary images, whereas in eight patients (16%), equilibrated uptake was seen. No increased uptake of the radioisotope by hepatic lesions was seen in 21 patients with localized liver diseases other than hepatoma. Moreover, in 18 patients with diffuse liver diseases, no focal accumulation of the radioisotope was seen in delayed 99mTc-PMT images. In addition, of 28 patients with hepatocellular carcinoma in whom the serum alpha-fetoprotein level showed little or no increase, 12 showed increased uptake of 99mTc-PMT by the tumor. In assessing delayed 99mTc-PMT images, however, it was necessary to consider following complications: accumulation of tracer in obstructed and dilated biliary trees; retention of radioactivity in nonneoplastic liver tissues; difficulties in evaluating 99mTc-PMT uptake by small hepatic tumors; overlapping of radioactivity in the gut and gallbladder in delayed 99mTc-PMT images of tumors. This study indicates that delayed 99mTc-PMT images can be useful in the diagnosis of hepatocellular carcinoma.
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PMID:Specific diagnosis of hepatocellular carcinoma by delayed hepatobiliary imaging. 241 74

Serum alpha-L-fucosidase (AFU) was determined in 33 patients with hepatocellular carcinoma (HCC), 4 with secondary metastatic liver cancer, 61 with various liver diseases, 12 with gastrointestinal tumor and 50 healthy controls. The results showed that AFU level was significantly higher in HCC (14.48 +/- 5.77) than that in the controls (3.33 +/- 0.72) and in patient with other diseases (P less than 0.01). Serum AFU level was also increased in fulminant hepatitis (8.96 +/- 3.99), acute hepatitis (8.94 +/- 4.94) and chronic hepatitis (7.27 +/- 2.58), P less than 0.01 or 0.05. There was no significant difference in AFU level between the controls and patients with secondary metastatic liver cancer (6.25 +/- 0.84), cirrhosis (6.30 +/- 3.17), gastrointestinal tumor (4.43 +/- 1.64), liver hemangioma and liver abscess (4.86 +/- 2.22). A level exceeding 10.5u was a useful marker for the diagnosis of HCC with 78.8% sensitivity and 90.0% specificity. The diagnostic positivity was 81.8% in low AFP producing HCC, whereas 93.9% in those with elevated AFP. Our data indicate that serum AFU is a useful tumor marker for HCC, particularly in detection of AFP-low or negative HCC patients.
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PMID:[A preliminary study on serum alpha-L-fucosidase assay in the diagnosis of hepatocellular carcinoma]. 248 Feb 10

MR features of 153 proved primary liver tumors (95 malignant, 58 benign) in 55 patients with hepatocellular carcinoma (21), cholangiocarcinoma (seven), carcinosarcoma (one), hepatoblastoma (one), hemangioma (16), hepatic adenoma (four), focal nodular hyperplasia (three), leiomyoma (one), and hemangioendothelioma (one) were studied retrospectively to determine which techniques are most reliable for lesion detection and which criteria are most useful for differential diagnosis. MR data were correlated with histologic features such as fatty degeneration, fibrosis, and peritumoral edema. Unlike metastatic cancer, hepatocellular carcinoma was best detected (p less than .01) with T2-weighted pulse sequences. The mean tumor-liver T2 difference was 34.4%, while the mean T1 difference was only 21.8%. A tissue-specific diagnosis of hepatocellular carcinoma was possible in 14 of 21 patients by identification of fatty degeneration of the tumor (eight of 17), tumor capsule (five of 21), and/or vascular invasion (six of 21). MR features of peritumoral edema, present in six of 21 patients with hepatocellular carcinoma and in seven of 25 patients with metastases, were exclusively associated with malignant tumors. The large variation in tissue characteristics (relaxation times and proton density) seen in primary liver tumors necessitates the use of multiple pulse sequences to maximize lesion detection. However, the combined use of T1- and T2-weighted spin-echo and T2-weighted phase-contrast images had the advantage of distinguishing benign from malignant primary liver tumors in 48 of 55 patients in this series.
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PMID:Primary liver tumors: diagnosis by MR imaging. 253 70

Forty-two patients with hepatocellular carcinoma (hepatoma) and 18 patients with hemangioma were studied with MR imaging at 1.5 T to evaluate the efficacy of single-slice breath-hold FLASH (fast low-angle shot) images in distinguishing between the lesions and to compare with T2 differentiation using conventional spin-echo images. The difference between mean tumor-to-liver signal ratio on FLASH imaging of hepatocellular carcinoma (1.46 +/- 1.06) and hemangioma (0.86 +/- 0.45) was statistically significant (p less than .01). Fifty-one (82%) of 62 lesions were classified correctly when the borderline of tumor-to-liver signal ratio between hepatoma and hemangioma was set at 0.9. The mean T2 values of hepatomas and hemangiomas were 48 +/- 10 msec and 89 +/- 20 msec, respectively. Fifty-seven (92%) of 62 lesions were correctly diagnosed with the T2 borderline of 80 msec. The five misdiagnosed lesions with the T2 borderline were hemangiomas smaller than 2 cm with tumor-to-liver signal ratios less than 0.9. FLASH images appear promising for differentiating between hepatoma and hemangioma, and they complement T2 values in characterizing small lesions.
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PMID:MR differentiation of hepatocellular carcinoma from cavernous hemangioma: complementary roles of FLASH and T2 values. 253 97

47 patients with liver tumours (haemangioma, focal nodular hyperplasia, hepatocellular carcinoma) underwent MRI of the liver before and after i.v. injection of 0.2 ml./kg. gadolinium-DTPA in addition to other imaging methods. The demarcation of focal nodular hyperplasia is not influenced by use of the contrast agent as it almost behaves like surrounding normal liver tissue, thus only indirectly facilitating its identification. With regard to liver haemangiomas that show the most intensive uptake of gadolinium-DTPA, the contrast enhanced image does not reach the contrast and sensitivity of a native T2-weighted SE image, especially in cases of small haemangiomas. The contrast agent is helpful, however, in the recognition of large cavernous haemangiomas that are partially fibrotic or thrombotic. Emphasis is given to the contrast agent in hepatomas: gadolinium-DTPA presents a pattern of uptake and distribution frequently found in hepatocellular carcinoma providing additional information on the delineation of internal tumour details.
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PMID:[Differentiation of focal liver lesions using contrast-enhanced MRT]. 253 80

Forty patients with hepatocellular carcinoma (HCC) (n = 22) or cavernous hemangioma (diameter, 3 cm or less) (n = 18) were examined with serial magnetic resonance (MR) imaging at 1.5 T with the fast low-angle shot (FLASH) technique and an intravenously administered bolus injection of 0.05 mmol/kg Gd-DTPA. Two images per minute were obtained for 5 minutes, and one per minute thereafter until about 10 minutes. Dynamic MR studies revealed five criteria for differentiating these tumors. With HCC there was a hyperintense mass before contrast material enhancement (32%), peak contrast enhancement at about 10 seconds after injection (55%), slight to moderate peak contrast enhancement (73%), absent or minimal delayed enhancement (100%), and, at morphologic study, a capsule or nodules-in-nodule appearance (59%). With hemangioma there was a hypointense mass before contrast enhancement (72%), peak contrast enhancement more than 2 minutes after injection (72%), marked peak contrast enhancement (83%), moderate to marked delayed enhancement (100%), and, at morphologic study, spreading phenomenon (39%). Seventy-seven percent of HCCs and 83% of hemangiomas satisfied three or more criteria and thus could be differentiated from each other with certainty.
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PMID:Small hepatocellular carcinoma and cavernous hemangioma: differentiation with dynamic FLASH MR imaging with Gd-DTPA. 253 6

The role of adding single-photon emission CT (SPECT) to 99mTc-labeled RBC imaging of the liver was evaluated by specifically focusing on the differentiation between hepatic hemangioma and hepatocellular carcinoma. Planar RBC imaging followed by blood-pool SPECT scanning was performed in 77 patients with a total of 108 hemangiomas and in 29 patients with a total of 46 hepatocellular carcinomas. All lesions were smaller than 5 cm in diameter. Thirty-six (33%) of 108 hemangiomas were detected by planar delayed RBC imaging, whereas 63 (58%) were detected by the delayed RBC-SPECT scan. The smallest hemangioma shown by delayed RBC-SPECT scanning was 1.4 cm in diameter, compared with 1.7 cm by planar RBC scanning. When confined to nodules larger than 1.4 cm in diameter, 42% of hemangiomas (36/85) were detected by planar delayed RBC imaging, whereas 74% (63/85) were detected by delayed RBC-SPECT. Increase in sensitivity was noted in nodules 2.1-4.0 cm in diameter. No hepatocellular carcinomas were shown by delayed RBC planar or SPECT scans. We concluded that with the addition of SPECT, the sensitivity of delayed RBC scans in the detection of small hemangiomas is considerably improved. Delayed RBC-SPECT scanning can be used to distinguish hemangioma from hepatocellular carcinoma.
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PMID:Distinction between hemangioma of the liver and hepatocellular carcinoma: value of labeled RBC-SPECT scanning. 253 10

Characteristics and advantages of MRI (magnetic resonance imaging) in the diagnosis of cancer are represented using hepatic diseases as examples. MRI can detect as small as 10 mm lesion of hepatic tumor (less than 5 mm in favorite conditions) despite far longer acquisition time compared with CT. Although the prolongation of T1 (longitudinal relaxation time) and T2 (transverse relaxation time) is generally noted in cancer, the liver is the sole organ where in vivo measurement of T2 makes it possible to differentiate primary malignant tumor (hepatocellular carcinoma) from the most common benign tumor (cavernous hemangioma). Gd-DTPA, the clinically used contrast material on MRI, is as useful as iodine contrast material on dynamic CT for differentiation among hepatic tumors, and is safely administered in larger dose. Proton spectroscopic imaging can distinguish the signals of proton from water and fat, and can detect the presence of fat more specifically. Intravoxel incoherent motion imaging is a new technique to demonstrate diffusion (Brownish movement) and perfusion (blood flow in capillary) in the voxel as image, and has possibility to reveal the vascularity of tumor without contrast material. MRS (magnetic resonance spectroscopy) has been obtainable in vivo under the guidance of proton MRI. The pattern of 31P-MRS is essentially nonspecific but phosphorous compounds rapidly change in proportion after effective treatment against cancer. Therefore, 31P-MRS is useful in the early and noninvasive evaluation of anticancer treatment. Finally the so-called Fossel effect (widths of methyl and methylene of lipoprotein on 1H-MRS of plasma becomes narrow in patients with cancer) and critical paper against Fossel are discussed.
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PMID:[MRI and MRS in the diagnosis of cancer]. 253 87

Nodular hepatic lesions detected in 123 patients with chronic liver diseases were subjected to ultrasonically guided needle biopsy. Of these, 94 cases were diagnosed as hepatocellular carcinoma of a moderately or poorly differentiated type with classical histologic features of hepatocellular carcinoma. In 14 cases in whom hepatocytes had minimal atypical changes and were mostly of normotrabecular arrangement (one to two cells thick), a diagnosis of well-differentiated hepatocellular carcinoma was made on the basis of the following three histologic criteria: nuclear crowding, increased cytoplasmic basophilia and microacinar formation. The nodules which showed two or more of these findings were diagnosed as well-differentiated HCC. The diagnoses of these 14 cases were subsequently confirmed by clinical course, histology in the resected specimen and/or autopsy findings. The nodules that presented similar but equivocal changes were arbitrarily categorized as borderline lesions (five cases). The nodules showing the findings almost identical with those of pseudolobules were regarded as benign, large regenerative nodules (nine cases). The remaining one case had a hemangioma. Thus, these three histologic criteria proved to be useful in the biopsy diagnosis of nodular hepatic lesions, with certain limitations. Additionally, the majority of large regenerative nodules, borderline lesions and well-differentiated HCCs were found to be smaller than 2 cm.
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PMID:Biopsy diagnosis of well-differentiated hepatocellular carcinoma based on new morphologic criteria. 254 84


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