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)

This paper summarises the discussions from a meeting held on contrast ultrasound held on 21 October 2000 in Toronto, Canada. The aims of this meeting, supported by ATL/Philips Ultrasound, was to review the current clinical indications for contrast usage in the liver and kidney, arrive at recommendations for use of intravenous contrast agents, and speculate on the future uses. This paper is published to help understand this rapidly evolving field. Consensus points included a recommendation that Levovist in its post-vascular phase was of considerable value in detecting and excluding metastases in the liver, although unlikely realistically to replace CT or MR. Newer agents such as Sonovue, Definity and Sonazoid, suitable for low mechanical index (MI) imaging were also of great value and may have a further role for HCC detection. Equipment manufacturers should strive to keep improving low mechanical index modes for these agents. Promising applications for characterisation included further evaluation of lesions discovered on ultrasound and as a problem solver for CT or MR. To date no contrast agents have received approval from the FDA for radiological applications in the United States. The case for reimbursement for contrast agents was strongly supported by the panel.
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PMID:Seeking consensus: contrast ultrasound in radiology. 1186 Oct 95

Thirty-two dogs with spontaneous hepatic nodules were given intravenous ultrasound contrast medium (Definity or Sonovue) and imaged with contrast harmonic software on a conventional ultrasound machine system. Digital video images were initially reviewed to describe the perfusion pattern of malignant nodules. The images were reviewed again to test this pattern against all individual nodules. Subjectively, there was improved conspicuity of malignant nodules after contrast enhancement compared with conventional imaging and increased numbers of malignant nodules were often noted. There was decreased conspicuity of benign nodules and no additional nodules were seen after contrast enhancement. There was a highly significant (P < 0.0001) association of malignancy with a hypoechoic nodule at surrounding normal liver peak contrast enhancement. Benign nodules were isoechoic to the surrounding normal liver at peak contrast enhancement. Only one benign nodule (hepatoma) had regions of hypoechogenicity compared with the surrounding normal liver at peak liver contrast enhancement. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were highly significant (P < 0.0001) (100%, 94.1%, 93.8%, 100%, and 96.9%, respectively). No complications or morbidity was noted throughout the course of the study. Contrast harmonic ultrasound appears to be accurate at discriminating between naturally occurring benign and malignant nodules in the liver of dogs.
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PMID:Contrast harmonic ultrasound of spontaneous liver nodules in 32 dogs. 1560 47

We elucidated the features of the time-related contrast-enhanced ultrasound appearance of hypervascular liver tumor using Definity, which has no accumulation activity in the liver. Ten rabbits with VX2 tumors broadcast into the liver were used. Changes in contrast-enhanced sonograms were evaluated by real-time observation (FR 15 Hz) of harmonic imaging under extra-low MI (MI 0.065) with Definity, and their intensity changes were analyzed. Hepatic angiography (4/10) and histopathological examination (10/10) were performed to investigate the tumor vascularity. VX2 tumors were hypervascular on angiogram (4/10) and histology (10/10). They showed time-related sonographic appearance changes from hyperechoic to hypoechoic, which were confirmed by quantitative intensity analysis. Hypervascular VX2 tumors showed characteristic time-related shift on contrast-enhanced sonograms in real-time and extra-low MI harmonic images with Definity. These findings may be useful for the ultrasound diagnosis of human hypervascular liver tumor like hepatocellular carcinoma with blood-pool contrast agent.
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PMID:Sonographic shift of hypervascular liver tumor on blood pool harmonic images with definity: time-related changes of contrast-enhanced appearance in rabbit VX2 tumor under extra-low acoustic power. 1616 66

The diagnostic imaging of hepatocellular carcinoma (HCC) has recently undergone marked progress. The advent of the ultrasound (US) contrast agent Sonazoid, approved in January 2007, and magnetic resonance imaging (MRI) with the liver-specific MRI contrast agent gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA-MRI), approved in January 2008, are of particular significance. Sonazoid contrast-enhanced US (Sonazoid-CEUS) is useful not only for the diagnosis of HCC, but also for guiding treatment and assessing treatment response. Sonazoid-CEUS has proven to be particularly effective for screening and staging, which used to be considered impossible with CEUS, through the introduction of the newly developed diagnostic technique of defect reperfusion imaging. It is still not possible if other vascular agents such as SonoVue and Definity are used. In particular, Gd-EOB-DTPA-MRI has been suggested to be much more reliable in the differentiation of early HCC from precancerous dysplastic nodules than any other modalities such as multidetector raw computed tomography, dynamic MRI, and superparamagnetic iron oxide-MRI. A decrease in contrast uptake in the hepatocyte phase observed on EOB-MRI is strongly suggestive of cancer, and the absence of early staining in the arterial phase suggests early HCC. The differential diagnostic capacity of Gd-EOB-DTPA-MRI is considered to far exceed that of what were previously the most useful imaging techniques, computed tomography (CT) during hepatic arteriography or CT during arterial portography, and to be comparable to that of the pathological diagnosis by pathologists specialized in liver.
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PMID:Diagnostic imaging of hepatocellular carcinoma: recent progress. 2221 40