UMLS:C0019204 - FACTA Search

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Query: UMLS:C0019204 (hepatocellular carcinoma)
71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The goal of this investigation was to develop stable radioimmunoconjugates (RICs) of anti-HER2/neu monoclonal antibodies (MoAbs) for imaging and therapy in an animal model bearing human breast tumor xenografts that express normal (MCF-7 cells) and increased amounts of HER2/neu receptors (HCC-1954, BT-474, SKBR-3 cells) on their cell surface membranes. Pharmacy-grade Herceptin, a murine anti-HER2/neu MoAb, and nonspecific mouse IgG protein were conjugated with the recently developed DTPA linker known as CHX-A"-DTPA. These immunoconjugates were labeled with (111)InCl(3) and (90)YCl(3). Using a molar excess of 10:1 CHX-A"-DTPA to immunoglobulin, average specific activities of 1.87 microCi (111)In/microg RIC and 2.71 microCi (90)Y/microg RIC were obtained. The purity of RICs was 96%+ for (111)In and 99%+ for (90)Y. Stability in human plasma at 37 degrees C for both RICs ranged from 98% at 24 h to 85% at 96 h. Binding capacity of the RICs was tested with human cancer cell lines MCF-7, HCC-1954, BT-474, and SKBR-3. Using (111)In-labeled nonspecific IgG protein as a control, (111)In-Herceptin RIC was found to bind to MCF-7 cells with a ratio of 2.5:1 and to SKBR-3 cells with a ratio of 85:1 after 3 h of incubation. (111)In anti-HER2/neu RIC bound to MCF-7 cells with a ratio of 6:1 and to SKBR-3 cells with a ratio of 115:1 after 3 h of incubation. (90)Y-anti-HER2/neu RIC bound 10-times greater to BT-474 cells than to MCF-7 cells. Thus, these MoAbs can be labeled with (111)In and (90)Y using the CHX-A"-DTPA linker. The resulting RICs ((111)In- and (90)Y-anti HER2/neu antibodies) are stable and bind significantly to HER2 overexpressing tumor cell lines.
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PMID:Labeling anti-HER2/neu monoclonal antibodies with 111In and 90Y using a bifunctional DTPA chelating agent. 1295 22

The aim of this study was to compare Gd-DTPA-enhanced dynamic MR images, superparamagnetic iron oxide (SPIO)-enhanced MR images, combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images, vs combined CT arterial portography (CTAP) and CT hepatic arteriography (CTHA), in the detection of hepatocellular carcinoma (HCC) using receiver operating characteristic (ROC) analysis. Twenty-four patients with 38 nodular HCCs (5-60 mm, mean 23.0 mm) were retrospectively analyzed. Image reviews were conducted on a liver segment-by-segment basis. A total of 192 segments, including 36 segments with 38 HCC, were reviewed independently by three radiologists. Each radiologist read four sets of images (set 1, unenhanced and Gd-DTPA-enhanced dynamic MR images; set 2, unenhanced and SPIO-enhanced MR images; set 3, combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images; set 4, combined CTAP and CTHA). To minimize any possible learning bias, the reviewing order was randomized and the reviewing procedure was performed in four sessions at 2-week intervals. The diagnostic accuracy (A(z) values) for HCCs of combined CTAP and CTHA, combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images, Gd-DTPA-enhanced dynamic MR images, and SPIO-enhanced MR images for all observers were 0.934, 0.963, 0.878, and 0.869, respectively. The diagnostic accuracy of combined CTAP and CTHA and combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images was significantly higher than Gd-DTPA-enhanced dynamic MR images or SPIO-enhanced MR images ( p<0.005). The mean specificity of combined CTAP and CTHA (93%) and combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images (95%) was significantly higher than Gd-DTPA-enhanced dynamic MR images (87%) or SPIO-enhanced MR images (88%; p<0.05). Combined Gd-DTPA-enhanced dynamic and SPIO-enhanced MR images may obviate the need for more invasive combined CTAP and CTHA for the preoperative evaluation of patients with HCC.
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PMID:Preoperative detection of hepatocellular carcinoma: comparison of combined contrast-enhanced MR imaging and combined CT during arterial portography and CT hepatic arteriography. 1453 Oct 5

The aim was to compare the diagnostic performance of dynamic Gd-DTPA- and ferumoxides-enhanced MRI for hepatocellular carcinoma (HCC). Twenty-five patients with chronic hepatitis or liver cirrhosis underwent both dynamic gadopentetate- and ferumoxides-enhanced MRI studies of the liver for HCC detection on the same day. MR data of both studies were retrospectively and independently analyzed. Two observers determined in consensus the grade of diffuse fibrotic liver changes (mild, moderate or severe) and the number of focal lesions. HCCs were confirmed by histology (n=22) and/or follow-up studies for at least six months (n=64). Differences in results obtained from both MR data sets were tested for significance with the McNemar's test (p<0.05). Ferumoxides-enhanced MR images detected 84 of 99 hepatic lesions, including 82 of 86 HCCs and 2 false positive, nonmalignant lesions, while Gd-DTPA-enhanced MR images detected 92 of 99 hepatic lesions, including 81 of 86 HCCs and 11 false positive, nonmalignant lesions. Sensitivity of MRI for detection of HCCs was not significantly different between ferumoxides-enhanced (95.3%; p>0.05) and Gd-DTPA-enhanced scans (94.2%). Gd-DTPA- and ferumoxides-enhanced MRI perform equally well for HCC detection. The majority of small hypervascular hepatic lesions, detected on dynamic Gd-DTPA-enhanced MRI but not on ferumoxides-enhanced MRI, represent no HCCs.
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PMID:Detection of hepatocellular carcinoma: comparison of Gd-DTPA- and ferumoxides-enhanced MR imaging. 1580 Jul 73

We report a case of skull metastasis from a hepatocellular carcinoma (HCC). A 68-year-old male with hepatitis C virus-associated cirrhosis and HCC presented with painless subcutaneous mass in the left frontotemporal region. Radiologically, skull X-ray showed an osteolytic lesion, and non-contrast CT displayed a hyperdense tumor that homogeneously enhanced on contrast CT. Cerebral angiography demonstrated a hypervascular mass with the feeding arteries from the external carotid artery. The tumor was shown as an iso-intensity mass with flow voids on T1WI, as iso- to hypo- intensity on T2WI and FLAIR images, and as hypo-intensity on DWI. The lesion was markedly enhanced by Gd-DTPA. Previous reports have described a low incidence of skull metastasis in HCC patients. However, the incidence is gradually increasing due to the prolonged survival rates of HCC patients, indicating the significance of the disease as a differencial diagnosis for skull tumors. Recent reports describe characteristic MRI findings of skull metastasis from HCC (hypointensity on T2WI with flow void); however, owing to the rarity of this disease, more studies are needed to establish the typical MRI pathognomonic findings.
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PMID:[Skull metastasis of hepatocellular carcinoma: case report]. 1616 87

The aim of this study was to determine a moderate flip angle (FA) for dynamic liver MR imaging (MRI) with the three-dimensional volumetric interpolated breath-hold examination (3D-VIBE) technique. Images of phantoms with various T(1) values (44-560 msec) were acquired with the 3D-VIBE sequence (TR/TE=5.2/2.6 msec) using different FA (5-50 degree). We estimated signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), considered to indicate tumor-to-liver contrast, as a function of FA. In phantoms, in which T(1) values (44-191 msec) were assumed to be shortened by the effect of Gd-DTPA in hepatocellular carcinoma (HCC), the highest SNR in each phantom was observed at FA ranging from 15 to 30 degrees. SNRs in other phantoms, in which T(1) values (298-560 msec) were assumed to be normal liver-tissue pre- or post-enhancement, were high with FA of 10-12 degrees, and were remarkably decreased with FA of more than 30 degrees. CNR increased as FA increased in every phantom, especially in the phantom with shortened T(1) values (44-191 msec), suggesting that enlarging FA improved the tumor-to-liver contrast. Taking both results of SNR and CNR into account, we concluded that a moderate FA was approximately 25 degrees. The advantage with an FA of 25 degrees was confirmed in a clinical study of a patient with hypervascular HCC, in which we could observe coronal enhancement surrounding the lesion in the late phase of the double arterial phase by dynamic MRI using the 3D-VIBE technique.
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PMID:[Optimization of flip angle for 3D-VIBE technique in liver dynamic MRI]. 1627 23

In order to study MR features of the regenerative nodule (RN) and dysplastic nodule (DN) of the cirrhotic liver, 26 cases of cirrhotic liver with RNs and DNs, of which 8 cases accompanied with hepatocellular carcinoma, were subjected to MRI. Eighteen of 26 cases underwent additional enhanced MRI with administration of Gd-DTPA on T1WI and 10 of the 18 cases did additional SPIO (Feridex) enhancement on T2WI. Clinical data showed normal level of alpha-fetoprotein in 18 cases except 8 cases accompanied with HCC. The results showed that 12 cases had RNs with nodules measuring < 1 cm. The MR appearance of those RNs showed isointensity on T1WI and hypointensity on T2WI. The intensity of those RNs was isointense to the surrounding hepatic parenchyma on enhanced MRI with administration of Gd-DTPA or SPIO. Among the 14 cases of DNs, 8 cases had nodules measuring 1-3 cm in size and 6 had macroregenerative nodule measuring > 3 cm. In 8 cases with DNs measuring 1-3 cm in size, 5 cases appeared hyperintense on T1WI and hypointense on T2WI as well as the enhancement as that of nodules with < 1 cm in size; and the remaining 3 cases appeared hypointense on T1WI and hyperintense on T2WI, and were not isointense to the surrounding hepatic parenchyma on enhanced MRI but hyperintense on SPIO enhanced MRI. In 6 cases of macroregenerative nodule measuring > 3 cm in size, 2 cases appeared hyperintense to the surrounding hepatic parenchyma on T1, T2WI and enhanced MRI; 4 cases showed hyperintense on T1WI, and hypointense on T2WI and enhanced MRI. Sometimes, normal vessels were seen to pass through the surface of macroregenerative nodules. It was suggested that RNs of cirrhosis had features on MRI that usually allow distinction from hepatocellular carcinoma but not always from dysplastic nodules (DNs). A helpful distinction between HCC and DNs is that the latter are almost never hyperintense on T2WI. Additionally, low grade DNs appear hypointense on SPIO enhanced MRI.
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PMID:MR features of regenerative nodules and dysplastic nodules in the cirrhotic liver. 1646 87

A new class of intracellular contrast agents (CA) for magnetic resonance imaging has been developed, based on Gd(DTPA) with two positively charged amide-linked substituents. Uptake of Gd(DTPA) into cultured tumor cell lines (B16 mouse melanoma, MH3924A Morris hepatoma) was below the detection limit while CA with the melanin-binding pharmacophore 2-(diethylamino)ethylamine reached intracellular concentrations of ca. 0.03 fmol/cell (ca. 20 microM) for melanoma and 0.02 fmol/cell for hepatoma (24 h at 10 microM CA). With the polyamine substituents bis(2-aminoethyl)amine or spermidine, CA uptake increased up to 3-fold for melanoma (0.083 fmol/cell) and 9-fold for hepatoma (0.18 fmol/cell). Uptake of polyamine-substituted CA was reduced by the polyamine transport inhibitor benzyl viologen. Molar relaxivities for three Gd-DTPA-polyamine complexes were in the range 5.6-6.9 for the free complex in solution and 7.7-23.5 s-1 mM-1 for Morris hepatoma cell pellets. T1-weighted magnetic resonance imaging at 2.35 T of rats with MH3924A tumors showed contrast enhancement in tumor at 1 and 24 h postinjection of polyamine-substituted CA.
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PMID:Polyamine-substituted gadolinium chelates: a new class of intracellular contrast agents for magnetic resonance imaging of tumors. 1720 17

Gastro-entero-pancreatic tumors (GEP) contain, in their majority, somatostatin receptors. In-111-DTPA-phenyl-pentetreotide has been proved to have high affinity for somatostatin receptors subtypes 2, 3 and 5. The aim of the present study was to evaluate the utility of (111)In-DTPA-O somatostatin receptors' scintigraphy (SRS) in the diagnosis of suspected GEP. Thirty-five consecutive patients (17 males and 18 females-mean age 57.9+/-7.6) with GEP as a possible diagnosis were enrolled in the study. The primary diagnosis was diarrheic syndrome susceptive of intestinal carcinoid tumor (24 patients), carcinoid of the rectum (2 patients), adenocarcinoma of the pancreas (2 patients), insulinoma (2 patients), gastrinoma (3 patients) and hepatocellular carcinoma (2 patients). All patients were submitted to computerized tomography (CT) of the thorax and the abdomen and pentetreotide SRS was performed 4 h (total body and SPET acquisition) and 24 h (planar views), post iv injection of 185 MBq of the radiolabeled compound. Results showed: Four of the patients were false positive diagnosed as having inflammatory intestinal disease and gallbladder dilatation. At the time of the evaluation, 14 of the remaining patients were free of disease, concerning secondary involvement. In these cases, CT and SRS studies matched each other, with no pathological lesions and no abnormal accumulation of the radiopharmaceutical respectively. Concerning pathological cases, only one SRS study in a patient with rectum carcinoid was normal, with liver lesions in the CT study. These lesions were considered as subtypes 2, 3 and 5 somatostatin receptors negative. SRS revealed three lesions more than CT. According to these results, sensitivity of SRS study was 93.8% and specificity 86.9%. The authors believe that molecular imaging of somatostatin receptors, is a sensitive method for the evaluation of patients with GEP tumors. However, in cases of intestinal disease, we should be aware of false positive results due to inflammatory processes and the presence of lymphocyte infiltration.
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PMID:[Indium-111-DTPA-phenyl-pentetreotide somatostatin receptors' scintigraphy in the evaluation of patients with suspected gastro-entero-pancreatic tumors. Comparison with computerized tomography]. 1808 69

Hepatocellular carcinoma (HCC) is a malignant tumor which is becoming more prevalent worldwide. Patients at high risk of developing HCC, namely hepatitis B- and C-related liver cirrhosis patients, should be entered into surveillance programs, which should be performed using both ultrasonography and 3 tumor markers (AFP, PIVKA-II, AFP-L3). The surveillance interval needs to be shortened for patients at higher risk of HCC. Therefore, super-high-risk patients should be screened at 3- to 4-month intervals based on their risk of developing HCC. Sonazoid-enhanced US is extremely useful to characterize hepatic tumors when compared with multidetector-row computed tomography (MDCT). Moreover, Sonazoid-enhanced US with defect reperfusion imaging is a breakthrough approach in the treatment of HCC. This technique will markedly change the therapeutic strategy for liver cancer. Furthermore, diagnostic capability using the new imaging technique Gd-EOB-DTPA MRI is promising. A reduced uptake (low intensity) in the hepatobiliary phase of Gd-EOB-DTPA MRI strongly suggests HCC (including early-stage HCC) or a high-grade dysplastic nodule with high malignant potential. Empirically, intrahepatic arterial infusion chemotherapy using implanted reservoir port is known to be effective for advanced HCC with vascular invasion; however, no randomized study exists to prove its efficacy. Further controlled study is necessary to establish this treatment option as a standard of care in a treatment algorithm for HCC. In contrast, sorafenib was established as the first choice of treatment as a standard of care in advanced HCC patients with preserved liver function and vascular invasion/extrahepatic spread. Furthermore, global clinical trials are now ongoing using sorafenib as an adjuvant setting after resection, ablation or TACE. Efficacy of combined use of sorafenib with TACE or intra-arterial infusion chemotherapy is not clear. In order to clarify this issue a randomized clinical trial for intermediate and advanced HCC comparing sorafenib alone versus sorafenib combined with maintenance TACE/intra-arterial infusion chemotherapy and/or intra-arterial infusion chemotherapy is scheduled to be initiated in Japan in 2009. If positive results are obtained by these trials, its impact on treatment strategy for HCC will be drastically changed.
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PMID:Hepatocellular carcinoma 2009 and beyond: from the surveillance to molecular targeted therapy. 1909 66

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. The majority of HCCs develop in cirrhotic livers, and the early detection and characterization of this entity is very important. Pathologically, human HCC develops in a multistep fashion in the following sequence: from low-grade dysplastic nodule (LGDN), to high-grade dysplastic nodule (HGDN), early HCC, well-differentiated HCC, nodule-in-nodule HCC, and, finally, to moderately differentiated HCC. Differentiation between early HCC and DN is the most important issue in the clinical setting. CT during hepatic angiography (CTHA) and CT during arterial portography (CTAP) are the most sensitive tools in the differentiation of premalignant/borderline lesions (LGDN and HGDN) and early HCC. Recent progress in imaging modality, especially Sonazoidenhanced US and Gd-EOB-DTPA MRI, is starting to play a very important role in the imaging of multistep hepatocarcinogenesis, resulting in changing the therapeutic strategy of these nodular lesions associated with liver cirrhosis.
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PMID:Multistep human hepatocarcinogenesis: correlation of imaging with pathology. 1914 4

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