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)

In 47 patients with liver cirrhosis, we performed dynamic MRI with a multisection FLASH technique that enabled us to obtain 13 T 1-weighted images of the entire liver within a single breath hold. Computed tomographic arterial portography (CTAP), US, CT, angiography (AOG) and MRI (spin echo [SE] and dynamic MRI) were performed in all 47 patients. Except for cyst, hemangioma and metastatic tumor, 104 focal nodules less than 3 cm in diameter were detected. These 104 focal lesions were divided into three groups according to the pattern of CTAP: 69 portal supply negative, 11 portal supply decreased, and 24 portal supply normal. In the portal supply negative group, 63 lesions (91%) were detected by dynamic MRI, which was superior to other modalities (US 77%, CT 41%, AOG 70%, MRI-SE 61%). The superiority of dynamic MRI resulted from its excellent ability to detect liver lesions less than 1 cm in diameter. We confirmed histologically that dynamic MRI had almost the same ability to detect hepatocellular carcinoma (HCC) as CTAP. Dynamic MRI should be clinically useful as a noninvasive examination for the detection of HCC.
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PMID:[Evaluation of multislice dynamic MR imaging of the whole liver]. 819 Jun 5

128 Magnetic resonance (MR) investigations of single or multifocal nodular liver lesions were retrospectively reviewed. All lesions had been identified, but not characterized, with ultrasonography (US). All the studies were performed with a 0.5-T superconductive magnet (Philips Gyroscan); spin-echo (SE) T1/proton density/T2-weighted and inversion recovery (IR) pulse sequences were used routinely. Characterization was attempted considering the following variables: a) lesion outline; b) the presence of some kind of capsular or pseudocapsular ring; c-d) homogeneity of signal intensity and its difference from surrounding liver parenchyma; e) possible central scar and its signal features; f) associated lesions (multifocal nodules, ascites, locoregional adenopathies, venous thrombosis). Diagnostic confirmation was obtained by means of biopsy (63 patients), of other imaging techniques (35 patients), or of clinical follow-up over 12 months at least (30 patients). Our results confirm high MR accuracy in the diagnosis of hemangioma (48/50 cases, 96% confidence) and even higher accuracy in focal fatty liver infiltration (9/9 cases, 100% confidence), thanks to some typical MR signal patterns on appropriate acquisition techniques--i.e., SE multiecho pulse sequences and IR sequences, respectively, with liver and fat signal nulling. Primary non-malignant focal liver lesions were identified mainly on a morphological basis (smooth roundish outline with/without capsular or pseudocapsular ring; central starlet scar; "basket" or "spoked wheel" patterns): these features allowed the correct identification of 5/7 focal nodular hyperplasia cases. On the other hand, in the absence of these typical morphological features and of specific MR signal changes, adenomas were misdiagnosed in all cases but one. The study of focal lesions in cirrhotic liver disease exhibited 66.6% confidence in the diagnosis of regenerating nodules, on the basis of their iso/hypointensity relative to liver on T2-weighted pulse sequences. Such a behavior seems to be due to intracellular iron loading, to small cell size and to thin vascular network, which are typical of cirrhotic regenerating areas. The diagnosis of hepatocellular carcinoma relies on both morphostructural features and possible associated lesions: in our series, 22/25 cases (88% confidence) were correctly identified. Indeed, this result was somehow influenced by the case history of the patients and by specific serologic indexes. Finally, MRI exhibited high sensitivity in the detection of focal liver involvement in neoplastic patients. However, the intrinsic range of variability and the lack of specificity of MR signal intensity, because of different histopathologic cell types, do not usually allow an unquestionable diagnosis to be made, especially for single lesions.
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PMID:[The role of magnetic resonance in characterizing focal liver lesions]. 819 Sep 31

In this study, we report the synthesis and the evaluation as MRI contrast agent of a new compound (nitroxyl fatty acid, NFA), where a pyrrolidinoxyl radical (3-carboxy-proxyl, PCA) is linked to a fatty acid moiety. Fatty acids were selected as vector because they present a high affinity for the liver, their efficient cellular uptake being the result of a specific interaction with a transmembrane transporter (liver plasma membrane-fatty acid binding protein). The uptake of 3H-oleic acid is inhibited after the injection of 1 mmol/kg of NFA, suggesting that NFA recognizes the same transmembrane transporter as the natural fatty acids. The higher relaxivity R1 of NFA in albumin solutions, compared with PCA, was explained by the immobilization of the nitroxyl radical in the protein. MR imaging was performed using T1-weighted images on mice in order to compare the contrast effect obtained after the injection of 1 mmol/kg of radical. The % signal enhancement in the liver 5 min after intravenous injection was 49 +/- 4 and 14 +/- 5 for NFA and PCA, respectively. NFA allowed a better delimitation of some necrotic tumors (Novikoff hepatocarcinoma) due to its preferential uptake by the nontumorous tissue.
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PMID:Evaluation of a nitroxyl fatty acid as liver contrast agent for magnetic resonance imaging. 825 59

We evaluated the clinical efficacy of an embolizing emulsion produced by mixing lipiodol and Gd-DTPA, in transcatheter arterial chemoembolization (TAE). Subjects were 10 patients with hepatocellular carcinoma (HCC). The emulsion used was produced by mixing 3 ml of lipiodol and anticancer agents (mitomycin-C 10 mg and adriamycin 20 mg) dissolved in Gd-DTPA. This emulsion was infused into the proper hepatic artery. Subsequent embolization by Gelfoam was performed in eight patients. MRI and CT examinations were performed soon after TAE (1 or 2 days after) and two weeks afterwards. The position of lipiodol accumulation dipicted on CT at two weeks after TAE did not differ from the site of change in signal intensity induced by Gd-DTPA on MR images soon after TAE in any case. In almost all cases, the washout of Gd-DTPA occurred earlier than that of lipiodol. It might be suggested that Gd-DTPA, which is water-soluble, shows in vivo dynamics similar to anticancer agents rather than to lipiodol, which is oil-soluble. Since the normal tissues showed no definite signal changes, we could easily detect the site of tumors by using the emulsion containing Gd-DTPA even on MR studies immediately after TAE. In addition, the deposits of Gd-DTPA depicted on MR images created fewer artifacts than the lipiodol deposits on CT.
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PMID:Efficacy of emulsion containing Gd-DTPA and lipiodol in hepatic transcatheter arterial embolization. 829 Jun 93

A 79-year-old female with hepatocellular carcinoma with portal invasion and right adrenal gland metastasis was treated by low dose UFT (200 mg/day). Two months after the initiation of UFT administration, CT scan revealed marked contraction of the primary liver tumor and right adrenal metastasis. Serum AFP and PIVKA-II were also reduced, and right flank pain disappeared. Six months later, CT scan and MRI study were performed. The findings of liver and metastatic lesion were the same as in the earlier study, and the liver function and the patient condition were well controlled. This case is probably rare, but suggestive in the choice of treatment for advanced hepatocellular carcinoma.
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PMID:[A case of hepatocellular carcinoma with portal invasion and right adrenal gland metastasis showing marked contraction of primary tumor and metastasis with treated by UFT alone]. 829 6

Twenty small hepatocellular carcinomas (HCCs) < 20 mm in diameter in 18 patients, detected by MRI, were surgically resected and histologically confirmed. Quantitative analysis of signal intensity on MR images was performed with 14 homogeneous lesions. In the five grade I HCCs, T1-weighted SE sequences provided significantly higher mean tumor-liver contrast and contrast-to-noise ratio (C/N) than T2-weighted SE sequences (p < 0.01). However, in the other nine HCCs (grade I + II or greater), T2-weighted SE sequences had significantly higher mean tumor-liver contrast and C/N values than T1-weighted SE sequences (p < 0.001). The T2-weighted SE sequences appear superior to T1-weighted SE sequences for grade I + II or greater HCC detection, whereas T1-weighted SE sequences are valuable in the detection of grade I HCCs.
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PMID:MR features of various histological grades of small hepatocellular carcinoma. 838 Apr 27

Breath-hold multislice dynamic MRI was used to diagnose 115 hepatic tumors in 55 patients. With this technique 10 slice-section images were made during a single breath-hold, achieving nearly complete liver coverage. Early enhancement images were obtained 20 s after intravenous bolus injection of gadopentetate dimeglumine. The detection rate of untreated hepatocellular carcinomas was greater with breath-hold multislice dynamic imaging (91%) than with conventional spin echo techniques (73%), because the 10 early enhancement images obtained during a single breath-hold showed the arterial dominant phase throughout the entire liver. In cases of untreated hepatocellular carcinoma 44 (86%) of the 51 lesions showed rapid enhancement on arterial dominant phase images, and 44 (86%) were demonstrated as isointensity or low intensity areas on delayed images. In cases of hepatic hemangioma, peripheral enhancement was demonstrated in 25 (89%) of the 28 lesions on arterial dominant phase images, and partial or complete hyperintense fill-in was identified in all lesions on delayed images. In patients treated with lipiodol-transcatheter arterial embolization (TAE), the breath-hold multislice dynamic imaging technique allowed evaluation of therapeutic effectiveness by revealing the hemodynamics of each nodule without the influence of lipiodol. We conclude that breath-hold multislice dynamic MRI should be used on patients with suspected hepatic tumors and in follow-up studies after lipiodol-TAE.
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PMID:Multislice dynamic MRI of hepatic tumors. 838 4

Eight patients with histologically or clinically diagnosed hepatocellular carcinoma and a total of 23 nodules were studied. SE 2000/20 (PDW-SE), SE-2000/80 (T2W-SE), SE 500/20 (T1W-SE), GRE 167/13/70 degrees (T1W-GE), and GRE 167/13/15 degrees (T2*W-GE) were used. Using each pulse sequence the pre-and post-contrast detection rates of the 23 nodules visualized by CT arterial portography (CTAP) were compared. With plain MRI, the detection rates were PDW-SE: 48%, T2W-SE: 74%, T1W-SE: 52%, T1W-GE 48% and T2*W-GE: 48%. After the administration of contrast medium all pulses sequences showed enhanced detection rates: 100%, 83%, 87%, 91%, and 96% respectively. Superparamagnetic iron oxide particle enhanced MRI showed a high detection rate comparable to CTAP, suggesting that this agent can make a major contribution to the diagnosis of HCC, particularly the detection of small HCC.
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PMID:[Usefulness of superparamagnetic iron oxide particles in the detection of hepatocellular carcinoma by MR imaging]. 838 92

Twenty-seven patients were studied with MRI between 3 and 40 days following partial liver resection. Twenty-four patients had undergone major hepatectomy (three to six segments) and three had undergone minor hepatectomy (tumorectomy, one; bisegmentectomy, two). Indications for surgery were as follows: metastases (n = 16), hepatocellular carcinoma (n = 5), hemangioma (n = 3), focal nodular hyperplasia (n = 2), and cholangiocarcinoma (n = 1). A total of 36 MR examinations were performed using a 1.5 T superconducting unit. Three patients were studied three times and three patients were studied twice. The MR images were evaluated to detect and to characterize liver parenchymal abnormalities and intraabdominal fluid or blood collections as well as to assess vascular and/or graft patency. The MR images showed hepatic ischemia in two cases and allowed differentiation between intraabdominal hemorrhagic (n = 30 and nonhemorrhagic (n = 4) fluid collections. Gradient echo images allowed assessment of polytetrafluoroethylene graft patency as well as demonstration of iliac vein (one case) and portal vein (one case) thrombosis. The presence of surgical clips at the resection margins did not affect image quality.
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PMID:Early MR follow-up of partial hepatectomy. 845 55

A 77-year-old male with liver cirrhosis was admitted to our hospital for further examination and treatment of liver tumor. A tumor, which was in the S5 of liver and 7.2 cm in diameter, was revealed by ultrasonography, CT scan and MRI. The titers of serum AFP and PIVKA-II were 600 ng/ml and 3.5 AU/ml, respectively. According to the findings of imaging diagnosis and laboratory data, the patient was diagnosed as having hepatocellular carcinoma. He was treated by the oral administration of UFT (300 mg/day). Ultrasonically guided aspiration biopsy of the tumor and CT scan, which were performed ten and fourteen months after the beginning of administration of UFT, respectively, revealed the necrosis of the tumor. Twelve months later, the tumor size reduced to 1.4 cm in diameter, and the titer of PIVKA-II was reduced to the normal range. This case shows the clinical effectiveness of oral administration of UFT.
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PMID:[A case of hepatocellular carcinoma responding to oral administration of UFT]. 867 41


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