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

We report clinical characteristics and CT and MRI in 16 patients with brain metastases due to hepatocellular carcinoma (HCC). Eight of these 16 patients presented with apoplexy-like symptoms (50%). Pulmonary metastases were found in 13 cases (81.3%). The mean survival from the appearance of cerebral metastases to death was 6.2 weeks, which is one of the shortest survival terms in metastatic brain tumours. Haemorrhagic brain metastases were observed in 14 patients (87.5%) with a tendency for the frequency of bleeding to increase in proportion to the size of the tumour. On both contrast-enhanced CT and MRI, metastatic brain tumours enhanced strongly, suggesting that brain metastases, like HCC, are also hypervascular. MRI is useful in evaluating brain metastases from HCC, especially in order to differentiate tumour from haemorrhage. Our results demonstrated a poor prognosis and bleeding tendency of brain metastases due to HCC and showed the usefulness of CT and MRI in achieving a correct diagnosis.
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PMID:Intracranial metastases of hepatocellular carcinoma: CT and MRI. 881 76

Two cases of rare hepatic angiomyolipoma are reported. Both represented with slight abdominal discomfort. The first patient complained of abdominal fullness, and had a normal physical examination and laboratory data. The second came with epigastralgia. Tenderness over right upper quadrant was noted and positive hepatitis B antigen was found. Ultrasound demonstrated hyperechoic hepatic lesion in both. Although diagnosis of hepatic angiomyolipoma was suspected by the radiological findings of ultrasound, CT, MRI, and angiography, it was confirmed by the histological presence of three mesenchymal components: abundant vessels, mature fat cells and smooth muscle cells. For fear of the coexistence of hepatocellular carcinoma, especially given the high prevalence area of Taiwan, surgical intervention was recommended if liver function permitted. Successful treatment was achieved by hepatic resection in both cases.
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PMID:Hepatic angiomyolipoma: a report of two cases. 882 41

To assess the optimal scanning protocol for three-phase dynamic helical CT, 20 patients were examined according to the following 4 methods (5 cases each) : (1) 100 ml Iopamidol (300 mgI/ml), at a rate of 2 ml/sec ; (2) 120 ml,3 ml/sec, (3) 150 ml, 3 ml/sec ; (4) biphasic method, initial 100 ml, 3.3 ml/sec ; remaining 50 ml, 1.6 ml/sec. Assessment of the time-density curve of the aorta, and the liver parenchyma, indicated that protocol (4) was superior to the others. Using protocol (4), 32 patients (62 nodules) with hepatocellular carcinoma underwent three-phase scanning, consisting of early, late, and delayed phases. Out of 61 nodules, 43 nodules were detected as high density areas in the early phase, 7 nodules as low density areas only in the late phase, and 3 nodules as low density areas only in the delayed phase. Compared with MRI, three-phase dynamic helical CT demonstrated numerous nodules, especially those less than 10 mm in diameter, and, therefore, was useful for the detection of hepatocellular carcinoma.
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PMID:[Three-phase dynamic helical CT for hepatocellular carcinoma: optimal scanning protocol]. 883 Dec 16

A pathomorphological study was conducted to clarify the localization of Kupffer cells in hepatocellular carcinoma (HCC) tissues and such hyperplastic nodular lesions as adenomatous hyperplasia (AH) and focal nodular hyperplasia (FNH). Materials were surgical specimens of 50 HCCs, 7 AHs, and 13 FNHs. These tissues were immunohistochemically stained with an anti-human macrophage antibody (anti-CD68 antibody). Among CD68-positive cells, short spindle-shaped cells were considered as Kupffer cells, and Kupffer cell numbers in tumor lesions and surrounding liver tissues of each specimen were comparatively examined. As a result, the number of Kupffer cells in well-differentiated HCC tissues less than 1 cm in diameter was 27.8 +/- 3.3 (mean +/- SE/025 mm2); in noncancerous tissues, it was 302 +/- 3.2, showing no statistically significant differences. The number of Kupffer cells in cancerous tissues decreased in comparison with the number in noncancerous tissues, as the tumor size increased and histological grade decreased. In hyperplastic nodular lesions, the number was higher in nodular lesions than in the surrounding liver tissues in 4 of 7 AHs (57.1%) and 6 of 13 FNHs (46.2%). This could explain the reason why enhanced MRI, which utilizes the selective taken-up mechanism of chondroitin sulfate iron colloid and superparamagnetic iron oxide into the reticuloendothelial system of the liver and spleen, depicts well-differentiated HCC and AH at the same signal intensity as in the surrounding liver tissues. Our findings also indicate that there is a limitation in differentiating or diagnosing small HCC and hyperplastic nodular lesions by using enhanced MRI, which utilizes Kupffer cell functions.
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PMID:Pathomorphological study of Kupffer cells in hepatocellular carcinoma and hyperplastic nodular lesions in the liver. 885 80

The choice of management for the patient with HCC hinges on precise localization and staging of the disease process. All the major imaging modalities are employed to achieve this end. US is frequently the initial means of detection of the lesion. Since percutaneous needling may lead to tumour dissemination, the temptation to proceed to imaging-guided biopsy should be resisted until a full evaluation has been completed and it is clear that neither curative surgery nor transplantation is a therapeutic option. CT scanning is considered to be superior to ultrasound both in detection and staging of the disease. A variety of modifications to the technique, including CT arterio-portography and lipiodol-CT, is used to obtain optimum results. The role of MRI has not yet been established but initial results suggest that this may be the optimum means of scanning the patient following percutaneous or intra-arterial therapy. Angiography is generally performed prior to resection and may be combined with the delivery of chemotherapeutic and embolic agents pre-operatively or as a definitive palliative procedure. Imaging-guided percutaneous alcohol is also a useful palliative measure where the lesion is small. In the majority of cases, resection is not feasible. In a selected few liver transplantation is an option. Imaging requirements of the potential liver transplant candidate depend on the nature of the underlying liver problem. A general assessment including a chest X-ray and US with Doppler imaging of the hepatic vascular structures is sufficient in the majority. In children with complex structural anomalies and in patients with bile duct disease or tumours, the full range of investigations is required. US, cholangiography CT and angiography may all be required in the diagnosis and management of post-transplant complications.
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PMID:Imaging: focus on hepatocellular carcinoma and liver transplantation. 890 5

MRI was performed in 13 patients who had microwave coagulation therapy (MCT) for hepatocellular carcinoma. Six of them underwent surgery after MRI. The area (including tumor) treated by MCT showed low to high intensity on T1WI, and low to isointensity on T2WI. No enhancement was obtained on dynamic MRI. Histologically, this area was supposed to be coagulation necrosis. On T1WI, only tumor showed high intensity within the MCT area in 8 patients, and nearly uniform intensity was observed in 5 patients. Histologically, residual cell nuclei were observed in the former, and nearly uniform coagulation necrosis in the latter. The marginal part of the MCT area exhibited low intensity on T1WI, and high intensity on T2WI. Strong enhancement was obtained on dynamic MRI, and histologically, granulation tissue was noted. In the hepatic parenchyma around the MCT area, a ring-or wedge-shaped high intensity part was observed in 7 patients on T2WI, and that part was enhanced on dynamic MRI. This finding was considered to reflect changes such as hepatic hyperperfusion. In terms of the capability of visualizing residual tumor after MCT, MRI was superior to CT. Furthermore, a clear distinction was seen between the MCT area and non-MCT area on T2WI and dynamic MRI. Thus, MRI was useful in the determination of additional therapy.
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PMID:[MR imaging of hepatocellular carcinoma following microwave coagulation therapy]. 896 57

The effective clinical use of the anticancer drug 5-fluorouracil (5-FU) requires the non-invasive assessment of its transport and metabolism, particularly in the tumor and the liver, where the drug is catabolized to alpha-fluoro-beta-alanine (FBAL). In this study, the potentials and limitations of dynamic 18F PET and metabolic 19F MRI examinations for noninvasive 5-FU monitoring were investigated in ACI and Buffalo rats with transplanted MH3924A and TC5123 Morris hepatomas, respectively. Selective 5-[19F]FU and [19F]FBAL MR images were acquired 5 and 70 min after 5-FU injection using a CHESS MRI sequence. After administration of 5-[18F]FU, the kinetics of the regional 5-[18F]FU uptake were measured by dynamic PET scanning over 120 min. To allow a comparison between PET and MRI data, standardized uptake values (SUV) were computed at the same points in time. The TC5123 hepatoma showed a significantly (p < 0.002) higher mean SUV at 5 and 70 min post-5-FU injection than the MH3924A cell lines, whereas there were no significant differences between the mean SUV measured in the liver of both animal populations. In contrast to the PET data, no significant differences in the mean 5-[19F]FU and [19F]FBAL MR signal values in the tumor of both models were observed. The MR images, however, yielded the additional information that 5-FU is converted to FBAL only in the liver and not in the hepatomas.
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PMID:Assessment of the biodistribution and metabolism of 5-fluorouracil as monitored by 18F PET and 19F MRI: a comparative animal study. 897 57

Opinion is divided regarding the influence of iodized oil on MRI signal intensity of hepatic tumours treated with transcatheter arterial chemoembolization (TACE), in which lipiodol deposits. The aim of our study was to ascertain whether or not lipiodol directly influences the MRI signal intensity of hepatocellular carcinoma (HCC) treated by TACE and that of the surrounding liver. Thirteen patients with HCC were studied retrospectively. CT and MRI scans were performed both before and 3 months after TACE. The CT scan was performed to check whether embolized nodules contained lipiodol and how lipiodol was distributed within them. In addition, eight patients were examined prospectively within 7 days after TACE. In these patients a CT scan was performed to see how lipiodol was distributed in the neoplastic nodules and in normal hepatic parenchyma. In the first group of patients the contrast-to-noise (C/N) ratio on T1-weighted (T1W) images and the T2 relaxation time on T2-weighted (T2W) images were calculated for both neoplasm and surrounding liver. In the second group of patients we also measured the signal intensity of non-neoplastic liver that was either permeated or not permeated by lipiodol. The data were analysed with Wilcoxon's test. On T1W images we observed that the retention of lipiodol increased the C/N ratio in all the tumours studied within 1 week after TACE. In the patients studied 3 months after TACE the C/N ratio was not significantly increased. On T2W images lipiodol retention did not change tumour signal intensity. The iodized oil did not change the signal intensity of the liver surrounding the tumour, in comparison with the liver not permeated by lipiodol, on either T1W or T2W images. The results indicate that lipiodol does not modify the signal intensity in non-neoplastic hepatic parenchyma in which it is deposited; after 3 months it does not significantly affect the signal of the tumours that accumulated it. Lipiodol produces a high signal on T1W images over the first few days following TACE in those tumours in which it is deposited.
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PMID:Effects of lipiodol retention on MRI signal intensity from hepatocellular carcinoma and surrounding liver treated by chemoembolization. 900 Mar 87

Our objective was to study Gd-EOB-DTPA for the characterization of focal liver lesions by means of dynamic MR imaging. A double-blind and randomized dose-ranging phase-2 clinical trial was performed in 31 patients (liver metastases n = 23, hepatocellular carcinoma n = 4, and hemangioma n = 4) at a field strength of 1.0 Tesla. Gd-EOB-DTPA (Schering AG, Berlin, Germany) was administered as an IV bolus (12.5, 25, or 50 micromol/kg body weight) with dynamic T1-weighted MRI during the distribution and cellular uptake of the contrast agent at multiple time points up to 45 min post contrast. Dynamic changes in tumor signal intensity, tumor-liver contrast, enhancement patterns, side effects, and adverse events were evaluated. Monitoring of vital signs revealed no significant changes during bolus injection of Gd-EOB-DTPA. Liver metastases demonstrated an inhomogeneous uptake of Gd-EOB-DTPA during the distribution phase with a washout effect on delayed images > 3 min and highest tumor-liver contrast 20 and 45 min post contrast. Hepatocellular carcinomas showed prolonged enhancement as compared with metastases and hemangiomas. Hemangiomas exhibited an early peripheral-nodular enhancement with subsequent partial or complete filling, persisting enhancement < 10 min following injection of Gd-EOB-DTPA, and delayed washout as compared with liver metastases. Initial clinical experience suggests that Gd-EOB-DTPA as a bolus injectable hepatobiliary MR contrast agent may offer useful features for the characterization of focal liver lesions.
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PMID:Enhancement characteristics of liver metastases, hepatocellular carcinomas, and hemangiomas with Gd-EOB-DTPA: preliminary results with dynamic MR imaging. 903 30

Gradient-recalled echo magnetic resonance imaging (GRE MRI), which gives information on blood flow and oxygenation changes (Robinson SP, Howe FA, Griffiths JR 1995, Int J Radiat Oncol Biol Phys 33: 855), was used to observe the responses of six rodent tumour models to carbogen breathing. In one transplanted rat tumour, the Morris hepatoma 9618a, and a chemically induced rat tumour, the MNU-induced mammary adenocarcinoma, there were marked image intensity increases, similar to those previously observed in the rat GH3 prolactinoma. In contrast, the rat Walker carcinosarcoma showed no response. In two mouse tumours, the RIF-1 fibrosarcoma and the human xenograft HT29, carbogen breathing induced a transient fall in signal intensity that reversed spontaneously within a few minutes. The rat GH3 prolactinoma was xenografted into nude mice, and an increase in image intensity was found in response to carbogen, suggesting that any effects that carbogen may have had on the host were not significant determinants of the tumour response. The increases in GRE image intensity of the MNU, H9618a and GH3 tumours during carbogen breathing are consistent with increases in tumour oxygenation and blood flow, whereas the responses of the RIF-1 and HT29 tumours may be the result of a transient steal effect followed by homeostatic correction.
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PMID:The response to carbogen breathing in experimental tumour models monitored by gradient-recalled echo magnetic resonance imaging. 908 35


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