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Yan C, Xia C, Cao Q, Zhang J, Gao M, Han J, Liang X, Zhang M, Wang L, Zhao L. Predicting High-Risk Esophageal Varices in Cirrhosis: A Multi-Parameter Splenic CT Study. Acad Radiol 2024:S1076-6332(24)00419-7. [PMID: 38997882 DOI: 10.1016/j.acra.2024.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/21/2024] [Accepted: 06/22/2024] [Indexed: 07/14/2024]
Abstract
RATIONALE AND OBJECTIVES To explore the value of splenic hemodynamic parameters from low-dose one-stop dual-energy and perfusion CT (LD-DE&PCT) in non-invasively predicting high-risk esophageal varices (HREV) in cirrhotic patients. METHODS We retrospectively analyzed cirrhotic patients diagnosed with esophageal varices (EV) through clinical, laboratory, imaging, and endoscopic examinations from September 2021 to December 2023 in our hospital. All patients underwent LD-DE&PCT to acquire splenic iodine concentration and perfusion parameters. Radiation dose was recorded. Patients were classified into non-HREV and HREV groups based on endoscopy. Univariate and multivariate logistic regression analysis were performed, and the prediction model for HREV was constructed. P < 0.05 was considered statistically significant. RESULTS Univariate analysis revealed that significant differences were found in portal iodine concentration (PIC), blood flow (BF), permeability surface (PS), spleen volume (V-S), total iodine concentration (TIC), and total blood volume of the spleen (BV-S) between groups. TIC demonstrated the highest predictive value with an area under the curve (AUC) value of 0.87. Multivariate analysis showed that PIC, PS, and BV-S were independent risk factors for HREV. The logistic regression model for predicting HREV had an AUC of 0.93. The total radiation dose was 20.66 ± 4.07 mSv. CONCLUSION Splenic hemodynamic parameters obtained from LD-DE&PCT can non-invasively and accurately assess the hemodynamic status of the spleen in cirrhotic patients with EV and predict the occurrence of HREV. Despite the retrospective study design and limited sample size of this study, these findings deserve further validation through prospective studies with larger cohorts.
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Affiliation(s)
- Cheng Yan
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Chunhua Xia
- Medical Image Center, The Third Affiliated Hospital of Anhui Medical University/ Hefei No1. People's Hospital (Binhu Campus), Hefei 230601, China
| | - Qiuting Cao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Jingwen Zhang
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Mingzi Gao
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Jing Han
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Xiaohong Liang
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Mingxin Zhang
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Lin Wang
- Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Liqin Zhao
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
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Zhang T, Xie Y, Li T, Deng Y, Wan Q, Bai T, Zhang Q, Cai Z, Chen M, Zhang J. Phytochemical analysis and hepatotoxicity assessment of braised Polygoni Multiflori Radix (Wen-He-Shou-Wu). Biomed Chromatogr 2024; 38:e5768. [PMID: 38087457 DOI: 10.1002/bmc.5768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 01/26/2024]
Abstract
Polygoni Multiflori Radix (PMR) is a medicinal herb commonly used in China and Eastern Asia. Recently, the discovery of hepatotoxicity in PMR has received considerable attention from scientists. Processing is a traditional Chinese medicine technique used for the effective reduction of toxicity. One uncommon technique is the braising method-also known as 'Wen-Fa' in Chinese-which is used to prepare tonics or poisonous medications. Braised PMR (BPMR)-also known as 'Wen-He-Shou-Wu'-is one of the processed products of the braising method. However, the non-volatile components of BPMR have not been identified and examined in detail, and therefore, the hepatotoxic advantage of BPMR remains unknown. In this study, we compared the microscopic characteristics of different samples in powder form using scanning electron microscopy (SEM), investigated the non-volatile components, assessed the effects of different processed PMR products on the liver, and compared the differences between BPMR and PMR Praeparata recorded in the Chinese Pharmacopoeia (2020 edition). We found that the hepatotoxicity of BPMR was dramatically decreased, which may be related to an increase in polysaccharide content and a decrease in toxic substances. The present study provides an important foundation for future investigations of the processing mechanisms of BPMR.
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Affiliation(s)
- Tao Zhang
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, China
| | - Yating Xie
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, China
| | - Tao Li
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, China
| | - Yaling Deng
- Department of Pharmacy, Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, China
| | - Quan Wan
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, China
| | - Tingting Bai
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, China
| | - Qing Zhang
- Jianchangbang Pharmaceutical Co., Ltd., Nanchang, China
- Key Laboratory of Traditional Chinese Medicine Processing (Braising Method), Nanchang, China
| | - Zhongxi Cai
- Jianchangbang Pharmaceutical Co., Ltd., Nanchang, China
- Key Laboratory of Traditional Chinese Medicine Processing (Braising Method), Nanchang, China
| | - Mingxia Chen
- Jianchangbang Pharmaceutical Co., Ltd., Nanchang, China
- Key Laboratory of Traditional Chinese Medicine Processing (Braising Method), Nanchang, China
- Beijing Scrianen Pharmaceutical Co., Ltd., Beijing, China
| | - Jinlian Zhang
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, China
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Notake T, Shimizu A, Kubota K, Sugenoya S, Umemura K, Goto T, Yamada A, Fujinaga Y, Soejima Y. Usefulness of intratumoral perfusion analysis for assessing biological features of non-functional pancreatic neuroendocrine neoplasm. Langenbecks Arch Surg 2024; 409:38. [PMID: 38221590 DOI: 10.1007/s00423-023-03219-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/29/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE Here, we evaluated the usefulness of intratumoral perfusion analysis using preoperative contrast-enhanced CT (E-CT) to assess biological features of non-functional pancreatic neuroendocrine neoplasms (NF-PanNENs). METHODS We retrospectively studied 44 patients who underwent curative surgery for NF-PanNENs. We used preoperative E-CT with compartment model analysis to calculate the tumor perfusion parameters K1 (inflow rate constant), 1/k2 (mean transit time), and K1/k2 (distribution volume). We assessed the association between perfusion parameters and biological features of NF-PanNENs, including the WHO classification tumor histopathological grade and prognosis after surgery. RESULTS Patients in this study had a neuroendocrine tumor (NET) G1 (n = 32) or NET G2 (n = 12). Neither NET G3 or NEC tumors were observed. Among perfusion parameters, K1 was the most accurate predictor of the high-grade tumor (AUC: 0.726). K1-low (< 0.028 s-1) was significantly associated with large tumors (≥ 20 mm) (p = 0.022), high mitotic index (p = 0.017), high Ki-67 index (p = 0.004), and lymphatic invasion (p = 0.025). Synchronous extra-pancreatic metastasis, including lymph node metastasis or liver metastasis, more frequently developed in K1-low patients than in K1-high patients (29% vs 4%, p = 0.025). Disease-free survival of patients with a K1-low tumor was poorer than that of patients with a K1-high tumor (p = 0.005). Furthermore, no patient with a K1-high tumor developed recurrence after initial surgery. CONCLUSION The perfusion parameters obtained using E-CT were significantly associated with biological features and prognosis of NF-PanNENs.
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Affiliation(s)
- Tsuyoshi Notake
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.
| | - Akira Shimizu
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - Koji Kubota
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - Shinsuke Sugenoya
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - Kentaro Umemura
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - Takamune Goto
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - Akira Yamada
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yasunari Fujinaga
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuji Soejima
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
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Yamada A, Kamagata K, Hirata K, Ito R, Nakaura T, Ueda D, Fujita S, Fushimi Y, Fujima N, Matsui Y, Tatsugami F, Nozaki T, Fujioka T, Yanagawa M, Tsuboyama T, Kawamura M, Naganawa S. Clinical applications of artificial intelligence in liver imaging. LA RADIOLOGIA MEDICA 2023:10.1007/s11547-023-01638-1. [PMID: 37165151 DOI: 10.1007/s11547-023-01638-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/21/2023] [Indexed: 05/12/2023]
Abstract
This review outlines the current status and challenges of the clinical applications of artificial intelligence in liver imaging using computed tomography or magnetic resonance imaging based on a topic analysis of PubMed search results using latent Dirichlet allocation. LDA revealed that "segmentation," "hepatocellular carcinoma and radiomics," "metastasis," "fibrosis," and "reconstruction" were current main topic keywords. Automatic liver segmentation technology using deep learning is beginning to assume new clinical significance as part of whole-body composition analysis. It has also been applied to the screening of large populations and the acquisition of training data for machine learning models and has resulted in the development of imaging biomarkers that have a significant impact on important clinical issues, such as the estimation of liver fibrosis, recurrence, and prognosis of malignant tumors. Deep learning reconstruction is expanding as a new technological clinical application of artificial intelligence and has shown results in reducing contrast and radiation doses. However, there is much missing evidence, such as external validation of machine learning models and the evaluation of the diagnostic performance of specific diseases using deep learning reconstruction, suggesting that the clinical application of these technologies is still in development.
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Affiliation(s)
- Akira Yamada
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Bunkyo-Ku, Tokyo, Japan
| | - Kenji Hirata
- Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Rintaro Ito
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Kumamoto University Graduate School of Medicine, Chuo-Ku, Kumamoto, Japan
| | - Daiju Ueda
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Abeno-Ku, Osaka, Japan
| | - Shohei Fujita
- Department of Radiology, University of Tokyo, Tokyo, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Sakyoku, Kyoto, Japan
| | - Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Yusuke Matsui
- Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Kita-Ku, Okayama, Japan
| | - Fuminari Tatsugami
- Department of Diagnostic Radiology, Hiroshima University, Minami-Ku, Hiroshima City, Hiroshima, Japan
| | - Taiki Nozaki
- Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
| | - Tomoyuki Fujioka
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Yanagawa
- Department of Radiology, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
| | - Takahiro Tsuboyama
- Department of Radiology, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
| | - Mariko Kawamura
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Non-invasive evaluation of esophageal varices in patients with liver cirrhosis using low-dose splenic perfusion CT. Eur J Radiol 2022; 152:110326. [DOI: 10.1016/j.ejrad.2022.110326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 11/21/2022]
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Bae JS, Lee DH, Yoo J, Yi NJ, Lee KW, Suh KS, Kim H, Lee KB. Association between spleen volume and the post-hepatectomy liver failure and overall survival of patients with hepatocellular carcinoma after resection. Eur Radiol 2020; 31:2461-2471. [PMID: 33026503 DOI: 10.1007/s00330-020-07313-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/05/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Post-hepatectomy liver failure (PHLF) can occur as a major complication after hepatic resection (HR) in patients with hepatocellular carcinoma (HCC) and negatively affects the prognosis. We aimed to retrospectively assess whether the spleen volume (SV) measured from preoperative CT images would be associated with the development of PHLF and overall survival (OS) after HR in patients with HCC. METHODS We enrolled 317 consecutive patients with very early/early stage HCC who underwent a preoperative CT and HR between January 2010 and December 2016. The SV was obtained from preoperative CT images using semi-automated volumetric software and was divided by body surface area to yield SVBSA. Receiver operating characteristic (ROC) curves and logistic regression analyses were performed to identify factors affecting the development of PHLF. The Cox proportional hazard model was used to identify prognostic factors for OS. RESULTS PHLF was observed in 72 patients (22.7% [72/317]). SVBSA was associated with the development of PHLF (odds ratio, 2.321; 95% CI, 1.347-4.001; p = 0.002) with the area under the ROC curve of 0.663 using the cutoff value of 107.5 cm3 (p < 0.001). SVBSA was also an influencing factor for OS (hazard ratio, 3.935; 95% CI 1.520-10.184; p = 0.005), with the optimal cutoff of 146 cm3. The 5-year OS rate was higher in 245 patients with a SVBSA ≤ 146 cm3 than in 72 patients with a SVBSA > 146 cm3 (95.0% vs. 78.7%, p < 0.001). CONCLUSIONS In patients with HCC, a larger SVBSA was associated with a higher rate of PHLF and worse OS after HR. The SVBSA may be useful in selecting good surgical candidates. KEY POINTS • A significantly higher spleen volume divided by body surface area was observed in patients who experienced post-hepatectomy liver failure than in patients who did not (148 cm3 vs. 112 cm3, p < 0.001). • The area under the receiver operating characteristic curve of spleen volume divided by body surface area to predict the development of post-hepatectomy liver failure was 0.663 (p < 0.001). • Spleen volume divided by body surface area was a significant influencing factor for overall survival (hazard ratio, 3.935; 95% CI, 1.520-10.184; p < 0.001), with the optimal cutoff of 146 cm3.
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Affiliation(s)
- Jae Seok Bae
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Dong Ho Lee
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Jeongin Yoo
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Haeryoung Kim
- Department of Pathology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung Bun Lee
- Department of Pathology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
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Kapoor H, Nisiewicz MJ, Jayavarapu R, Gedaly R, Raissi D. Early Outcomes with Single-antenna High-powered Percutaneous Microwave Ablation for Primary and Secondary Hepatic Malignancies: Safety, Effectiveness, and Predictors of Ablative Failure. J Clin Imaging Sci 2020; 10:10. [PMID: 32257586 PMCID: PMC7110402 DOI: 10.25259/jcis_173_2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 01/29/2020] [Indexed: 02/07/2023] Open
Abstract
Objective: Microwave ablation (MWA) of liver malignancies has gained much traction over the past 5 years. However, MWA carries relatively higher rates of residual disease compared to resection. Likelihood of MWA success is multifactorial and newer devices with more reliable ablation zones are being developed to overcome these drawbacks. This manuscript is a review of our first 100 liver ablations with the newer single antenna high powered MWA system. Materials and Methods: Retrospective chart review of patients that underwent MWA for either primary or secondary hepatic malignancies between March 2015 and July 2016 was conducted. The complete ablation rates, rate of new lesions, complications, and short-term survival were analyzed. Multiple statistical tests, including multivariate regression, were used to assess risk factors for local residual and recurrent disease. Results: Fifty-three patients (median age 61 ± 9 years, 39 males) underwent 100 MWAs. Of the 100 lesions ablated, 76 were hepatocellular cancers (HCCs) and 24 were metastases. Median lesion size was 16 ± 9 mm. Seventy- five of these patients had multifocal disease targeted in the same session. Seventy patients had cirrhosis (median model for end-stage liver disease score 9 ± 3; Child-Pugh B and C in 42%). An 83% complete lesion ablation rate was seen on follow-up imaging with liver protocol magnetic resonance imaging/computed tomography (median follow-up of 1 year). The minor complication rate was 9.4% with no major complications or 30-day mortality. Despite this, evidence of new foci of hepatic disease was found in 47% of patients, the majority (80%) of which were in HCC patients (P < 0.01) and most of these new lesions were in a different hepatic segment (64%). Degree of cirrhosis (P < 0.01), presence of non-alcoholic steatohepatitis (NASH) (P = 0.01) and lesion’s subcapsular location (P = 0.03) was significant predictors of residual disease. With the subset analysis of only HCC lesions larger than 1 cm, only the presence of NASH remained significant. Conclusion: The single probe high power MWA of malignant hepatic lesions is safe and effective with minimal morbidity. Degree of cirrhosis, NASH, and subcapsular location was associated with an increased rate of residual disease on short-term follow-up.
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Affiliation(s)
- Harit Kapoor
- Departments of Radiology, University of Kentucky, Lexington, Kentucky
| | | | - Ravi Jayavarapu
- Departments of Radiology, University of Kentucky, Lexington, Kentucky
| | - Roberto Gedaly
- Departments of Surgery, University of Kentucky, Lexington, Kentucky
| | - Driss Raissi
- Departments of Radiology, University of Kentucky, Lexington, Kentucky
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Non-invasive diagnosis of liver fibrosis: A review of current imaging modalities. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 43:211-221. [PMID: 32089376 DOI: 10.1016/j.gastrohep.2019.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/05/2019] [Accepted: 11/20/2019] [Indexed: 12/18/2022]
Abstract
Hundreds of millions of patients are suffering from cirrhosis and other chronic liver diseases worldwide, and this public health problem continues to grow. It has been proven that liver fibrosis is reversible after the elimination of the etiology, especially in the early stage. Thus, early diagnosis of liver fibrosis is of vital importance for clinical treatment. Liver biopsy remains the gold standard for both diagnosis and staging of fibrosis, but is suboptimal, due in large parts to its invasive nature and sundry associated complications. To overcome this, a number of non-invasive diagnosis based on serum biomarkers or imaging modalities have been developed. While diagnosis based on serum biomarkers is cheaper and more acceptable to patients, almost none developed to date are liver-specific, and may engender a false positive error. The imaging modalities have evolved rapidly and are taking on more and more important roles in the diagnosis of liver fibrosis.
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Komatsu D, Yamada A, Suzuki T, Kurozumi M, Fujinaga Y, Ueda K, Kadoya M. Compartment model analysis of intravenous contrast-enhanced dynamic computed tomography in hepatic hemodynamics: A validation study using intra-arterial contrast-enhanced computed tomography. Hepatol Res 2018; 48:829-838. [PMID: 29476594 DOI: 10.1111/hepr.13073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 02/17/2018] [Accepted: 02/20/2018] [Indexed: 01/24/2023]
Abstract
AIM To verify the utility of the 2-in-1-out-compartment model analysis (CMA) of intravenous contrast-enhanced dynamic computed tomography (IV-CT) for evaluating hepatic arterial and portal venous flow using intra-arterial contrast-enhanced CT (IA-CT). METHODS We retrospectively evaluated 49 consecutive patients who underwent IV-CT and were radiologically or histologically diagnosed as having hepatic malignant lesion (51 classical hepatocellular carcinomas [HCC], 4 early HCC, 3 cholangiolocellular carcinomas, 1 mixed HCC, 3 cholangiocellular carcinomas). As a gold standard for hepatic arterial and portal blood flows, we defined the normalized enhancement in CT values on CTAP (nCTAP) and CTHA (nCTHA). The hepatic arterial (k1a ) and portal venous inflow velocity (k1p ) constants in hepatic lesions and surrounding liver parenchyma were obtained from the CMA of IV-CT with various outflow velocity constant (k2 ) limits using the nonlinear least square method. The correlation coefficient between the normalized enhancement in IA-CT and CMA of IV-CT was statistically evaluated according to various k2 limits. RESULTS The highest mean correlation coefficient between k1a and nCTHA (r = 0.65, P < 0.0001) was observed when k2 ≦0.035. The highest mean correlation coefficient between k1p and nCTAP (r = 0.69, P < 0.0001) was observed when k2 ≦0.045. The decrease in correlation coefficient was significant when the upper k2 limit was lower than 0.03 or higher than 0.07 compared to the best mean correlation coefficient (P < 0.05). CONCLUSION Hepatic arterial and portal venous flows can be evaluated quantitatively to some extent with appropriate outflow velocity constant limits using the CMA of IV-CT.
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Affiliation(s)
- Daisuke Komatsu
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
| | - Akira Yamada
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
| | - Takeshi Suzuki
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
| | - Masahiro Kurozumi
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
| | - Yasunari Fujinaga
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
| | - Kazuhiko Ueda
- Diagnostic Imaging Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masumi Kadoya
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
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