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Fujita N, Ushijima Y, Ishimatsu K, Okamoto D, Wada N, Takao S, Murayama R, Itoyama M, Harada N, Maehara J, Oda Y, Ishigami K, Nishie A. Multiparametric assessment of microvascular invasion in hepatocellular carcinoma using gadoxetic acid-enhanced MRI. Abdom Radiol (NY) 2024:10.1007/s00261-023-04179-3. [PMID: 38360959 DOI: 10.1007/s00261-023-04179-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 02/17/2024]
Abstract
PURPOSE To elucidate how precisely microvascular invasion (MVI) in hepatocellular carcinoma (HCC) can be predicted using multiparametric assessment of gadoxetic acid-enhanced MRI. METHODS In this retrospective single-center study, patients who underwent liver resection or transplantation of HCC were evaluated. Data obtained in patients who underwent liver resection were used as the training set. Nine kinds of MR findings for predicting MVI were compared between HCCs with and without MVI by univariate analysis, followed by multiple logistic regression analysis. Using significant findings, a predictive formula for diagnosing MVI was obtained. The diagnostic performance of the formula was investigated in patients who underwent liver resection (validation set 1) and in patients who underwent liver transplantation (validation set 2) using a receiver operating characteristic curve analysis. The area under the curves (AUCs) of these three groups were compared. RESULTS A total of 345 patients with 356 HCCs were selected for analysis. Tumor diameter (D) (P = 0.021), tumor washout (TW) (P < 0.01), and peritumoral hypointensity in the hepatobiliary phase (PHH) (P < 0.01) were significantly associated with MVI after multivariate analysis. The AUCs for predicting MVI of the predictive formula were as follows: training set, 0.88 (95% confidence interval (CI) 0.82,0.93); validation set 1, 0.81 (95% CI 0.73,0.87); validation set 2, 0.67 (95% CI 0.51,0.80). The AUCs were not significantly different among three groups (training set vs validation set 1; P = 0.15, training set vs validation set 2; P = 0.09, validation set 1 vs validation set 2; P = 0.29, respectively). CONCLUSION Our multiparametric assessment of gadoxetic acid-enhanced MRI performed quite precisely and with good reproducibility for predicting MVI.
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Affiliation(s)
- Nobuhiro Fujita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Yasuhiro Ushijima
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Keisuke Ishimatsu
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Daisuke Okamoto
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Noriaki Wada
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Seiichiro Takao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Ryo Murayama
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masahiro Itoyama
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Junki Maehara
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Akihiro Nishie
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, 903-0125, Japan
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Endo Y, Shinoda M, Maehara J, Hibi T, Hasegawa Y, Obara H, Kitago M, Ojima H, Tanabe M, Kitagawa Y. Early-onset hepatic veno-occlusive disease after liver transplantation: an institutional experience and analysis of a literature-based cohort. Surg Today 2023:10.1007/s00595-023-02770-1. [PMID: 38055106 DOI: 10.1007/s00595-023-02770-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/14/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE Hepatic veno-occlusive disease (HVOD) after liver transplantation (LT) is almost always a fatal complication. We assessed the outcomes of HVOD in a single institute and analyzed a literature-based cohort. METHODS We reviewed the medical records of recipients of LT performed between 1995 and 2020 at our institute and the literature on HVOD after LT. We then analyzed the clinical features based on a "pooled" cohort of cases identified in our institute and reported in the literature. RESULTS HVOD was diagnosed in 3 of 331 LT recipients, all of whom died in hospital, on days 164, 12, and 13, respectively. Our comprehensive review of the literature, as well as our cases, identified eight cases of HVOD that developed within 14 days after LT (early-onset type). Early-onset HVOD had a significantly worse prognosis than HVOD that developed beyond 2 weeks after LT (non-early-onset type), which was identified in 22 cases (25.0% vs. 86.1% of the 3-month graft survival rate). The most common causes of early-onset and non-early-onset types were acute cellular rejection (50%) and drug-induced disease (50%), respectively. CONCLUSION Early-onset HVOD developing within 14 days after LT has a poor prognosis.
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Affiliation(s)
- Yutaka Endo
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Shinoda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
- Digestive Disease Center, Mita Hospital, International University of Health and Welfare, Tokyo, Japan.
| | - Junki Maehara
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Taizo Hibi
- Department of Pediatric Surgery and Transplantation, Kumamoto University School of Medicine, Kumamoto, Japan
| | - Yasushi Hasegawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hidenori Ojima
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Minoru Tanabe
- Department of Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences Advanced Therapeutic Sciences, Hepatobiliary and Pancreatic Surgery, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Nishimuta Y, Tsurumaru D, Kai S, Maehara J, Asayama Y, Oki E, Ishigami K. Extracellular volume fraction determined by equilibrium contrast-enhanced computed tomography: correlation with histopathological findings in gastric cancer. Jpn J Radiol 2023; 41:752-759. [PMID: 36735208 PMCID: PMC10313564 DOI: 10.1007/s11604-023-01393-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/12/2023] [Indexed: 02/04/2023]
Abstract
PURPOSE To assess the relationship between histopathological features of gastric cancer and the extracellular volume fraction (ECV) measured by preoperative equilibrium contrast-enhanced computed tomography (CECT). MATERIALS AND METHODS The study group consisted of 66 patients with surgically resected gastric adenocarcinoma who underwent preoperative multiphasic CECT. Tumor ECVs were calculated using region-of-interest measurements within the gastric cancer and aorta of each case on unenhanced and equilibrium-phase images. The relationship between the mean ECV values and clinicopathological parameters was examined by univariate analysis. Parameters showing a significant difference in the former test were further tested by linear regression and receiver operating characteristic (ROC) curve analyses. RESULTS In the univariate analysis, the values of venous invasion (p = 0.0487) and tumor infiltration (INF) pattern (p < 0.0001) were significantly correlated with the tumor ECV. INF was significantly correlated (β = 0.57, p < 0.0001) in the linear regression analysis. The tumor ECV showed better diagnostic accuracy for predicting INF (INFa/b vs INFc), and the area under the ROC curve value was 0.89. CONCLUSION Tumor ECV determined by equilibrium CECT is significantly correlated with the pathological INF of gastric cancer.
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Affiliation(s)
- Yusuke Nishimuta
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Daisuke Tsurumaru
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Satohiro Kai
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
- Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Junki Maehara
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Yoshiki Asayama
- Department of Radiology, Faculty of Medicine, Oita University, Yufu City, Oita, 879-5593, Japan
| | - Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
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Yamashita K, Sugimori H, Nakamizo A, Amano T, Kuwashiro T, Watanabe T, Kawamata K, Furuya K, Harada S, Kamei R, Maehara J, Okada Y, Noguchi T. Different hemodynamics of basal ganglia between moyamoya and non-moyamoya diseases using intravoxel incoherent motion imaging and single-photon emission computed tomography. Acta Radiol 2023; 64:769-775. [PMID: 35466686 DOI: 10.1177/02841851221092895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Moyamoya disease (MMD) and non-MMD have different pathogenesis, clinical presentation, and treatment policy. PURPOSE To identify differences in hemodynamics between MMD and non-MMD using intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT). MATERIAL AND METHODS Patients who had undergone 99mTc-ECD or 123I-IMP SPECT, and IVIM imaging were retrospectively studied. IVIM imaging was acquired using six different b-values. Cerebral blood flow ratio (CBFR) in the basal ganglia was calculated using a standardized volume-of-interest template. The cerebellum was used as a reference region. IVIM perfusion fraction (f) was obtained using a two-step fitting algorithm. Elliptical regions of interest were placed in bilateral basal ganglia on the IVIM f map. Patients were classified into MMD and non-MMD groups. The correlation between CBFR and mean IVIM f (fmean) in the basal ganglia was evaluated using Spearman's rank correlation coefficient. RESULTS In total, 20 patients with MMD and 28 non-MMD patients were analyzed. No significant differences in fmean were observed among MMD, affected hemisphere with non-MMD (non-MMDaff), and unaffected hemispheres with non-MMD (non-MMDunaff). A negative correlation was seen between fmean and CBFR in the MMD group (r = -0.40, P = 0.0108), but not in the non-MMD group (non-MMDaff, r = 0.07, P = 0.69; non-MMDunaff, r = -0.22, P = 0.29). No significant differences were found among MMD and non-MMD patients, irrespective of SPECT tracers. CONCLUSION The combination of IVIM MRI and SPECT appears to allow non-invasive identification of differences in hemodynamics between MMD and non-MMD.
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Affiliation(s)
- Koji Yamashita
- Department of Radiology, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hiroshi Sugimori
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Akira Nakamizo
- Department of Neurosurgery, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Toshiyuki Amano
- Department of Neurosurgery, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Takahiro Kuwashiro
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Takeharu Watanabe
- Department of Medical Technology, Division of Radiology, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Keisuke Kawamata
- Department of Medical Technology, Division of Radiology, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Kiyomi Furuya
- Department of Radiology, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Shino Harada
- Department of Radiology, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Ryotaro Kamei
- Department of Radiology, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Junki Maehara
- Department of Radiology, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yasushi Okada
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Tomoyuki Noguchi
- Department of Radiology, Clinical Research Institute, 37085National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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Abstract
A narrative review regarding percutaneous vertebroplasty (PVP) for osteoporotic vertebral fracture (OVF) is provided herein, addressing the epidemic of OVF in Japan, the latest response to the criticism of PVP for OVFs, the indications and potential risks of PVP for OVFs, and a future perspective for PVP. Each year in Japan, approximately 32,000 patients aged 55 years or older suffer from chronic low back pain for several months to several years due to a compression fracture. PVP is one of the surgical treatments for an OVF, and it is less invasive compared to the traditional open surgery. PVP is suitable for OVF patients who have difficulty walking as assessed by the modified Yokoyama's activities of daily living (ADL) scoring system, and for patients with Kummell's disease diagnosed by CT and MRI examinations. Serious adverse events related to PVP occur in 1.1-3.3% of the cases, but direct deaths from PVP are extremely rare at less than 1%. Recent studies demonstrated that OVF patients treated with PVP are less likely to die after the treatment than non-surgically treated patients, which conflicts with the Cochran reviews' conclusion not supporting PVP for OVFs. Novel robotic systems and procedure-support devices are being developed, providing a next step toward fully automated PVP procedures.
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Affiliation(s)
- Tomoyuki Noguchi
- Department of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, 810-8563, Japan.
- Department of Clinical Research, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, 810-8563, Japan.
- Education and Training Office, Department of Clinical Research, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Koji Yamashita
- Department of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, 810-8563, Japan
| | - Ryotaro Kamei
- Department of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, 810-8563, Japan
| | - Junki Maehara
- Department of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, 810-8563, Japan
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Yamashita K, Kamei R, Sugimori H, Kuwashiro T, Tokunaga S, Kawamata K, Furuya K, Harada S, Maehara J, Okada Y, Noguchi T. Interobserver Reliability on Intravoxel Incoherent Motion Imaging in Patients with Acute Ischemic Stroke. AJNR Am J Neuroradiol 2022; 43:696-700. [PMID: 35450854 PMCID: PMC9089262 DOI: 10.3174/ajnr.a7486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/11/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Noninvasive perfusion-weighted imaging with short scanning time could be advantageous in order to determine presumed penumbral regions and subsequent treatment strategy for acute ischemic stroke (AIS). Our aim was to evaluate interobserver agreement and the clinical utility of intravoxel incoherent motion MR imaging in patients with acute ischemic stroke. MATERIALS AND METHODS We retrospectively studied 29 patients with AIS (17 men, 12 women; mean age, 75.2 [SD, 12.0 ] years; median, 77 years). Each patient underwent intravoxel incoherent motion MR imaging using a 1.5T MR imaging scanner. Diffusion-sensitizing gradients were applied sequentially in the x, y, and z directions with 6 different b-values (0, 50, 100, 150, 200, and 1000 seconds/mm2). From the intravoxel incoherent motion MR imaging data, diffusion coefficient, perfusion fraction, and pseudodiffusion coefficient maps were obtained using a 2-step fitting algorithm based on the Levenberg-Marquardt method. The presence of decreases in the intravoxel incoherent motion perfusion fraction and pseudodiffusion coefficient values compared with the contralateral normal-appearing brain was graded on a 2-point scale by 2 independent neuroradiologists. Interobserver agreement on the rating scale was evaluated using the κ statistic. Clinical characteristics of patients with a nondecreased intravoxel incoherent motion perfusion fraction and/or pseudodiffusion coefficient rated by the 2 observers were also assessed. RESULTS Interobserver agreement was shown for the intravoxel incoherent motion perfusion fraction (κ = 0.854) and pseudodiffusion coefficient (κ = 0.789) maps, which indicated almost perfect and substantial agreement, respectively. Patients with a nondecreased intravoxel incoherent motion perfusion fraction tended to show recanalization of the occluded intracranial arteries more frequently than patients with a decreased intravoxel incoherent motion perfusion fraction. CONCLUSIONS Intravoxel incoherent motion MR imaging could be performed in < 1 minute in addition to routine DWI. Intravoxel incoherent motion parameters noninvasively provide feasible, qualitative perfusion-related information for assessing patients with acute ischemic stroke.
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Affiliation(s)
- K Yamashita
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
| | - R Kamei
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
| | - H Sugimori
- Cerebrovascular Medicine and Neurology (H.S., T.K., Y.O.)
| | - T Kuwashiro
- Cerebrovascular Medicine and Neurology (H.S., T.K., Y.O.)
| | - S Tokunaga
- Neuroendovascular Therapy (S.T.), Clinical Research Institute
| | - K Kawamata
- Medical Technology (K.K.), Division of Radiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - K Furuya
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
| | - S Harada
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
| | - J Maehara
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
| | - Y Okada
- Cerebrovascular Medicine and Neurology (H.S., T.K., Y.O.)
| | - T Noguchi
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
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Takayama Y, Nishie A, Ishimatsu K, Ushijima Y, Fujita N, Kubo Y, Yoshizumi T, Kouhashi KI, Maehara J, Akamine Y, Ishigami K. Diagnostic potential of T1ρ and T2 relaxations in assessing the severity of liver fibrosis and necro-inflammation. Magn Reson Imaging 2022; 87:104-112. [PMID: 34999164 DOI: 10.1016/j.mri.2022.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE To investigate the utility of T1ρ and T2 relaxations for assessing the severity of liver fibrosis (F stage) and necro-inflammation (A stage) in patients with chronic liver disease (CLD). MATERIALS AND METHODS We calculated T1ρ and T2 relaxations of the liver parenchyma in 82 patients who underwent liver surgery. F and A stages of enrolled patients were assessed by referring to surgically resected specimens. The relationships between T1ρ or T2 relaxation and F or A stage were assessed using one-way analysis of variance followed by Tukey's multiple comparison test, Spearman's rank correlation test and a receiver operating characteristic analysis. RESULTS The T1ρ and T2 values of the liver parenchyma were significantly increased as the F and A stages progressed. The T1ρ and T2 values showed significant differences between F0 and F4, between F1 and F4, and between F2 and F4. In addition, T1ρ values showed a significant difference between F0 and F3 as well. The highest diagnostic ability for fibrosis was obtained when differentiating ≥F3 from ≤F2 using T1ρ: the sensitivity was 82.8%, the specificity 79.2% and the area under the curve (AUC) 0.87. The sensitivity and AUC of T1ρ relaxation (46.9% and 0.67) were significantly higher than those of T2 relaxation (29.7% and 0.60) for differentiating ≥A1 from A0. CONCLUSION T1ρ and T2 relaxations have potential as a biochemical marker for assessing the severity of liver fibrosis and necro-inflammation. T1ρ relaxation may be slightly superior to T2 relaxation in terms of diagnostic ability for liver fibrosis and necro-inflammation.
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Affiliation(s)
- Yukihisa Takayama
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Radiology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Akihiro Nishie
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Keisuke Ishimatsu
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yasuhiro Ushijima
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Nobuhiro Fujita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yuichiro Kubo
- Department of Molecular Imaging and Diagnostic Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Ken-Ichi Kouhashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Junki Maehara
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yuta Akamine
- Philips Japan. Ltd., Konan 2-13-37, Minato-ku, Tokyo 108-8507, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Morita K, Nishie A, Ushijima Y, Takayama Y, Fujita N, Kubo Y, Ishimatsu K, Yoshizumi T, Maehara J, Ishigami K. Noninvasive assessment of liver fibrosis by dual-layer spectral detector CT. Eur J Radiol 2021; 136:109575. [PMID: 33548853 DOI: 10.1016/j.ejrad.2021.109575] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/08/2021] [Accepted: 01/25/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE To elucidate the diagnostic ability of liver fibrosis using (1) liver parenchymal iodine density on equilibrium computed tomographic imaging and (2) extracellular volume (ECV) measured by dual-layer spectral detector CT. METHODS From April 2018 to June 2019, 68 patients [mean age, 62 years; 39 males, 29 females] underwent dynamic contrast-enhanced CT by a dual-layer spectral detector CT system before liver transplantation or liver resection. The iodine densities of liver parenchyma (I liver) and aorta (I aorta) were independently measured by two radiologists at the equilibrium phase. The iodine-density ratio (I-ratio) (I liver/ I aorta) and the CT-ECV were calculated. Spearman's rank correlation coefficient was used to analyze the relationship between the I-ratio or the CT-ECV and the fibrosis stage. A receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of the I-ratio and the CT-ECV for discriminating fibrosis stages. RESULTS For both readers, the I-ratio and the CT-ECV increased significantly as the fibrosis stage advanced (I-ratio: rho = 0.380 and 0.443, p < 0.01; CT-ECV: rho = 0.423 and 0.469, p < 0.01). The CT-ECV showed better diagnostic accuracy for staging fibrosis, and the area under the ROC curve values for discriminating F4 stage were 0.884 and 0.925. The two readers' cutoff values of the CT-ECV for diagnosing fibrosis as F4 were 26.2 % and 29.3 %, with 95.0 % and 90.0 % sensitivity and 72.9 % and 85.4 % specificity, respectively. CONCLUSION The liver parenchymal iodine density on the equilibrium phase and the CT-ECV can be useful for predicting a high stage of liver fibrosis.
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Affiliation(s)
- Koichiro Morita
- Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Akihiro Nishie
- Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yasuhiro Ushijima
- Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yukihisa Takayama
- Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Nobuhiro Fujita
- Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yuichiro Kubo
- Departments of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Keisuke Ishimatsu
- Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Tomoharu Yoshizumi
- Departments of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Junki Maehara
- Departments of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Kousei Ishigami
- Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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9
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Maehara J, Masugi Y, Abe T, Tsujikawa H, Kurebayashi Y, Ueno A, Ojima H, Okuda S, Jinzaki M, Shinoda M, Kitagawa Y, Oda Y, Honda H, Sakamoto M. Quantification of intratumoral collagen and elastin fibers within hepatocellular carcinoma tissues finds correlations with clinico-patho-radiological features. Hepatol Res 2020; 50:607-619. [PMID: 31886596 DOI: 10.1111/hepr.13484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/24/2019] [Accepted: 12/26/2019] [Indexed: 02/08/2023]
Abstract
AIM Emerging evidence suggests a promising role for tumor stromal factors in characterizing patients with various types of malignancies, including hepatocellular carcinoma (HCC). We quantified the amount of collagen and elastin fibers in HCC samples with the aim of clarifying the clinico-patho-radiological significance of fiber deposition in HCC. METHODS We computed the amount of collagen and elastin fibers using digital image analysis of whole-slide images of Elastica van Gieson-stained tissues from 156 surgically resected HCCs. Furthermore, we assessed the correlations between the fiber content of HCC samples and clinical, pathological, and radiological features, including immunohistochemistry-based molecular subtypes and immunosubtypes. RESULTS The intratumoral area ratio of collagen in HCC tissues (median 3.4%, range 0.1-22.2%) was more than threefold that of elastin (median 0.9%, range 0.1-9.0%); there was a strong positive correlation between the amounts of collagen and elastin. Higher levels of combined collagen and elastin were significantly associated with the confluent multinodular macroscopic tumor type, the absence of a fibrous capsule, intratumoral steatosis, scirrhous tumor stroma, dense inflammatory-cell infiltrates, and the biliary/stem cell markers-positive HCC subtype. The associations of higher collagen levels with radiological findings, including heterogeneous enhancement and persistent enhancement on dynamic computed tomography, were significant. In contrast, the associations of radiological findings with elastin fibers were not significant. Intratumoral fibrous stroma in HCC comprised septum-like and perisinusoidal fibrosis; these two forms represented distinct distribution patterns of fibers and fibroblasts. CONCLUSION Quantitative analysis suggested that stromal fiber-rich HCCs likely represent a distinct clinico-patho-radiological entity.
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Affiliation(s)
- Junki Maehara
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan.,Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yohei Masugi
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Tokiya Abe
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Hanako Tsujikawa
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Yutaka Kurebayashi
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Akihisa Ueno
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Hidenori Ojima
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Shigeo Okuda
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Shinoda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michiie Sakamoto
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
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10
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Ogawa T, Miyata J, Maehara J, Inoue T, Betsuyaku T. Fatal Airway Inflammation Induced by Pembrolizumab in a Patient With NSCLC. J Thorac Oncol 2020; 14:e9-e10. [PMID: 30579555 DOI: 10.1016/j.jtho.2018.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/02/2018] [Accepted: 09/03/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Takunori Ogawa
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan; Department of Respiratory Medicine, Sano Kosei General Hospital, Sano, Tochigi, Japan
| | - Jun Miyata
- Department of Respiratory Medicine, Sano Kosei General Hospital, Sano, Tochigi, Japan; Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
| | - Junki Maehara
- Department of Pathology, Sano Kosei General Hospital, Sano, Tochigi, Japan
| | - Takashi Inoue
- Department of Respiratory Medicine, Sano Kosei General Hospital, Sano, Tochigi, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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11
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Kurebayashi Y, Ojima H, Tsujikawa H, Kubota N, Maehara J, Abe Y, Kitago M, Shinoda M, Kitagawa Y, Sakamoto M. Landscape of immune microenvironment in hepatocellular carcinoma and its additional impact on histological and molecular classification. Hepatology 2018; 68:1025-1041. [PMID: 29603348 DOI: 10.1002/hep.29904] [Citation(s) in RCA: 287] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 03/17/2018] [Accepted: 03/25/2018] [Indexed: 12/12/2022]
Abstract
UNLABELLED Immune cells constitute an important element of tumor tissue. Accumulating evidence indicates their clinicopathological significance in predicting prognosis and therapeutic efficacy. Nonetheless, the combinations of immune cells forming the immune microenvironment and their association with histological findings remain largely unknown. Moreover, it is unclear which immune cells or immune microenvironments are the most prognostically significant. Here, we comprehensively analyzed the immune microenvironment and its intratumor heterogeneity in 919 regions of 158 hepatocellular carcinomas (HCCs), and the results were compared with the corresponding histological and prognostic data. Consequently, we classified the immune microenvironment of HCC into three distinct immunosubtypes: Immune-high, Immune-mid, and Immune-low. The Immune-high subtype was characterized by increased B-/plasma-cell and T cell infiltration, and the Immune-high subtype and B-cell infiltration were identified as independent positive prognostic factors. Varying degrees of intratumor heterogeneity of the immune microenvironment were observed, some of which reflected the multistep nature of HCC carcinogenesis. However, the predominant pattern of immunosubtype and immune cell infiltration of each tumor was prognostically important. Of note, the Immune-high subtype was associated with poorly differentiated HCC, cytokeratin 19 (CK19)+ , and/or Sal-like protein 4 (SALL4)+ high-grade HCC, and Hoshida's S1/Boyault's G2 subclasses. Furthermore, patients with high-grade HCC of the predominant Immune-high subtype had significantly better prognosis. These results provide a rationale for evaluating the immune microenvironment in addition to the usual histological/molecular classification of HCC. CONCLUSION The immune microenvironment of HCC can be classified into three immunosubtypes (Immune-high, Immune-mid, and Immune-low) with additional prognostic impact on histological and molecular classification of HCC. (Hepatology 2018).
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Affiliation(s)
- Yutaka Kurebayashi
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Hidenori Ojima
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Hanako Tsujikawa
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Naoto Kubota
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Junki Maehara
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan.,Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuta Abe
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Shinoda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Michiie Sakamoto
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
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12
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Maehara J, Nishie A, Asayama Y, Ishigami K, Ushijima Y, Takayama Y, Okamoto D, Fujita N, Sugimoto M, Inokuchi J, Honda H. Tumor Enhancement on Dynamic CT: A Predictive Factor for Recurrence After Nephrectomy in Localized T1 Clear Cell Renal Cell Carcinoma. Anticancer Res 2018; 38:2377-2383. [PMID: 29599364 DOI: 10.21873/anticanres.12486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 11/10/2022]
Abstract
AIM To investigate whether radiological parameters obtained on dynamic computed tomography (CT), especially those related to tumor enhancement, are predictive factors for recurrence after nephrectomy in localized stage T1 clear cell renal cell carcinoma (ccRCC). MATERIALS AND METHODS We retrospectively studied 88 patients with localized stage T1 ccRCC who underwent dynamic CT preoperatively. Seven patients had recurrent disease after surgery. Tumor attenuations were measured by placing a region of interest in the solid region. TApre and TAneph were defined as the tumor attenuation values of the pre-contrast and nephrographic phase, respectively. The correlations between disease-free survival and clinicopathological factors, including the radiological parameter TAneph - TApre (ΔTAneph), were analyzed by Cox proportional hazards model or Kaplan-Meier method with the log-rank test. RESULTS Only ΔTAneph was significantly and positively correlated with disease-free survival (p<0.05). Tumor size also tended to be negatively correlated with disease-free survival (p<0.1). The 5- and 10-year disease-free survival rates of the group with high ΔTAneph (≥86 HU) were 97.4% and 97.4%, while those of the group with low ΔTAneph (<86 HU) were 89.6% and 71.6%, respectively. CONCLUSION Tumor enhancement in the nephrographic phase of CT was a predictive factor for recurrence after nephrectomy in patients with localized stage T1 ccRCC.
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Affiliation(s)
- Junki Maehara
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akihiro Nishie
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshiki Asayama
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuhiro Ushijima
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukihisa Takayama
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Okamoto
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuhiro Fujita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaaki Sugimoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Junichi Inokuchi
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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13
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Yamashita K, Hiwatashi A, Togao O, Kondo M, Kikuchi K, Inoguchi T, Maehara J, Kyuragi Y, Honda H. Additive value of "otosclerosis-weighted" images for the CT diagnosis of fenestral otosclerosis. Acta Radiol 2017; 58:1215-1221. [PMID: 28090791 DOI: 10.1177/0284185116687172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Otosclerotic foci are usually seen as minute low-density lesions and this may be attributed to relatively low sensitivity on visual assessment using computed tomography (CT). Otosclerotic foci can be detected by using the accurate region of interest (ROI) setting, while small ROI settings by less-experienced radiologists may result in false negative findings. Purpose To evaluate the diagnostic ability of our proposed method ("otosclerosis-weighted" imaging [OWI]), which is based on reversing the density, compared with conventional CT (CCT) imaging alone. Material and Methods Temporal bone CTs of consecutive patients with otosclerosis were analyzed. Gender- and age-matched control participants were also included. All CT images were obtained using a 64-detector row scanner. OWI was obtained by extracting the temporal bone region using the threshold technique and reversing the density (black to white). Four independent radiologists took part in two reading sessions. In the first session, the observers read only CCT imaging. In the second session, they read OWI along with the CCT imaging. Sensitivity was assessed for the four readers. Results Thirty temporal bones of 25 patients with otosclerosis (3 men, 22 women; mean age, 53.9 ± 9.0 years) and 30 temporal bones of 30 control participants (4 men, 26 women; mean age, 44.0 ± 16.2 years) were included. For all observers, reading with a combination of the two methods was associated with a higher sensitivity (63.3-80.0%) than with conventional CT images alone (30.0-60.0%; P < 0.05, each). Conclusion Application of our proposed method based on threshold value may help detect foci of fenestral otosclerosis.
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Affiliation(s)
- Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akio Hiwatashi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masatoshi Kondo
- Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takashi Inoguchi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Junki Maehara
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Kyuragi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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14
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Maehara J, Yamashita K, Hiwatashi A, Togao O, Kikuchi K, Matsumoto Y, Iura K, Oda Y, Ichino I, Nakamoto Y, Honda H. Primary phosphaturic mesenchymal tumour of the lumbar spine: utility of 68Ga-DOTATOC PET/CT findings. BJR Case Rep 2016; 2:20150497. [PMID: 30460030 PMCID: PMC6243314 DOI: 10.1259/bjrcr.20150497] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 05/04/2016] [Accepted: 05/17/2016] [Indexed: 11/20/2022] Open
Abstract
Primary phosphaturic mesenchymal tumours (PMTs) frequently occur in the soft tissue or bone, but rarely in the spine. The majority of patients experience long-term ostalgia and recurrent fractures. Detection of PMT can be challenging, but the clinical symptoms dramatically improve after removal of the tumour.Wepresent a case of primary PMT in the lumbar spine. CT scan showed a low-density tumour with a well-defined sclerotic margin in the L5 vertebra. MRI revealed a hypointense tumour on T2 weighted imaging and heterogeneous enhancement. 68Ga-labelled 1,4,7,10-tetraazacyclododecane-N,N′,N″, N‴-tetraacetic acid-D-Phe1-Tyr3-octreotide (68Ga-DOTATOC) positron emission tomography/CT scan demonstrated intense focal uptake within the tumour. Histologically, proliferation of oval to short spindle-shaped cells with fibrocollagenous stroma, abundant various-sized vessels, microcysts and thickened anastomosed bone trabeculae were seen. Mitotic figures were rarely seen. Immunohistochemically, the tumour cells were focally positive for fibroblast growth factor 23. The imaging findings in the current case are in accordance with the histological features. Among them, 68Ga-DOTATOC positron emission tomography/CT scan for somatostatin receptor imaging provides valuable information for determining PMT localization and characterization.
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Affiliation(s)
- Junki Maehara
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akio Hiwatashi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kunio Iura
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Isao Ichino
- Department of Internal Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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15
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Saitoh C, Momose K, Tanaka H, Sato S, Taguchi K, Saitoh M, Maehara J, Asano M, Usuda S. Pharmacological profile of nicardipine hydrochloride in anesthetized dogs with acute heart failure. Part 1: Hemodynamic effects in normal dogs and dogs with acute heart failure. Arzneimittelforschung 1998; 48:125-32. [PMID: 9541721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardiovascular effects of nicardipine hydrochloride (NIC, CAS 54527-84-3, Perdipine), a calcium channel blocker, were investigated in anesthetized normal dogs and dogs with acute heart failure (AHF), and compared with those of nitroglycerin (NTG). In open-chest anesthetized dogs, NIC (0.1-10 micrograms/kg/min i.v.) dose-dependently increased cardiac output (CO) and coronary blood flow as well as decreased mean blood pressure (MBP). NIC had no effect on heart rate (HR) or maximum rate of rise of left ventricular pressure (max. dp/dt). In contrast (0.1-10 micrograms/kg/min i.v.) decreased MBP, but did not change the other cardiovascular parameters. NIC and NTG did not prolong PQ, QRS or QTc intervals. In addition, NIC was effective in the presence of dobutamine. In the anesthetized dog model of ischemic AHF induced by coronary ligation, and ischemia/angiotensin II-induced AHF, NIC (1 and 3 micrograms/kg/min i.v.) increased CO and stroke volume, and reduced total peripheral resistance without decreasing HR or cardiac contractility. Furthermore, in the ischemia/angiotension II-induced AHF model, NIC decreased left ventricular end-diastolic pressure (LVEDP). In contrast, NTG (1-10 micrograms/kg/min i.v.) decreased LVEDP in both AHF models; but did not increase CO. These results suggest that NIC improves hemodynamics in dogs with AHF mainly by reducing afterload without adversely affecting the cardiac contractility or conduction system, while NTG exerts its effect on AHF by reducing preload. NIC injection would thus appear to be beneficial in the treatment of AHF.
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Affiliation(s)
- C Saitoh
- Applied Pharmacology Laboratories, Yamanouchi Pharmaceutical Co., Ltd., Ibaraki, Japan
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16
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Saitoh C, Momose K, Tanaka H, Sato S, Taguchi K, Saitoh M, Maehara J, Asano M, Usuda S. Pharmacological profile of nicardipine hydrochloride in anesthetized dogs with acute heart failure. Part 2: Effect on myocardial metabolism. Arzneimittelforschung 1998; 48:133-7. [PMID: 9541722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The effect of nicardipine hydrochloride (NIC, CAS 54527-84-3, Perdipine) on myocardial metabolism was investigated in an experimental model of ischemic acute heart failure (AHF) induced by coronary ligation in anesthetized dogs. The left anterior descending and/or circumflex coronary ligation decreased coronary sinus blood flow (CBF), maximum rate of rise of left ventricular pressure (max. dp/dt), cardiac output (CO) and stroke volume (SV), and increased left ventricular end-diastolic pressure, indicating the development of AHF. In this ischemic AHF model, NIC (3 micrograms/kg/min i.v. infusion for 15 min) increased CBF, CO and SV, and reduced systemic and coronary artery resistances, resulting in the improvement of AHF. During the effective period, NIC decreased myocardial oxygen consumption and the coronary arterio-venous difference of oxygen content, carbon dioxide pressure and pH. At the same time, NIC did not decrease the lactate extraction. These results suggest that NIC improves hemodynamics and the balance of myocardium oxygen supply and demand in dogs with AHF by means of reducing afterload and dilating coronary artery.
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Affiliation(s)
- C Saitoh
- Applied Pharmacology Laboratories, Yamanouchi Pharmaceutical Co., Ltd., Tokyo, Japan
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17
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Utoguchi N, Watanabe Y, Suzuki T, Maehara J, Matsumoto Y, Matsumoto M. Carrier-mediated transport of monocarboxylic acids in primary cultured epithelial cells from rabbit oral mucosa. Pharm Res 1997; 14:320-4. [PMID: 9098874 DOI: 10.1023/a:1012046021028] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Using primary cultured rabbit oral mucosal epithelial cells (ROEpi), we investigated whether carrier-mediated drug absorption via the oral mucosal route occurs. METHODS Oral mucosal epithelial cells were isolated from rabbit buccal mucosa and cultured on tissue culture plates. When the cells reached confluence, drug uptake experiments were performed. [14C]Benzoic acid or [14C]acetic acid was used as a marker for monocarboxylic acid carrier-mediated transport. RESULTS The uptake of [14C]benzoic acid by ROEpi occurred at a much lower rate at 4 degrees C than at 37 degrees C. The metabolic inhibitors, sodium azide and 2,4-dinitrophenol, significantly inhibited the uptake of [14C]benzoic acid by ROEpi. Various monocarboxylic acids inhibited the uptake of [14C]benzoic acid or [14C]acetic acid by ROEpi, whereas dicarboxylic acids did not affect the uptake. Kinetic analysis using Lineweaver-Burk plots revealed that acetic acid competitively inhibited the uptake of [14C]benzoic acid, and benzoic acid competitively inhibited the uptake of [14C]acetic acid by ROEpi. CONCLUSIONS There exists a carrier-mediated transport system for monocarboxylic acids in oral mucosal epithelial cells.
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Affiliation(s)
- N Utoguchi
- Department of Pharmaceutics, Showa College of Pharmaceutical Sciences, Tokyo, Japan
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