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Aiga K, Kometani M, Karashima S, Konishi S, Higashitani T, Aono D, Mai X, Usukura M, Asano T, Wakayama A, Noda Y, Koda W, Minami T, Kobayashi S, Murayama T, Yoneda T. A clinical assessment of portable point-of-care testing for quick cortisol assay during adrenal vein sampling. Sci Rep 2023; 13:22429. [PMID: 38104216 PMCID: PMC10725449 DOI: 10.1038/s41598-023-49808-5] [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: 07/18/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023] Open
Abstract
This study assessed the clinical performance of point-of-care testing (POCT) for quick cortisol assay (QCA) during adrenal vein sampling (AVS) using a newly invented portable quantitative assay instrument. An observational study was conducted prospectively at two centres in Japan. Forty-eight patients with primary aldosteronism considered for adrenalectomy were enrolled in this study and underwent AVS. Three basal adrenal vein samples from each adrenal vein and two from the inferior vena cava were collected sequentially. The cortisol concentration of adrenal vein samples was measured by routine method and QCA. A total of 338 adrenal vein samples were analysed from 250 sites to determine AVS success or failure. The distribution of turnaround time of the QCA for AVS success or failure followed a normal distribution with an average of 20.5 min. A positive correlation between the routine method and QCA was observed regarding cortisol concentration or selectivity index. No significant difference between the two methods was observed regarding the success rate of AVS. Using the routine method as a reference, the sensitivity and specificity of AVS success or failure were 99.1% (210/212) and 81.6% (31/38), respectively. Easy, quick, portable, and precise POCT-QCA demonstrated its compatibility with routine methods regarding clinical performance.
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Affiliation(s)
- Ko Aiga
- Department of Health Promotion and Medicine of Future, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, 920-8641, Japan
| | - Mitsuhiro Kometani
- Department of Health Promotion and Medicine of Future, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Shigehiro Karashima
- Department of Health Promotion and Medicine of Future, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, 920-8641, Japan
| | - Seigo Konishi
- Department of Health Promotion and Medicine of Future, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takuya Higashitani
- Department of Health Promotion and Medicine of Future, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, 920-8641, Japan
| | - Daisuke Aono
- Department of Health Promotion and Medicine of Future, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, 920-8641, Japan
| | - Xurong Mai
- Department of Health Promotion and Medicine of Future, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, 920-8641, Japan
| | - Mikiya Usukura
- Department of Internal Medicine, Houju Memorial Hospital, Nomi, Ishikawa, 923-1226, Japan
| | - Takahiro Asano
- Department of Internal Medicine, Houju Memorial Hospital, Nomi, Ishikawa, 923-1226, Japan
| | - Ayako Wakayama
- Department of Internal Medicine, Houju Memorial Hospital, Nomi, Ishikawa, 923-1226, Japan
| | - Yuko Noda
- Department of Health Promotion and Medicine of Future, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, 920-8641, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, 920-8641, Japan
| | - Tetsuya Minami
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, 920-8641, Japan
| | - Satoshi Kobayashi
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, 920-8641, Japan
| | - Toshinori Murayama
- Innovative Clinical Research Center, Kanazawa University, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takashi Yoneda
- Department of Health Promotion and Medicine of Future, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, 920-8641, Japan
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Kitao A, Matsui O, Zhang Y, Ogi T, Nakada S, Sato Y, Harada K, Yoneda N, Kozaka K, Inoue D, Yoshida K, Koda W, Yamashita T, Yamashita T, Kaneko S, Kobayashi S, Gabata T. Dynamic CT and Gadoxetic Acid-enhanced MRI Characteristics of P53-mutated Hepatocellular Carcinoma. Radiology 2023; 306:e220531. [PMID: 36219111 DOI: 10.1148/radiol.220531] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background Imaging markers of hepatocellular carcinoma (HCC) on the basis of molecular classification are important for predicting malignancy grade and prognosis. P53-mutated HCC is a major aggressive subtype; however, its imaging characteristics have not been clarified. Purpose To clarify the imaging characteristics of P53-mutated HCC at dynamic CT and gadoxetic acid-enhanced MRI that are correlated with its clinical features, pathologic findings, and prognosis. Materials and Methods In this retrospective single-center study, patients with surgically resected HCC between January 2015 and May 2018 in a university hospital were evaluated. HCC was classified into P53-mutated HCC and non-P53-mutated HCC using immunostaining. Dynamic CT and gadoxetic acid-enhanced MRI findings, clinical features, pathologic findings, and prognosis were compared using Mann-Whitney test, χ2 test, multivariable regression analysis, receiver operating characteristic analysis, Kaplan-Meier method, and log-rank test. Immunohistochemical expression of P53, organic anion transporting polypeptide 1B3 (OATP1B3), and CD34 were evaluated, and the correlations were analyzed using the Pearson correlation test. Results In total, 149 patients (mean age, 67 years ± 9 [SD]; 103 men) with 173 HCCs were evaluated. P53-mutated HCC (n = 28) demonstrated higher serum α-fetoprotein (median, 127.5 ng/mL vs 5.5 ng/mL; P < .001), larger size (40.4 mm ± 29.7 vs 26.4 mm ± 20.5; P = .001), and higher rates of poorly differentiated HCC (22 of 28 [79%] vs 24 of 145 [17%]; P < .001). Dilated vasculature in the arterial phase of dynamic CT (odds ratio, 14; 95% CI: 3, 80; P = .002) and a lower relative enhancement ratio in the hepatobiliary phase (odds ratio, 0.05; 95% CI: 0.01, 0.34; cutoff value, 0.69; P = .002) independently predicted P53-mutated HCC. OATP1B3 expression and P53 expression were inversely correlated (P = .002; R = -0.24). Five-year overall survival was worse for P53-mutated HCC (50.0% vs 72.6%; P = .02). Conclusion Dilated vasculature at the arterial phase of dynamic CT and a lower relative enhancement ratio at the hepatobiliary phase of gadoxetic acid-enhanced MRI were useful markers for P53-mutated hepatocellular carcinoma with poor prognosis. © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Azusa Kitao
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Osamu Matsui
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Yu Zhang
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Takahiro Ogi
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Satoko Nakada
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Yasunori Sato
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Kenichi Harada
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Norihide Yoneda
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Kazuto Kozaka
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Dai Inoue
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Kotaro Yoshida
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Wataru Koda
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Taro Yamashita
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Tatsuya Yamashita
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Shuichi Kaneko
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Satoshi Kobayashi
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Toshifumi Gabata
- From the Departments of Radiology (A.K., O.M., Y.Z., T.O., N.Y., K.K., D.I., K.Y., W.K., T.G.), Pathology (S.N., Y.S., K.H.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S. Kaneko), and Quantum Medical Technology (S. Kobayashi), Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
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Okumura K, Kobayashi S, Ogi T, Sugiura T, Zhang Y, Kanatani M, Yoneda N, Kitao A, Kozaka K, Gabata T, Koda W. Transcatheter arterial embolization of iatrogenic massive arterioportal fistula in the liver. Acta Radiol 2022; 63:867-876. [PMID: 34121466 DOI: 10.1177/02841851211023995] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Massive arterioportal fistula (APF) is naturally irreversible and can induce portal hypertension and portal vein thrombosis (PVT), worsening survival outcomes. PURPOSE To evaluate the clinical course and details of transarterial embolization (TAE) procedures for massive APF. MATERIAL AND METHODS This retrospective single-center observational study evaluated the time until embolization after puncture, imaging, embolization methods, and laboratory data of 10 consecutive patients who were diagnosed with massive APF after puncture and underwent TAE at our hospital from 1 April 2012 to 30 September 2019. RESULTS Out of 10 cases, eight demonstrated a simple type and the other two cases a complex network type on the digital subtraction angiography pattern of massive APF. In two simple-type cases for which re-embolization was required, other subsegmental branches were embolized. The two cases showing a complex network type had been embolized via not only the subsegmental branch, but also the extrahepatic and multiple subsegmental branches. Child-Pugh scores were improved in eight of the ten cases. PVT was seen in six cases before embolization, but disappeared after embolization in all cases, despite the fact that three cases had not received anticoagulant therapy. Six cases had digestive varices before embolization, suggesting portal hypertension, and two of the six cases with esophageal varices and one with gastric varices decreased after embolization. CONCLUSION TAE for massive APF contributed to the improvement of hepatic reserve, the disappearance of PVT, and the improvement of portal hypertension; however, embolization of multiple branches may still be required in some cases.
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Affiliation(s)
- Kenichiro Okumura
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Satoshi Kobayashi
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
- Department of Quantum Medical Technology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Takahiro Ogi
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Takumi Sugiura
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Yu Zhang
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Mao Kanatani
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Norihide Yoneda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Azusa Kitao
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
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Sugiura T, Okumura K, Matsumoto J, Sakaguchi M, Komori T, Ogi T, Inoue D, Koda W, Kobayashi S, Gabata T. Predicting intestinal viability by consecutive photoacoustic monitoring of oxygenation recovery after reperfusion in acute mesenteric ischemia in rats. Sci Rep 2021; 11:19474. [PMID: 34593923 PMCID: PMC8484661 DOI: 10.1038/s41598-021-98904-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/27/2021] [Accepted: 09/16/2021] [Indexed: 11/21/2022] Open
Abstract
The purpose was to assess whether consecutive monitoring of oxygenation by photoacoustic imaging (PAI) can objectively predict intestinal viability during surgery for acute mesenteric ischemia (AMI). PAI uses laser light to detect relative amounts of oxygenated and deoxygenated hemoglobin in intestinal tissue. In 30 rats, AMI was induced by clamping the mesenteric and marginal vessels of the ileum for 0 min in the control group, 30 min in the mild group, and 180 min in the severe group (10 rats per group). After 60 min of reperfusion, intestinal damage was evaluated pathologically. Oxygenation of the intestine was monitored throughout the procedure in real time by a commercially available PAI system and compared among the groups. All rats showed irreversible (i.e. transmucosal or transmural infarction) damage in the severe group. After reperfusion, the oxygenation in the mild group recovered immediately and was significantly higher than in the severe group at 1, 5, 10, 30, and 60 min (P = .011, 002, < .001, 001, and 001, respectively). Oxygenation showed a significant strong negative correlation with pathological severity (rs = − 0.7783, − 0.7806, − 0.7422, − 0.7728, and − 0.7704, respectively). In conclusion, PAI could objectively predict irreversible ischemic damage immediately after reperfusion, which potentially prevents inadequate surgery.
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Affiliation(s)
- Takumi Sugiura
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Kenichiro Okumura
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Junichi Matsumoto
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Maki Sakaguchi
- Department of Diagnostic Pathology, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takahiro Komori
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takahiro Ogi
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Satoshi Kobayashi
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Department of Quantum Medical Technology, Kanazawa University Graduate School of Medical Sciences, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
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Kobayashi S, Kozaka K, Gabata T, Matsui O, Koda W, Okuda M, Okumura K, Sugiura T, Ogi T. Pathophysiology and Imaging Findings of Bile Duct Necrosis: A Rare but Serious Complication of Transarterial Therapy for Liver Tumors. Cancers (Basel) 2020; 12:cancers12092596. [PMID: 32932894 PMCID: PMC7565329 DOI: 10.3390/cancers12092596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Bile duct necrosis (BDN) is rare but serious complication of transarterial therapy for liver tumors. During development of BDN, ischemia of the peribiliary vascular plexus (PBP) induces the disruption of the bile duct epithelial protection mechanism, causing necrosis of the surrounding tissue by the detergent action of exuded bile acids, and eventually a biloma forms. Once BDN starts, persistent tissue damage to the surrounding bile duct is induced by imbibed bile acids, and portal vein thrombosis may also be observed. On CT images, BDN shows similar findings to intrahepatic bile duct dilatation, and, therefore, it is sometimes misdiagnosed. Clinicians should be aware that although BDN and biloma can usually be treated conservatively, in the presence of symptoms such as moderate or severe infection or interval growth of the biloma, prompt treatment is essential to avoid lethal abscess formation and sepsis. Abstract Bile duct necrosis (BDN) with biloma formation is a type of ischemic bile duct injury that is one of the serious complications associated with transarterial therapies, such as transcatheter chemoembolization therapy (TACE), and radioembolization for hepatocellular carcinoma (HCC) and hepatic arterial infusion chemotherapy (HAIC) for metastatic liver cancer from colorectal carcinoma. In terms of the occurrence of BDN and subsequent biloma formation, ischemic injury to the peribiliary vascular plexus (PBP), the supporting vessel of bile duct epithelium, is thought to be intimately associated. In this paper, we first describe the anatomy, blood supply, and function of the intrahepatic bile duct, and then illustrate the pathophysiology of BDN, and finally present the imaging findings of BDN. Under the process of BDN formation, ischemia of the PBP induces the disruption of the bile duct epithelial protection mechanism that causes coagulation and fibrinoid necrosis of the surrounding tissue by the detergent action of exuded bile acids, and eventually a biloma forms. Once BDN occurs, persistent tissue damage to the surrounding bile duct is induced by imbibed bile acids, and portal vein thrombosis may also be observed. On pre-contrast and contrast-enhanced computed tomography (CT), BDN shows similar findings to intrahepatic bile duct dilatation, and, therefore, it is sometimes misdiagnosed. Differentiation of imaging findings on CT and ultrasound (US)/magnetic resonance (MR) imaging/MR cholangiopancreatography (MRCP) is important for correct diagnosis of BDN.
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Terada K, Ogi T, Yoneda N, Yokka A, Sugiura T, Koda W, Kobayashi S, Gabata T. Coil-assisted retrograde transvenous obliteration (CARTO) for the treatment of gastric varices via a single access route using steerable microcatheter: a case report. CVIR Endovasc 2020; 3:30. [PMID: 32537683 PMCID: PMC7293971 DOI: 10.1186/s42155-020-00124-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/10/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Coil-assisted retrograde transvenous obliteration (CARTO) is a modified balloon-occluded retrograde transvenous obliteration (BRTO) technique using coils instead of an indwelling balloon. A method involving two microcatheter systems forming a double access route has been reported. We report a case of CARTO using a steerable microcatheter to successfully treat gastric varices (GV). CASE PRESENTATION A 79-year-old man was admitted for treatment of intractable GV due to liver cirrhosis. The GV were drained mainly into the left inferior phrenic vein, not the usual gastrorenal shunt. Introducing the balloon catheter to the left inferior phrenic vein was difficult due to mild stenosis between the inferior vena cava and inferior phrenic vein and the shunt angle. A CARTO technique was performed with 5% ethanolamine oleate with iopamidol from a single access route by inverting the steerable microcatheter distal to the coil placement site. CONCLUSION CARTO has advantages in cases where performing BRTO is difficult. Using a steerable microcatheter simplifies the procedure by reducing the required access routes in CARTO.
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Affiliation(s)
- Kanako Terada
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Takahiro Ogi
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan.
| | - Norihide Yoneda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Akira Yokka
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Takumi Sugiura
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Satoshi Kobayashi
- Department of Quantum Medical Imaging, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
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Tanaka Y, Matsumoto I, Takata M, Saito D, Yoshida S, Tamura M, Koda W, Waseda R, Takemura H. Vitamin B2 lung-marking method using black light irradiation. J Thorac Dis 2020; 12:651-658. [PMID: 32274130 PMCID: PMC7139060 DOI: 10.21037/jtd.2020.01.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 11/06/2022]
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Yusuke Tanaka
- Department of Thoracic, Cardiovascular and General Surgery, Kanazawa University, Kanazawa, Japan
| | - Isao Matsumoto
- Department of Thoracic, Cardiovascular and General Surgery, Kanazawa University, Kanazawa, Japan
| | - Munehisa Takata
- Department of Thoracic, Cardiovascular and General Surgery, Kanazawa University, Kanazawa, Japan
| | - Daisuke Saito
- Department of Thoracic, Cardiovascular and General Surgery, Kanazawa University, Kanazawa, Japan
| | - Shuhei Yoshida
- Department of Thoracic, Cardiovascular and General Surgery, Kanazawa University, Kanazawa, Japan
| | - Masaya Tamura
- Department of Thoracic, Cardiovascular and General Surgery, Kanazawa University, Kanazawa, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Ryuichi Waseda
- Department of Thoracic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hirofumi Takemura
- Department of Thoracic, Cardiovascular and General Surgery, Kanazawa University, Kanazawa, Japan
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8
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Okumura K, Ogawa H, Yoshie Y, Nadamura T, Igarashi T, Tone K, Kozaka K, Koda W, Kobayashi S, Gabata T. Mucus plugs and bronchial wall thickening on three-dimensional computed tomography in patients with unexplained chronic cough whose sputum yielded filamentous Basidiomycetes. Eur Radiol 2020; 30:3268-3276. [DOI: 10.1007/s00330-020-06664-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/11/2019] [Accepted: 01/17/2020] [Indexed: 12/20/2022]
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Matsubara T, Kozaka K, Matsui O, Nakanuma Y, Uesaka K, Inoue D, Yoneda N, Yoshida K, Kitao A, Yokka A, Koda W, Gabata T, Kobayashi S. Peribiliary glands: development, dysfunction, related conditions and imaging findings. Abdom Radiol (NY) 2020; 45:416-436. [PMID: 31707436 DOI: 10.1007/s00261-019-02298-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Peribiliary glands are minute structures that are distributed along the intrahepatic large bile ducts, extrahepatic bile duct, and cystic duct. These glands regulate many physiological functions, such as enzyme secretion. Pancreatic exocrine tissues and enzymes are often observed in peribiliary glands; thus, peribiliary glands are involved in enzyme secretion. As such, these glands can be affected by conditions such as IgG4-related sclerosing cholangitis based on commonalities with their pancreatic counterparts. Cystic changes in peribiliary glands can occur de novo, as part of a congenital syndrome, or secondary to insults such as alcoholic cirrhosis. Biliary tree stem/progenitor cells have recently been identified in peribiliary glands. These cells are involved in turnover and regeneration of biliary epithelia as well as in sclerosing reactions in some pathological conditions, such as primary sclerosing cholangitis and hepatolithiasis. Notably, hepatolithiasis is involved in mucin secretion by the peribiliary glands. Additionally, these cells are associated with the manifestation of several neoplasms, including intraductal papillary neoplasm, cystic micropapillary neoplasm, and cholangiocarcinoma. Normal peribiliary glands themselves are particularly small structures that cannot be recognized using any available imaging modalities; however, these glands are closely associated with several diseases, as mentioned above, which have typical imaging features. Therefore, knowledge of the basic pathophysiology of peribiliary glands is helpful for understanding biliary diseases associated with the peribiliary glands.
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Hamaoka M, Kozaka K, Matsui O, Komori T, Matsubara T, Yoneda N, Yoshida K, Inoue D, Kitao A, Koda W, Gabata T, Kobayashi S. Early detection of intrahepatic cholangiocarcinoma. Jpn J Radiol 2019; 37:669-684. [PMID: 31372893 DOI: 10.1007/s11604-019-00860-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/25/2019] [Indexed: 02/07/2023]
Abstract
Cholangiocarcinoma (CC) is a malignant tumor which arises from the biliary epithelium and most cases represent adenocarcinoma. CC can be classified into intrahepatic CC (ICC), perihilar CC, and distal CC, based on the site of anatomic origin. The incidence of ICC is increasing in both Western and Eastern countries, while that of extrahepatic cholangiocarcinoma remains fairly stable. ICC infiltrates into adjacent nerves and lymphatic vessels, resulting in progressive disease with a poor prognosis; thus, early detection of ICC is critical for achieving better outcomes and providing better patient care. However, it is difficult for clinicians to detect an ICC, especially in its early stage. Different from hepatocellular carcinoma, the lack of surveillance system for the high-risk group of CC does not allow for a reliable screening examination. In this context, for early detection and diagnosis of ICC, radiologists need to know predisposing conditions that can lead to the development of ICC, such as chronic biliary or hepatic inflammation, primary sclerosing cholangitis, congenital biliary diseases, and other conditions. In this article, we discuss and illustrate the radiologic features of ICC with special attention to early disease stages and of predisposing conditions of ICC.
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Affiliation(s)
- Mami Hamaoka
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
| | - Osamu Matsui
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Takahiro Komori
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Takashi Matsubara
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Norihide Yoneda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Kotaro Yoshida
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Azusa Kitao
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Satoshi Kobayashi
- Department of Radiological Technology, School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
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11
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Kozaka K, Kobayashi S, Yoneda N, Kitao A, Yoshida K, Inoue D, Ogi T, Koda W, Sato Y, Gabata T, Matsui O. Doughnut-like hyperintense nodules on hepatobiliary phase without arterial-phase hyperenhancement in cirrhotic liver: imaging and clinicopathological features. Eur Radiol 2019; 29:6489-6498. [DOI: 10.1007/s00330-019-06329-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/04/2019] [Accepted: 06/13/2019] [Indexed: 02/06/2023]
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12
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Yoneda N, Matsui O, Kobayashi S, Kitao A, Kozaka K, Inoue D, Yoshida K, Minami T, Koda W, Gabata T. Current status of imaging biomarkers predicting the biological nature of hepatocellular carcinoma. Jpn J Radiol 2019; 37:191-208. [PMID: 30712167 DOI: 10.1007/s11604-019-00817-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 11/12/2018] [Accepted: 01/21/2019] [Indexed: 02/07/2023]
Abstract
Hepatocellular carcinoma (HCC) is heterogeneous in terms of its biological nature. Various factors related to its biological nature, including size, multifocality, macroscopic morphology, grade of differentiation, macro/microvascular invasion, bile duct invasion, intra-tumoral fat and molecular factors, and their value as prognostic imaging biomarkers have been reported. And recently, genome-based molecular HCC classification correlated with clinical outcome has been elucidated. The imaging biomarkers suggesting a less aggressive nature of HCC are smaller size, solitary tumor, smooth margin suggesting small nodular type with indistinct margin and simple nodular type with distinct margin, capsule, imaging biomarkers predicting early or well-differentiated grade, intra-tumoral fat detection, and low fluorodeoxyglucose (FDG) accumulation. The imaging biomarkers suggesting an aggressive HCC nature are larger size, multifocality, non-smooth margin suggesting simple nodular type with extranodular growth, confluent multinodular, and infiltrative type, imaging biomarkers predicting poor differentiation, macrovascular tumor thrombus, predicting microvascular invasion imaging biomarkers, bile duct dilatation or tumor thrombus, and high FDG accumulation. In the genome-based molecular classification, CTNNB-1 mutated HCC shows a less aggressive nature, while CK19/EpCAM positive HCC and macrotrabecular massive HCC show an aggressive one. Better understanding of these imaging biomarkers can contribute to devising more appropriate treatment plans for HCC.
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Affiliation(s)
- Norihide Yoneda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan.
| | - Osamu Matsui
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Satoshi Kobayashi
- Department of Quantum Medical Imaging, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Azusa Kitao
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Kotaro Yoshida
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Tetsuya Minami
- Department of Radiology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
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13
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Wakisaka N, Endo K, Kitazawa T, Shimode Y, Kato K, Moriyama-Kita M, Koda W, Ikeda H, Ishikawa K, Ueno T, Nakanishi Y, Kondo S, Sugimoto H, Yoshimura K, Tsuji H, Kawashiri S, Omoto K, Yoshizaki T. Detection of sentinel lymph node using contrast-enhanced agent, Sonazoid ™, and evaluation of its metastasis with superb microvascular imaging in oral and oropharyngeal cancers: a preliminary clinical study. Acta Otolaryngol 2019; 139:94-99. [PMID: 30676845 DOI: 10.1080/00016489.2018.1535193] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/27/2022]
Abstract
BACKGROUND In sentinel lymph node (SLN) biopsy for head and neck cancers, the radioisotope method has been the gold standard. However, this method has several problems, such as unavoidable radiation exposure and requirements of expensive equipment. AIMS/OBJECTIVES To overcome these problems, we evaluated the contrast-enhanced ultrasonography (CEUS)-guided SLN-detection method, and predicted the SLN metastatic status using novel ultrasound technology, superb microvascular imaging (SMI). METHODS Ten patients (6 with oral and 4 with oropharyngeal cancers) without neck lymph node metastasis were enrolled in this study. Ultrasound contrast agent, Sonazoid™, was infiltrated into the mucosa at the primary site to observe the lymphatic ducts and SLNs in the neck field. The detected SLNs were examined for blood flow using SMI to categorize the SLNs metastases-positive or negative. RESULTS SLNs were successfully detected in 8 out of 10 cases. In 7 out of the 8 cases, in whom SLNs were successfully detected, the metastatic status of SLNs was correctly diagnosed with SMI. CONCLUSIONS AND SIGNIFICANCE Although more clinical data are needed based on a larger cohort, establishing the CEUS-guided SLN-detection and criteria for the accurate diagnosis of SLN-metastases using SMI would be valuable as an alternative to radioisotope method, in oral and oropharyngeal cancers.
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Affiliation(s)
- Naohiro Wakisaka
- Department of Otolaryngology, and Head & Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Kazuhira Endo
- Department of Otolaryngology, and Head & Neck Surgery, Kanazawa University, Kanazawa, Japan
| | | | - Yuzo Shimode
- Department of Head and Neck Surgery, Kanazawa Medical University, Uchinada, Japan
| | - Koroku Kato
- Department of Oral and Maxillofacial Surgery, Kanazawa University, Kanazawa, Japan
| | - Makiko Moriyama-Kita
- Department of Otolaryngology, and Head & Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University, Kanazawa, Japan
| | - Hiroko Ikeda
- Division of Pathology, Kanazawa University, Kanazawa, Japan
| | - Kazuya Ishikawa
- Department of Otolaryngology, and Head & Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Takayoshi Ueno
- Department of Otolaryngology, and Head & Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Yosuke Nakanishi
- Department of Otolaryngology, and Head & Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Satoru Kondo
- Department of Otolaryngology, and Head & Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Hisashi Sugimoto
- Department of Otolaryngology, and Head & Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Kenichi Yoshimura
- Department of Biomedical Statistics, Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Tsuji
- Department of Head and Neck Surgery, Kanazawa Medical University, Uchinada, Japan
| | - Shuichi Kawashiri
- Department of Oral and Maxillofacial Surgery, Kanazawa University, Kanazawa, Japan
| | - Kiyoka Omoto
- Department of Laboratory Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Tomokazu Yoshizaki
- Department of Otolaryngology, and Head & Neck Surgery, Kanazawa University, Kanazawa, Japan
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14
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Yoneda N, Matsui O, Kitao A, Komori T, Kozaka K, Ikeda H, Yoshida K, Inoue D, Minami T, Koda W, Kobayashi S, Gabata T. Peri-tumoral hyperintensity on hepatobiliary phase of gadoxetic acid-enhanced MRI in hepatocellular carcinomas: correlation with peri-tumoral hyperplasia and its pathological features. Abdom Radiol (NY) 2018; 43:2103-2112. [PMID: 29260280 DOI: 10.1007/s00261-017-1437-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Peri-tumoral hyperintensity (P-hyperintensity) is occasionally seen in hepatocellular carcinoma (HCC) on the hepatobiliary (HB) phase of gadoxetic acid-enhanced MRI (EOB-MRI). A recent study reported peri-tumoral hyperplasia (P-hyperplasia) associated with over-expression of glutamine synthetase (GS) in HCC or metastatic carcinoma. The aim of this study was to analyze the correlation between P-hyperintensity on the HB phase and GS expression indicating P-hyperplasia and reveal its pathological features. METHODS Seventy-seven surgically resected HCCs from 68 patients were analyzed. The grade of P-hyperintensity on HB phase was divided according to the degree of the peri-tumoral hyperintense signal: grade 0 (no P-hyperintensity), grade 1 (less than 50% of the tumor border), grade 2 (50%-80%), grade 3 (80%-100%). Immunohistochemical staining for GS and organic anion transporter polypeptides (OATP)1B3 was performed. The relationships among P-hyperplasia (peri-tumoral GS expression) and OATP1B3 expression, P-hyperintensity, and pathological features of the tumor were analyzed. RESULTS Thirty-four HCCs were classified as P-hyperintensity grade 0, 29 HCCs as grade 1,10 nodules as grade 2, and 4 HCCs as grade 3. P-hyperplasia was observed in 3/34 (8.8%) P-hyperintensity grade 0, 16/29 (55.2%) grade 1, 9/10 (90%) grade 2, and 4/4 (100%) grade 3. The incidence of P-hyperplasia was significantly increased in P-hyperintensity grades 1-3 compared with grade 0 (p < 0.0001). Hepatocytes in all P-hyperplasia sites demonstrated definite OATP1B3 expression. Microscopic hepatic venous invasion was significantly increased in P-hyperintensity-positive HCCs compared with negative HCCs (p = 0.0017). CONCLUSIONS P-hyperintensity on HB phase in HCC may indicate p-hyperplasia with GS and OATP1B3 expression and a higher incidence of microscopic hepatic venous invasion.
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Affiliation(s)
- Norihide Yoneda
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan.
| | - Osamu Matsui
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Azusa Kitao
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Takahiro Komori
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Hiroko Ikeda
- Division of Pathology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Kotaro Yoshida
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Tetsuya Minami
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Satoshi Kobayashi
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
- Department of Quantum Medical Imaging, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
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Okumura K, Yoshida K, Yoshioka K, Aki S, Yoneda N, Inoue D, Kitao A, Ogi T, Kozaka K, Minami T, Koda W, Kobayashi S, Takuwa Y, Gabata T. Photoacoustic imaging of tumour vascular permeability with indocyanine green in a mouse model. Eur Radiol Exp 2018; 2:5. [PMID: 29708213 PMCID: PMC5909364 DOI: 10.1186/s41747-018-0036-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/15/2018] [Indexed: 01/10/2023] Open
Abstract
Background We analysed the haemodynamics of indocyanine green (ICG) in mouse organs and tumours and evaluated responses to anti-angiogenic agents in an allograft tumour mouse model by photoacoustic imaging. Methods Thirty-six male mice (aged 10–14 weeks; body weight 20–25 g) were used. Real-time photoacoustic imaging of organs and tumours after intravenous injection of ICG was conducted in mice until 10 min after ICG injection. ICG distribution in tumour tissues was assessed by immunohistochemical staining and observation of ICG-derived fluorescence. Vascular permeability changes induced by the vascular endothelial growth factor (VEGF)-blocking agent VEGF-trap on tumour photoacoustic signals were studied. Results The photoacoustic signals in salivary glands and tumours after intravenous injection of iCG (0.604 ± 0.011 and 0.994 ± 0.175 [mean ± standard deviation], respectively) were significantly increased compared with those in the liver, kidney, and great vessel (0.234 ± 0.043, 0.204 ± 0.058 and 0.127 ± 0.040, respectively; p < 0.010). In tumours, the photoacoustic signal increased within 30 s after ICG injection in a dose-dependent manner (r2 = 0.899) and then decreased gradually. ICG was found to extravasate in tumour tissues. In VEGF-trap-treated mice, the photoacoustic signal in the tumour decreased at the early phase before inhibition of tumour growth was detected (0.297 ± 0.052 vs 1.011 ± 0.170 in the control; p < 0.001). Conclusions Photoacoustic imaging with ICG administration demonstrated extravasation of ICG in mouse organs and tumours, indicating the potential for early detection of changes in vascular permeability during cancer therapy.
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Affiliation(s)
- Kenichiro Okumura
- 1Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
| | - Kotaro Yoshida
- 1Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
| | - Kazuaki Yoshioka
- 2Department of Physiology, Kanazawa University School of Medical Sciences, Ishikawa, Japan
| | - Sho Aki
- 2Department of Physiology, Kanazawa University School of Medical Sciences, Ishikawa, Japan
| | - Norihide Yoneda
- 1Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
| | - Dai Inoue
- 1Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
| | - Azusa Kitao
- 1Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
| | - Takahiro Ogi
- 1Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
| | - Kazuto Kozaka
- 1Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
| | - Tetsuya Minami
- 1Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
| | - Wataru Koda
- 1Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
| | - Satoshi Kobayashi
- 3Department of Quantum Medical Technology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Yoh Takuwa
- 2Department of Physiology, Kanazawa University School of Medical Sciences, Ishikawa, Japan
| | - Toshifumi Gabata
- 1Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
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Yoshida K, Matsui O, Miyayama S, Ibukuro K, Yoneda N, Inoue D, Kozaka K, Minami T, Koda W, Gabata T. Isolated Arteries Originating from the Intrahepatic Arteries: Anatomy, Function, and Importance in Intervention. J Vasc Interv Radiol 2018; 29:531-537.e1. [PMID: 29477620 DOI: 10.1016/j.jvir.2017.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/02/2017] [Accepted: 12/05/2017] [Indexed: 02/07/2023] Open
Abstract
Isolated hepatic arteries are defined as hepatic terminal arterioles that are not accompanied by portal venules or bile ductules and penetrate the liver parenchyma and distribute to the hepatic capsule and intrahepatic hepatic veins. Abundant communications exist between intra- and extrahepatic arteries through isolated arteries and capsular arterial plexus. They play a principal role in the development of subcapsular hemorrhage and arterial collateral formation following transcatheter arterial chemoembolization for liver cancers. The anatomy, function, and clinical importance of isolated hepatic arteries in interventional radiology, especially regarding subcapsular hemorrhage and arterial collateral formation, are highlighted in this article.
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Affiliation(s)
- Kotaro Yoshida
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Osamu Matsui
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Shiro Miyayama
- Department of Diagnostic Radiology, Fukui-ken Saiseikai Hospital, Fukui City, Fukui, Japan
| | - Kenji Ibukuro
- Department of Radiology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Norihide Yoneda
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Tetsuya Minami
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
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Kitao A, Matsui O, Yoneda N, Kozaka K, Kobayashi S, Koda W, Minami T, Inoue D, Yoshida K, Yamashita T, Yamashita T, Kaneko S, Takamura H, Ohta T, Ikeda H, Sato Y, Nakanuma Y, Harada K, Kita R, Gabata T. Gadoxetic acid-enhanced magnetic resonance imaging reflects co-activation of β-catenin and hepatocyte nuclear factor 4α in hepatocellular carcinoma. Hepatol Res 2018; 48:205-216. [PMID: 28488786 DOI: 10.1111/hepr.12911] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 01/21/2017] [Revised: 05/04/2017] [Accepted: 05/08/2017] [Indexed: 02/08/2023]
Abstract
AIM The aim of this study is to clarify the correlation of the co-activation of β-catenin and hepatocyte nuclear factor (HNF)4α with the findings of gadoxetic acid-enhanced magnetic resonance imaging (MRI), organic anion transporting polypeptide (OATP)1B3 expression, and histological findings in hepatocellular carcinoma (HCC). METHODS One hundred and ninety-six HCCs surgically resected from 174 patients were enrolled in this study. The HCCs were classified into four groups by immunohistochemical expression of β-catenin, glutamine synthetase (GS), and HNF4α: (i) β-catenin/GS (positive [+]) HNF4α (+); (ii) β-catenin/GS (+) HNF4α (negative [-]); (iii) β-catenin/GS (-) HNF4α (+); and (iv) β-catenin/GS (-) HNF4α (-). We compared the four groups in terms of the enhancement ratio on the hepatobiliary phase of gadoxetic acid-enhanced MRI, immunohistochemical organic anion transporter polypeptide (OATP)1B3 (a main uptake transporter of gadoxetic acid) expression and histological features, overall survival, and no recurrence survival. The Kruskal-Wallis test, Steel-Dwass multiple comparisons test, Fisher's exact test, and log-rank (Mantel-Cox) test were used for statistical analyses. RESULTS Enhancement ratio on gadoxetic acid-enhanced MRI in HCC with β-catenin/GS (+) HNF4α (+) was significantly higher than those of the other three groups (P < 0.001). The OATP1B3 grade was also significantly higher in HCC with β-catenin/GS (+) HNF4α (+) (P < 0.001). Hepatocellular carcinoma with β-catenin/GS (+) HNF4α (+) showed the highest differentiation grade as compared to the other groups (P < 0.004). There were no significant differences in portal vein invasion, macroscopic growth pattern, or prognosis analyses between the four groups. CONCLUSION Co-activation of β-catenin and HNF4α would promote OATP1B3 expression, and consequently higher enhancement ratio on gadoxetic acid-enhanced MRI and higher differentiation grade in HCC.
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Affiliation(s)
- Azusa Kitao
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Osamu Matsui
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Norihide Yoneda
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Satoshi Kobayashi
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Tetsuya Minami
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Kotaro Yoshida
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Taro Yamashita
- Department of Gastroenterology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Tatsuya Yamashita
- Department of Gastroenterology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Shuichi Kaneko
- Department of Gastroenterology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Hiroyuki Takamura
- Department of Gaetroenterologic Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Tetsuo Ohta
- Department of Gaetroenterologic Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Hiroko Ikeda
- Department of Human Pathology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yasunori Sato
- Department of Human Pathology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yasuni Nakanuma
- Department of Human Pathology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Kenichi Harada
- Department of Human Pathology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Ryuichi Kita
- Department of Gastroenterology, Osaka Red Cross Hospital, Osaka, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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Orisaka S, Kagami K, Mizumoto Y, Koda W, Ono M, Nakamura M, Fujiwara H. Successful detection of SRY gene via fine needle biopsy: A case of extragenital gestational choriocarcinoma in the kidney. Mol Clin Oncol 2017; 7:1057-1060. [DOI: 10.3892/mco.2017.1460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 10/13/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Shunsuke Orisaka
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Kyosuke Kagami
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Yasunari Mizumoto
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Masanori Ono
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Mitsuhiro Nakamura
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Hiroshi Fujiwara
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
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Kozaka K, Matsui O, Kobayashi S, Koda W, Minami T, Kitao A, Inoue D, Yoneda N, Yoshida K, Toshima F, Nakanuma Y, Gabata T. Dynamic CT findings of cholangiolocellular carcinoma: correlation with angiography-assisted CT and histopathology. Abdom Radiol (NY) 2017; 42:861-869. [PMID: 27747442 DOI: 10.1007/s00261-016-0944-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To elucidate the dynamic CT features of pure type of cholangiolocellular carcinoma (pure CoCC) in comparison with those of cholangiocellular carcinoma (CCC) and to analyze their bases by angiography-assisted CT with histopathologic correlation. METHODS Surgically confirmed 10 pure CoCCs, 10 CCCs and 7 mixed CoCC and CCCs from August 2001 to May 2012 were included in this study. Among them, dynamic CT features were compared. In 8 pure CoCCs, the correlative study between angiography-assisted CT and histopathological study was performed to clarify the basic mechanism of dynamic CT features. RESULTS All pure CoCCs showed early and prolonged enhancement homogeneously or inhomogeneously and 8 of 10 pure CoCCs showed early peritumoral enhancement on dynamic CT. Time-attenuation curve provided by dynamic CT showed significant higher Hounsfield unit value of pure CoCC than those of CCC at each phases (p < 0.05). The depiction of peritumoral enhancement in CoCC was nearly simultaneous to tumor stain on dynamic CT during hepatic arteriography. Pathologic analysis revealed there were abundant communications between blood sinusoids of the tumor and intra and peritumoral portal venules and surrounding hepatic sinusoids. CONCLUSION Early tumoral staining and peritumoral enhancement due to early drainage from the tumor and prolonged enhancement are characteristic findings in pure CoCCs.
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Affiliation(s)
- Kazuto Kozaka
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
| | - Osamu Matsui
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Satoshi Kobayashi
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Tetsuya Minami
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Azusa Kitao
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Norihide Yoneda
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Kotaro Yoshida
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Fumihito Toshima
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Yasuni Nakanuma
- Department of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
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Takanaka T, Kumano T, Takamatsu S, Minami T, Koda W, Gabata T, Matsui O, Noto K, Ueda S, Kurata Y. Multiple breath-hold segmented volumetric modulated arc therapy under real-time fluoroscopic image guidance with implanted fiducial markers: preliminary clinical experience. BJR Case Rep 2017; 3:20160087. [PMID: 30363308 PMCID: PMC6159290 DOI: 10.1259/bjrcr.20160087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/26/2016] [Accepted: 09/13/2016] [Indexed: 11/30/2022] Open
Abstract
A technique for multiple breath-hold segmented volumetric modulated arc therapy (VMAT) has been proposed under real-time fluoroscopic image guidance with implanted fiducial markers. Fiducial markers were embedded as close as possible to a tumour and the patient was asked to breathe in slowly under fluoroscopy. Immediately after the marker positions on the fluoroscopic image moved inside the planned marker contours transferred from a digitally reconstructed radiographic image at each gantry start angle, the patient was asked to hold their breath and a segmented VMAT beam was delivered. During beam delivery, the breath-hold status was continuously monitored by viewing a pointer in a breath monitoring system, Abches (Apex Medical, Tokyo, Japan), with the aid of a video camera installed in the treatment room. As long as the pointer stayed still, the segmented VMAT delivery continued for a preset period of 15–30 s, depending on the breath-hold capability of each patient. As soon as each segmented delivery was completed, the beam interrupt button was pushed; subsequently, the patient was asked to breathe freely. Because the preset breath-hold period was determined in order for each patient to hold their breath without fail, an intermediate beam interrupt due to breath-hold failure during the segmented beam delivery was not observed. This procedure was repeated until all the segmented VMAT beams were delivered. A case of pancreatic cancer is reported here as a preliminary study. The proposed technique may be clinically advantageous for treating tumours that move with respiration, including pancreatic cancer, lung tumour and other abdominal cancers.
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Ozaki K, Kobayashi S, Matsui O, Minami T, Koda W, Gabata T. Extrahepatic Arteries Originating from Hepatic Arteries: Analysis Using CT During Hepatic Arteriography and Visualization on Digital Subtraction Angiography. Cardiovasc Intervent Radiol 2017; 40:822-830. [PMID: 28083645 DOI: 10.1007/s00270-017-1568-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 10/09/2016] [Accepted: 01/02/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the prevalence and site of origin of extrahepatic arteries originating from hepatic arteries on early phase CT during hepatic arteriography (CTHA) was accessed. Visualization of these elements on digital subtraction hepatic angiography (DSHA) was assessed using CTHA images as a gold standard. MATERIALS AND METHODS A total of 943 patients (mean age 66.9 ± 10.3 years; male/female, 619/324) underwent CTHA and DSHA. The prevalence and site of origin of extrahepatic arteries were accessed using CTHA and visualized using DSHA. RESULTS In 924 (98.0%) patients, a total of 1555 extrahepatic branches, representing eight types, were found to originate from hepatic arteries on CTHA. CTHA indicated the following extrahepatic branch prevalence rates: right gastric artery, 890 (94.4%); falciform artery, 386 (40.9%); accessory left gastric artery, 161 (17.1%); left inferior phrenic artery (IPA), 43 (4.6%); posterior superior pancreaticoduodenal artery, 33 (3.5%); dorsal pancreatic artery, 26 (2.8%); duodenal artery, 12 (1.3%); and right IPA, 4 (0.4%). In addition, 383 patients (40.6%) had at least one undetectable branch on DSHA. The sensitivity, specificity, and accuracy of visualization on DSHA were as follows: RGA, 80.0, 86.8, and 80.4%; falciform artery, 53.9, 97.7, and 80.0%; accessory LGA, 64.6, 98.6, and 92.3%; left IPA, 76.7, 99.8, and 98.7%; PSPDA, 100, 99.7, and 99.9%; dorsal pancreatic artery, 57.7, 100, and 98.8%; duodenal artery, 8.3, 99.9, and 98.7%; and right IPA, 0, 100, and 99.6%, respectively. CONCLUSION Extrahepatic arteries originating from hepatic arteries were frequently identified on CTHA images. These arteries were frequently overlooked on DSHA.
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Affiliation(s)
- Kumi Ozaki
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
| | - Satoshi Kobayashi
- Department of Quantum Medicine Technology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Osamu Matsui
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Tetsuya Minami
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
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22
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Miura S, Ueda N, Fujita H, Kinami S, Kosaka T, Funaki H, Sakata N, Nishino R, Koda W. [Remission of Advanced Gastric Cancer with Concurrent Portal Vein Tumor Thrombosis via Chemotherapy - A Case Report]. Gan To Kagaku Ryoho 2016; 43:1911-1913. [PMID: 28133173] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The following is a case report of moderately differentiated tubular adenocarcinoma of the stomach with widespread thrombosis of the portal vein, for which chemotherapy proved effective. A 75-year-old man presented to the clinic with a new onset ofmalaise. The patient had anemia, elevation ofliver and biliary enzymes, and significantly elevated CA19-9 levels at 43,581 U/mL and CEA levels at 2,560 ng/mL. An upper endoscopy revealed a mass lesion extending from the fundus to the pylorus as well as to the duodenum along the smaller curvature of the stomach. A biopsy revealed moderately differentiated tubular adenocarcinoma. Abdominal CT showed a mass lesion extending from the body of the stomach and penetrating through the gastric wall, and extensive lymphadenopathy in the surrounding areas. In addition, multiple thromboses were identified in the portal vein and its tributaries, including the inferior mesenteric vein, splenic vein, and intrahepatic capillaries. The patient subsequently received a single round ofS -1 and CDDP. The tumor demonstrated a marked response; the tumor size and lymphadenopathy showed a significant improvement and the CA19-9 level decreased. Because the patient's condition deteriorated, this chemotherapy regimen was discontinued. The patient was switched to S-1 monotherapy and is still alive today, 2 years 10 months after the initial diagnosis.
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Affiliation(s)
- Seiko Miura
- Dept. of Surgical Oncology, Kanazawa Medical University
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23
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Yoneda T, Karashima S, Kometani M, Usukura M, Demura M, Sanada J, Minami T, Koda W, Gabata T, Matsui O, Idegami K, Takamura Y, Tamiya E, Oe M, Nakai M, Mori S, Terayama N, Matsuda Y, Kamemura K, Fujii S, Seta T, Sawamura T, Okuda R, Takeda Y, Hayashi K, Yamagishi M, Takeda Y. Impact of New Quick Gold Nanoparticle-Based Cortisol Assay During Adrenal Vein Sampling for Primary Aldosteronism. J Clin Endocrinol Metab 2016; 101:2554-61. [PMID: 27011114 DOI: 10.1210/jc.2016-1011] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT Adrenal vein sampling (AVS) is essential for identifying a surgically curable form of primary aldosteronism (PA), but accurate placement of the sampling catheter is technically challenging. Intraprocedural cortisol measurement can confirm the catheter's position, thereby increasing the AVS success rate. OBJECTIVE AND METHODS We developed a quick cortisol assay (QCA) that uses immunochromatography and gold nanoparticles and can be performed either semiquantitatively or quantitatively. The assay was evaluated in two studies. In a single-center study, PA patients were assigned to undergo AVS incorporating the semiquantitative QCA (n = 30), the quantitative QCA (n = 30), or without the QCA (n = 30), and the rates of successful AVS were determined. In a prospective multicenter randomized, controlled study, the success rates of AVS performed with (n = 148) or without (n = 145) the semiquantitative QCA were determined. RESULTS Cortisol concentrations were measured during AVS in 6 minutes or less in the radiology suite, without additional technical assistance, and significantly correlated with a conventional reference assay (R(2) = 0.994; P < .001). In the single-center study, the differences in the AVS success rates associated with semiquantitative and quantitative QCAs were not significant (both 93%); however, the success rates were significantly higher than the rate of successful AVS performed without using the QCA (63%; P < .001). The success rate of AVS performed in the multicenter study was 94% for the semiquantitative QCA, which was significantly higher than the rate for the patients without QCA (60%; P < .001). CONCLUSIONS Our novel QCA was rapidly and easily performed at the point of care and improved the rate of successful AVS.
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Affiliation(s)
- Takashi Yoneda
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Shigehiro Karashima
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Mitsuhiro Kometani
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Mikiya Usukura
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Masashi Demura
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Junichirou Sanada
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Tetsuya Minami
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Wataru Koda
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Toshifumi Gabata
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Osamu Matsui
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Koutarou Idegami
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yuzuru Takamura
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Eiichi Tamiya
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Masashi Oe
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Masuo Nakai
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Shunsuke Mori
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Noboru Terayama
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yuichi Matsuda
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Kouhei Kamemura
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Sumie Fujii
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Takashi Seta
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Toshitaka Sawamura
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Rika Okuda
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yoshimichi Takeda
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Kenshi Hayashi
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Masakazu Yamagishi
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yoshiyu Takeda
- Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan
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Wu Z, Matsui O, Kitao A, Kozaka K, Koda W, Kobayashi S, Ryu Y, Minami T, Sanada J, Gabata T. Hepatitis C related chronic liver cirrhosis: feasibility of texture analysis of MR images for classification of fibrosis stage and necroinflammatory activity grade. PLoS One 2015; 10:e0118297. [PMID: 25742285 PMCID: PMC4351185 DOI: 10.1371/journal.pone.0118297] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 12/15/2014] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To assess the feasibility of texture analysis for classifying fibrosis stage and necroinflammatory activity grade in patients with chronic hepatitis C on T2-weighted (T2W), T1-weighted (T1W) and Gd-EOB-DTPA-enhanced hepatocyte-phase (EOB-HP) imaging. MATERIALS AND METHODS From April 2008 to June 2012, MR images from 123 patients with pathologically proven chronic hepatitis C were retrospectively analyzed. Texture parameters derived from histogram, gradient, run-length matrix, co-occurrence matrix, autoregressive model and wavelet transform methods were estimated with imaging software. Fisher, probability of classification error and average correlation, and mutual information coefficients were used to extract subsets of optimized texture features. Linear discriminant analysis in combination with 1-nearest neighbor classifier (LDA/1-NN) was used for lesion classification. In compliance with the software requirement, classification was performed based on datasets from all patients, the patient group with necroinflammatory activity grade 1, and that with fibrosis stage 4, respectively. RESULTS Based on all patient dataset, LDA/1-NN produced misclassification rates of 28.46%, 35.77% and 20.33% for fibrosis staging and 34.15%, 25.20% and 28.46% for necroinflammatory activity grading in T2W, T1W and EOB-HP images. In the patient group with necroinflammatory activity grade 1, LDA/1-NN yielded misclassification rates of 5.00%, 0% and 12.50% for fibrosis staging in T2W, T1W and EOB-HP images respectively. In the patient group with fibrosis stage 4, LDA/1-NN yielded misclassification rates of 5.88%, 12.94% and 11.76% for necroinflammatory activity grading in T2W, T1W and EOB-HP images respectively. CONCLUSION Texture quantitative parameters of MR images facilitate classification of the fibrosis stage as well as necroinflammatory activity grade in chronic hepatitis C, especially after categorizing the input dataset according to the activity or fibrosis degree in order to remove the interference between the fibrosis stage and necroinflammatory activity grade on texture features.
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Affiliation(s)
- Zhuo Wu
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13–1 Takaramachi, Kanazawa 920–8640, Japan
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang Xi Road, Guangzhou 510120, Guangdong, China
| | - Osamu Matsui
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13–1 Takaramachi, Kanazawa 920–8640, Japan
| | - Azusa Kitao
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13–1 Takaramachi, Kanazawa 920–8640, Japan
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13–1 Takaramachi, Kanazawa 920–8640, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13–1 Takaramachi, Kanazawa 920–8640, Japan
| | - Satoshi Kobayashi
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13–1 Takaramachi, Kanazawa 920–8640, Japan
| | - Yasuji Ryu
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13–1 Takaramachi, Kanazawa 920–8640, Japan
| | - Tetsuya Minami
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13–1 Takaramachi, Kanazawa 920–8640, Japan
| | - Junichiro Sanada
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13–1 Takaramachi, Kanazawa 920–8640, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medical Science, 13–1 Takaramachi, Kanazawa 920–8640, Japan
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Kitao A, Matsui O, Yoneda N, Kozaka K, Kobayashi S, Sanada J, Koda W, Minami T, Inoue D, Yoshida K, Yamashita T, Yamashita T, Kaneko S, Takamura H, Ohta T, Ikeda H, Nakanuma Y, Kita R, Gabata T. Hepatocellular Carcinoma with β-Catenin Mutation: Imaging and Pathologic Characteristics. Radiology 2015; 275:708-17. [PMID: 25668519 DOI: 10.1148/radiol.14141315] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To identify the imaging features of hepatocellular carcinoma (HCC) associated with β-catenin mutation and their relationship to pathologic findings. MATERIALS AND METHODS Institutional ethics committee approval and informed consent were obtained. One hundred thirty-eight surgically resected HCCs were analyzed in this study. Immunohistochemical expression of β-catenin and its transcriptional product, glutamine synthetase (GS), were graded and classified into three groups: the β-catenin positive and GS positive group (HCC with β-catenin mutation), the β-catenin negative and GS positive group (intermediate HCC), and the β-catenin negative and GS negative group (HCC without β-catenin mutation). Clinical, pathologic, and imaging findings from dynamic computed tomography (CT) and gadoxetic acid-enhanced magnetic resonance (MR) imaging (T1-weighted, T2-weighted, diffusion-weighted, and hepatobiliary phase imaging) were evaluated. Correlations among immunohistochemical expression of β-catenin, GS, and organic anion transporting polypeptide 1B3 (uptake transporter of gadoxetic acid) were evaluated. The χ(2), Kruskal-Wallis, and Spearman correlation tests were used. RESULTS HCCs with β-catenin mutation (n = 27) showed a lower median contrast-to-noise ratio at diffusion-weighted imaging than did intermediate HCCs (n = 23) and HCCs without β-catenin mutation (n = 84) (13.2, 24.4, and 27.0, respectively; P = .02), higher apparent diffusion coefficient (1.33, 1.13, and 1.12, respectively; P < .0001), higher contrast-to-noise ratio (0.58, -28.7, and -45.0, respectively; P < .0001) and higher enhancement ratio during the hepatobiliary phase (0.90, 0.50, and 0.42, respectively; P < .0001). At pathologic examination, HCCs with β-catenin mutation showed pseudoglandular proliferation and bile production with a higher grade of differentiation (P = .04, .001, and .005, respectively). There were significant positive correlations among expression of β-catenin, GS, and organic anion transporting polypeptide 1B3 (P < .0001). CONCLUSION HCCs with β-catenin mutation showed a higher grade of differentiation with frequent pseudoglandular patterns and bile production, and characteristic imaging findings included a high enhancement ratio at gadoxetic acid-enhanced MR imaging and a high apparent diffusion coefficient at diffusion-weighted imaging. Online supplemental material is available for this article.
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Affiliation(s)
- Azusa Kitao
- From the Departments of Radiology (A.K., O.M., N.Y., K.K., S.K., J.S., W.K., T.M., D.I., K.Y., T.G.), Gastroenterology (Taro Yamashita, Tatsuya Yamashita, S.K.), Gastroenterologic Surgery (H.T., T.O.), and Human Pathology (H.I., Y.N.), Kanazawa University Graduate School of Medical Science13-1 Takaramachi, Kanazawa 920-8640, Japan; and Department of Gastroenterology, Osaka Red Cross Hospital, Osaka, Japan (R.K.)
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Yoshida K, Kobayashi S, Matsui O, Gabata T, Sanada J, Koda W, Minami T, Ryu Y, Kozaka K, Kitao A. Hepatic pseudolymphoma: imaging-pathologic correlation with special reference to hemodynamic analysis. ACTA ACUST UNITED AC 2014; 38:1277-85. [PMID: 23744440 DOI: 10.1007/s00261-013-0016-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [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: 12/17/2022]
Abstract
OBJECTIVES To clarify radiological findings and hemodynamic characteristics of hepatic pseudolymphoma, as compared with the histopathological findings. METHODS Radiological findings of ten histopathologically confirmed hepatic pseudolymphomas in seven patients were examined using US, CT, and MRI. Six patients also underwent angiography-assisted CT, including CT during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) to analyze hemodynamics. RESULTS The nodules were depicted as hypoechoic on US, hypodense on precontrast CT, hypointense on T1-weighted images, and hyperintense on T2-weighted images. On contrast-enhanced CT/MRI, they showed various degrees of enhancement, and sometimes, perinodular enhancement was observed at the arterial dominant and/or equilibrium phase. On CTAP, the nodules showed portal perfusion defects, including some in the perinodular liver parenchyma. On CTHA, irregular bordered enhancement was observed in perinodular liver parenchyma on early phase, and continued until delayed phase. Some nodules had preserved intra-tumoral portal tracts. Histopathologically, the nodules consisted of marked lymphoid cells. In perinodular liver parenchyma, stenosis or disappearance of portal venules, caused by lymphoid cell infiltration in the portal tracts, was observed. CONCLUSIONS Hepatic pseudolymphoma showed some characteristic radiological findings including hemodynamics on CT, MRI, and angiography-assisted CT. These findings are useful in the differentiation from hepatocellular carcinoma and other tumors.
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Affiliation(s)
- Kotaro Yoshida
- Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara-Machi, Kanazawa, 920-8641, Japan,
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Endo T, Kozaka K, Kobayashi S, Sanada J, Koda W, Minami T, Kitao A, Yoneda N, Nakanuma Y, Gabata T, Matsui O. Hemodynamics and progression of a hypervascular focus in a borderline lesion of hepatocellular carcinoma: analysis by angiography-assisted CT and histopathology. Jpn J Radiol 2013; 32:69-79. [DOI: 10.1007/s11604-013-0268-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 11/13/2013] [Indexed: 02/02/2023]
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Tajima H, Kitagawa H, Shoji M, Okamoto K, Nakanuma S, Sakai S, Kinoshita J, Makino I, Hayashi H, Nakamura K, Oyama K, Nakagawara H, Miyashita T, Takamura H, Ohta T, Minami T, Koda W, Sanada J, Gabata T, Sai Y. [Hepatic arterial infusion chemotherapy with gemcitabine for patients with postoperative liver metastases from pancreatic cancer]. Gan To Kagaku Ryoho 2013; 40:1668-71. [PMID: 24393883] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Herein, we describe hepatic arterial infusion (HAI) chemotherapy with gemcitabine (GEM) for the treatment of patients with postoperative liver metastases from pancreatic cancer. Seven patients received HAI with GEM plus 5-fluorouracil (5- FU) or oral S-1 from 2008 to 2010 at the Kanazawa University Hospital. Of the 7 patients, partial response (PR) and stable disease( SD) were observed in 6 patients according to the Response Evaluation Criteria In Solid Tumors( RECIST) evaluation criteria (response rate, 85.7%). The median survival time was 14 months; however, all 7 patients ultimately died of another metastatic lesion. Importantly, there were no life-threatening toxicities. However, 6 patients developed catheter- related complications, and the HAI catheter and the subcutaneous implantable port system had to be removed. Peripheral blood concentrations of GEM after HAI were analyzed in 7 other patients. At a dose level of 400 to 800 mg/standard liver volume( SLV),the GEM concentrations were less than one-tenth that of the intravenously administered 1,000 mg/m2. However, at a dose level of 1,000 mg/SLV, the GEM concentration in the peripheral blood was almost the same as that administered intravenously. In conclusion, HAI chemotherapy is safe and effective for the treatment of patients with liver metastases from pancreatic cancer. Our results suggest that a dose level of 800 mg/SLV could be considered optimal for local therapy.
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Affiliation(s)
- Hidehiro Tajima
- Dept. of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University
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Takanaka T, Kumano T, Minami T, Koda W, Matsui O, Noto K, Ueda S, Kurata Y. Breath-Holding Volumetric Modulated Radiation Therapy Based on Implanted Fiducial Marks Using the Image Guided Radiation Therapy System With Fluoroscopic Function. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ofude M, Kitagawa Y, Koda W, Ueno S, Kadono Y, Konaka H, Mizokami A, Gabata T, Namiki M. Preserved renal function after percutaneous radiofrequency ablation for renal tumors: experience of a single institution. Anticancer Res 2013; 33:4669-4673. [PMID: 24123047] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Percutaneous radiofrequency ablation (RFA) for small renal tumors has been reported to be effective in patients with poor surgical status. We retrospectively analyzed clinical outcomes, including renal function, after RFA. PATIENTS AND METHODS We retrospectively analyzed data of 24 patients with small renal tumors treated by RFA in our institution from January 2007 to November 2012. RESULTS A total of 36 tumors (35 renal cell carcinomas and one colon cancer metastasis) with a mean diameter of 21.1 mm (10-45 mm) in 24 patients were treated. Complete ablation was achieved in 22 patients (91.7%). There were two recurrences in other sites of the kidney (8.3%) and two distant metastases (8.3%) during the mean follow-up period of 21 months (1-57 months). No severe perioperative complications were observed. No significant difference in serum creatinine levels before and after RFA procedures in the 22 evaluable patients, nor in seven patients with a solitary kidney. CONCLUSION RFA for small renal tumors is a safe treatment with sufficient preservation of renal function, even in patients with a solitary kidney.
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Affiliation(s)
- Mitsuo Ofude
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan, 920-8640.
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Tajima H, Kitagawa H, Tsukada T, Okamoto K, Nakanuma SI, Sakai S, Makino I, Furukawa H, Hayashi H, Oyama K, Inokuchi M, Nakagawara H, Miyashita T, Itoh H, Fujita H, Takamura H, Ninomiya I, Fushida S, Fujimura T, Ohta T, Koda W, Minami T, Ryu Y, Sanada J, Gabata T, Matsui O, Sai Y. Hepatic arterial infusion chemotherapy with gemcitabine and 5-fluorouracil or oral S-1 improves the prognosis of patients with postoperative liver metastases from pancreatic cancer. Mol Clin Oncol 2013; 1:869-874. [PMID: 24649263 PMCID: PMC3916203 DOI: 10.3892/mco.2013.152] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 04/23/2013] [Indexed: 01/13/2023] Open
Abstract
Hepatic metastasis is a common cause of treatment failure following resection of pancreatic cancer. In this study, we report our results of hepatic arterial infusion (HAI) chemotherapy with gemcitabine (GEM) plus 5-fluorouracil (5-FU) or oral S-1 treatment for postoperative liver metastases from pancreatic cancer. Seven patients with postoperative liver metastases from pancreatic cancer received HAI with GEM plus 5-FU or oral S-1 between October, 2008 and September, 2010 at Kanazawa University Hospital (Kanazawa, Japan). Three out of the 7 cases exhibited a partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST) and stable disease (SD) was achieved in 3 out of the 7 cases (response rate, 85.7%). A decrease in serum tumor marker CA 19-9 levels was observed after 10 HAI treatment cycles in 5 out of the 7 cases. The median time to treatment failure was 8 months (range, 0–17 months). Adverse events included grade 3 leukocytopenia in 1 case and anemia in all 7 cases, although 5 out of the 7 patients were anemic prior to HAI therapy. Grade 2 thrombocytopenia was also observed in 2 cases. Non-hematological events, such as nausea, diarrhea, liver injury or neuropathy and life-threatening toxicities were not reported; however, 6 patients (85.7%) developed catheter-related complications and the HAI catheter and subcutaneous implantable port system had to be removed. These findings demonstrated that HAI may deliver high doses of chemotherapeutic agents directly into the tumor vessels, producing increased regional levels with greater efficacy and a lower incidence/severity of systemic side effects. In conclusion, HAI chemotherapy is a safe and effective treatment for liver metastases from pancreatic cancer.
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Affiliation(s)
- Hidehiro Tajima
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Hirohisa Kitagawa
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Tomoya Tsukada
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Koichi Okamoto
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Shin-Ichi Nakanuma
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Seisho Sakai
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Isamu Makino
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Hiroyuki Furukawa
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Hironori Hayashi
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Katsunobu Oyama
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Masafumi Inokuchi
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Hisatoshi Nakagawara
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Tomoharu Miyashita
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Hiroshi Itoh
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Hideto Fujita
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Hiroyuki Takamura
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Itasu Ninomiya
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Sachio Fushida
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Takashi Fujimura
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Tetsuo Ohta
- Department of Gastroenterological Surgery and, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Wataru Koda
- Department of Radiology, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Tetsuya Minami
- Department of Radiology, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Yasuji Ryu
- Department of Radiology, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Junichiro Sanada
- Department of Radiology, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Toshifumi Gabata
- Department of Radiology, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Osamu Matsui
- Department of Radiology, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Yoshimichi Sai
- Division of Pharmacy, Kanazawa University Hospital, Kanazawa, Ishikawa 920-8641, Japan
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Kitao A, Matsui O, Yoneda N, Kozaka K, Kobayashi S, Koda W, Gabata T, Yamashita T, Kaneko S, Nakanuma Y, Kita R, Arii S. Hypervascular hepatocellular carcinoma: correlation between biologic features and signal intensity on gadoxetic acid-enhanced MR images. Radiology 2013; 265:780-9. [PMID: 23175543 DOI: 10.1148/radiol.12120226] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To analyze the correlation among biologic features, tumor marker production, and signal intensity at gadoxetic acid-enhanced MR imaging in hepatocellular carcinomas (HCCs). MATERIALS AND METHODS Institutional ethics committee approval and informed consent were obtained for this retrospective study. From April 2008 to September 2011, 180 surgically resected HCCs in 180 patients (age, 65.0 years ± 10.3 [range, 34-83 years]; 138 men, 42 women) were classified as either hypointense (n = 158) or hyperintense (n = 22) compared with the signal intensity of the background liver on hepatobiliary phase gadoxetic acid-enhanced MR images. Pathologic features were analyzed and a fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) production were compared by means of serum analysis and immunohistochemical staining. Recurrence and survival rates were also evaluated. The Mann-Whitney and Pearson correlation tests were used for statistical analysis. RESULTS The grade of differentiation was higher (P = .028) and portal vein invasion was less frequent in hyperintense HCCs (13.6%) than in hypointense HCCs (36.7%) (P = .039). The serum levels of AFP, Lens culinaris agglutinin reactive fraction of AFP, and PIVKA-II were lower in hyperintense than in hypointense HCCs (P = .003, .004, and .026, respectively). Immunohistochemical AFP and PIVKA-II expression were lower in hyperintense than in hypointense HCCs (both P < .001). The recurrence rate was lower in hyperintense than in hypointense HCCs (P = .039). CONCLUSION The results suggest that hyperintense HCCs on gadoxetic acid-enhanced MR images are less aggressive than hypointense HCCs. SUPPLEMENTAL MATERIAL http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120226/-/DC1.
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Affiliation(s)
- Azusa Kitao
- Departments of Radiology, Gastroenterology, and Human Pathology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
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Wu Z, Matsui O, Kitao A, Kozaka K, Koda W, Kobayashi S, Ryu Y, Minami T, Sanada J, Gabata T. Usefulness of Gd-EOB-DTPA-enhanced MR imaging in the evaluation of simple steatosis and nonalcoholic steatohepatitis. J Magn Reson Imaging 2012; 37:1137-43. [PMID: 23172731 DOI: 10.1002/jmri.23921] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 09/27/2012] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To evaluate the usefulness of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MR imaging (EOB-MRI) in differentiating between simple steatosis and nonalcoholic steatohepatitis (NASH), as compared with MR in-phase/out-of-phase imaging. The correlations between the MR features and histological characteristics were preliminarily investigated. MATERIALS AND METHODS From April 2008 to October 2011, 25 patients (13 simple steatosis and 12 NASH) who underwent both EOB-MRI and in-phase/out-of-phase imaging were analyzed. The hepatobiliary-phase enhancement ratio and signal intensity loss on opposed-phase T1-weighted images (fat fraction) were compared between the simple steatosis and NASH groups. In the simple steatosis and NASH groups, the correlations between enhancement ratio and histological grade/stage were explored. In the NASH group, fat fraction was correlated with the steatosis score. RESULTS The enhancement ratio in NASH was significantly lower than that in simple steatosis (P = 0.03). In the simple steatosis and NASH groups, the enhancement ratio was significantly correlated with the fibrosis stage (r = -0.469, P = 0.018). Fat fraction in NASH was strongly correlated with the steatosis score (r = 0.728, P = 0.007). CONCLUSION In simple steatosis and NASH, the hepatobiliary-phase enhancement ratio of EOB-MRI showed significant association with fibrosis stage, and may be a useful discriminating parameter compared with the fat fraction measured by in-phase/out-of-phase imaging.
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Affiliation(s)
- Zhuo Wu
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
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Kobayashi S, Matsui O, Gabata T, Koda W, Minami T, Ryu Y, Kozaka K, Kitao A. Intranodular signal intensity analysis of hypovascular high-risk borderline lesions of HCC that illustrate multi-step hepatocarcinogenesis within the nodule on Gd-EOB-DTPA-enhanced MRI. Eur J Radiol 2012; 81:3839-45. [PMID: 22884705 DOI: 10.1016/j.ejrad.2012.06.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 06/12/2012] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To analyze intranodular signal intensity pattern of hypovascular high-risk borderline lesions of HCC that illustrate multi-step hepatocarcinogenesis within the nodule on Gd-EOB-DTPA-enhanced MRI. METHODS A total of 73 nodules showing hypervascular foci in hypovascular high-risk borderline lesions identified by angiography-assisted CT were included in this study. The intranodular signal intensities of both the hypervascular foci and the hypovascular high-risk borderline lesions were evaluated on hepatobiliary-phase EOB-enhanced MRI obtained 20 min after intravenous injection of contrast media. RESULTS Among 59 hypervascular foci within hypointense hypovascular high-risk borderline lesions, 6 showed more hypointensity, 32 isointensity, and 21 hyperintensity compared to the surrounding hypointense, hypovascular portion of the nodules. Among 14 hypervascular foci within isointense hypovascular high-risk borderline lesions, 5 showed isointensity, and 9 hypointensity compared to the surrounding isointense hypovascular high-risk borderline lesions. No hypervascular foci showed hyperintensity compared to the surrounding isointense hypovascular high-risk borderline lesions. CONCLUSIONS In most of the hypovascular high-risk borderline lesions containing hypervascular foci within the nodule, the signal intensity was decreased in hypervascular foci as compared with hypovascular high-risk borderline lesions and the surrounding background liver parenchyma. This supports the concept of signal intensity decrease during the dedifferentiation process in multistep hepatocarcinogenesis. However, around 30% of the nodules did not follow this rule, and hypervascular foci showed hyperintensity relative to the hypovascular high-risk borderline lesions.
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Affiliation(s)
- Satoshi Kobayashi
- Dept of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641, Japan.
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Kobayashi S, Matsui O, Gabata T, Koda W, Minami T, Ryu Y, Kozaka K, Kitao A. Relationship between signal intensity on hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MR imaging and prognosis of borderline lesions of hepatocellular carcinoma. Eur J Radiol 2012; 81:3002-9. [PMID: 22748558 DOI: 10.1016/j.ejrad.2012.03.029] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 03/05/2012] [Indexed: 12/30/2022]
Abstract
PURPOSE To elucidate the incidence of signal intensity patterns of borderline lesions of hepatocellular carcinoma (HCC) on hepatobiliary phase Gd-EOB-DTPA (EOB) enhanced MRI and clarify the natural histories of these lesions. MATERIALS AND METHODS Total 99 borderline lesions of HCC were identified by angiography-assisted CT. The signal intensity of borderline lesions on hepatobiliary phase of EOB-enhanced MRI was analyzed. Progress rate from borderline lesions to hypervascular HCC was calculated with the Kaplan-Meier method among each signal intensity groups of nodules. RESULTS On hepatobiliary phase of EOB-enhanced MRI, 41.4% of the borderline lesions showed hypo-, 42.4% showed iso-, and 16.2% showed hyperintense, compared to background liver. Overall progress rates from borderline lesions to HCC were 10% in 1-year, 14% in 2-year and 20% in 3-year follow-up period. Progress rates to HCC in hypointense borderline lesions were 17% in 1-year, 28% in 2-year and 41% in 3-year follow-up period, and in isointense borderline lesions were 7% in 1-year, 7% in 2-year and 7% in 3-year follow-up period. No hyperintense borderline lesions progressed to HCC in follow-up period. CONCLUSION Although borderline lesions of HCC may show hypo-, iso- and hyperintensity on hepatobiliary phase of EOB-enhanced MRI, hypointense borderline lesions are high risk to progress HCC.
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Affiliation(s)
- Satoshi Kobayashi
- Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641, Japan.
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Yoneda N, Matsui O, Kitao A, Kita R, Kozaka K, Koda W, Kobayashi S, Gabata T, Ikeda H, Sato Y, Nakanuma Y. Hepatocyte transporter expression in FNH and FNH-like nodule: correlation with signal intensity on gadoxetic acid enhanced magnetic resonance images. Jpn J Radiol 2012; 30:499-508. [PMID: 22618456 DOI: 10.1007/s11604-012-0085-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [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: 12/21/2011] [Accepted: 04/22/2012] [Indexed: 12/12/2022]
Abstract
PURPOSE Our aim was to evaluate the hepatocyte transporters in focal nodular hyperplasia (FNH) and FNH-like lesions and to correlate the grade of its expression with signal intensity on the hepatobiliary phase (HB phase) of gadoxetic-acid-enhanced magnetic resonance imaging (EOB-MRI). MATERIALS AND METHODS Thirteen histopathological confirmed cases including eight with EOB-MRI were studied. Immunohistochemical staining for transporter was performed and its grade semiquantitatively analyzed. RESULTS Histopathologically, ten cases showed almost equal organic anion transporter polypeptide (OATP) 8 expression relative to the surrounding liver; the remaining three showed stronger OATP8 expression. In eight cases with EOB-MRI, two demonstrated more hyperintensity on the HB phase, and their OATP8 expression was stronger compared with the surrounding liver. The remaining six cases showed isointensity on the HB phase and revealed almost equal OATP8 expression. The expression of export transporter multi-drug-resistant proteins (MRP) 1 and 2 were almost equal relative to the surrounding liver in most cases (11/12, 92 %; 11/12, 92 %, respectively), whereas MRP3 focally overexpressed in 75 % (9/12) of cases. CONCLUSION FNH and FNH-like nodules revealed equal or stronger OATP8 expression than background liver. OATP8 expression showed significant correlation with signal intensity on the HB phase.
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Affiliation(s)
- Norihide Yoneda
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
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Hirose A, Tajima H, Okamoto K, Makino I, Kinoshita J, Hayashi H, Nakamura K, Oyama K, Nakagawara H, Inokuchi M, Fujita H, Takamura H, Ninomiya I, Kitagawa H, Fushida S, Tani T, Fujimura T, Ohta T, Koda W, Matsui O. [A safely resected case of hypervascular pancreatic giant tumor after preoperative arterial embolization]. Gan To Kagaku Ryoho 2011; 38:2451-2453. [PMID: 22202410] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 73-year-old woman visited our hospital for a treatment of pancreatic tumor that increased steadily in size of 6 cm in diameter in 1999 to 13 cm in 2008, while remaining in asymptomatic condition throughout this follow-up time. The tumor was big and flowed from many vessels such as portal and superior mesenteric veins and the celiac and superior mesenteric arteries. These were critical for determining tumor respectability and the risk of massive intra-operative hemorrhage was felt to be considerable. Therefore, preoperative embolization of the tumor-feeding arteries arising from the celiac axis (gastroduodenal, splenic and dorsal pancreatic arteries) was performed on the previous day of operation. Tumor resection with pancreaticoduodenectomy and partial resection of portal vein and reconstruction were performed. We got to SMA with the use of "paraduodenal mesenteric approach", we called, and we finished the operation without a blood transfusion. The final pathology confirmed the diagnosis of serous microcystic adenoma.
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Affiliation(s)
- Atsushi Hirose
- Dept. of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medicine Science, Kanazawa University
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Kitao A, Matsui O, Yoneda N, Kozaka K, Shinmura R, Koda W, Kobayashi S, Gabata T, Zen Y, Yamashita T, Kaneko S, Nakanuma Y. The uptake transporter OATP8 expression decreases during multistep hepatocarcinogenesis: correlation with gadoxetic acid enhanced MR imaging. Eur Radiol 2011; 21:2056-66. [PMID: 21626360 DOI: 10.1007/s00330-011-2165-8] [Citation(s) in RCA: 192] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 04/20/2011] [Accepted: 04/30/2011] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To clarify the changes in organic anion-transporting polypeptide 8 (OATP8) expression and enhancement ratio on gadoxetic acid-enhanced MR imaging in hepatocellular nodules during multistep hepatocarcinogenesis. METHODS In imaging analysis, we focused on 71 surgically resected hepatocellular carcinomas (well, moderately and poorly differentiated HCCs) and 1 dysplastic nodule (DN). We examined the enhancement ratio in the hepatobiliary phase of gadoxetic acid enhanced MR imaging [(1/postcontrast T1 value-1/precontrast T1 value)/(1/precontrast T1 value)], then analysed the correlation among the enhancement ratio, tumour differentiation grade and intensity of immunohistochemical OATP8 expression. In pathological analysis, we focused on surgically resected 190 hepatocellular nodules: low-grade DNs, high-grade DNs, early HCCs, well-differentiated, moderately differentiated and poorly differentiated HCCs, including cases without gadoxetic acid-enhanced MR imaging. We evaluated the correlation between the immunohistochemical OATP8 expression and the tumour differentiation grade. RESULTS The enhancement ratio of HCCs decreased in accordance with the decline in tumour differentiation (P < 0.0001, R = 0.28) and with the decline of OATP8 expression (P < 0.0001, R = 0.81). The immunohistochemical OATP8 expression decreased from low-grade DNs to poorly differentiated HCCs (P < 0.0001, R = 0.15). CONCLUSIONS The immunohistochemical expression of OATP8 significantly decreases during multistep hepatocarcinogenesis, which may explain the decrease in enhancement ratio on gadoxetic acid-enhanced MR imaging.
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Affiliation(s)
- Azusa Kitao
- Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, 920-8640, Japan.
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Tajima H, Ohta T, Kitagawa H, Sakai S, Makino I, Hayashi H, Oyama K, Nakagawara H, Fujita H, Onishi I, Takamura H, Ninomiya I, Fushida S, Tani T, Fujimura T, Koda W, Minami T, Ryu Y, Sanada J, Gabata T, Matsui O. Pilot study of hepatic arterial infusion chemotherapy with gemcitabine and 5-fluorouracil for patients with postoperative liver metastases from pancreatic cancer. Exp Ther Med 2011; 2:265-269. [PMID: 22977495 DOI: 10.3892/etm.2011.190] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2010] [Accepted: 12/28/2010] [Indexed: 01/11/2023] Open
Abstract
Hepatic metastasis is a common cause of treatment failure after curative resection of pancreatic cancer. We report a pilot study of hepatic arterial infusion (HAI) chemotherapy with gemcitabine and 5-fluorouracil (5-FU) for postoperative liver metastases from pancreatic cancer. Five patients who had undergone curative resection of liver metastases from pancreatic cancer received HAI of gemcitabine and 5-FU between October 2008 and September 2010 at Kanazawa University Hospital. Gemcitabine at a dose of 800 mg was infused over 30 min via a bedside pump. After gemcitabine administration, 250 mg of 5-FU was infused continuously over 24 h on days 1-5, comprising one cycle of therapy. These treatment cycles were continued biweekly. In the evaluation according to RECIST criteria, a partial response was obtained in 2 of the 5 cases, with stable disease being achieved in the remaining 3 cases (response rate, 100%). In 4 of the 5 cases, a decrease in serum tumor marker CA19-9 was observed after 10 HAI treatment cycles. The median time to treatment failure was 10 months (range 3-17). As to adverse events, leukocytopenia was grade 3 in 1 of 4 affected cases and all 5 were anemic, although 4 of the 5 cases had anemia prior to HAI therapy. Grade 2 thrombocytopenia was observed in 2 cases. No nonhematologic events, such as nausea, diarrhea, liver injury and neuropathy, occurred. There were no life-threatening toxicities, but 4 cases (80%) developed catheter complications, and the HAI catheter and subcutaneous implantable port system had to be removed. HAI delivers high doses of chemotherapeutic agents directly into tumor vessels, producing increased regional levels with greater efficacy and a lower incidence/severity of systemic side effects. In conclusion, HAI chemotherapy is useful and safe for the treatment of malignancies confined to the liver.
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Matsui O, Kitao A, Kobayashi S, Sanada J, Ryu Y, Minami T, Kozaka K, Shinnmura R, Nakamura K, Yoneda N, Koda W, Gabata T. Imaging of multi-step hepatocarcinogenesis: imaging, pathophysiologic and molecular correlation. ACTA ACUST UNITED AC 2011. [DOI: 10.2957/kanzo.52.415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ozaki K, Matsui O, Kobayashi S, Sanada J, Koda W, Minami T, Kawai K, Gabata T. Selective Atrophy of the Middle Hepatic Venous Drainage Area in Hepatitis C–related Cirrhotic Liver: Morphometric Study by Using Multidetector CT. Radiology 2010; 257:705-14. [DOI: 10.1148/radiol.10100468] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Tajima H, Ohta T, Kitagawa H, Sakai S, Makino I, Hayashi H, Nakagawara H, Onishi I, Takamura H, Ninomiya I, Fushida S, Tani T, Fujimura T, Kayahara M, Koda W, Minami T, Ryu Y, Sanada J, Matsui O. Hepatic arterial infusion chemotherapy for post-operative liver metastases from pancreatic cancer in a patient with leukocytopenia: A case report. Exp Ther Med 2010; 1:987-990. [PMID: 22993630 DOI: 10.3892/etm.2010.160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 09/23/2010] [Indexed: 12/22/2022] Open
Abstract
Here, we present a case of post-operative liver metastases from pancreatic head cancer in a patient with leukocytopenia, who was safely treated by hepatic arterial infusion (HAI) chemotherapy consisting of gemcitabine and 5-FU. The patient was a 61-year-old woman who underwent pancreaticoduodenectomy for pancreatic head cancer, but was found to be an unsuitable candidate for adjuvant systemic chemotherapy due to the presence of leukocytopenia. Five months after surgery, a follow-up CT revealed two liver metastases. Intravenous systemic chemotherapy was also contraindicated due to the leukocytopenia. In the apparent absence of recurrence, excepting the liver metastases, we decided to administer HAI chemotherapy, which had already been administered following the curative surgery. HAI chemotherapy has been shown to be associated with a lower incidence of systemic side effects. Gemcitabine at a dose of 400 mg was administered via a bedside pump and infused over 30 min. After gemcitabine infusion, 250 mg of 5-FU was infused continuously over 24 h from days 1 to 5. This comprised 1 cycle of therapy. The treatment cycles were continued biweekly. After 10 cycles without severe side effects, it was found that though the size of the metastatic tumors was not reduced, tumor vascularity was. However, after the 13th treatment cycle, local recurrence and lymph node metastases were detected. By this time, the patient had recovered from the leukocytopenia, and could thus be administered systemic chemotherapy. In conclusion, HAI chemotherapy is useful and safe for the treatment of malignancies confined to the liver, even in cases where the patient is in a reduced physical condition.
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Tajima H, Ohta T, Kitagawa H, Shinbashi H, Hirose A, Sakai S, Makino I, Hayashi H, Nakagawara H, Onishi I, Takamura H, Ninomiya I, Fushida S, Tani T, Fujimura T, Kayahara M, Koda W, Matsui O. Giant serous microcystic adenoma of the pancreas safely resected after preoperative arterial embolization. Oncol Lett 2010; 1:841-844. [PMID: 22966391 DOI: 10.3892/ol_00000148] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 05/24/2010] [Indexed: 11/06/2022] Open
Abstract
Serous microcystic adenomas are rare and account for 1-2% of all exocrine pancreatic tumors and 25% of all pancreatic cystic neoplasms. Recently, with advances in imaging techniques, these adenomas have been identified at an increasing frequency. A 63-year-old woman visited her doctor in 1999 due to a gastric deformity detected by upper gastrointestinal endoscopy. An abdominal computed tomography scan revealed a cystic lesion measuring 6.0 cm in diameter, resulting in a diagnosis of serous microcystic adenoma of the pancreatic head. During follow-up, the tumor increased steadily in size, measuring 6.0 cm in diameter in 1999 and 13.0 cm in 2008, while remaining asymptomatic throughout this period of time. The risk of malignant transformation appears to be low even over the long-term. However, some cases of malignant transformation to serous cystadenocarcinoma have recently been reported. In this case, assessment of the relationship between the tumor and adjacent vascular structures, such as massive drainage vein development on the surface or tumor flow into the portal and superior mesenteric veins and the celiac and superior mesenteric arteries, was critical for determining tumor resectability. The risk of massive intra-operative hemorrhage was felt to be considerable, given the extent of the veins on the surface of the tumor, as well as the size and location of the primary pancreatic mass. Therefore, preoperative embolization of the tumor-feeding arteries arising from the celiac axis (gastroduodenal, splenic and dorsal pancreatic arteries) was performed. Tumor resection with pancreaticoduodenectomy was performed without a blood transfusion, with an estimated blood loss of 570 ml. The final pathology confirmed the diagnosis of serous microcystic adenoma. The patient is currently alive and disease-free. Preoperative partial embolization of the tumor feeding arteries and intra-operative resection of the right gastric and inferior pancreatoduodenal arteries, allowed the tumor blood supply to be arrested without preoperative tumor necrosis. Subsequently, intraoperative blood loss was reduced. Preoperative partial embolization of the feeding arteries is useful for the resection of hypervascular large tumors of the pancreas.
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Affiliation(s)
- Hidehiro Tajima
- Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medicine Science, Kanazawa University, Kanazawa, Japan
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Kitao A, Zen Y, Matsui O, Gabata T, Kobayashi S, Koda W, Kozaka K, Yoneda N, Yamashita T, Kaneko S, Nakanuma Y. Hepatocellular carcinoma: signal intensity at gadoxetic acid-enhanced MR Imaging--correlation with molecular transporters and histopathologic features. Radiology 2010; 256:817-26. [PMID: 20663969 DOI: 10.1148/radiol.10092214] [Citation(s) in RCA: 284] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To analyze the correlation between signal intensity in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance (MR) imaging and the expression of hepatocyte transporters with histopathologic features in hepatocellular carcinoma (HCC). MATERIALS AND METHODS Institutional ethics committee approval and informed consent were obtained. Forty surgically resected HCCs were classified as hypointense (n = 32) or iso- or hyperintense (n = 8) on the basis of findings in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging. The following were compared between hypointense and iso- or hyperintense HCCs: the time-signal intensity curves at gadoxetic acid-enhanced MR imaging, the expression levels of seven transporters (four organic anion-transporting polypeptides [OATPs] and three multidrug-resistant proteins [MRPs]) at polymerase chain reaction (PCR) (for 22 nodules), results of immunostaining of OATP8, and histologic features. Statistical analysis (unpaired t test, Mann-Whitney test, chi(2) test, and Fisher exact test) was performed for each result. RESULTS On the time-signal intensity curves, hypointense HCCs showed a decreasing pattern, whereas iso- or hyperintense HCCs showed an increasing pattern after the dynamic phase. PCR revealed that expression of OATP8 (an uptake transporter) in hypointense HCCs was lower and that in iso- or hyperintense HCCs was higher than in background liver (P < .001). The expression level of MRP3 (a sinusoidal export transporter) showed a similar trend to that of OATP8 (P < .001). Immunostaining revealed that OATP8 expression was weak in hypointense HCCs, whereas it was sustained in iso- or hyperintense HCCs (P < .001). At histologic examination, a pseudoglandular proliferation pattern with bile plugs was more commonly observed in iso- or hyperintense HCCs than in hypointense HCCs (P = .01 for proliferation patterns and P = .006 for bile plugs). CONCLUSION The enhancement ratio of HCCs in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging positively correlated with expression levels of OATP8 and MRP3, indicating that gadoxetic acid is taken up by OATP8 and excreted by MRP3.
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Affiliation(s)
- Azusa Kitao
- Department of Radiology, Human Pathology, and Gastroenterology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
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Hayashi N, Miyati T, Koda W, Suzuki M, Sanada S, Ohno N, Hamaguchi T, Matsuura Y, Kawahara K, Yamamoto T, Matsui O. [Quantitative evaluation of Gd-EOB-DTPA uptake in phantom study for liver MRI]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2010; 66:502-508. [PMID: 20628218 DOI: 10.6009/jjrt.66.502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 05/29/2023]
Abstract
Gd-EOB-DTPA is a new liver specific MRI contrast media. In the hepatobiliary phase, contrast media is trapped in normal liver tissue, a normal liver shows high intensity, tumor/liver contrast becomes high, and diagnostic ability improves. In order to indicate the degree of uptake of the contrast media, the enhancement ratio (ER) is calculated. The ER is obtained by calculating (signal intensity (SI) after injection-SI before injection) / SI before injection. However, because there is no linearity between contrast media concentration and SI, ER is not correctly estimated by this method. We discuss a method of measuring ER based on SI and T(1) values using the phantom. We used a column phantom, with an internal diameter of 3 cm, that was filled with Gd-EOB-DTPA diluted solution. Moreover, measurement of the T(1) value by the IR method was also performed. The ER measuring method of this technique consists of the following three components: 1) Measurement of ER based on differences in 1/T(1) values using the variable flip angle (FA) method, 2) Measurement of differences in SI, and 3) Measurement of differences in 1/T(1) values using the IR method. ER values calculated by these three methods were compared. In measurement made using the variable FA method and the IR method, linearity was found between contrast media concentration and ER. On the other hand, linearity was not found between contrast media concentration and SI. For calculation of ER using Gd-EOB-DTPA, a more correct ER is obtained by measuring the T(1) value using the variable FA method.
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Affiliation(s)
- Norio Hayashi
- Department of Radiological Technology, Kanazawa University Hospital
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Suzuki M, Matsui O, Kawashima H, Takemura A, Matsubara K, Hayashi N, Koda W, Shibata Y. Radioanatomical study of a true tracheal bronchus using multidetector computed tomography. Jpn J Radiol 2010; 28:188-92. [PMID: 20437128 DOI: 10.1007/s11604-009-0405-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Accepted: 11/30/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE True tracheal bronchus (TTB) is a rare anomaly in which a lobar or segmental ectopic bronchus arises from the trachea. We examined the frequency and multidetector computed tomography (MDCT) appearances of TTB. MATERIALS AND METHODS We retrospectively analyzed 9781 chest MDCT examinations. In cases in which there was an abnormal bronchus suggesting TTB on axial CT images, the following imaging of the abnormal bronchi was undertaken: multiplanar reformation (MPR), multiprojection volume reconstruction (MPVR), volume rendering (VR), and virtual endoscopy (VE). RESULTS Of 9781 MDCT examinations, 30 TTBs were observed in 10 females and 20 males. The frequency of TTB was 0.21% among 4622 females, 0.39% among 5159 males (0.31 % in the overall patient population). TTBs arose from the right lateral wall of the trachea; 17 TTBs were of the displaced type and 13 of the supernumerary type. With the displaced type, all segments of the right upper lobe were supplied by the TTB in 8 patients, and the apical segment was supplied in 8 patients. With the supernumerary type, TTBs showed blind termination in 10 patients, and the TTB had a small lobule in 3 patients. All TTBs were clearly visualized on MPR, MPVR, VR, and VE. CONCLUSION TTB was identified by MDCT with an incidence of 0.31%.
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Affiliation(s)
- Masayuki Suzuki
- Department of Quantum Medical Technology, Graduate School of Medical Science, Kanazawa University, Kodatsuno, Kanazawa, Japan.
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Furusawa T, Matsumoto I, Oda M, Yachi T, Miyazu K, Watanabe G, Zen Y, Minato H, Shibata Y, Koda W. [Intractable pneumothorax secondary to pulmonary metastasis of angiosarcoma]. Kyobu Geka 2008; 61:779-783. [PMID: 18697460] [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: 05/26/2023]
Abstract
A 68-year-old male suffered from right pneumothorax and was admitted to our hospital. He had a previous history of angiosarcoma of the scalp, and had received local resection and chemoradiotherapy. Chest computed tomography (CT) on admission revealed right pneumothorax and bilateral multiple thin-walled cavities of the lung. We performed partial resection of right lung. Histopathological examination showed a small metastatic lesion around the thin-walled cavities of the lung. Four months after the 1st lung resection, he suffered left pneumothorax. We performed partial resection of the left lung. Ten days after the 2nd lung resection, left pneumothorax recurred. Nine days later, he also developed right pneumothorax. We performed the 3rd operation for right lung. Thoracoscopy demonstrated multiple bullas in right lung and it showed impossibility for radical surgery. Although surgical resection for pneumothorax secondary to metastatic lung cancer is usually efficient, it is very hard to manage the pneumothorax of metastatic angiosarcoma.
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Affiliation(s)
- T Furusawa
- Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan
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Kobayashi S, Matsui O, Gabata T, Sanada J, Koda W, Minami T, Kobayashi T. Hemodynamics of small sclerosing hepatocellular carcinoma without fibrous capsule: evaluation with single-level dynamic CT during hepatic arteriography. ACTA ACUST UNITED AC 2008; 33:425-7. [PMID: 17657527 DOI: 10.1007/s00261-007-9288-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/23/2022]
Abstract
The tumor drainage pathway of a hypervascular liver tumor without fibrous capsule was evaluated histologically and using single-level dynamic CT during hepatic arteriography (CTHA) in a case of sclerosing type of hepatocellular carcinoma. This tumor had a thin corona on CTHA, which represented drainage from the tumor sinusoids to the surrounding liver sinusoids. Additionally, the corona of the hypervascular tumor was thinner without than with the fibrous capsule.
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Affiliation(s)
- Satoshi Kobayashi
- Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara-Machi, Kanazawa, 920-8641, Japan.
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Terayama N, Matsui O, Kobayashi S, Sanada J, Gabata T, Koda W, Minami T. Portosystemic shunt on CT during arterial portography: prevalence in patients with and without liver cirrhosis. ACTA ACUST UNITED AC 2008; 33:80-6. [PMID: 17334875 DOI: 10.1007/s00261-007-9196-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 11/25/2022]
Abstract
BACKGROUND To review various portosystemic shunts (PS) and to evaluate their prevalence by CT during arterial portography (CTAP) using a multidetector-row CT (MDCT). METHODS CTAP of 116 patients (liver cirrhosis 70 patients, non-liver cirrhosis 46 patients) was retrospectively reviewed. CTAP was performed with the catheter placed in the superior mesenteric artery using MDCT. Axial CT images of 0.625- and 3.75- or 2.5-mm thickness were obtained. Multiplanar reformation images and maximum intensity projection images were subjected to review. RESULTS A part of the veins in the ileocecal region drained into the right renal vein or the inferior vena cava (IVC) via the right gonadal vein in 57 patients (81%). A part of the veins of the ascending colon drained via the right renal capsular vein into the IVC in 37 patients (53%). In 46 patients without liver cirrhosis, the right gonadal and right renal capsular veins were opacified on CTAP in 22 patients (48%) and 20 patients (43%), respectively. CONCLUSIONS Portosystemic shunts in retroperitoneum were frequently recognized on CTAP images in patients with liver cirrhosis. The right gonadal vein and the right renal capsular vein were the most frequent routes of the portosystemic shunts. They may exist in physiological condition.
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Affiliation(s)
- Noboru Terayama
- Department of Radiology, Kanazawa University, Graduate School of Medical Science , Kanazawa, 920-8641, Japan.
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Watanabe SI, Arai K, Watanabe T, Koda W, Urayama H. Use of three-dimensional computed tomographic angiography of pulmonary vessels for lung resections. Ann Thorac Surg 2003; 75:388-92; discussion 392. [PMID: 12607645 DOI: 10.1016/s0003-4975(02)04375-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Identification and appropriate treatment of the pulmonary artery (PA) is a key to successful anatomic resection of the lung. Preoperative identification of branching pattern of the PA seems to make pulmonary resection easier and safer especially when there is severe adhesion or incomplete fissure between the lobes. With the development of the multidetector row spiral computed tomography (MDCT), three-dimensional (3D) CT angiography can be obtained easily and can provide very useful information about various organs. We studied the usefulness of 3D-CT pulmonary angiography (3D-CTPA) in evaluating the PA branching pattern before anatomic pulmonary resection. METHODS Fourteen patients with primary lung cancer undergoing anatomic pulmonary resections were the subjects of this study. The 3D-CTPA images were obtained using MDCT. The obtained images of the PA branching pattern were compared with intraoperative findings in each case at the time of thoracotomy. RESULTS MDCT scanning required approximately 15 seconds per patient during a single respiratory pause and the 3D images were processed within 10 minutes after scannning. According to intraoperative findings, 98% (84 of 86) of PA branches were revealed to be successfully identified on preoperative 3D-CTPA. Two missed branches on 3D-CTPA were small vessels, which were less than 1.5 mm in actual diameter. Pulmonary vessels were clearly identified even when contrast medium was not administered intravenously. CONCLUSIONS Obtaining 3D-CTPA using MDCT is noninvasive yet it provides precise preoperative information regarding pulmonary vessels. This technique is a far less invasive and an easier investigation than conventional pulmonary angiography. The 3D-CTPA navigation may have the potential to increase the safety of surgical procedure and to reduce surgical morbidity in anatomic lung resection.
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Affiliation(s)
- Shun-ichi Watanabe
- Department of Thoracic and Vascular Surgery, Kurobe City Hospital, Kurobe, Japan.
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