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Cirrhosis imaging

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https://www.readbyqxmd.com/read/28337405/tailored-algorithms-for-hepatocellular-carcinoma-surveillance-is-one-size-fits-all-strategy-outdated
#1
Nicolas Goossens, C Billie Bian, Yujin Hoshida
PURPOSE OF REVIEW: Current clinical practice guidelines recommend regular hepatocellular carcinoma (HCC) surveillance with biannual ultrasound with or without serum alpha-fetoprotein uniformly applied to all patients with cirrhosis. However, clinical implementation of this one-size-fits-all strategy has been challenging as evidenced by very low application rate below 20% due to various reasons, including suboptimal performance of the surveillance modalities. RECENT FINDINGS: Newly emerging imaging techniques such as abbreviated MRI (AMRI) and molecular HCC risk biomarkers have increasingly become available for clinical evaluation and implementation...
March 2017: Current Hepatology Reports
https://www.readbyqxmd.com/read/28321540/ct-perfusion-imaging-of-the-liver-and-the-spleen-in-patients-with-cirrhosis-is-there-a-correlation-between-perfusion-and-portal-venous-hypertension
#2
Emina Talakić, Silvia Schaffellner, Daniela Kniepeiss, Helmut Mueller, Rudolf Stauber, Franz Quehenberger, Helmut Schoellnast
OBJECTIVES: To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. METHODS: Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL)...
March 20, 2017: European Radiology
https://www.readbyqxmd.com/read/28301997/hepatocellular-carcinoma-in-the-cirrhotic-liver-evaluation-using-computed-tomography-and-magnetic-resonance-imaging
#3
Mehmet Coskun
Hepatocellular carcinoma is the fifth most common tumor in patients worldwide and the third most common cause of cancer-related death, after lung and stomach cancer. Cirrhosis of the liver is the strongest predisposing factor for hepatocellular carcinoma, with approximately 80% of cases of hepatocellular carcinoma developing in a cirrhotic liver. The annual incidence of hepatocellular carcinoma is 2.0% to 6.6% in patients with cirrhosis compared with 0.4% in patients without cirrhosis. The 5-year survival rates of patients undergoing curative therapies for hepatocellular carcinoma, including liver transplant, hepatic resection, and percutaneous ablative techniques, range between 40% and 75%...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28298743/the-powerful-lens-of-magnetic-resonance-imaging-in-the-diagnosis-of-hepatic-nodules-in-patients-with-cirrhosis-diagnosis-of-hepatocellular-carcinoma-without-the-need-of-histopathological-confirmation-fact
#4
EDITORIAL
https://www.readbyqxmd.com/read/28298731/magnetic-resonance-imaging-of-the-cirrhotic-liver-diagnosis-of-hepatocellular-carcinoma-and-evaluation-of-response-to-treatment-part-1
#5
REVIEW
Miguel Ramalho, António P Matos, Mamdoh AlObaidy, Fernanda Velloni, Ersan Altun, Richard C Semelka
Magnetic resonance imaging (MRI) is the modern gold standard for the noninvasive evaluation of the cirrhotic liver. The combination of arterial phase hyperenhancement and delayed wash-out allows a definitive diagnosis of hepatocellular carcinoma (HCC) in patients with liver cirrhosis or chronic liver disease, without the requirement for confirmatory biopsy. That pattern is highly specific and has been endorsed in Western and Asian diagnostic guidelines. However, the sensitivity of the combination is relatively low for small HCCs...
January 2017: Radiologia Brasileira
https://www.readbyqxmd.com/read/28297797/-research-advances-in-diagnosis-of-non-alcoholic-fatty-liver-disease
#6
J H Wang, C H Yu
Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in clinical practice, and the spectrum of NAFLD includes nonalcoholic simple fatty liver, nonalcoholic steatohepatitis, and liver cirrhosis. Some patients may even progress to hepatocellular carcinoma. At present, the gold standard for the diagnosis of NAFLD is liver biopsy, but since this is an invasive examination and has high costs, its application is limited in clinical practice. More and more studies have focused on noninvasive diagnostic methods for NAFLD, including serological markers, fatty liver predictive model, and imaging examinations...
February 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28293379/clinical-features-histology-and-histogenesis-of-combined-hepatocellular-cholangiocarcinoma
#7
REVIEW
Shweta Gera, Mark Ettel, Gabriel Acosta-Gonzalez, Ruliang Xu
Combined hepatocellular-cholangiocarcinoma (CHC) is a rare tumor with poor prognosis, with incidence ranging from 1.0%-4.7% of all primary hepatic tumors. This entity will be soon renamed as hepato-cholangiocarcinoma. The known risk factors for hepatocellular carcinoma (HCC) have been implicated for CHC including viral hepatitis and cirrhosis. It is difficult to diagnose this tumor pre-operatively. The predominant histologic component within the tumor largely determines the predominant radiographic features making it a difficult distinction...
February 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28289936/comparison-of-spin-echo-echoplanar-imaging-and-gradient-recalled-echo-based-mr-elastography-at-3-tesla-with-and-without-gadoxetic-acid-administration
#8
Yong Seek Kim, Ji Soo Song, Stephan Kannengiesser, Seung Young Seo
OBJECTIVE: To compare spin-echo echoplanar imaging (SE-EPI) and gradient recalled echo (GRE) MR elastography (MRE) at 3 T with and without gadoxetic acid administration. METHODS: We included 84 patients who underwent MRE before and after gadoxetic acid administration, each time using SE-EPI and GRE sequences. Diagnostic performance for predicting clinical liver cirrhosis and high-risk oesophageal varices was assessed using the area under the receiver-operating characteristic curve (AUC)...
March 13, 2017: European Radiology
https://www.readbyqxmd.com/read/28277807/magnetic-resonance-imaging-and-transient-elastography-in-the-management-of-nonalcoholic-fatty-liver-disease-nafld
#9
Ma Ai Thanda Han, Rola Saouaf, Walid Ayoub, Tsuyoshi Todo, Edward Mena, Mazen Noureddin
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease and cirrhosis worldwide and the second most common cause of liver transplantation in major medical centers. Because liver steatosis and fibrosis severity are related to disease morbidity and mortality, the extent of disease, and disease progression, they need to be assessed and monitored. In addition, innovation with new drug developments requires disease staging and monitoring in both phase 2 and 3 clinical trials. Currently, disease assessment in both clinical practice and research is mostly performed by liver biopsy, an invasive, procedure with risks...
April 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28276105/adctotal-ratio-and-d-ratio-derived-from-intravoxel-incoherent-motion-early-after-tace-are-independent-predictors-for-survival-in-hepatocellular-carcinoma
#10
Lifang Wu, Pengju Xu, Shengxiang Rao, Li Yang, Caizhong Chen, Hao Liu, Caixia Fu, Mengsu Zeng
PURPOSE: To explore the threshold of intravoxel incoherent motion (IVIM) parameters, apparent diffusion coefficient [ADCtotal and ADC(0,500) ] ratios 24-48 hours after transarterial chemoembolization (TACE) to assess early response in patients with unresectable hepatocellular carcinoma (HCC) and to compare the association between diffusion-weighted imaging with the intravoxel incoherent motion (IVIM-DWI) and mRECIST with survival. MATERIALS AND METHODS: Institutional Review Board approval and informed consent were obtained for this prospective study...
March 9, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28275294/anatomical-resection-of-hepatocellular-carcinoma-a-critical-review-of-the-procedure-and-its-benefits-on-survival
#11
REVIEW
Koo Jeong Kang, Keun Soo Ahn
Hepatocellular carcinoma (HCC) is the sixth most common type of cancer and the third most frequent cause of cancer-related death. Advances in preoperative assessment of HCC (e.g., imaging studies and liver function tests), surgical techniques, and postoperative care have improved the surgical outcomes and survival of patients who undergo hepatic resection for HCC. However, in the last 20 years, the long-term survival after hepatectomy has remained unsatisfactory owing to the high rates of local recurrence and multicentric occurrence...
February 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28267700/ultrasonography-for-noninvasive-assessment-of-portal-hypertension
#12
REVIEW
Hitoshi Maruyama, Osamu Yokosuka
Portal hypertension is a major pathophysiology in patients with cirrhosis. Portal pressure is the gold standard to evaluate the severity of portal hypertension, and radiological intervention is the only procedure for pressure measurement. Ultrasound (US) is a simple and noninvasive imaging modality available worldwide. B-mode imaging allows broad applications for patients to detect and characterize chronic liver diseases and focal hepatic lesions. The Doppler technique offers real-time observation of blood flow with qualitative and quantitative assessments, and the application of microbubble-based contrast agents has improved the detectability of peripheral blood flow...
March 9, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28263464/assessment-of-hepatic-impairment-and-implications-for-pharmacokinetics-of-substance-use-treatment
#13
Andrew H Talal, Charles S Venuto, Islam Younis
Although the liver is the primary site of metabolism and biliary excretion for many medications, data are limited on the liver's pharmacokinetic abilities in cirrhosis. Cirrhosis develops through collagen deposition, eventually culminating in end-stage liver disease that compromises hepatic drug metabolism. Consequently, the US Food and Drug Administration (FDA) recommends evaluating the pharmacokinetics of medications in subjects with hepatic impairment if hepatic metabolism constitutes more than 20% of their elimination or if they have a narrow therapeutic range...
March 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28260429/low-utility-of-fluorodeoxyglucose-positron-emission-tomography-computed-tomography-for-detecting-hepatocellular-carcinoma-in-patients-before-liver-transplantation
#14
Faisal Alotaibi, Monther Kabbani, Faisal Abaalkhail, Alicia Chorley, Hany Elbeshbeshy, Waleed Al-Hamoudi, Saleh Alabbad, Markus U Boehnert, Mohammad Alsofayan, Wael Al-Kattan, Baderaldeen Ahmed, Dieter Broering, Mohamed Al Sebayel, Hussien Elsiesy
OBJECTIVES: Our program routinely used fluorodeoxyglucose-positron emission tomography/computed tomography as part of the liver transplant evaluation of patients with hepatocellular carcinoma. The aim of this study was to evaluate the role of this imaging modality in the pretransplant work-up. MATERIALS AND METHODS: This was a retrospective chart review of our liver transplant database from January 2011 to December 2014 for all patients with hepatocellular carcinoma who underwent a liver transplant...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28259768/-18-f-fp-cit-dopamine-transporter-pet-findings-in-cirrhotic-patients-with-parkinsonism
#15
Hui-Jun Yang, Seol Hoon Park, Minjung Seo, Young Cheol Weon, Yangho Kim
We report the clinical features and imaging findings of presynaptic dopamine transporter (DAT) positron emission tomography (PET) in four of patients with liver cirrhosis and concurrent parkinsonism. We also reviewed previously reported cases of cirrhosis-related parkinsonism using dopaminergic molecular imaging. Our results using (18)F-radiolabeled N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane (FP-CIT) DAT PET in four patients with cirrhosis and parkinsonism showed two different molecular imaging patterns well related to their neurological symptoms...
March 1, 2017: Neurotoxicology
https://www.readbyqxmd.com/read/28258743/loco-regional-treatment-of-hcc-current-status
#16
REVIEW
L Crocetti, I Bargellini, R Cioni
Hepatocellular carcinoma (HCC) represents one of the few cancers for which locoregional treatments are recognised as being able to cure and/or prolong survival and are included in international guidelines. This is due to the unique nature of HCC, in most cases occurring in patients with underlying virus- or alcohol-related cirrhosis. The treatment choice in patients with HCC is therefore driven not only by tumour staging, as in the great majority of cancers, but also by careful evaluation of liver function and physical status...
February 28, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28257439/diminished-liver-microperfusion-in-fontan-patients-a-biexponential-dwi-study
#17
Hildebrand Dijkstra, Djoeke Wolff, Joost P van Melle, Beatrijs Bartelds, Tineke P Willems, Matthijs Oudkerk, Hans Hillege, Aad P van den Berg, Tjark Ebels, Rolf M F Berger, Paul E Sijens
It has been demonstrated that hepatic apparent diffusion coefficients (ADC) are decreasing in patients with a Fontan circulation. It remains however unclear whether this is a true decrease of molecular diffusion, or rather reflects decreased microperfusion due to decreased portal blood flow. The purpose of this study was therefore to differentiate diffusion and microperfusion using intravoxel incoherent motion (IVIM) modeled diffusion-weighted imaging (DWI) for different liver segments in patients with a Fontan circulation, compare to a control group, and relate with liver function, chronic hepatic congestion and hepatic disease...
2017: PloS One
https://www.readbyqxmd.com/read/28257031/portal-vein-embolization-impact-of-chemotherapy-and-genetic-mutations
#18
Amy R Deipolyi, Yu Shrike Zhang, Ali Khademhosseini, Sailendra Naidu, Mitesh Borad, Burcu Sahin, Amit K Mathur, Rahmi Oklu
We characterized the effect of systemic therapy given after portal vein embolization (PVE) and before hepatectomy on hepatic tumor and functional liver remnant (FLR) volumes. All 76 patients who underwent right PVE from 2002-2016 were retrospectively studied. Etiologies included colorectal cancer (n = 44), hepatocellular carcinoma (n = 17), cholangiocarcinoma (n = 10), and other metastases (n = 5). Imaging before and after PVE was assessed. Chart review revealed systemic therapy administration, SNaPshot genetic profiling, and comorbidities...
March 1, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28255371/non-invasive-imaging-techniques-in-assessing-non-alcoholic-fatty-liver-disease-a-current-status-of-available-methods
#19
REVIEW
A M Lăpădat, I R Jianu, B S Ungureanu, L M Florescu, D I Gheonea, S Sovaila, I A Gheonea
Non-alcoholic fatty liver disease (NAFLD) is an ailment affecting and increasing a number of people worldwide diagnosed via non-invasive imaging techniques, at a time when a minimum harm caused by medical procedures is rightfully emphasized, more sought after, than ever before. Liver steatosis should not be taken lightly even if its evolution is largely benign as it has the potential to develop into non-alcoholic steatohepatitis (NASH) or even more concerning, hepatic cirrhosis, and hepatocellular carcinoma (HCC)...
January 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28251119/fibrosis-assessment-in-patients-with-chronic-hepatitis-b-virus-hbv-infection
#20
REVIEW
Pathik Parikh, John D Ryan, Emmanuel A Tsochatzis
Chronic hepatitis B virus (HBV) infection is a major cause of liver morbidity and mortality worldwide. While a proportion of the 250 million individuals chronically infected with HBV will not come to significant harm or require therapy, many others risk developing complications of the end-stage liver disease such as decompensated cirrhosis and hepatocellular carcinoma (HCC), without intervention. Due to the complex natural history of HBV infection, patients require an expert assessment to interpret biochemistry, viral serology and appropriately stage the disease, and to initiate monitoring and/or therapy where indicated...
February 2017: Annals of Translational Medicine
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