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Krolak C, Dighe M, Clark A, Shumaker M, Yeung R, Barr RG, Kono Y, Averkiou M. Quantification of Hepatocellular Carcinoma Vascular Dynamics With Contrast-Enhanced Ultrasound for LI-RADS Implementation. Invest Radiol 2024; 59:337-344. [PMID: 37725492 PMCID: PMC10939991 DOI: 10.1097/rli.0000000000001022] [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] [Indexed: 09/21/2023]
Abstract
OBJECTIVE The aim of this study is to describe a comprehensive contrast-enhanced ultrasound (CEUS) imaging protocol and analysis method to implement CEUS LI-RADS (Liver Imaging Reporting and Data System) in a quantifiable manner. The methods that are validated with a prospective single-center study aim to simplify CEUS LI-RADS evaluation, remove observer bias, and potentially improve the sensitivity of CEUS LI-RADS. MATERIALS AND METHODS This prospective single-center study enrolled patients with hepatocellular carcinoma (April 2021-June 2022; N = 31; mean age ± SD, 67 ± 6 years; 24 men/7 women). For each patient, at least 2 CEUS loops spanning over 5 minutes were collected for different lesion scan planes using an articulated arm to hold the transducer. Automatic respiratory gating and motion compensation algorithms removed errors due to breathing motion. The long axis of the lesion was measured in the contrast and fundamental images to capture nodule size. Parametric processing of time-intensity curve analysis on linearized data provided quantifiable information of the wash-in and washout dynamics via rise time ( RT ) and degree of washout ( DW ) parameters extracted from the time-intensity curve, respectively. A Welch t test was performed between lesion and parenchyma RT for each lesion to confirm statistically significant differences. P values for bootstrapped 95% confidence intervals of the relative degree of washout ( rDW ), ratio of DW between the lesion and surrounding parenchyma, were computed to quantify lesion washout. Coefficient of variation (COV) of RT , DW , and rDW was calculated for each patient between injections for both the lesion and surrounding parenchyma to gauge reproducibility of these metrics. Spearman rank correlation tests were performed among size, RT , DW , and rDW values to evaluate statistical dependence between the variables. RESULTS The mean ± SD lesion diameter was 23 ± 8 mm. The RT for all lesions, capturing arterial phase hyperenhancement, was shorter than that of surrounding liver parenchyma ( P < 0.05). All lesions also demonstrated significant ( P < 0.05) but variable levels of washout at both 2-minute and 5-minute time points, quantified in rDW . The COV of RT for the lesion and surrounding parenchyma were both 11%, and the COV of DW and rDW at 2 and 5 minutes ranged from 22% to 31%. Statistically significant relationships between lesion and parenchyma RT and between lesion RT and lesion DW at the 2- and 5-minute time points were found ( P < 0.05). CONCLUSIONS The imaging protocol and analysis method presented provide robust, quantitative metrics that describe the dynamic vascular patterns of LI-RADS 5 lesions classified as hepatocellular carcinomas. The RT of the bolus transit quantifies the arterial phase hyperenhancement, and the DW and rDW parameters quantify the washout from linearized CEUS intensity data. This unique methodology is able to implement the CEUS-LIRADS scheme in a quantifiable manner for the first time and remove its existing issues of currently being qualitative and suffering from subjective evaluations.
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Affiliation(s)
- Connor Krolak
- University of Washington Department of Bioengineering, Seattle, USA
| | - Manjiri Dighe
- University of Washington Department of Radiology, Seattle, USA
| | - Alicia Clark
- University of Washington Department of Bioengineering, Seattle, USA
| | - Marissa Shumaker
- University of Washington Department of Bioengineering, Seattle, USA
| | - Raymond Yeung
- University of Washington Department of Surgery, Seattle, USA
| | | | - Yuko Kono
- University of California at San Diego Department of Radiology, San Diego, USA
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2
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Hassan MM, Li D, Han Y, Byun J, Hatia RI, Long E, Choi J, Kelley RK, Cleary SP, Lok AS, Bracci P, Permuth JB, Bucur R, Yuan JM, Singal AG, Jalal PK, Ghobrial RM, Santella RM, Kono Y, Shah DP, Nguyen MH, Liu G, Parikh ND, Kim R, Wu HC, El-Serag H, Chang P, Li Y, Chun YS, Lee SS, Gu J, Hawk E, Sun R, Huff C, Rashid A, Amin HM, Beretta L, Wolff RA, Antwi SO, Patt Y, Hwang LY, Klein AP, Zhang K, Schmidt MA, White DL, Goss JA, Khaderi SA, Marrero JA, Cigarroa FG, Shah PK, Kaseb AO, Roberts LR, Amos CI. Genome-wide association study identifies high-impact susceptibility loci for HCC in North America. Hepatology 2024:01515467-990000000-00763. [PMID: 38381705 DOI: 10.1097/hep.0000000000000800] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/18/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND AND AIMS Despite the substantial impact of environmental factors, individuals with a family history of liver cancer have an increased risk for HCC. However, genetic factors have not been studied systematically by genome-wide approaches in large numbers of individuals from European descent populations (EDP). APPROACH AND RESULTS We conducted a 2-stage genome-wide association study (GWAS) on HCC not affected by HBV infections. A total of 1872 HCC cases and 2907 controls were included in the discovery stage, and 1200 HCC cases and 1832 controls in the validation. We analyzed the discovery and validation samples separately and then conducted a meta-analysis. All analyses were conducted in the presence and absence of HCV. The liability-scale heritability was 24.4% for overall HCC. Five regions with significant ORs (95% CI) were identified for nonviral HCC: 3p22.1, MOBP , rs9842969, (0.51, [0.40-0.65]); 5p15.33, TERT , rs2242652, (0.70, (0.62-0.79]); 19q13.11, TM6SF2 , rs58542926, (1.49, [1.29-1.72]); 19p13.11 MAU2 , rs58489806, (1.53, (1.33-1.75]); and 22q13.31, PNPLA3 , rs738409, (1.66, [1.51-1.83]). One region was identified for HCV-induced HCC: 6p21.31, human leukocyte antigen DQ beta 1, rs9275224, (0.79, [0.74-0.84]). A combination of homozygous variants of PNPLA3 and TERT showing a 6.5-fold higher risk for nonviral-related HCC compared to individuals lacking these genotypes. This observation suggests that gene-gene interactions may identify individuals at elevated risk for developing HCC. CONCLUSIONS Our GWAS highlights novel genetic susceptibility of nonviral HCC among European descent populations from North America with substantial heritability. Selected genetic influences were observed for HCV-positive HCC. Our findings indicate the importance of genetic susceptibility to HCC development.
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Affiliation(s)
- Manal M Hassan
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Younghun Han
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas, USA
| | - Jinyoung Byun
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas, USA
| | - Rikita I Hatia
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Erping Long
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jiyeon Choi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Robin Kate Kelley
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California, USA
| | - Sean P Cleary
- Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Anna S Lok
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Paige Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Jennifer B Permuth
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Roxana Bucur
- Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Jian-Min Yuan
- Cancer Epidemiology and Prevention Program, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Amit G Singal
- Division of Digestive and Liver Diseases, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Prasun K Jalal
- Department of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA
| | - R Mark Ghobrial
- J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas, USA
| | - Regina M Santella
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Yuko Kono
- Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, California, USA
| | - Dimpy P Shah
- Mays Cancer Center, The University of Texas Health Science Center San Antonio MD Anderson, San Antonio, Texas, USA
| | - Mindie H Nguyen
- Division of Gastroenterology and Hepatology, Department of Epidemiology and Population Health, Stanford University Medical Center, Palo Alto, California, USA
| | - Geoffrey Liu
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Neehar D Parikh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Richard Kim
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Hui-Chen Wu
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Hashem El-Serag
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Ping Chang
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yanan Li
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yun Shin Chun
- Division of Surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sunyoung S Lee
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jian Gu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ernest Hawk
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ryan Sun
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Chad Huff
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Asif Rashid
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Hesham M Amin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Laura Beretta
- Department of Molecular and Cellular Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Robert A Wolff
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Samuel O Antwi
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida, USA
| | - Yehuda Patt
- Division of Hematology/Oncology, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Lu-Yu Hwang
- Department of Epidemiology, Human Genetics, and Environment Science, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Alison P Klein
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA
| | - Karen Zhang
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California, USA
| | - Mikayla A Schmidt
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Donna L White
- Sections of Gastroenterology and Hepatology and Health Services Research, Baylor College of Medicine, Houston, Texas, USA
| | - John A Goss
- Division of Abdominal Transplantation, Michael E. DeBakey School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Saira A Khaderi
- Division of Abdominal Transplantation, Baylor College of Medicine, Houston, Texas, USA
| | - Jorge A Marrero
- Division of Digestive and Liver Diseases, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Francisco G Cigarroa
- Transplant Center, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Pankil K Shah
- Mays Cancer Center, The University of Texas Health Science Center San Antonio MD Anderson, San Antonio, Texas, USA
| | - Ahmed O Kaseb
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lewis R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Christopher I Amos
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas, USA
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Aoyama Y, Kono Y, Kawahara Y. Gastrointestinal: Carcinoma of the duodenal bulb with rapid growth and distant metastasis. J Gastroenterol Hepatol 2024. [PMID: 38361450 DOI: 10.1111/jgh.16502] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/18/2023] [Accepted: 01/07/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Y Aoyama
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Y Kono
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Y Kawahara
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Lyshchik A, Wessner CE, Bradigan K, Eisenbrey JR, Forsberg F, Yi M, Keith SW, Kono Y, Wilson SR, Medellin A, Rodgers SK, Planz V, Kamaya A, Finch L, Fetzer DT, Berzigotti A, Sidhu PS, Piscaglia F. Contrast-enhanced ultrasound liver imaging reporting and data system: clinical validation in a prospective multinational study in North America and Europe. Hepatology 2024; 79:380-391. [PMID: 37548928 DOI: 10.1097/hep.0000000000000558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 05/08/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND AIMS The objective of this study is to determine the diagnostic accuracy of the American College of Radiology Contrast-Enhanced Ultrasound (CEUS) Liver Imaging Reporting and Data System LR-5 characterization for HCC diagnosis in North American or European patients. APPROACH AND RESULTS A prospective multinational cohort study was performed from January 2018 through November 2022 at 11 academic and nonacademic centers in North America and Europe. Patients at risk for HCC with at least 1 liver observation not previously treated, identified on ultrasound (US), or multiphase CT or MRI performed as a part of standard clinical care were eligible for the study. All participants were examined with CEUS of the liver within 4 weeks of CT/MRI or tissue diagnosis to characterize up to 2 liver nodules per participant using ACR CEUS Liver Imaging Reporting and Data System. Definite HCC diagnosis on the initial CT/MRI, imaging follow-up, or histology for CT/MRI-indeterminate nodules were used as reference standards. A total of 545 nodules had confirmed reference standards in 480 patients, 73.8% were HCC, 5.5% were other malignancies, and 20.7% were nonmalignant. The specificity of CEUS LR-5 for HCC was 95.1% (95% CI 90.1%-97.7%), sensitivity 62.9% (95% CI 57.9%-67.7%), positive predictive value 97.3% (95% CI 94.5%-98.7%), and negative predictive value 47.7% (95% CI 41.7%-53.8%). In addition, benign CEUS characterization (LR-1 or LR-2) had 100% specificity and 100% positive predictive value for nonmalignant liver nodules. CONCLUSIONS CEUS Liver Imaging Reporting and Data System provides an accurate categorization of liver nodules in participants at risk for HCC.
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Affiliation(s)
- Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Corinne E Wessner
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Kristen Bradigan
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - John R Eisenbrey
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Flemming Forsberg
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Misung Yi
- Department of Pharmacology, Physiology, and Cancer Biology, Division of Biostatistics, Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
| | - Scott W Keith
- Department of Pharmacology, Physiology, and Cancer Biology, Division of Biostatistics, Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
- Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Yuko Kono
- University of California, San Diego, San Diego, California, USA
| | | | | | - Shuchi K Rodgers
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
- Einstein Medical Center, Philadelphia, Pennsylvania, USA
| | | | - Aya Kamaya
- Stanford University, Stanford, California, USA
| | - Lisa Finch
- Swedish Medical Center, Seattle, Washington, USA
| | | | - Annalisa Berzigotti
- Department of Visceral Surgery and Medicine, Bern, University Hospital, University of Bern, Bern Switzerland
| | - Paul S Sidhu
- Department of Imaging Sciences, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Radiology, King's College Hospital, London, UK
| | - Fabio Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy
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5
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Savsani E, Shaw CM, Forsberg F, Wessner CE, Lyshchik A, O'Kane P, Liu JB, Balasubramanya R, Roth CG, Naringrekar H, Keith SW, Tan A, Anton K, Bradigan K, Civan J, Schultz S, Shamimi-Noori S, Hunt S, Soulen MC, Mattrey RF, Kono Y, Eisenbrey JR. Contrast-enhanced US Evaluation of Hepatocellular Carcinoma Response to Chemoembolization: A Prospective Multicenter Trial. Radiology 2023; 309:e230727. [PMID: 37847138 PMCID: PMC10623205 DOI: 10.1148/radiol.230727] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/04/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
Background Contrast-enhanced (CE) US has been studied for use in the detection of residual viable hepatocellular carcinoma (HCC) after locoregional therapy, but multicenter data are lacking. Purpose To compare two-dimensional (2D) and three-dimensional (3D) CE US diagnostic performance with that of CE MRI or CT, the current clinical standard, in the detection of residual viable HCC after transarterial chemoembolization (TACE) in a prospective multicenter trial. Materials and Methods Participants aged at least 21 years with US-visible HCC scheduled for TACE were consecutively enrolled at one of three participating academic medical centers from May 2016 to March 2022. Each underwent baseline 2D and 3D CE US before TACE, 2D and 3D CE US 1-2 weeks and/or 4-6 weeks after TACE, and CE MRI or CT 4-6 weeks after TACE. CE US and CE MRI or CT were evaluated by three fellowship-trained radiologists for the presence or absence of viable tumors and were compared with reference standards of pathology (18%), angiography on re-treatment after identification of residual disease at 1-2-month follow-up imaging (31%), 4-8-month CE MRI or CT (42%), or short-term (approximately 1-2 months) CE MRI or CT if clinically decompensated and estimated viability was greater than 50% at imaging (9%). Diagnostic performance criteria, including sensitivity and specificity, were obtained for each modality and time point with generalized estimating equation analysis. Results A total of 132 participants were included (mean age, 64 years ± 7 [SD], 87 male). Sensitivity of 2D CE US 4-6 weeks after TACE was 91% (95% CI: 84, 95), which was higher than that of CE MRI or CT (68%; 95% CI: 58, 76; P < .001). Sensitivity of 3D CE US 4-6 weeks after TACE was 89% (95% CI: 81, 94), which was higher than that of CE MRI or CT (P < .001), with no evidence of a difference from 2D CE US (P = .22). CE MRI or CT had 85% (95% CI: 76, 91) specificity, higher than that of 4-6-week 2D and 3D CE US (70% [95% CI: 56, 80] and 67% [95% CI: 53, 78], respectively; P = .046 and P = .023, respectively). No evidence of differences in any diagnostic criteria were observed between 1-2-week and 4-6-week 2D CE US (P > .21). Conclusion The 2D and 3D CE US examinations 4-6 weeks after TACE revealed higher sensitivity in the detection of residual HCC than CE MRI or CT, albeit with lower specificity. Importantly, CE US performance was independent of follow-up time. Clinical trial registration no. NCT02764801 © RSNA, 2023 Supplemental material is available for this article.
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Affiliation(s)
- Esika Savsani
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Colette M. Shaw
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Flemming Forsberg
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Corinne E. Wessner
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Andrej Lyshchik
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Patrick O'Kane
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Ji-Bin Liu
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Rashmi Balasubramanya
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Christopher G. Roth
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Haresh Naringrekar
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Scott W. Keith
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Allison Tan
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Kevin Anton
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Kristen Bradigan
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Jesse Civan
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Susan Schultz
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Susan Shamimi-Noori
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Stephen Hunt
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Michael C. Soulen
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Robert F. Mattrey
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Yuko Kono
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - John R. Eisenbrey
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
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6
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Igata S, Kono Y, Van Houten T, Hang CT, Cotter BR, Strachan MG, Morikawa N, DeMaria AN. Role of Quantitation of Saline Bubble Studies in Patients with Liver Cirrhosis. Ultrasound Med Biol 2023; 49:1804-1810. [PMID: 37198087 DOI: 10.1016/j.ultrasmedbio.2023.04.003] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Microbubble contrast echocardiography with a late positive signal enables the detection of intrapulmonary vascular dilation, including hepatopulmonary syndrome, in patients with end-stage liver disease. We assessed the relationship between the severity of bubble study and clinical outcome. METHODS We retrospectively analyzed 163 consecutive patients with liver cirrhosis who underwent an echocardiogram with bubble study from 2018 to 2021. Patients who were diagnosed with a late positive signal were divided into three groups: grade 1 (1-9 bubbles), grade 2 (10-30 bubbles) and grade 3 (>30 bubbles). RESULTS Fifty-six percent of the patients had a late positive bubble study (grade 1: 31%, grade 2: 23%, grade 3: 46%). Patients with grade 3 had a significantly higher international normalized ratio, model for end-stage liver disease score and Child-Pugh score and a lower peripheral oxygen saturation compared with patients with a negative study. In patients undergoing liver transplant (LT), survival rates were similar among the groups (3-mo: >87%, 1-y: >87%, 2-y: >83%). However, survival rate was lower in grade 3 patients without LT (3-mo: 81%, 1-y: 64%, 2-y: 39%). CONCLUSION Patients with grade 3 had much worse mortality without LT compared with other groups. However, after LT, all grades had equal survival. Therefore, patients with grade 3 may be considered as higher priority for LT.
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Affiliation(s)
- Sachiyo Igata
- Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA.
| | - Yuko Kono
- Division of Hepatology, Department of Medicine, University of California, San Diego, CA, USA
| | - Thomas Van Houten
- Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA
| | - Calvin T Hang
- Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA
| | - Bruno R Cotter
- Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA
| | - Monet G Strachan
- Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA
| | - Nagisa Morikawa
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Anthony N DeMaria
- Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA
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7
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Moon AM, Kim HP, Singal AG, Owen D, Mendiratta-Lala M, Parikh ND, Rose SC, McGinty KA, Agala CB, Burke LM, Abate A, Altun E, Beyer C, Do J, Folkert MR, Forbes C, Hattangadi-Gluth JA, Hayashi PH, Jones K, Khatri G, Kono Y, Lawrence TS, Maurino C, Mauro DM, Mayo CS, Pak T, Patil P, Sanders EC, Simpson DR, Tepper JE, Thapa D, Yanagihara TK, Wang K, Gerber DA. Thermal ablation compared to stereotactic body radiation therapy for hepatocellular carcinoma: A multicenter retrospective comparative study. Hepatol Commun 2023; 7:e00184. [PMID: 37314737 PMCID: PMC10270501 DOI: 10.1097/hc9.0000000000000184] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND AIMS Early-stage HCC can be treated with thermal ablation or stereotactic body radiation therapy (SBRT). We retrospectively compared local progression, mortality, and toxicity among patients with HCC treated with ablation or SBRT in a multicenter, US cohort. APPROACH RESULTS We included adult patients with treatment-naïve HCC lesions without vascular invasion treated with thermal ablation or SBRT per individual physician or institutional preference from January 2012 to December 2018. Outcomes included local progression after a 3-month landmark period assessed at the lesion level and overall survival at the patient level. Inverse probability of treatment weighting was used to account for imbalances in treatment groups. The Cox proportional hazard modeling was used to compare progression and overall survival, and logistic regression was used for toxicity. There were 642 patients with 786 lesions (median size: 2.1 cm) treated with ablation or SBRT. In adjusted analyses, SBRT was associated with a reduced risk of local progression compared to ablation (aHR 0.30, 95% CI: 0.15-0.60). However, SBRT-treated patients had an increased risk of liver dysfunction at 3 months (absolute difference 5.5%, aOR 2.31, 95% CI: 1.13-4.73) and death (aHR 2.04, 95% CI: 1.44-2.88, p < 0.0001). CONCLUSIONS In this multicenter study of patients with HCC, SBRT was associated with a lower risk of local progression compared to thermal ablation but higher all-cause mortality. Survival differences may be attributable to residual confounding, patient selection, or downstream treatments. These retrospective real-world data help guide treatment decisions while demonstrating the need for a prospective clinical trial.
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Affiliation(s)
- Andrew M. Moon
- Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Hannah P. Kim
- Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Amit G. Singal
- Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Dawn Owen
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Neehar D. Parikh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Steven C. Rose
- Department of Radiology, University of California-San Diego, San Diego, California, USA
| | - Katrina A. McGinty
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Chris B. Agala
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lauren M. Burke
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Anjelica Abate
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ersan Altun
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Christian Beyer
- Division of Hospital Medicine, Baylor Scott and White Hospital System, Waxahachie, Texas, USA
| | - John Do
- Department of Radiology, University of California-San Diego, San Diego, California, USA
| | - Michael R. Folkert
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Chalon Forbes
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jona A. Hattangadi-Gluth
- Department of Radiation Oncology, University of California-San Diego, San Diego, California, USA
| | - Paul H. Hayashi
- Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Keri Jones
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Gaurav Khatri
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Yuko Kono
- Department of Radiology, University of California-San Diego, San Diego, California, USA
- Department of Medicine, University of California-San Diego, San Diego, California, USA
| | - Theodore S. Lawrence
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Christopher Maurino
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - David M. Mauro
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Charles S. Mayo
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Taemee Pak
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Preethi Patil
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily C. Sanders
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University, Durham, North Carolina, USA
| | - Daniel R. Simpson
- Department of Radiation Oncology, University of California-San Diego, San Diego, California, USA
| | - Joel E. Tepper
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Diwash Thapa
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Ted K. Yanagihara
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kyle Wang
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio, USA
| | - David A. Gerber
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
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8
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Chernyak V, Fowler KJ, Do RKG, Kamaya A, Kono Y, Tang A, Mitchell DG, Weinreb J, Santillan CS, Sirlin CB. LI-RADS: Looking Back, Looking Forward. Radiology 2023; 307:e222801. [PMID: 36853182 PMCID: PMC10068888 DOI: 10.1148/radiol.222801] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/09/2023] [Accepted: 01/23/2023] [Indexed: 03/01/2023]
Abstract
Since its initial release in 2011, the Liver Imaging Reporting and Data System (LI-RADS) has evolved and expanded in scope. It started as a single algorithm for hepatocellular carcinoma (HCC) diagnosis with CT or MRI with extracellular contrast agents and has grown into a multialgorithm network covering all major liver imaging modalities and contexts of use. Furthermore, it has developed its own lexicon, report templates, and supplementary materials. This article highlights the major achievements of LI-RADS in the past 11 years, including adoption in clinical care and research across the globe, and complete unification of HCC diagnostic systems in the United States. Additionally, the authors discuss current gaps in knowledge, which include challenges in surveillance, diagnostic population definition, perceived complexity, limited sensitivity of LR-5 (definite HCC) category, management implications of indeterminate observations, challenges in reporting, and treatment response assessment following radiation-based therapies and systemic treatments. Finally, the authors discuss future directions, which will focus on mitigating the current challenges and incorporating advanced technologies. Tha authors envision that LI-RADS will ultimately transform into a probability-based system for diagnosis and prognostication of liver cancers that will integrate patient characteristics and quantitative imaging features, while accounting for imaging modality and contrast agent.
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Affiliation(s)
- Victoria Chernyak
- From the Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, NY (V.C., R.K.G.D.); Liver Imaging Group, Department of
Radiology, University of California, San Diego, San Diego, Calif (K.J.F.,
C.S.S., C.B.S.); Department of Radiology, Stanford University Medical Center,
Stanford, Calif (A.K.); Department of Medicine and Radiology, University of
California, San Diego, San Diego, Calif (Y.K.); Department of Radiology,
Radiation Oncology and Nuclear Medicine, Université de Montréal,
Montréal, Canada (A.T.); Department of Radiology, Thomas Jefferson
University Hospital, Philadelphia, Pa (D.G.M.); and Department of Radiology,
Yale Medical School, New Haven, Conn (J.W.)
| | - Kathryn J. Fowler
- From the Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, NY (V.C., R.K.G.D.); Liver Imaging Group, Department of
Radiology, University of California, San Diego, San Diego, Calif (K.J.F.,
C.S.S., C.B.S.); Department of Radiology, Stanford University Medical Center,
Stanford, Calif (A.K.); Department of Medicine and Radiology, University of
California, San Diego, San Diego, Calif (Y.K.); Department of Radiology,
Radiation Oncology and Nuclear Medicine, Université de Montréal,
Montréal, Canada (A.T.); Department of Radiology, Thomas Jefferson
University Hospital, Philadelphia, Pa (D.G.M.); and Department of Radiology,
Yale Medical School, New Haven, Conn (J.W.)
| | - Richard K. G. Do
- From the Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, NY (V.C., R.K.G.D.); Liver Imaging Group, Department of
Radiology, University of California, San Diego, San Diego, Calif (K.J.F.,
C.S.S., C.B.S.); Department of Radiology, Stanford University Medical Center,
Stanford, Calif (A.K.); Department of Medicine and Radiology, University of
California, San Diego, San Diego, Calif (Y.K.); Department of Radiology,
Radiation Oncology and Nuclear Medicine, Université de Montréal,
Montréal, Canada (A.T.); Department of Radiology, Thomas Jefferson
University Hospital, Philadelphia, Pa (D.G.M.); and Department of Radiology,
Yale Medical School, New Haven, Conn (J.W.)
| | - Aya Kamaya
- From the Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, NY (V.C., R.K.G.D.); Liver Imaging Group, Department of
Radiology, University of California, San Diego, San Diego, Calif (K.J.F.,
C.S.S., C.B.S.); Department of Radiology, Stanford University Medical Center,
Stanford, Calif (A.K.); Department of Medicine and Radiology, University of
California, San Diego, San Diego, Calif (Y.K.); Department of Radiology,
Radiation Oncology and Nuclear Medicine, Université de Montréal,
Montréal, Canada (A.T.); Department of Radiology, Thomas Jefferson
University Hospital, Philadelphia, Pa (D.G.M.); and Department of Radiology,
Yale Medical School, New Haven, Conn (J.W.)
| | - Yuko Kono
- From the Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, NY (V.C., R.K.G.D.); Liver Imaging Group, Department of
Radiology, University of California, San Diego, San Diego, Calif (K.J.F.,
C.S.S., C.B.S.); Department of Radiology, Stanford University Medical Center,
Stanford, Calif (A.K.); Department of Medicine and Radiology, University of
California, San Diego, San Diego, Calif (Y.K.); Department of Radiology,
Radiation Oncology and Nuclear Medicine, Université de Montréal,
Montréal, Canada (A.T.); Department of Radiology, Thomas Jefferson
University Hospital, Philadelphia, Pa (D.G.M.); and Department of Radiology,
Yale Medical School, New Haven, Conn (J.W.)
| | - An Tang
- From the Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, NY (V.C., R.K.G.D.); Liver Imaging Group, Department of
Radiology, University of California, San Diego, San Diego, Calif (K.J.F.,
C.S.S., C.B.S.); Department of Radiology, Stanford University Medical Center,
Stanford, Calif (A.K.); Department of Medicine and Radiology, University of
California, San Diego, San Diego, Calif (Y.K.); Department of Radiology,
Radiation Oncology and Nuclear Medicine, Université de Montréal,
Montréal, Canada (A.T.); Department of Radiology, Thomas Jefferson
University Hospital, Philadelphia, Pa (D.G.M.); and Department of Radiology,
Yale Medical School, New Haven, Conn (J.W.)
| | - Donald G. Mitchell
- From the Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, NY (V.C., R.K.G.D.); Liver Imaging Group, Department of
Radiology, University of California, San Diego, San Diego, Calif (K.J.F.,
C.S.S., C.B.S.); Department of Radiology, Stanford University Medical Center,
Stanford, Calif (A.K.); Department of Medicine and Radiology, University of
California, San Diego, San Diego, Calif (Y.K.); Department of Radiology,
Radiation Oncology and Nuclear Medicine, Université de Montréal,
Montréal, Canada (A.T.); Department of Radiology, Thomas Jefferson
University Hospital, Philadelphia, Pa (D.G.M.); and Department of Radiology,
Yale Medical School, New Haven, Conn (J.W.)
| | - Jeffrey Weinreb
- From the Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, NY (V.C., R.K.G.D.); Liver Imaging Group, Department of
Radiology, University of California, San Diego, San Diego, Calif (K.J.F.,
C.S.S., C.B.S.); Department of Radiology, Stanford University Medical Center,
Stanford, Calif (A.K.); Department of Medicine and Radiology, University of
California, San Diego, San Diego, Calif (Y.K.); Department of Radiology,
Radiation Oncology and Nuclear Medicine, Université de Montréal,
Montréal, Canada (A.T.); Department of Radiology, Thomas Jefferson
University Hospital, Philadelphia, Pa (D.G.M.); and Department of Radiology,
Yale Medical School, New Haven, Conn (J.W.)
| | - Cynthia S. Santillan
- From the Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, NY (V.C., R.K.G.D.); Liver Imaging Group, Department of
Radiology, University of California, San Diego, San Diego, Calif (K.J.F.,
C.S.S., C.B.S.); Department of Radiology, Stanford University Medical Center,
Stanford, Calif (A.K.); Department of Medicine and Radiology, University of
California, San Diego, San Diego, Calif (Y.K.); Department of Radiology,
Radiation Oncology and Nuclear Medicine, Université de Montréal,
Montréal, Canada (A.T.); Department of Radiology, Thomas Jefferson
University Hospital, Philadelphia, Pa (D.G.M.); and Department of Radiology,
Yale Medical School, New Haven, Conn (J.W.)
| | - Claude B. Sirlin
- From the Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, NY (V.C., R.K.G.D.); Liver Imaging Group, Department of
Radiology, University of California, San Diego, San Diego, Calif (K.J.F.,
C.S.S., C.B.S.); Department of Radiology, Stanford University Medical Center,
Stanford, Calif (A.K.); Department of Medicine and Radiology, University of
California, San Diego, San Diego, Calif (Y.K.); Department of Radiology,
Radiation Oncology and Nuclear Medicine, Université de Montréal,
Montréal, Canada (A.T.); Department of Radiology, Thomas Jefferson
University Hospital, Philadelphia, Pa (D.G.M.); and Department of Radiology,
Yale Medical School, New Haven, Conn (J.W.)
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9
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Brubaker AL, Urey MA, Taj R, Parekh JR, Berumen J, Kearns M, Shah M, Khan A, Kono Y, Ajmera V, Barman P, Tran H, Adler ED, Silva Enciso J, Asimakopoulos F, Costello C, Bower R, Sanchez R, Pretorius V, Schnickel GT. Heart-liver-kidney transplantation for AL amyloidosis using normothermic recovery and storage from a donor following circulatory death: Short-term outcome in a first-in-world experience. Am J Transplant 2023; 23:291-293. [PMID: 36804136 DOI: 10.1016/j.ajt.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/18/2022] [Accepted: 11/10/2022] [Indexed: 01/13/2023]
Abstract
AL amyloidosis is a rare condition characterized by the overproduction of an unstable free light chain, protein misfolding and aggregation, and extracellular deposition that can progress to multiorgan involvement and failure. To our knowledge, this is the first worldwide report to describe triple organ transplantation for AL amyloidosis and triple organ transplantation using thoracoabdominal normothermic regional perfusion recovery with a donation from a circulatory death (DCD) donor. The recipient was a 40-year-old man with multiorgan AL amyloidosis with a terminal prognosis without multiorgan transplantation. An appropriate DCD donor was selected for sequential heart, liver, and kidney transplants via our center's thoracoabdominal normothermic regional perfusion pathway. The liver was additionally placed on an ex vivo normothermic machine perfusion, and the kidney was maintained on hypothermic machine perfusion while awaiting implantation. The heart transplant was completed first (cold ischemic time [CIT]: 131 minutes), followed by the liver transplant (CIT: 87 minutes, normothermic machine perfusion: 301 minutes). Kidney transplantation was performed the following day (CIT: 1833 minutes). He is 8 months posttransplant without evidence of heart, liver, or kidney graft dysfunction or rejection. This case highlights the feasibility of normothermic recovery and storage modalities for DCD donors, which can expand transplant opportunities for allografts previously not considered for multiorgan transplantations.
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Affiliation(s)
- Aleah L Brubaker
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA.
| | - Marcus A Urey
- Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, California, USA
| | - Raeda Taj
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA
| | - Justin R Parekh
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA
| | - Jennifer Berumen
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA
| | - Mark Kearns
- Department of Surgery, Division of Cardiothoracic Surgery, University of California San Diego, San Diego, California, USA
| | - Mita Shah
- Department of Medicine, Division of Nephrology, University of California San Diego, San Diego, California, USA
| | - Adnan Khan
- Department of Medicine, Division of Nephrology, University of California San Diego, San Diego, California, USA
| | - Yuko Kono
- Department of Medicine, Division of Hepatology, University of California San Diego, San Diego, California, USA
| | - Veeral Ajmera
- Department of Medicine, Division of Hepatology, University of California San Diego, San Diego, California, USA
| | - Pranab Barman
- Department of Medicine, Division of Hepatology, University of California San Diego, San Diego, California, USA
| | - Hao Tran
- Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, California, USA
| | - Eric D Adler
- Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, California, USA
| | - Jorge Silva Enciso
- Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, California, USA
| | - Fotis Asimakopoulos
- Department of Medicine, Division of Bone Marrow Transplant, University of California San Diego, San Diego, California, USA
| | - Caitlin Costello
- Department of Medicine, Division of Bone Marrow Transplant, University of California San Diego, San Diego, California, USA
| | - Richard Bower
- Department of Gastroenterology, Naval Medical Center San Diego, California, USA
| | - Ramon Sanchez
- Department of Anesthesia, University of California San Diego, San Diego, California, USA
| | - Victor Pretorius
- Department of Surgery, Division of Cardiothoracic Surgery, University of California San Diego, San Diego, California, USA
| | - Gabriel T Schnickel
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA
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10
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Abushamat F, Dietrich CF, Clevert DA, Piscaglia F, Fetzer DT, Meloni MF, Shiehmorteza M, Kono Y. Contrast-Enhanced Ultrasound (CEUS) in the Evaluation of Hemoperitoneum in Patients With Cirrhosis. J Ultrasound Med 2023; 42:247-253. [PMID: 35579375 DOI: 10.1002/jum.16002] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/09/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
Hemoperitoneum in cirrhosis is a life-threatening condition that requires emergent evaluation. Contrast-enhanced ultrasound (CEUS) permits multiple dynamic characterizations of abdominal structures through all vascular phases, and contrast extravasation or the presence of microbubbles in the ascites could be a sensitive tool. We reviewed 13 patients with cirrhosis that underwent CEUS due to high suspicion for intra-abdominal bleeding. In 10 cases, CEUS demonstrated extravasation of contrast, including 2 instances where CEUS detected active bleeding despite negative computed tomography. These data support further study of CEUS in direct comparison to other imaging modalities in this clinical context.
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Affiliation(s)
| | | | | | - Fabio Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | | | | | - Yuko Kono
- University of California San Diego, San Diego, CA, USA
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11
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Mimura C, Kaneshiro K, Fujimoto S, Dokuni R, Iwamoto N, Matsumura K, Hatakeyama Y, Kono Y, Tachihara M. TAPO in first-line osimertinib therapy and continuation of osimertinib. Thorac Cancer 2022; 14:584-591. [PMID: 36578073 PMCID: PMC9968596 DOI: 10.1111/1759-7714.14782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Osimertinib is associated with a relatively high frequency of drug-induced interstitial lung disease (D-ILD), and transient asymptomatic pulmonary opacities (TAPO) have been reported to occur during osimertinib administration. The frequency of TAPO during first-line treatment and the pros and cons of osimertinib continuation is unknown. METHODS This was a multicenter, retrospective study. The purpose of this study was to research the frequency of TAPO and to evaluate osimertinib continuation in first-line therapy. We also evaluated progression-free survival (PFS) including subgroup analysis. RESULTS From August 2018 to December 2020, 133 patients were enrolled into the study. The median observation period was 23.2 months (0.3-48.3 months). Thirty patients (22.6%) experienced D-ILD events, including 16 patients (12.1%) with CTCAE grade 1, five patients (3.8%) with grade 2, and nine patients (6.7%) with grade 3 and above D-ILD. Among the patients with grade 1 D-ILD, 11 cases (8.3%) of TAPO were observed, and all patients succeeded in osimertinib continuation. The TAPO images were characterized by localized patchy opacities (73%). The median PFS was 22.6 months (95% confidence interval [CI]: 17.8-28.7 months). Patients with TAPO had a significantly longer PFS than patients with non-TAPO D-ILD in the multivariate analysis. CONCLUSIONS This study showed that grade 1 D-ILD might include TAPO and that patients with TAPO might have good PFS. We need to consider the possibility of osimertinib continuation when lung opacities appear.
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Affiliation(s)
- Chihiro Mimura
- Division of Respiratory Medicine, Department of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Kazumi Kaneshiro
- Department of Respiratory MedicineKita‐Harima Medical CenterOno‐CityJapan
| | - Shodai Fujimoto
- Division of Respiratory Medicine, Department of Internal MedicineKobe University Graduate School of MedicineKobeJapan,Department of Respiratory MedicineAkashi Medical CenterAkashiJapan
| | - Ryota Dokuni
- Department of Respiratory MedicineHyogo Prefectural Awaji Medical CenterSumotoJapan
| | - Natsuhiko Iwamoto
- Department of Respiratory MedicineTakatsuki General HospitalOsakaJapan
| | - Kanoko Matsumura
- Department of Respiratory MedicineTakatsuki General HospitalOsakaJapan
| | | | - Yuko Kono
- Department of Respiratory MedicineKita‐Harima Medical CenterOno‐CityJapan
| | - Motoko Tachihara
- Division of Respiratory Medicine, Department of Internal MedicineKobe University Graduate School of MedicineKobeJapan
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12
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Wang M, Singal AG, Parikh N, Kono Y, Marrero J, Mehta A. A Biomarker Panel Based upon AFP, Fucosylated Kininogen and PEG-Precipitated IgG Is Highly Accurate for the Early Detection Hepatocellular Carcinoma in Patients with Cirrhosis in Phase II and Phase III Biomarker Evaluation. Cancers (Basel) 2022; 14:5970. [PMID: 36497452 PMCID: PMC9740205 DOI: 10.3390/cancers14235970] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/07/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
We have previously identified alterations in glycosylation on serum proteins from patients with HCC and developed plate-based assays using lectins to detect the change in glycosylation. However, heterophilic antibodies, which increase with non-malignant liver disease, compromised these assays. To address this, we developed a method of polyethylene glycol (PEG) precipitation that removed the contaminating IgG and IgM but allowed for the lectin detection of the relevant glycoprotein. We found that this PEG-precipitated material itself could differentiate between cirrhosis and HCC. In the analysis of three training cohorts and one validation cohort, consisting of 571 patients, PEG-IgG had AUC values that ranged from 0.713 to 0.810. In the validation cohort, which contained samples from patients at a time of 1-6 months prior to HCC detection or 7+ months prior to detection, the AUC of this marker remained consistent (0.813 and 0.846, respectively). When this marker was incorporated into a biomarker algorithm that also consisted of AFP and fucosylated kininogen, the AUROC increased to 0.816-0.883 in the training cohort and was 0.909 in the external validation cohort. Biomarker performance was also examined though the analysis of partial ROC curves, at false positive values less than 10% (90-ROC), ≤20% (80-ROC) or ≤30% (70-ROC), which highlighted the algorithm's improvement over the individual markers at clinically relevant specificity values.
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Affiliation(s)
- Mengjun Wang
- Basic Science Building Room 310, Department of Cell and Molecular Pharmacology, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC 29425, USA
| | - Amit G. Singal
- Division of Digestive and Liver Diseases, University of Texas Southwestern, 5959 Harry Hines Blvd POB I Suite 420B, Dallas, TX 75201, USA
| | - Neehar Parikh
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Yuko Kono
- Division of Gastroenterology, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Jorge Marrero
- Division of Gastroenterology, University of Pennsylvania, 3400 Civic Center Boulevard South Pavilion, 4th Floor, Philadelphia, PA 19104, USA
| | - Anand Mehta
- Basic Science Building Room 310, Department of Cell and Molecular Pharmacology, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC 29425, USA
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13
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Tamaki N, Ahlholm N, Luukkonen PK, Porthan K, Sharpton SR, Ajmera V, Kono Y, Dave S, Ahmed A, Sundaram V, Wilkinson MJ, Patton H, Gupta H, Cervantes V, Hernandez C, Lopez SJ, Loomba R, Baumgartner A, Richards L, Arkkila PE, Nemes K, Isoniemi H, Yki-Järvinen H, Loomba R. Risk of advanced fibrosis in first-degree relatives of patients with nonalcoholic fatty liver disease. J Clin Invest 2022; 132:162513. [PMID: 36317632 PMCID: PMC9621132 DOI: 10.1172/jci162513] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/08/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUNDA pilot, single-center study showed that first-degree relatives of probands with nonalcoholic fatty liver disease (NAFLD) cirrhosis have a high risk of advanced fibrosis. We aimed to validate these findings using 2 independent cohorts from the US and Europe.METHODSThis prospective study included probands with NAFLD with advanced fibrosis, NAFLD without advanced fibrosis, and non-NAFLD, with at least 1 first-degree relative. A total of 396 first-degree relatives - 220 in a derivation cohort and 176 in a validation cohort - were enrolled in the study, and liver fibrosis was evaluated using magnetic resonance elastography and other noninvasive imaging modalities. The primary outcome was prevalence of advanced fibrosis in first-degree relatives.RESULTSPrevalence of advanced fibrosis in first-degree relatives of probands with NAFLD with advanced fibrosis, NAFLD without advanced fibrosis, and non-NAFLD was 15.6%, 5.9%, and 1.3%, respectively (P = 0.002), in the derivation cohort, and 14.0%, 2.6%, and 1.3%, respectively (P = 0.004), in the validation cohort. In multivariable-adjusted logistic regression models, age of ≥50 years (adjusted OR [aOR]: 2.63, 95% CI 1.0-6.7), male sex (aOR: 3.79, 95% CI 1.6-9.2), diabetes mellitus (aOR: 3.37, 95% CI 1.3-9), and a first-degree relative with NAFLD with advanced fibrosis (aOR: 11.8, 95% CI 2.5-57) were significant predictors of presence of advanced fibrosis (all P < 0.05).CONCLUSIONFirst-degree relatives of probands with NAFLD with advanced fibrosis have significantly increased risk of advanced fibrosis. Routine screening should be done in the first-degree relatives of patients with advanced fibrosis.FUNDINGSupported by NCATS (5UL1TR001442), NIDDK (U01DK061734, U01DK130190, R01DK106419, R01DK121378, R01DK124318, P30DK120515, K23DK119460), NHLBI (P01HL147835), and NIAAA (U01AA029019); Academy of Finland grant 309263; the Novo Nordisk, EVO, and Sigrid Jusélius Foundations; and the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement 777377. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation program and the EFPIA.
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Affiliation(s)
- Nobuharu Tamaki
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA.,Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - Noora Ahlholm
- Department of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Panu K. Luukkonen
- Department of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Internal Medicine, Yale University, New Haven, Connecticut, USA
| | - Kimmo Porthan
- Department of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Suzanne R. Sharpton
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Veeral Ajmera
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Yuko Kono
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Shravan Dave
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Aijaz Ahmed
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
| | - Vinay Sundaram
- Karsh Division of Gastroenterology and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Michael J. Wilkinson
- Division of Cardiovascular Diseases, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Heather Patton
- Gastroenterology Section, VA San Diego Healthcare System, San Diego, California, USA
| | - Hersh Gupta
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Vanessa Cervantes
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Christie Hernandez
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Scarlett J. Lopez
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Ria Loomba
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Amanda Baumgartner
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Lisa Richards
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | | | - Katriina Nemes
- Department of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Transplantation and Liver Surgery Unit, Abdominal Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Helena Isoniemi
- Transplantation and Liver Surgery Unit, Abdominal Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Hannele Yki-Järvinen
- Department of Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Rohit Loomba
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA.,Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA.,Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
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14
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Wu W, Jing X, Xue GQ, Zhu XL, Wang J, Du RQ, Lv B, Wang KF, Yan JP, Zhang ZY, Li MD, Kono Y, Yan K. A Multicenter Randomized Controlled Study of Contrast-enhanced US versus US-guided Biopsy of Focal Liver Lesions. Radiology 2022; 305:721-728. [PMID: 35916680 DOI: 10.1148/radiol.212317] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Retrospective or single-center prospective studies with relatively small samples have shown that contrast-enhanced US (CEUS) can improve the diagnostic accuracy of percutaneous biopsy, but larger prospective studies are lacking. Purpose To assess the diagnostic performance of CEUS-guided biopsy (CEUS-GB) of focal liver lesions (FLLs) compared with US-guided biopsy (US-GB) in a prospective multicenter study. Materials and Methods In this randomized controlled study conducted in nine hospitals in China between March 2016 and August 2019, adult participants with FLLs detected with US, CT, or MRI and planned for percutaneous biopsy were randomly assigned to undergo either US-GB or CEUS-GB. Lesions diagnosed as malignant at histopathologic analysis were considered true-positive findings. Benign or indeterminate lesions required further confirmation with either repeat biopsy or clinical follow-up at 6 months or later. The primary endpoint was the diagnostic accuracy rate, and comparison between groups was made using the χ2 test. Results In this study, 2056 participants (1297 men, 759 women; mean age, 58 years ± 11 [SD]) were analyzed: 1030 underwent biopsy with US guidance and 1026 underwent biopsy with CEUS guidance. The overall diagnostic accuracy rate of CEUS-GB was 96% (983 of 1026) versus 93% (953 of 1030) for US-GB (P = .002), CEUS-GB enabled correct identification in 96% of participants (983 of 1026) compared with 92% (953 of 1030) with US-GB (P = .002). The negative predictive value (NPV) for both biopsy methods was moderate but significantly higher for CEUS-GB than for US-GB (74% vs 57%, P = .001). The difference was remarkable for lesions smaller than 2.0 cm, with CEUS-GB showing higher diagnostic accuracy (96% vs 88%, P = .004) and sensitivity (95% vs 87%, P = .007) than US-GB. Among lesions smaller than 2.0 cm, the accuracy of CEUS-GB and US-GB for detection of hepatocellular carcinoma was 93% and 80%, respectively (P = .008), while it was comparable for liver metastases (98% vs 95%, P = .63). Conclusion Contrast-enhanced US-guided biopsy of focal liver lesions is an effective and safe procedure with a higher diagnostic accuracy than US-guided biopsy, especially for lesions smaller than 2.0 cm and for hepatocellular carcinoma diagnosis. Clinical trial registration no. NCT02413437 © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Wei Wu
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Xiang Jing
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Gai-Qin Xue
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Xiao-Lin Zhu
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Jing Wang
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Rui-Qing Du
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Bin Lv
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Ke-Feng Wang
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Ji-Ping Yan
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Zhong-Yi Zhang
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Man-di Li
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Yuko Kono
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
| | - Kun Yan
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasonography, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China (W.W., Z.Y.Z., K.Y.); Department of Ultrasonography, Tianjin Third Central Hospital, Tianjin, People's Republic of China (X.J.); Department of Ultrasonography, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, People's Republic of China (G.Q.X.); Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China (X.L.Z.); Department of Ultrasonography, Yantai Qishan Hospital, Yantai, People's Republic of China (J.W.); Department of Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China (R.Q.D.); Department of Ultrasonography, Jining No. 1 People's Hospital, Jining, People's Republic of China (B.L.); Department of Ultrasonography, Cangzhou Infectious Disease Hospital, Cangzhou, People's Republic of China (K.F.W.); Department of Ultrasonography, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China (J.P.Y.); Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China (M.D.L.); and Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, Calif (Y.K.)
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15
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Schnickel GT, Fabbri K, Hosseini M, Misel M, Berumen J, Parekh J, Mekeel K, Dehghan Y, Kono Y, Ajmera V. Liver transplantation for hepatocellular carcinoma following checkpoint inhibitor therapy with nivolumab. Am J Transplant 2022; 22:1699-1704. [PMID: 35080128 PMCID: PMC9177653 DOI: 10.1111/ajt.16965] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [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: 09/10/2021] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 01/25/2023]
Abstract
Limited case series describe conflicting results regarding the safety of checkpoint inhibitors (CPI) prior to liver transplantation (LT). We reviewed single-center data on all consecutive patients who underwent LT for hepatocellular carcinoma treated with CPI between January 1, 2018, and January 30, 2021. Time from CPI to LT, immunosuppression, biopsy-proven acute cellular rejection (BPACR), graft loss and death were evaluated. Five patients with a mean age 65 (range 61-71) years underwent LT after CPI with nivolumab. Time from last CPI to LT ranged from 0.3 to 11 months. Two patients with <3 months from the last dose of CPI to LT developed BPACR and severe hepatic necrosis, one of whom required retransplantation with recurrent BPACR but without recurrent graft loss over 38 months of follow up. None of the patients who underwent LT >3 months from the last dose of CPI had BPACR. In conclusion, pretransplant use of CPIs, particularly within 90 days of LT, was associated with BPACR and immune-mediated hepatic necrosis. Future multicenter studies should consider a sufficient interval from the last dose of CPI to LT to mitigate the risk for adverse immune-mediated outcomes and graft loss.
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Affiliation(s)
- Gabriel T. Schnickel
- Division of Transplant and Hepatobiliary Surgery, Department of Surgery, University of California San Diego, San Diego, California
| | - Kassandra Fabbri
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, California
| | - Mojgan Hosseini
- Department of Pathology, University of California San Diego, San Diego, California
| | - Michael Misel
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, California
| | - Jennifer Berumen
- Division of Transplant and Hepatobiliary Surgery, Department of Surgery, University of California San Diego, San Diego, California
| | - Justin Parekh
- Division of Transplant and Hepatobiliary Surgery, Department of Surgery, University of California San Diego, San Diego, California
| | - Kristin Mekeel
- Division of Transplant and Hepatobiliary Surgery, Department of Surgery, University of California San Diego, San Diego, California
| | - Yalda Dehghan
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, San Diego, California
| | - Yuko Kono
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, San Diego, California
| | - Veeral Ajmera
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, San Diego, California
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16
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Dave S, Yang K, Schnickel GT, Kono Y, Delebecque F, Arellano D, Liu A, Zhang X, Tu XM, Ajmera V. The Impact of Treatment of Hepatocellular Carcinoma With Immune Checkpoint Inhibitors on Pre- and Post-liver Transplant Outcomes. Transplantation 2022; 106:e308-e309. [PMID: 35616911 PMCID: PMC9937048 DOI: 10.1097/tp.0000000000004108] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Shravan Dave
- Division of Gastroenterology & Hepatology, Department of Medicine, University of California, San Diego, CA
| | - Kun Yang
- School of Public Health, University of California, San Diego, CA
| | - Gabriel T. Schnickel
- Division of Transplant and Hepatobiliary Surgery, Department of Surgery, University of California, San Diego, CA
| | - Yuko Kono
- Division of Gastroenterology & Hepatology, Department of Medicine, University of California, San Diego, CA
| | - Fanny Delebecque
- Altman Clinical and Translational Research Institute (ACTRI), University of California, San Diego, CA
| | - Deyna Arellano
- Altman Clinical and Translational Research Institute (ACTRI), University of California, San Diego, CA
| | - Amy Liu
- University of California, San Diego School of Medicine, San Diego, CA
| | - Xinlian Zhang
- School of Public Health, University of California, San Diego, CA
| | - Xin M. Tu
- School of Public Health, University of California, San Diego, CA
| | - Veeral Ajmera
- Division of Gastroenterology & Hepatology, Department of Medicine, University of California, San Diego, CA
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17
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Fazeli S, Covarrubias Y, Bassirian S, Cuevas J, Fowler K, Vodkin I, Kono Y, Marks R, Loomba R, Taouli B, Sirlin C, Carlos R. Eliciting Patient Preferences for Hepatocellular Carcinoma Screening: A Choice-Based Conjoint Analysis. J Am Coll Radiol 2022; 19:502-512. [DOI: 10.1016/j.jacr.2022.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/04/2022] [Accepted: 01/04/2022] [Indexed: 12/22/2022]
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18
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Scott DA, Wang M, Grauzam S, Pippin S, Black A, Angel PM, Drake RR, Castellino S, Kono Y, Rockey DC, Mehta AS. GlycoFibroTyper: A Novel Method for the Glycan Analysis of IgG and the Development of a Biomarker Signature of Liver Fibrosis. Front Immunol 2022; 13:797460. [PMID: 35197973 PMCID: PMC8858972 DOI: 10.3389/fimmu.2022.797460] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/14/2022] [Indexed: 12/13/2022] Open
Abstract
Our group has recently developed the GlycoTyper assay which is a streamlined antibody capture slide array approach to directly profile N-glycans of captured serum glycoproteins including immunoglobulin G (IgG). This method needs only a few microliters of serum and utilizes a simplified processing protocol that requires no purification or sugar modifications prior to analysis. In this method, antibody captured glycoproteins are treated with peptide N-glycosidase F (PNGase F) to release N-glycans for detection by MALDI imaging mass spectrometry (IMS). As alterations in N-linked glycans have been reported for IgG from large patient cohorts with fibrosis and cirrhosis, we utilized this novel method to examine the glycosylation of total IgG, as well as IgG1, IgG2, IgG3 and IgG4, which have never been examined before, in a cohort of 106 patients with biopsy confirmed liver fibrosis. Patients were classified as either having no evidence of fibrosis (41 patients with no liver disease or stage 0 fibrosis), early stage fibrosis (10 METAVIR stage 1 and 18 METAVIR stage 2) or late stage fibrosis (6 patients with METAVIR stage 3 fibrosis and 37 patients with METAVIR stage 4 fibrosis (cirrhosis)). Several major alterations in glycosylation were observed that classify patients as having no fibrosis (sensitivity of 92% and a specificity of 90%), early fibrosis (sensitivity of 84% with 90% specificity) or significant fibrosis (sensitivity of 94% with 90% specificity).
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Affiliation(s)
| | - Mengjun Wang
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, Charleston, SC, United States
| | - Stephane Grauzam
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, Charleston, SC, United States
| | | | - Alyson Black
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, Charleston, SC, United States
| | - Peggi M. Angel
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, Charleston, SC, United States
| | - Richard R. Drake
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, Charleston, SC, United States
| | | | - Yuko Kono
- Department of Medicine, Gastroenterology and Hepatology, University of California San Diego, San Diego, CA, United States
| | - Don C. Rockey
- Digestive Disease Research Center, Medical University of South Carolina, Charleston, SC, United States
| | - Anand S. Mehta
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, Charleston, SC, United States
- *Correspondence: Anand S. Mehta,
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19
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Dehghan Y, Schnickel GT, Hosseini M, Burgoyne AM, Ajmera VH, Morris GP, Mendler MH, Parekh JR, Abushamat F, Vodkin I, Kono Y. Rescue liver re-transplantation after graft loss due to severe rejection in the setting of pre-transplant nivolumab therapy. Clin J Gastroenterol 2021; 14:1718-1724. [PMID: 34643885 PMCID: PMC8557174 DOI: 10.1007/s12328-021-01521-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/12/2021] [Indexed: 12/19/2022]
Abstract
Immune checkpoint inhibitors (ICI) have been used to treat hepatocellular carcinoma (HCC) since 2017. The safety of ICIs in the setting of solid organ transplantation remains controversial. When used in the post-transplant setting, ICIs have been associated with high allograft rejection rates, but there are few published reports on the use of ICIs prior to transplant. We present the first reported case of rescue liver re-transplantation after loss of the first allograft due to severe acute rejection with extensive hepatic necrosis in the setting of pre-transplant ICI therapy with the PD-1 inhibitor nivolumab. It is likely that the durable immune response triggered by nivolumab contributes to graft rejection, therefore extreme caution should be taken when using ICIs before transplant until further investigation has been conducted on their safety in the pre-transplant setting.
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Affiliation(s)
- Yalda Dehghan
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Gabriel T Schnickel
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Mojgan Hosseini
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Adam M Burgoyne
- Division of Hematology-Oncology, Department of Medicine, Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Veeral H Ajmera
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Gerald P Morris
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Michel H Mendler
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Justin R Parekh
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Farid Abushamat
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Irine Vodkin
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Yuko Kono
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
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Otsuka K, Ishikawa H, Kono Y, Shirasawa K, Hirata K, Kasayuki N. Clinical significance of aortic arch plaques simultaneously assessed with coronary atherosclerosis on cardiovascular outcomes in patients undergoing coronary CT angiography. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0158] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Computed tomography (CT) coronary angiography is a useful diagnostic imaging modality in assessing presence, severity, and extent of coronary artery disease (CAD). Aortic arch plaques have been shown to be an underlying cause of embolic stroke and also related to increased risk of cardiovascular events. Yet, conventional CTCA imaging protocol does not include aortic arch for the reduction of radiation exposure. This study aimed to investigate prevalence of aortic arch plaques simultaneously assessed by CTCA and their clinical significance in combination with the presence of obstructive CAD for prediction of CVD events in patients with suspected CAD.
Methods
This study consisted of 310 (mean age, 66 years old, 42% female) patients with suspected CAD undergoing CTCA between 2017 and 2019. All CTCA examination was performed with 320-row detector scanner using ECG-triggered prospective gating method. Aortic arch images were simultaneously acquired during CTCA scanning without an increase of contrast media. Using Agatston method, coronary artery calcium score (CACS) was categorized into either of the groups having CACS of 0, 0–99, 100–299, or more than 300. The presence of CAD was reported as non-obstructive or obstructive CAD. High-risk featured aortic plaque was defined as large plaques >4 mm in thickness showing ulceration or protrusion. A composite event of cardiovascular disease, including all-cause mortality, non-fatal myocardial infarction, unplanned hospitalization requiring revascularization or stroke was defined as the primary endpoint.
Results
Patients having CACS of 0, 0–99, 100–299, and >300 were found in 41%, 24%, 15%, 20%%, respectively, where obstructive CAD was diagnosed in 11%. Aortic HRPs in ascending aorta, aortic arch, and thoracic descending aorta were observed in 1.6%, 6.9%, and 15%, respectively. During a mean follow-up period of 2.2 years, the primary endpoint was observed in 27 patients (8.7%). Cox regression hazard model demonstrated an independent association of aortic arch high-risk plaques (HR; 3.2, 95% CI; 1.20–8.64, p=0.02) and obstructive CAD (HR; 3.3, 95% CI; 1.45–7.92, P=0.005) when adjusted by age, CACS, and chronic kidney disease. Kaplan-Meier curve analysis showed a worse outcome of patients with aortic HRP and obstructive CAD compared to those without aortic plaques and obstructive CAD (p<0.001).
Conclusion
This study demonstrated an independent association of aortic arch high-risk featured plaques with CVD events. Further study is warranted whether pharmacological interventional therapies can reduce future CVD risks in patients with CAD and aortic arch plaques.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Otsuka
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - H Ishikawa
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - Y Kono
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - K Shirasawa
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - K Hirata
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - N Kasayuki
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
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21
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Takatsu H, Onoda S, Kittaka S, Kasahara A, Kono Y, Sakakibara T, Kato Y, Fåk B, Ollivier J, Lynn JW, Taniguchi T, Wakita M, Kadowaki H. Erratum: Quadrupole Order in the Frustrated Pyrochlore Tb_{2+x}Ti_{2-x}O_{7+y} [Phys. Rev. Lett. 116, 217201 (2016)]. Phys Rev Lett 2021; 127:069902. [PMID: 34420355 DOI: 10.1103/physrevlett.127.069902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Indexed: 06/13/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.116.217201.
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22
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Brunsing RL, Brown D, Almahoud H, Kono Y, Loomba R, Vodkin I, Sirlin CB, Alley MT, Vasanawala SS, Hsiao A. Quantification of the Hemodynamic Changes of Cirrhosis with Free-Breathing Self-Navigated MRI. J Magn Reson Imaging 2021; 53:1410-1421. [PMID: 33594733 PMCID: PMC9161739 DOI: 10.1002/jmri.27488] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/28/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Non-invasive assessment of the hemodynamic changes of cirrhosis might help guide management of patients with liver disease but are currently limited. PURPOSE To determine whether free-breathing 4D flow MRI can be used to quantify the hemodynamic effects of cirrhosis and introduce hydraulic circuit indexes of severity. STUDY TYPE Retrospective. POPULATION Forty-seven patients including 26 with cirrhosis. FIELD STRENGTH/SEQUENCE 3 T/free-breathing 4D flow MRI with soft gating and golden-angle view ordering. ASSESSMENT Measurements of the supra-celiac abdominal aorta, supra-renal abdominal aorta (SRA), celiac trunk (CeT), superior mesenteric artery (SMA), splenic artery (SpA), common hepatic artery (CHA), portal vein (PV), and supra-renal inferior vena cava (IVC) were made by two radiologists. Measures of hepatic vascular resistance (hepatic arterial relative resistance [HARR]; portal resistive index [PRI]) were proposed and calculated. STATISTICAL ANALYSIS Bland-Altman, Pearson's correlation, Tukey's multiple comparison, and Cohen's kappa. P < 0.05 was considered significant. RESULTS Forty-four of 47 studies yielded adequate image quality for flow quantification (94%). Arterial structures showed high inter-reader concordance (range; ρ = 0.948-0.987) and the IVC (ρ = 0.972), with moderate concordance in the PV (ρ = 0.866). Conservation of mass analysis showed concordance between large vessels (SRA vs. IVC; ρ = 0.806), small vessels (celiac vs. CHA + SpA; ρ = 0.939), and across capillary beds (CeT + SMA vs. PV; ρ = 0.862). Splanchnic flow was increased in patients with portosystemic shunting (PSS) relative to control patients and patients with cirrhosis without PSS (P < 0.05, difference range 0.11-0.68 liter/m). HARR was elevated and PRI was decreased in patients with PSS (3.55 and 1.49, respectively) compared to both the control (2.11/3.18) and non-PSS (2.11/2.35) cohorts. DATA CONCLUSION 4D flow MRI with self-navigation was technically feasible, showing promise in quantifying the hemodynamic effects of cirrhosis. Proposed quantitative metrics of hepatic vascular resistance correlated with PSS. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Ryan L Brunsing
- Department of Radiology, Stanford University, Palo Alto, California, USA
| | - Dustin Brown
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Hashem Almahoud
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Yuko Kono
- Department of Radiology, Stanford University, Palo Alto, California, USA
- Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Rohit Loomba
- Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, USA
- Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, California, USA
- NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Irene Vodkin
- Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Claude B Sirlin
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Marcus T Alley
- Department of Radiology, Stanford University, Palo Alto, California, USA
| | | | - Albert Hsiao
- Department of Radiology, University of California San Diego, La Jolla, California, USA
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23
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Fetzer DT, Kono Y, Rodgers SK. Using Contrast-Enhanced Ultrasound to Characterize Focal Liver Lesions. Clin Liver Dis (Hoboken) 2021; 17:119-124. [PMID: 33868650 PMCID: PMC8043708 DOI: 10.1002/cld.998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- David T. Fetzer
- Department of RadiologyUT Southwestern Medical CenterDallasTX
| | - Yuko Kono
- Division of Gastroenterology & HepatologyDepartment of RadiologyUniversity of California, San DiegoSan DiegoCA
| | - Shuchi K. Rodgers
- Department of RadiologyEinstein Medical CenterSKMC at Thomas Jefferson UniversityPhiladelphiaPA
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24
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Rodgers SK, Fetzer DT, Kono Y. Using LI-RADS With Contrast-Enhanced Ultrasound. Clin Liver Dis (Hoboken) 2021; 17:154-158. [PMID: 33868657 PMCID: PMC8043704 DOI: 10.1002/cld.1077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/03/2020] [Accepted: 11/22/2020] [Indexed: 02/04/2023] Open
Affiliation(s)
- Shuchi K. Rodgers
- Department of RadiologyEinstein Healthcare NetworkSidney Kimmel Medical College at Thomas Jefferson UniversityPhiladelphiaPA
| | - David T. Fetzer
- Department of RadiologyUT Southwestern Medical CenterDallasTX
| | - Yuko Kono
- Division of Gastroenterology & HepatologyClinical Professor of RadiologyUniversity of California, San DiegoSan DiegoCA
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25
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Kono Y, Kusumoto C, Kiguchi T, Okada H. Gastrointestinal: Rapid emergence of double-expressor lymphoma after Helicobacter pylori eradication therapy. J Gastroenterol Hepatol 2021; 36:299. [PMID: 32648301 DOI: 10.1111/jgh.15162] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/23/2020] [Indexed: 12/09/2022]
Affiliation(s)
- Y Kono
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - C Kusumoto
- Department of Medical Science and Technology, Faculty of Health Sciences, Hiroshima International University, Hiroshima, Japan
| | - T Kiguchi
- Department of Hematology, Chugoku Central Hospital, Fukuyama, Japan
| | - H Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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26
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Kawano H, Ebisawa S, Ayano M, Kono Y, Saito M, Johno T, Maruoka H, Ryoji N, Yamashita H, Nakanishi K, Honda Y, Amano T, Unno Y, Komatsu Y, Ogawa Y, Shiokawa Y, Hirano T. Improving Acute In-Hospital Stroke Care by Reorganization of an In-Hospital Stroke Code Protocol. J Stroke Cerebrovasc Dis 2021; 30:105433. [DOI: 10.1016/j.jstrokecerebrovasdis.2020.105433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/17/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022] Open
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27
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Cunha GM, Fowler KJ, Abushamat F, Sirlin CB, Kono Y. Imaging Diagnosis of Hepatocellular Carcinoma: The Liver Imaging Reporting and Data System, Why and How? Clin Liver Dis 2020; 24:623-636. [PMID: 33012449 DOI: 10.1016/j.cld.2020.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 02/07/2023]
Abstract
The Liver Imaging Reporting and Data System (LI-RADS) provides standardized lexicon, technique, interpretation, and reporting of liver imaging in patients at risk for hepatocellular carcinoma (HCC). When applied to at-risk populations, LI-RADS achieves higher than 95% positive predictive value for the noninvasive diagnosis of HCC on computed tomography (CT), MRI and contrast-enhanced ultrasound (CEUS). This article focuses on similarities and differences between the CT/MRI diagnostic algorithm (CT/MRI LI-RADS) and the CEUS diagnostic algorithm (CEUS LI-RADS) to inform health care professionals for efficient and appropriate clinical decisions through the management of patients at risk.
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Affiliation(s)
- Guilherme Moura Cunha
- Liver Imaging Group, Department of Radiology, University of California, 9500 Gilman Drive, San Diego, CA 92093, USA.
| | - Kathryn J Fowler
- Liver Imaging Group, Department of Radiology, University of California, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Farid Abushamat
- Division of Gastroenterology & Hepatology, University of California, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Claude B Sirlin
- Liver Imaging Group, Department of Radiology, University of California, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Yuko Kono
- Division of Gastroenterology & Hepatology, University of California, 9500 Gilman Drive, San Diego, CA 92093, USA.
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28
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Dietrich CF, Nolsøe CP, Barr RG, Berzigotti A, Burns PN, Cantisani V, Chammas MC, Chaubal N, Choi BI, Clevert DA, Cui X, Dong Y, D'Onofrio M, Fowlkes JB, Gilja OH, Huang P, Ignee A, Jenssen C, Kono Y, Kudo M, Lassau N, Lee WJ, Lee JY, Liang P, Lim A, Lyshchik A, Meloni MF, Correas JM, Minami Y, Moriyasu F, Nicolau C, Piscaglia F, Saftoiu A, Sidhu PS, Sporea I, Torzilli G, Xie X, Zheng R. Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver - Update 2020 - WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS. Ultraschall Med 2020; 41:562-585. [PMID: 32707595 DOI: 10.1055/a-1177-0530] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS), first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications.The 2012 guideline requires updating as previously the differences of the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including the United States Food and Drug Administration (FDA) approval as well as the extensive Asian experience, to produce a truly international perspective.These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCA) and are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis to improve the management of patients.
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Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
- Johann Wolfgang Goethe Universitätsklinik Frankfurt, Germany
| | - Christian Pállson Nolsøe
- Center for Surgical Ultrasound, Dep of Surgery, Zealand University Hospital, Køge. Copenhagen Academy for Medical Education and Simulation (CAMES). University of Copenhagen, Denmark
| | - Richard G Barr
- Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio, USA and Southwoods Imaging, Youngstown, Ohio, USA
| | - Annalisa Berzigotti
- Hepatology, University Clinic for Visceral Surgery and Medicine, DBMR, Inselspital, University of Bern, Switzerland
| | - Peter N Burns
- Dept Medical Biophysics, University of Toronto, Imaging Research, Sunnybrook Research Institute, Toronto
| | - Vito Cantisani
- Uos Ecografia Internistico-chirurgica, Dipartimento di Scienze Radiologiche, Oncologiche, Anatomo-Patologiche, Policlinico Umberto I, Univ. Sapienza, Rome, Italy
| | - Maria Cristina Chammas
- Institute of Radiology, Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil
| | - Nitin Chaubal
- Thane Ultrasound Centre, Jaslok Hospital and Research Centre, Mumbai, India
| | - Byung Ihn Choi
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Dirk-André Clevert
- Interdisciplinary Ultrasound-Center, Department of Radiology, University of Munich-Grosshadern Campus, Munich, Germany
| | - Xinwu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mirko D'Onofrio
- Department of Radiology, G.B. Rossi University Hospital, University of Verona, Verona, Italy
| | - J Brian Fowlkes
- Basic Radiological Sciences Division, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, United States
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, and Department of Clinical Medicine, University of Bergen, Norway
| | - Pintong Huang
- Department of Ultrasound in Medicine, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Andre Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - Christian Jenssen
- Krankenhaus Märkisch Oderland, Department of Internal Medicine, Strausberg/Wriezen, Germany
| | - Yuko Kono
- Departments of Medicine and Radiology, University of California, San Diego, USA
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Nathalie Lassau
- Imaging Department. Gustave Roussy and BIOMAPS. Université Paris-Saclay, Villejuif, France
| | - Won Jae Lee
- Department of Radiology and Center For Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Departments of Health and Science and Technology and Medical Device Management and Research, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
| | - Jae Young Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Adrian Lim
- Department of Imaging, Imperial College London and Healthcare NHS Trust, Charing Cross Hospital Campus, London United Kingdom
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, United States
| | | | - Jean Michel Correas
- Service de Radiologie Adultes, Hôpital Necker, Université Paris Descartes, Paris, France
| | - Yasunori Minami
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Fuminori Moriyasu
- Center for Cancer Ablation Therapy, Sanno Hospital, International University of Health and Welfare, Tokyo, Japan
| | - Carlos Nicolau
- Radiology Department, Hospital Clinic. University of Barcelona, Barcelona, Spain
| | - Fabio Piscaglia
- Unit of Internal Medicine, Dept of Medical and Surgical Sciences, University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Adrian Saftoiu
- Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Romania
| | - Paul S Sidhu
- Department of Radiology, King's College Hospital, King's College London, London
| | - Ioan Sporea
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Guido Torzilli
- Department of Surgery, Division of Hepatobiliary & General Surgery, Humanitas University & Research Hospital, Rozzano, Milano, Italy
| | - Xiaoyan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Rongqin Zheng
- Department of Ultrasound, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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29
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Dietrich CF, Nolsøe CP, Barr RG, Berzigotti A, Burns PN, Cantisani V, Chammas MC, Chaubal N, Choi BI, Clevert DA, Cui X, Dong Y, D'Onofrio M, Fowlkes JB, Gilja OH, Huang P, Ignee A, Jenssen C, Kono Y, Kudo M, Lassau N, Lee WJ, Lee JY, Liang P, Lim A, Lyshchik A, Meloni MF, Correas JM, Minami Y, Moriyasu F, Nicolau C, Piscaglia F, Saftoiu A, Sidhu PS, Sporea I, Torzilli G, Xie X, Zheng R. Guidelines and Good Clinical Practice Recommendations for Contrast-Enhanced Ultrasound (CEUS) in the Liver-Update 2020 WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS. Ultrasound Med Biol 2020; 46:2579-2604. [PMID: 32713788 DOI: 10.1016/j.ultrasmedbio.2020.04.030] [Citation(s) in RCA: 192] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 05/14/2023]
Abstract
The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast-enhanced ultrasound, first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology. The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications. The 2012 guideline requires updating as, previously, the differences in the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including U.S. Food and Drug Administration approval and the extensive Asian experience, to produce a truly international perspective. These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCAs) and are intended to create standard protocols for the use and administration of UCAs in liver applications on an international basis to improve the management of patients.
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Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland; Johann Wolfgang Goethe Universitätsklinik, Frankfurt, Germany.
| | - Christian Pállson Nolsøe
- Center for Surgical Ultrasound, Dep of Surgery, Zealand University Hospital, Køge. Copenhagen Academy for Medical Education and Simulation (CAMES). University of Copenhagen, Denmark
| | - Richard G Barr
- Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio, USA; Southwoods Imaging, Youngstown, Ohio, USA
| | - Annalisa Berzigotti
- Hepatology, University Clinic for Visceral Surgery and Medicine, DBMR, Inselspital, University of Bern, Switzerland
| | - Peter N Burns
- Department of Medical Biophysics, University of Toronto, Imaging Research, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Vito Cantisani
- Uos Ecografia Internistico-chirurgica, Dipartimento di Scienze Radiologiche, Oncologiche, Anatomo-Patologiche, Policlinico Umberto I, Univ. Sapienza, Rome, Italy
| | - Maria Cristina Chammas
- Institute of Radiology, Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil
| | - Nitin Chaubal
- Thane Ultrasound Centre, Jaslok Hospital and Research Centre, Mumbai, India
| | - Byung Ihn Choi
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Dirk-André Clevert
- Interdisciplinary Ultrasound-Center, Department of Radiology, University of Munich-Grosshadern Campus, Munich, Germany
| | - Xinwu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mirko D'Onofrio
- Department of Radiology, G. B. Rossi University Hospital, University of Verona, Verona, Italy
| | - J Brian Fowlkes
- Basic Radiological Sciences Division, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, and Department of Clinical Medicine, University of Bergen, Norway
| | - Pintong Huang
- Department of Ultrasound in Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Andre Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - Christian Jenssen
- Krankenhaus Märkisch Oderland, Department of Internal Medicine, Strausberg/Wriezen, Germany
| | - Yuko Kono
- Departments of Medicine and Radiology, University of California, San Diego, California, USA
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Nathalie Lassau
- Imaging Department, Gustave Roussy and BIOMAPS, Université Paris-Saclay, Villejuif, France
| | - Won Jae Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Departments of Health and Science and Technology and Medical Device Management and Research, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
| | - Jae Young Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Adrian Lim
- Department of Imaging, Imperial College London and Healthcare NHS Trust, Charing Cross Hospital Campus, London, United Kingdom
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | | | - Jean Michel Correas
- Service de Radiologie Adultes, Hôpital Necker, Université Paris Descartes, Paris, France
| | - Yasunori Minami
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Fuminori Moriyasu
- Center for Cancer Ablation Therapy, Sanno Hospital, International University of Health and Welfare, Tokyo, Japan
| | - Carlos Nicolau
- Radiology Department, Hospital Clinic. University of Barcelona, Barcelona, Spain
| | - Fabio Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Adrian Saftoiu
- Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Romania
| | - Paul S Sidhu
- Department of Radiology, King's College Hospital, King's College London, London, United Kingdom
| | - Ioan Sporea
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Guido Torzilli
- Department of Surgery, Division of Hepatobiliary & General Surgery, Humanitas University & Research Hospital, Rozzano, Milan, Italy
| | - Xiaoyan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Rongqin Zheng
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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Kikuchi R, Ishiwari M, Takoi H, Kono Y, Yoshimura A, Abe S. Pulmonary intravascular lymphoma mimicking hypersensitivity pneumonitis. Pulmonology 2020; 26:409-412. [PMID: 32622735 DOI: 10.1016/j.pulmoe.2020.03.008] [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: 01/05/2020] [Revised: 02/08/2020] [Accepted: 03/06/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- R Kikuchi
- Department of Respiratory Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan.
| | - M Ishiwari
- Department of Respiratory Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan
| | - H Takoi
- Department of Respiratory Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan
| | - Y Kono
- Department of Respiratory Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan
| | - A Yoshimura
- Department of Clinical Oncology, Tokyo Medical University Hospital, Tokyo, Japan
| | - S Abe
- Department of Respiratory Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan
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31
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Burrowes DP, Kono Y, Medellin A, Wilson SR. RadioGraphics Update: Contrast-enhanced US Approach to the Diagnosis of Focal Liver Masses. Radiographics 2020; 40:E16-E20. [PMID: 32609595 DOI: 10.1148/rg.2020200109] [Citation(s) in RCA: 3] [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] [Indexed: 12/30/2022]
Abstract
Editor's Note.-Articles in the RadioGraphics Update section provide current knowledge to supplement or update information found in full-length articles previously published in RadioGraphics. Authors of the previously published article provide a brief synopsis that emphasizes important new information such as technological advances, revised imaging protocols, new clinical guidelines involving imaging, or updated classification schemes. Articles in this section are published solely online and are linked to the original article.
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Affiliation(s)
- David P Burrowes
- From the Department of Radiology, University of Calgary Cumming School of Medicine, 1403 29 St NW, Calgary, AB, Canada T2N 2T9 (D.P.B., A.M., S.R.W.); Department of Radiology, University of California, San Diego, San Diego, Calif (Y.K.); and Department of Diagnostic Imaging, Foothills Medical Centre, Calgary, Alberta, Canada (S.R.W.)
| | - Yuko Kono
- From the Department of Radiology, University of Calgary Cumming School of Medicine, 1403 29 St NW, Calgary, AB, Canada T2N 2T9 (D.P.B., A.M., S.R.W.); Department of Radiology, University of California, San Diego, San Diego, Calif (Y.K.); and Department of Diagnostic Imaging, Foothills Medical Centre, Calgary, Alberta, Canada (S.R.W.)
| | - Alexandra Medellin
- From the Department of Radiology, University of Calgary Cumming School of Medicine, 1403 29 St NW, Calgary, AB, Canada T2N 2T9 (D.P.B., A.M., S.R.W.); Department of Radiology, University of California, San Diego, San Diego, Calif (Y.K.); and Department of Diagnostic Imaging, Foothills Medical Centre, Calgary, Alberta, Canada (S.R.W.)
| | - Stephanie R Wilson
- From the Department of Radiology, University of Calgary Cumming School of Medicine, 1403 29 St NW, Calgary, AB, Canada T2N 2T9 (D.P.B., A.M., S.R.W.); Department of Radiology, University of California, San Diego, San Diego, Calif (Y.K.); and Department of Diagnostic Imaging, Foothills Medical Centre, Calgary, Alberta, Canada (S.R.W.)
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Kosaka M, Kono Y, Nakagawa M. Gastrointestinal: Acute esophageal necrosis causing severe esophageal stenosis. J Gastroenterol Hepatol 2020; 35:919. [PMID: 31900954 DOI: 10.1111/jgh.14909] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/09/2019] [Accepted: 10/13/2019] [Indexed: 12/09/2022]
Affiliation(s)
- M Kosaka
- Department of Internal Medicine, Hiroshima Citizens Hiroshima City Hospital, Hiroshima, Japan
| | - Y Kono
- Department of Internal Medicine, Hiroshima Citizens Hiroshima City Hospital, Hiroshima, Japan
| | - M Nakagawa
- Department of Endoscopy, Hiroshima Citizens Hiroshima City Hospital, Hiroshima, Japan
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33
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Piscaglia F, Stefanini F, Cantisani V, Sidhu PS, Barr R, Berzigotti A, Chammas MC, Correas JM, Dietrich CF, Feinstein S, Huang P, Jenssen C, Kono Y, Kudo M, Liang P, Lyshchik A, Nolsøe C, Xie X, Tovoli F. Benefits, Open questions and Challenges of the use of Ultrasound in the COVID-19 pandemic era. The views of a panel of worldwide international experts. Ultraschall Med 2020; 41:228-236. [PMID: 32294795 DOI: 10.1055/a-1149-9872] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Fabio Piscaglia
- COVID-19 Unit & Unit of Internal Medicine, Azienda Ospedaliero Universitaria S.Orsola Malpighi, Bologna, Italy
| | - Federico Stefanini
- COVID-19 Unit & Unit of Internal Medicine, Azienda Ospedaliero Universitaria S.Orsola Malpighi, Bologna, Italy
| | - Vito Cantisani
- Radiological, Anatomo-pathological and Oncologic Sciences Department, Policlinico Umberto I, University La Sapienza, Rome, Italy
| | - Paul S Sidhu
- Department of Radiology, King's College London. King's College Hospital, London, UK
| | - Richard Barr
- Radiology, Northeastern Ohio Medical University, USA
| | - Annalisa Berzigotti
- Hepatology, University Clinic for visceral surgery and medicine, Inselspital, University of Bern, Switzerland
| | - Maria Cristina Chammas
- Ultrasound Division of Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jean-Michel Correas
- Department of Adult Radiology, Paris University & Necker University Hospital, Paris, France
| | | | | | - Pintong Huang
- Department of Ultrasound in Medicine,the Second Affiliated Hospital of Zhejiang University School of Medicine, China
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch-Oderland, Strausberg, and Brandenburg Institute for Clinical Ultrasound (BICUS), Medical University Brandenburg, Neuruppin, Germany
| | - Yuko Kono
- Department of Medicine, Radiology, University of California, San Diego, USA
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
| | - Ping Liang
- Interventional Ultrasound Department, Chinese PLA General Hospital, Beijing, China
| | - Andrej Lyshchik
- Radiology Unity, Thomas Jefferson University Hospital, Philadelphia, USA
| | - Christian Nolsøe
- Centre for Surgical Ultrasound, Dep of Surgery, Zealand University Hospital, Køge, Copenhagen Denmark
| | - Xyaoyan Xie
- Institute of Diagnostic and Interventional Ultrasound The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Francesco Tovoli
- COVID-19 Unit & Unit of Internal Medicine, Azienda Ospedaliero Universitaria S.Orsola Malpighi, Bologna, Italy
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34
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Dietrich CF, Dong Y, Kono Y, Caraiani C, Sirlin CB, Cui XW, Tang A. LI-RADS ancillary features on contrast-enhanced ultrasonography. Ultrasonography 2020; 39:221-228. [PMID: 32475089 PMCID: PMC7315297 DOI: 10.14366/usg.19052] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 10/01/2019] [Accepted: 05/09/2020] [Indexed: 12/11/2022] Open
Abstract
The Liver Imaging Reporting and Data System (LI-RADS) was created to standardize liver imaging in patients at high risk for hepatocellular carcinoma (HCC), and it uses a diagnostic algorithm to assign categories that reflect the relative probability of HCC, non-HCC malignancies, or benign focal liver lesions. In addition to major imaging features, ancillary features (AFs) are used by radiologists to refine the categorization of liver nodules. In the present document, we discuss and explain the application of AFs currently defined within the LI-RADS guidelines. We also explore possible additional AFs visible on contrast-enhanced ultrasonography (CEUS). Finally, we summarize the management of CEUS LI-RADS features, including the role of current and potential future AFs.
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Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Beau Site, Salem und Permanence, Hirslanden, Bern, Switzerland.,Ultrasound Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuko Kono
- Department of Medicine and Radiology, University of California, San Diego, CA, USA
| | - Cosmin Caraiani
- Department of Medical Imaging, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Claude B Sirlin
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Tang
- Department of Radiology, Université de Montréal, Montreal, Canada
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35
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Wilson SR, Burns PN, Kono Y. Contrast-Enhanced Ultrasound of Focal Liver Masses: A Success Story. Ultrasound Med Biol 2020; 46:1059-1070. [PMID: 32059917 DOI: 10.1016/j.ultrasmedbio.2019.12.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 06/10/2023]
Abstract
The epidemic of increasing fatty liver disease and liver cancer worldwide, and especially in Western society, has given new importance to non-invasive liver imaging. Contrast-enhanced ultrasound (CEUS) using microbubble contrast agents provides unique advantages over computed tomography (CT) and magnetic resonance imaging (MRI), the currently established methods. CEUS provides determination of malignancy and allows excellent differential diagnosis of a focal liver mass, based on arterial phase enhancement patterns and assessment of the timing and intensity of washout. Today, increased use of CEUS has provided safe and rapid diagnosis of incidentally detected liver masses, improved multidisciplinary management of nodules in a cirrhotic liver, facilitated ablative therapy for liver tumors and allowed diagnosis of hepatocellular carcinoma without biopsy. Benefits of CEUS include the dynamic real-time depiction of tumor perfusion and the fact that it is a purely intravascular agent, accurately reflecting tumoral and inflammatory blood flow. CEUS has many similarities to contrast-enhanced CT and MRI but also unique differences, which are described. The integration of CEUS into a multimodality imaging setting optimizes patient care.
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Affiliation(s)
- Stephanie R Wilson
- Department of Radiology, and Division of Gastroenterology, Department of Medicine, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada.
| | - Peter N Burns
- Department of Medical Biophysics, University of Toronto, Imaging Research, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Yuko Kono
- Department of Medicine, Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, CA
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36
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Kono Y, Sirlin CB, Fetzer DT, Kim TK, Rodgers SK, Piscaglia F, Lyshchik A, Dietrich CF, Wilson SR. Time to Clarify Common Misconceptions about the Liver Imaging Reporting and Data System for Contrast-enhanced US. Radiology 2020; 295:245-247. [PMID: 32068508 DOI: 10.1148/radiol.2020192557] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Affiliation(s)
- Yuko Kono
- Department of Medicine, Department of Radiology, University of California, San Diego, 200 W Arbor Dr, San Diego, CA 92103
| | - Claude B Sirlin
- Department of Medicine, Department of Radiology, University of California, San Diego, 200 W Arbor Dr, San Diego, CA 92103
| | - David T Fetzer
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
| | - Tae K Kim
- Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada
| | - Shuchi K Rodgers
- Department of Radiology, Einstein Medical Center, Philadelphia, Pa
| | - Fabio Piscaglia
- Division of Internal Medicine, University and General Hospital S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pa
| | - Christoph F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
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37
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Rodgers SK, Fetzer DT, Gabriel H, Seow JH, Choi HH, Maturen KE, Wasnik AP, Morgan TA, Dahiya N, O'Boyle MK, Kono Y, Sirlin CB, Kamaya A. Role of US LI-RADS in the LI-RADS Algorithm. Radiographics 2020; 39:690-708. [PMID: 31059393 DOI: 10.1148/rg.2019180158] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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
The US Liver Imaging Reporting and Data System (LI-RADS) was released in 2017 and is the newest of the four American College of Radiology (ACR) LI-RADS algorithms. US LI-RADS provides standardized terminology, technical recommendations, and a reporting framework for US examinations performed for screening or surveillance in patients at risk for developing hepatocellular carcinoma (HCC). The appropriate patient population for screening and surveillance includes individuals who are at risk for developing HCC but do not have known or suspected cancer. This includes patients with cirrhosis from any cause and subsets of patients with chronic hepatitis B virus infection in the absence of cirrhosis. In an HCC screening or surveillance study, US LI-RADS recommends assigning two scores that apply to the entire study: the US category, which determines follow-up, and a visualization score, which communicates the expected level of sensitivity of the examination but does not affect management. Three US categories are possible: US-1 negative, a study with no evidence of HCC; US-2 subthreshold, a study in which an observation less than 10 mm is depicted that is not definitely benign; and US-3 positive, a study in which an observation greater than or equal to 10 mm or a new thrombus in vein is identified, for which diagnostic contrast material-enhanced imaging is recommended. Three visualization scores are possible: A (no or minimal limitations), B (moderate limitations), and C (severe limitations). ©RSNA, 2019.
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Affiliation(s)
- Shuchi K Rodgers
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - David T Fetzer
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - Helena Gabriel
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - James H Seow
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - Hailey H Choi
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - Katherine E Maturen
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - Ashish P Wasnik
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - Tara A Morgan
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - Nirvikar Dahiya
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - Mary K O'Boyle
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - Yuko Kono
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - Claude B Sirlin
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
| | - Aya Kamaya
- From the Department of Radiology, Einstein Medical Center, 5501 Old York Rd, Levy Ground, Philadelphia, PA 19141 (S.K.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (H.G.); Department of Radiology, Royal Perth Hospital, Perth, Australia (J.H.S.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.H.C.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (K.E.M., A.P.W.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.A.M.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (N.D.); Department of Radiology (M.K.O., Y.K.) and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego Medical Center, San Diego, Calif; and Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.)
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Tanaka M, Hattori Y, Ishii T, Tohnai R, Itoh S, Kawa Y, Kono Y, Urata Y, Satouchi M. The efficacy of carboplatin plus nanoparticle albumin-bound paclitaxel after cisplatin plus pemetrexed in non-squamous non-small-cell lung cancer patients. Respir Investig 2020; 58:269-274. [PMID: 32111518 DOI: 10.1016/j.resinv.2019.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Received: 09/04/2019] [Revised: 12/09/2019] [Accepted: 12/23/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Carboplatin plus nanoparticle albumin-bound paclitaxel (nab-PTX) is one of the available first-line treatments for non-small cell lung cancer (NSCLC) patients. However, the efficacy of carboplatin plus nab-PTX as second-line, remains unknown. We examined the efficacy of carboplatin plus nab-PTX after cisplatin plus pemetrexed in non-squamous NSCLC patients. METHODS We retrospectively reviewed advanced non-squamous NSCLC patients who received carboplatin plus nab-PTX as a second-line chemotherapy regimen after cisplatin plus pemetrexed in our hospital between March 2013 and December 2017. We assessed clinical characteristics, efficacy, and toxicities. RESULTS Forty-four patients were recruited. The overall response rate (ORR) was 29% and the disease control rate (DCR), 69%. The median progression-free survival (mPFS) was 3.7 months (95% CI: 2.4-5.5 months) and the median overall survival, 16.6 months (95% CI:8.8-19.5 months). We assessed the ORR and mPFS using the best overall response in the prior regimen. The ORR and mPFS were better in the PD group (ORR; 44% and mPFS: 5.6 months). CONCLUSIONS Carboplatin plus nab-PTX after cisplatin plus pemetrexed in non-squamous NSCLC patients is a treatment option. There were several cases where cisplatin plus pemetrexed was not effective, but Carboplatin plus nab-PTX was.
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Affiliation(s)
- Miho Tanaka
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan.
| | - Yoshihiro Hattori
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan.
| | - Tatsuya Ishii
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Rie Tohnai
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Shoichi Itoh
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Yoshitaka Kawa
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Yuko Kono
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Yoshiko Urata
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Miyako Satouchi
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
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Hattori Y, Kono Y, Itoh S, Inoue T, Urata Y, Kawa Y, Tohnai R, Kumagai T, Nishino K, Uozumi R, Morita S, Negoro S, Imamura F, Satouchi M. A phase I/II study of weekly nab-paclitaxel plus cisplatin in chemotherapy-naïve patients with advanced non-small-cell lung cancer. BMC Cancer 2020; 20:115. [PMID: 32046667 PMCID: PMC7014598 DOI: 10.1186/s12885-020-6588-y] [Citation(s) in RCA: 3] [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: 07/24/2019] [Accepted: 01/29/2020] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to evaluate the efficacy and safety of nab-paclitaxel plus cisplatin in chemotherapy-naïve patients with advanced non-small-cell lung cancer (NSCLC). Methods Chemotherapy-naïve patients with advanced NSCLC were eligible. In the phase I dose-escalation cohort (3 + 3 design), patients received nab-paclitaxel (80 or 100 mg/m2 given intravenously on days 1, 8 and 15) plus cisplatin (60 or 75 mg/m2 given intravenously on day 1) every 4 weeks. The maximum tolerated dose was not reached. Nab-paclitaxel (100 mg/m2 given intravenously on days 1, 8 and 15) plus cisplatin (75 mg/m2 given intravenously on day 1) every 4 weeks was selected for the phase II cohort. The primary endpoint was the objective response rate (ORR). Results Twenty-three patients (phase I, n = 6; phase II, n = 17) were enrolled, and 22 patients were eligible. The median age was 67.5 years (range 37–75), 90.9% were males, 45.5% had adenocarcinoma and 81.8% had stage IV disease. The ORR was 59.1% (90% confidence interval (CI); 41.8–74.4), and the disease control rate was 86.4% (95% CI; 66.7–95.3). The median progression-free survival was 5.1 months (95% CI; 4.0–6.7), and the median overall survival was 24.2 months (95% CI; 8.4 months to not estimable). The common grade ≥ 3 adverse events were neutropenia (31.8%), leukopenia (27.3%), lung infection (18.2%) and hyponatremia (18.2%). There was one instance of grade 2 interstitial pneumonia and no treatment-related death. Conclusions Nab-paclitaxel plus cisplatin was well tolerated and associated with encouraging response outcomes in chemotherapy-naïve patients with advanced NSCLC. Further investigation is warranted. Trial registration UMIN Clinical Trials Registry: UMIN000011776; Date of registration: 17 September 2013; Date of enrolment of the first participant to the trial: 23 January 2014.
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Affiliation(s)
- Yoshihiro Hattori
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi-shi, Hyogo, 673-8558, Japan
| | - Yuko Kono
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi-shi, Hyogo, 673-8558, Japan
| | - Shoichi Itoh
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi-shi, Hyogo, 673-8558, Japan
| | - Takako Inoue
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yoshiko Urata
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi-shi, Hyogo, 673-8558, Japan
| | - Yoshitaka Kawa
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi-shi, Hyogo, 673-8558, Japan
| | - Rie Tohnai
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi-shi, Hyogo, 673-8558, Japan
| | - Toru Kumagai
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Kazumi Nishino
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Ryuji Uozumi
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shunichi Negoro
- Department of Medical Oncology, Takarazuka City Hospital, Takarazuka, Japan
| | - Fumio Imamura
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Miyako Satouchi
- Department of Thoracic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi-shi, Hyogo, 673-8558, Japan.
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Ogasawara N, Imamura T, Sato Y, Tamura T, Urasaki Y, Kono Y, Koyama R, Inoshita N, Nishida A. Simultaneous macroamylasemia and macrolipasemia in a patient with mucosa-associated lymphoid tissue lymphoma. Clin J Gastroenterol 2020; 13:626-631. [PMID: 31916217 DOI: 10.1007/s12328-019-01090-7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 12/27/2019] [Indexed: 12/01/2022]
Abstract
We report a case of simultaneous macroamylasemia and macrolipasemia complicated with mucosa-associated lymphoid tissue (MALT) lymphoma. A 78-year-old man presented with hyperamylasemia and hyperlipasemia for 2 years and was misdiagnosed with chronic pancreatitis at another hospital. However, his other pancreatic enzymes were normal, his amylase-creatinine clearance ratio was low, and no definite findings of pancreatic disease were evident. Immunological analyses revealed that both amylase and lipase were bound to immunoglobulin (Ig) A-κ, and that serum IgA was high (827.1 mg/dL). He was diagnosed with simultaneous macroamylasemia and macrolipasemia. Since these diseases are associated with malignancy, an additional investigation was performed which revealed the complication of MALT lymphoma, and polymerase chain reaction analysis showed monoclonal immunoglobulin light chain gene rearrangement (κ >> λ). In this case, macroamylasemia and macrolipasemia may have developed due to the formation of macroenzymes resulting from excess IgA-κ secreted by the MALT lymphoma. Simultaneous macroamylasemia and macrolipasemia are very rare and difficult to diagnose and can lead to diagnostic and therapeutic errors. When encountering atypical clinical features associated with hyperamylasemia and hyperlipasemia, the possibility of macroenzymes and underlying diseases such as lymphoproliferative disorders should be considered.
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Affiliation(s)
- Nobuhiko Ogasawara
- Department of Gastroenterology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Tsunao Imamura
- Department of Gastroenterology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan.
| | - Yoshiki Sato
- Department of Gastroenterology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Tetsuo Tamura
- Department of Gastroenterology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Yuji Urasaki
- Department of Gastroenterology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Yuko Kono
- Department of Gastroenterology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Rikako Koyama
- Department of Gastroenterology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Naoko Inoshita
- Department of Pathology, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
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Brunsing RL, Chen DH, Schlein A, Wolfson T, Gamst A, Mamidipalli A, Violi NV, Marks RM, Taouli B, Loomba R, Kono Y, Sirlin CB. Gadoxetate-enhanced Abbreviated MRI for Hepatocellular Carcinoma Surveillance: Preliminary Experience. Radiol Imaging Cancer 2019; 1:e190010. [PMID: 33778680 DOI: 10.1148/rycan.2019190010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 12/15/2022]
Abstract
Purpose To describe a single-center preliminary experience with gadoxetate disodium-enhanced abbreviated MRI for hepatocellular carcinoma (HCC) screening and surveillance in patients with cirrhosis or chronic hepatitis B virus (cHBV). Materials and Methods This was a retrospective study of consecutive patients aged 18 years and older with cirrhosis or cHBV who underwent at least one gadoxetate-enhanced abbreviated MRI examination for HCC surveillance from 2014 through 2016. Examinations were interpreted prospectively by one of six abdominal radiologists for clinical care. Clinical, imaging, and other data were extracted from electronic medical records. Diagnostic adequacy was assessed in all patients. Diagnostic accuracy was assessed in the subset of patients who could be classified as having HCC or not having HCC on the basis of a composite reference standard. Results In this study, 330 patients (93% with cirrhosis; 45% women; mean age, 59 years) underwent gadoxetate-enhanced abbreviated MRI. In the 330 patients, 311 (94.2%) baseline gadoxetate-enhanced abbreviated MRI examinations were diagnostically adequate. Of 141 (43%) of the 330 patients, 91.4% (129 of 141) could be classified as not having HCC and 8.6% (12 of 141) could be classified as having HCC. Baseline gadoxetate-enhanced abbreviated MRI had 0.92 sensitivity (95% confidence interval [CI]: 0.62, 1.00) and 0.91 specificity (95% CI: 0.84, 0.95) for detection of HCC. Of the 330 patients who underwent baseline gadoxetate-enhanced abbreviated MRI, 187 (57%) were lost to follow-up. Conclusion Gadoxetate-enhanced abbreviated MRI is feasible clinically, has a high diagnostic adequacy rate, and, on the basis of our preliminary experience, accurately depicts HCC in high-risk patients. Strategies to enhance follow-up compliance are needed.© RSNA, 2019Keywords: Abdomen/GI, Cirrhosis, Liver, MR-Imaging, Oncology, ScreeningSupplemental material is available for this article.
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Affiliation(s)
- Ryan L Brunsing
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Dennis H Chen
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Alexandra Schlein
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Tanya Wolfson
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Anthony Gamst
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Adrija Mamidipalli
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Naik Vietti Violi
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Robert M Marks
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Bachir Taouli
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Rohit Loomba
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Yuko Kono
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
| | - Claude B Sirlin
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W Arbor Dr, San Diego, CA 92103 (R.L.B., D.H.C., A.S., A.M., C.B.S.); Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (N.V.V., B.T.); Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (N.V.V.); Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, Md (R.M.M.); Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California San Diego, La Jolla, Calif (R.L.); NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, Calif (R.L.); and Department of Medicine and Radiology, University of California San Diego, La Jolla, Calif (Y.K.)
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Yang HK, Burns PN, Jang HJ, Kono Y, Khalili K, Wilson SR, Kim TK. Contrast-enhanced ultrasound approach to the diagnosis of focal liver lesions: the importance of washout. Ultrasonography 2019; 38:289-301. [PMID: 31311068 PMCID: PMC6769186 DOI: 10.14366/usg.19006] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [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: 01/15/2019] [Accepted: 03/17/2019] [Indexed: 12/12/2022] Open
Abstract
Contrast-enhanced ultrasound (CEUS) is a powerful technique for differentiating focal liver lesions (FLLs) without the risks of potential nephrotoxicity or ionizing radiation. In the diagnostic algorithm for FLLs on CEUS, washout is an important feature, as its presence is highly suggestive of malignancy and its characteristics are useful in distinguishing hepatocellular from nonhepatocellular malignancies. Interpreting washout on CEUS requires an understanding that microbubble contrast agents are strictly intravascular, unlike computed tomography or magnetic resonance imaging contrast agents. This review explains the definition and types of washout on CEUS in accordance with the 2017 version of the CEUS Liver Imaging Reporting and Data System and presents their applications to differential diagnosis with illustrative examples. Additionally, we propose potential mechanisms of rapid washout and describe the washout phenomenon in benign entities.
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Affiliation(s)
- Hyun Kyung Yang
- Joint Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Peter N Burns
- Department of Medical Biophysics, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Hyun-Jung Jang
- Joint Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Yuko Kono
- Departments of Medicine and Radiology, University of California, San Diego, CA, USA
| | - Korosh Khalili
- Joint Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Stephanie R Wilson
- Diagnostic Imaging, Department of Radiology, University of Calgary, Calgary, Canada
| | - Tae Kyoung Kim
- Joint Department of Medical Imaging, University of Toronto, Toronto, Canada
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Kielar AZ, Chernyak V, Bashir MR, Do RK, Fowler KJ, Santillan C, Sirlin CB, Mitchell DG, Cerny M, Tang A, Elsayes KM, Kamaya A, Kono Y, Arora SS. An update for LI‐RADS: Version 2018. Why so soon after version 2017? J Magn Reson Imaging 2019; 50:1990-1991. [DOI: 10.1002/jmri.26715] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 02/19/2019] [Accepted: 02/19/2019] [Indexed: 01/08/2023] Open
Affiliation(s)
- Ania Z. Kielar
- Joint Department of Medical ImagingUniversity of Toronto Toronto Canada
| | | | - Mustafa R. Bashir
- Department of RadiologyDuke University Medical Center Durham North Carolina USA
| | - Richard K. Do
- Department of RadiologyMemorial Sloan Kettering Cancer Center New York New York USA
| | - Kathryn J. Fowler
- Department of RadiologyUniversity of California San Diego California USA
| | - Cynthia Santillan
- Department of RadiologyUniversity of California San Diego California USA
| | - Claude B. Sirlin
- Department of RadiologyUniversity of California San Diego California USA
| | - Donald G. Mitchell
- Department of RadiologyThomas Jefferson University Philadelphia Pennsylvania USA
| | - Milena Cerny
- Department of RadiologyCentre Hospitalier de l'Université de Montréal (CHUM) Montréal Québec Canada
| | - An Tang
- Department of RadiologyCentre Hospitalier de l'Université de Montréal (CHUM) Montréal Québec Canada
| | | | - Aya Kamaya
- Department of RadiologyStanford University Palo Alto California USA
| | - Yuko Kono
- Department of GastroenterologyUniversity of California San Diego California USA
| | - Sandeep S. Arora
- Department of Radiology and Radiological SciencesVanderbilt University Medical Center Nashville Tennessee USA
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Scott DA, Norris-Caneda K, Spruill L, Bruner E, Kono Y, Angel PM, Mehta AS, Drake RR. Specific N-Linked Glycosylation Patterns in Areas of Necrosis in Tumor Tissues. Int J Mass Spectrom 2019; 437:69-76. [PMID: 31031563 PMCID: PMC6483403 DOI: 10.1016/j.ijms.2018.01.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Tissue necrosis is a form of cell death common in advanced and aggressive solid tumors, and is associated with areas of intratumoral chronic ischemia. The histopathology of necrotic regions appear as a scaffold of cellular membrane remnants, reflective of the hypoxia and cell degradation events associated with this cellular death pathway. Changes in the glycosylation of cell surface proteins is another common feature of cancer progression. Using a recently developed mass spectrometry imaging approach to evaluate N-linked glycan distributions in human formalin-fixed clinical cancer tissues, differences in the glycan structures of regions of tumor, stroma and necrosis were evaluated. While the structural glycan classes detected in the tumor and stromal regions are typically classified as high mannose or branched glycans, the glycans found in necrotic regions displayed limited branching, contained sialic acid modifications and lack fucose modifications. While this phenomenon was initially classified in breast cancer tissues, it has been also seen in cervical, thyroid and liver cancer samples. These changes in glycosylation within the necrotic regions could provide further mechanistic insight to necrotic changes in cancer tissue and provide new research directions for identifying prognostic markers of necrosis.
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Affiliation(s)
- Danielle A Scott
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics and MUSC Proteomics Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
- Department of Medicine, University of California San Diego, San Diego, California
| | - Kim Norris-Caneda
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics and MUSC Proteomics Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
- Department of Medicine, University of California San Diego, San Diego, California
| | - Laura Spruill
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics and MUSC Proteomics Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
- Department of Medicine, University of California San Diego, San Diego, California
| | - Evelyn Bruner
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics and MUSC Proteomics Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
- Department of Medicine, University of California San Diego, San Diego, California
| | - Yuko Kono
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics and MUSC Proteomics Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
- Department of Medicine, University of California San Diego, San Diego, California
| | - Peggi M Angel
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics and MUSC Proteomics Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
- Department of Medicine, University of California San Diego, San Diego, California
| | - Anand S Mehta
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics and MUSC Proteomics Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
- Department of Medicine, University of California San Diego, San Diego, California
| | - Richard R Drake
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics and MUSC Proteomics Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
- Department of Medicine, University of California San Diego, San Diego, California
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Hong CW, Park CC, Mamidipalli A, Hooker JC, Fazeli Dehkordy S, Igarashi S, Alhumayed M, Kono Y, Loomba R, Wolfson T, Gamst A, Murphy P, Sirlin CB. Longitudinal evolution of CT and MRI LI-RADS v2014 category 1, 2, 3, and 4 observations. Eur Radiol 2019; 29:5073-5081. [PMID: 30809719 DOI: 10.1007/s00330-019-06058-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 01/04/2019] [Accepted: 02/01/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVES This study assesses the risk of progression of Liver Imaging Reporting and Data System (LI-RADS) categories, and the effects of inter-exam changes in modality or radiologist on LI-RADS categorization. METHODS Clinical LI-RADS v2014 CT and MRI exams at our institution between January 2014 and September 2017 were retrospectively identified. Untreated LR-1, LR-2, LR-3, and LR-4 observations with at least one follow-up exam were included. Three hundred and seventy-two observations in 214 patients (149 male, 65 female, mean age 61 ± 10 years) were included during the study period (715 exams total). Cumulative incidence curves for progression to malignant LI-RADS categories (LR-5 or LR-M) and to LR-4 or higher were generated for each index category and compared using log-rank tests with a resampling extension. Relationships between inter-exam changes in LI-RADS category and modality or radiologist, adjusted for inter-exam time intervals, were modeled using mixed effect logistic regressions. RESULTS Median inter-exam follow-up interval and total follow-up duration were 123 and 227 days, respectively. Index LR-1, LR-2, LR-3, and LR-4 differed significantly in their cumulative incidences of progression to malignant categories (p < 0.0001), which were 0%, 2%, 7%, and 32% at 6 months, respectively. Index LR-1, LR-2, and LR-3 differed significantly in cumulative incidences of progression to LR-4 or higher (p = 0.003). MRI-MRI exam pairs had more stable LI-RADS categorization compared to CT-CT (OR = 0.460, p = 0.0018). CONCLUSIONS LI-RADS observations demonstrate increasing risk of progression to malignancy with increasing category ranging from 0% for LR-1 to 32% for LR-4 at 6 months. Inter-exam modality changes are associated with LI-RADS category changes. KEY POINTS • While the majority of LR-2 observations remain stable over long-term follow-up, LR-3 and especially LR-4 observations have a higher risk for category progression. • Category transitions between sequential exams using different modalities (CT vs. MRI) may reflect modality differences rather than biological change. MRI, especially with the same type of contrast agent, may provide the most reproducible categorization, although this needs additional validation. • In a clinical practice setting, in which radiologists refer to prior imaging and reports, there was no significant association between changes in radiologist and changes in LI-RADS categorization.
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Affiliation(s)
- Cheng William Hong
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Charlie C Park
- School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Adrija Mamidipalli
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Jonathan C Hooker
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Soudabeh Fazeli Dehkordy
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Saya Igarashi
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Mohanad Alhumayed
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Yuko Kono
- Computational and Applied Statistics Laboratory, University of California San Diego, San Diego, CA, USA
| | - Rohit Loomba
- Computational and Applied Statistics Laboratory, University of California San Diego, San Diego, CA, USA
| | - Tanya Wolfson
- Division of Gastroenterology, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Anthony Gamst
- Division of Gastroenterology, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Paul Murphy
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Claude B Sirlin
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA.
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Elsayes KM, Kielar AZ, Chernyak V, Morshid A, Furlan A, Masch WR, Marks RM, Kamaya A, Do RKG, Kono Y, Fowler KJ, Tang A, Bashir MR, Hecht EM, Jambhekar K, Lyshchik A, Rodgers SK, Heiken JP, Kohli M, Fetzer DT, Wilson SR, Kassam Z, Mendiratta-Lala M, Singal AG, Lim CS, Cruite I, Lee J, Ash R, Mitchell DG, McInnes MDF, Sirlin CB. LI-RADS: a conceptual and historical review from its beginning to its recent integration into AASLD clinical practice guidance. J Hepatocell Carcinoma 2019; 6:49-69. [PMID: 30788336 PMCID: PMC6368120 DOI: 10.2147/jhc.s186239] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The Liver Imaging Reporting and Data System (LI-RADS®) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver observations in individuals at high risk for hepatocellular carcinoma (HCC). LI-RADS is supported and endorsed by the American College of Radiology (ACR). Upon its initial release in 2011, LI-RADS applied only to liver observations identified at CT or MRI. It has since been refined and expanded over multiple updates to now also address ultrasound-based surveillance, contrast-enhanced ultrasound for HCC diagnosis, and CT/MRI for assessing treatment response after locoregional therapy. The LI-RADS 2018 version was integrated into the HCC diagnosis, staging, and management practice guidance of the American Association for the Study of Liver Diseases (AASLD). This article reviews the major LI-RADS updates since its 2011 inception and provides an overview of the currently published LI-RADS algorithms.
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Affiliation(s)
- Khaled M Elsayes
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,
| | - Ania Z Kielar
- Department of Radiology, University of Toronto, ON, Canada
| | | | - Ali Morshid
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,
| | - Alessandro Furlan
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - William R Masch
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Robert M Marks
- Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Aya Kamaya
- Department of Radiology, Stanford University Medical Center, Stanford, CA, USA
| | - Richard K G Do
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yuko Kono
- Department of Radiology, University of California San Diego, CA, USA
| | - Kathryn J Fowler
- Department of Radiology, University of California San Diego, CA, USA
| | - An Tang
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Mustafa R Bashir
- Department of Radiology, Center for Advanced Magnetic Resonance Development, and Division of Gastroenterology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Elizabeth M Hecht
- Department of Radiology, Columbia University Medical Center, New York, NY, USA
| | - Kedar Jambhekar
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Andrej Lyshchik
- Department of Radiology, Einstein Medical Center, Philadelphia, PA, USA
| | - Shuchi K Rodgers
- Department of Radiology, Einstein Medical Center, Philadelphia, PA, USA
| | - Jay P Heiken
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Marc Kohli
- Department of Radiology, University of California San Francisco, CA, USA
| | - David T Fetzer
- Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, TX, USA
| | | | - Zahra Kassam
- Department of Diagnostic Imaging, Schulich School of Medicine, London, ON, Canada
| | | | - Amit G Singal
- Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, TX, USA
| | - Christopher S Lim
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada
| | - Irene Cruite
- Department of Radiology, Inland Imaging, Spokane, WA, USA
| | - James Lee
- Department of Radiology, University of Kentucky, Lexington, KY, USA
| | - Ryan Ash
- Department of Radiology, University of Kansas, Kansas City, KS, USA
| | - Donald G Mitchell
- Department of Radiology, Einstein Medical Center, Philadelphia, PA, USA
| | | | - Claude B Sirlin
- Department of Radiology, University of California San Diego, CA, USA
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47
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Chernyak V, Fowler KJ, Kamaya A, Kielar AZ, Elsayes KM, Bashir MR, Kono Y, Do RK, Mitchell DG, Singal AG, Tang A, Sirlin CB. Liver Imaging Reporting and Data System (LI-RADS) Version 2018: Imaging of Hepatocellular Carcinoma in At-Risk Patients. Radiology 2018; 289:816-830. [PMID: 30251931 DOI: 10.1148/radiol.2018181494] [Citation(s) in RCA: 575] [Impact Index Per Article: 95.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The Liver Imaging Reporting and Data System (LI-RADS) is composed of four individual algorithms intended to standardize the lexicon, as well as reporting and care, in patients with or at risk for hepatocellular carcinoma in the context of surveillance with US; diagnosis with CT, MRI, or contrast material-enhanced US; and assessment of treatment response with CT or MRI. This report provides a broad overview of LI-RADS, including its historic development, relationship to other imaging guidelines, composition, aims, and future directions. In addition, readers will understand the motivation for and key components of the 2018 update.
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Affiliation(s)
- Victoria Chernyak
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - Kathryn J Fowler
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - Aya Kamaya
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - Ania Z Kielar
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - Khaled M Elsayes
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - Mustafa R Bashir
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - Yuko Kono
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - Richard K Do
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - Donald G Mitchell
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - Amit G Singal
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - An Tang
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
| | - Claude B Sirlin
- From the Department of Radiology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467 (V.C.); Mallinckrodt Institute of Radiology, Washington University, School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.K.); Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Radiology, Duke University Medical Center, Durham, NC (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Medicine and Radiology (Y.K.), and Liver Imaging Group, Department of Radiology (C.B.S.), University of California-San Diego, San Diego, Calif; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.D.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (D.G.M.); Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas Tex (A.G.S.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada (A.T.)
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Kono Y, Iwasaki A, Fujita T. Effect of surface charge, particle size, and modification by polyethylene glycol of liposomes on their association with Caco-2 cells across an unstirred water layer. Pharmazie 2018; 73:3-8. [PMID: 29441943 DOI: 10.1691/ph.2018.7110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
For the development of orally available liposomes, understanding the interaction of liposomes with the intestinal mucosa is important. An unstirred water layer (UWL) on the intestinal epithelium surface is a considerable permeability barrier for lipophilic drugs. Therefore, the effects of an UWL on liposome transport across intestinal epithelial cells must be elucidated. We evaluated the effects of the surface charge, particle size, and polyethylene glycol (PEG) modification of liposomes on their association with Caco-2 cells across an UWL. When the association of cationic liposomes with Caco-2 cells was evaluated under a reduction in UWL thickness by shaking, the uptake and/or amount of surface-bound cationic liposomes in cells was increased significantly in a shaking rate-dependent manner. The uptake and/or amount of surface-bound neutral liposomes were increased only at the highest shaking rate. No significant differences in the cellular association of anionic liposomes and PEG-modified liposomes were observed with or without shaking. The association of large liposomes with Caco-2 cells was affected considerably by an UWL compared with that of small liposomes. These results suggest that an UWL affects the surface binding and subsequent uptake of liposomes in Caco-2 cells according to their particle size, surface charge, and PEG modification.
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Koizumi K, Hosiai M, Katsumata N, Toda T, Kise H, Hasebe Y, Kono Y, Sunaga Y, Yoshizawa M, Watanabe A, Moriguchi T, Matsuda K, Sugita K. P3794Plasma exchange regulates CD14+CD16+ activated monocytes and CD4+CD25+FOXP3+ regulatory T cells in Kawasaki disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3794] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Koizumi
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - M Hosiai
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - N Katsumata
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - T Toda
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - H Kise
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - Y Hasebe
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - Y Kono
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - Y Sunaga
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - M Yoshizawa
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - A Watanabe
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - T Moriguchi
- Faculty of Medicine, University of Yamanashi, Department of Emergency and Critical Care Medicine, Chuo, Yamanashi, Japan
| | - K Matsuda
- Faculty of Medicine, University of Yamanashi, Department of Emergency and Critical Care Medicine, Chuo, Yamanashi, Japan
| | - K Sugita
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
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50
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Hasebe Y, Yokota S, Takeda K, Sugama S, Kono Y, Koizumi K, Fukushi I, Hoshiai M, Kakinuma Y, Pokorski M, Horiuchi J, Sugita K, Okada Y. P4780Activation of astrocytes is requred for the persistence of post-stress blood pressure elevation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4780] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Hasebe
- University of Yamanashi, Department of Pediatrics, Graduate School of Medicine, Yamanashi, Japan
| | - S Yokota
- Shimane University, Anatomy and Morphological Neuroscience, Izumo, Japan
| | - K Takeda
- Fujita Health University, Faculty of Rehabilitation, School of Health Sciences, Mie, Japan
| | - S Sugama
- Nippon Medical School, Department of Physiology, Tokyo, Japan
| | - Y Kono
- University of Yamanashi, Department of Pediatrics, Graduate School of Medicine, Yamanashi, Japan
| | - K Koizumi
- University of Yamanashi, Department of Pediatrics, Graduate School of Medicine, Yamanashi, Japan
| | - I Fukushi
- National Hospital Organization Murayama Medical Center, Clinical Research Center, Musashimurayama, Tokyo, Japan
| | - M Hoshiai
- University of Yamanashi, Department of Pediatrics, Graduate School of Medicine, Yamanashi, Japan
| | - Y Kakinuma
- Nippon Medical School, Department of Physiology, Tokyo, Japan
| | - M Pokorski
- Opole Medical School, Faculty of Physiotherapy, Opole, Poland
| | - J Horiuchi
- Toyo University, Department of Biomedical Engineering, Graduate School of Science & Engineering, Saitama, Japan
| | - K Sugita
- University of Yamanashi, Department of Pediatrics, Graduate School of Medicine, Yamanashi, Japan
| | - Y Okada
- National Hospital Organization Murayama Medical Center, Clinical Research Center, Musashimurayama, Tokyo, Japan
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