Science.gov

Sample records for hepatic tumors ct

  1. Hepatic perfusion in a tumor model using DCE-CT: an accuracy and precision study

    NASA Astrophysics Data System (ADS)

    Stewart, Errol E.; Chen, Xiaogang; Hadway, Jennifer; Lee, Ting-Yim

    2008-08-01

    In the current study we investigate the accuracy and precision of hepatic perfusion measurements based on the Johnson and Wilson model with the adiabatic approximation. VX2 carcinoma cells were implanted into the livers of New Zealand white rabbits. Simultaneous dynamic contrast-enhanced computed tomography (DCE-CT) and radiolabeled microsphere studies were performed under steady-state normo-, hyper- and hypo-capnia. The hepatic arterial blood flows (HABF) obtained using both techniques were compared with ANOVA. The precision was assessed by the coefficient of variation (CV). Under normo-capnia the microsphere HABF were 51.9 ± 4.2, 40.7 ± 4.9 and 99.7 ± 6.0 ml min-1 (100 g)-1 while DCE-CT HABF were 50.0 ± 5.7, 37.1 ± 4.5 and 99.8 ± 6.8 ml min-1 (100 g)-1 in normal tissue, tumor core and rim, respectively. There were no significant differences between HABF measurements obtained with both techniques (P > 0.05). Furthermore, a strong correlation was observed between HABF values from both techniques: slope of 0.92 ± 0.05, intercept of 4.62 ± 2.69 ml min-1 (100 g)-1 and R2 = 0.81 ± 0.05 (P < 0.05). The Bland-Altman plot comparing DCE-CT and microsphere HABF measurements gives a mean difference of -0.13 ml min-1 (100 g)-1, which is not significantly different from zero. DCE-CT HABF is precise, with CV of 5.7, 24.9 and 1.4% in the normal tissue, tumor core and rim, respectively. Non-invasive measurement of HABF with DCE-CT is accurate and precise. DCE-CT can be an important extension of CT to assess hepatic function besides morphology in liver diseases.

  2. Dynamic-thresholding level set: a novel computer-aided volumetry method for liver tumors in hepatic CT images

    NASA Astrophysics Data System (ADS)

    Cai, Wenli; Yoshida, Hiroyuki; Harris, Gordon J.

    2007-03-01

    Measurement of the volume of focal liver tumors, called liver tumor volumetry, is indispensable for assessing the growth of tumors and for monitoring the response of tumors to oncology treatments. Traditional edge models, such as the maximum gradient and zero-crossing methods, often fail to detect the accurate boundary of a fuzzy object such as a liver tumor. As a result, the computerized volumetry based on these edge models tends to differ from manual segmentation results performed by physicians. In this study, we developed a novel computerized volumetry method for fuzzy objects, called dynamic-thresholding level set (DT level set). An optimal threshold value computed from a histogram tends to shift, relative to the theoretical threshold value obtained from a normal distribution model, toward a smaller region in the histogram. We thus designed a mobile shell structure, called a propagating shell, which is a thick region encompassing the level set front. The optimal threshold calculated from the histogram of the shell drives the level set front toward the boundary of a liver tumor. When the volume ratio between the object and the background in the shell approaches one, the optimal threshold value best fits the theoretical threshold value and the shell stops propagating. Application of the DT level set to 26 hepatic CT cases with 63 biopsy-confirmed hepatocellular carcinomas (HCCs) and metastases showed that the computer measured volumes were highly correlated with those of tumors measured manually by physicians. Our preliminary results showed that DT level set was effective and accurate in estimating the volumes of liver tumors detected in hepatic CT images.

  3. Intraarterial Chemotherapy or Chemoembolization for Locally Advanced and/or Recurrent Hepatic Tumors: Evaluation of the Feeding Artery with an Interventional CT System

    SciTech Connect

    Hirai, Toshinori; Korogi, Yukunori; Ono, Ken; Maruoka, Kousei; Harada, Kazunori; Aridomi, Satoshi; Takahashi, Mutsumasa

    2001-05-15

    Purpose: To evaluate the utility of an interventional CT system for intraarterial chemotherapy or chemoembolization for locally advanced and/or recurrent hepatic tumors.Methods: Thirty-eight patients with locally advanced or recurrent hepatic tumors underwent 73 intraarterial contrast-enhanced CT (IA-CECT) examinations immediately before chemotherapy or chemoembolization. The degree of tumor vascularity on angiography and enhancement on IA-CECT was classified into three grades: no, mild, or marked vascularity. The IA-CECT grades were compared with the angiographic grades.Results: Twenty-nine (69%) of 42 examinations that were interpreted as having no or mild vascularity on angiography were classified as marked enhancement on IA-CECT. Based on IA-CECT findings, the position of the catheter was changed in 14 (19%) of 73 CT examinations. The reasons for the reposition were as follows: weak or no enhancement of the tumor (n = 11) or strong enhancement of the gallbladder wall (n = 3). The treatment strategy was changed in three patients (8%). No major complications relating to the interventional procedures were observed.Conclusions: IA-CECT is a reliable method when evaluating the perfusion of the tumor and adjacent normal tissues. The interventional CT system is useful for performing safe and effective intraarterial chemotherapy or chemoembolization in patients with locally advanced and/or recurrent hepatic tumors.

  4. Establishing models of portal vein occlusion and evaluating value of multi-slice CT in hepatic VX2 tumor in rabbits

    PubMed Central

    Qi, Yue-Yong; Zou, Li-Guang; Liang, Ping; Zhang, Dong

    2007-01-01

    AIM: To establish models of portal vein occlusion of hepatic VX2 tumor in rabbits and to evaluate the value of multi-slice CT. METHODS: Forty New Zealand rabbits were divided into 4 groups according to digital table: Immediate group (group A; transplantation of tumor immediately after the portal vein occlusion), 3-wk group (group B; transplantation of tumor at 3 wk after the portal vein occlusion), negative control group (group C) and positive control group (group D), 10 rabbits in each group. Hepatic VX2 tumor was transplanted with abdominal-embedding innoculation immediately after the portal vein occlusion and at 3 wk after the portal vein occlusion. Meanwhile, they were divided into negative control group (Left external branch of portal vein was occluded by sham-operation, and left exite was embedded and inoculated pseudoly) and positive control group (Transplanted tumor did not suffer from the portal vein occlusion). All rabbits were scanned with multi-slice CT. RESULTS: All 40 animals were employed in the final analysis without death. Tumor did not grow in both immediate group and 3-wk group. In 3-wk group, left endite was atrophied and growth of tumor was inhibited. The maximal diameter of tumor was significantly smaller than that in positive control group (2.55 ± 0.46 vs 3.59 ± 0.37 cm, t = 5.57, P < 0.001). Incidences of metastasis in the liver and lung were lower in 3-wk group than those in positive control group (10% vs 40%, and 90% vs 100%, respectively). The expression intensities of the vascular endothelium growth factor (VEGF) in groups A, B, C and D were 0.10 ± 0.06, 0.66 ± 0.21, 0.28 ± 0.09 and 1.48 ± 0.32, respectively. VEGF expression level in the test group A was significantly lower than that in the negative control group C (t = 5.07; P < 0.001). In addition, VEGF expression in the test group B was significantly lower than that in the positive control group D (t = 6.38; P < 0.001). Scanning with multi-slice CT showed that displaying rate of

  5. Primary hepatic neuroendocrine tumor: A case report

    PubMed Central

    MORISHITA, ASAHIRO; YONEYAMA, HIROHITO; NOMURA, TAKAKO; SAKAMOTO, TEPPEI; FUJITA, KOJI; TANI, JOJI; MIYOSHI, HISAAKI; HABA, REIJI; MASAKI, TSUTOMU

    2016-01-01

    We herein present a case of an 87-year-old patient with multiple liver tumors identified on abdominal ultrasound. The assessment performed on admission included physical examination, computed tomography (CT) during hepatic angiography and CT during arterial portography. The examination revealed contrast enhancement of a proportion of the liver tumors (20 mm maximum diameter) during the arterial phase and mild contrast washout of those tumors during the delayed phase. On contrast-enhanced magnetic resonance imaging using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid, certain liver tumors exhibited contrast enhancement during the early phase and contrast washout during the hepatocyte phase in both lobes. By contrast, no lesions were identified during positron emission tomography imaging of the liver. A liver biopsy was performed and immunohistochemical staining revealed enhanced expression of cytokeratin AE1/AE3, synaptophysin, chromogranin A and CD56 and no expression of hepatocyte antigen or CΚ7. The mindbomb E3 ubiquitin protein ligase-1 index was ~2% in most of the tumor. The liver tumors were finally diagnosed as multiple intrahepatic metastases from a primary hepatic neuroendocrine tumor (PHNET). The patient underwent transarterial chemoembolisation with a combination of miriplatin (84 mg) mixed with gelatin sponge particles and lipiodol. To the best of our knowledge, this is the first report of PHNET in an patient aged >85 years. PMID:27284429

  6. [Hepatic tumors and radiotherapy].

    PubMed

    Rio, E; Mornex, F; Peiffert, D; Huertas, A

    2016-09-01

    Recent technological developments led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumors as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. For hepatocellular carcinoma 5 to 10cm (or more), a conformational radiation with or without intensity modulation is performed. Stereotactic body radiotherapy (SBRT) is being evaluated and is increasingly proposed as an alternative to radiofrequency ablative treatment for primary or secondary tumors (typically less than 5cm). Tumor (and liver) movements induced by respiratory motions must be taken into account. Strict dosimetric criteria must be met with particular attention to the dose-volume histograms to liver and the hollow organs, including cases of SBRT. PMID:27521035

  7. CT of hepatic schistosomiasis mansoni

    SciTech Connect

    Fataar, S.; Bassiony, H.; Satyanath, S.; Rudwan, M.A.; Khaffaji, S.; El Magdy, W.; Al-Ansari, A.G.; Hanna, R.

    1985-07-01

    Schistosomal periportal fibrosis produced a typical pattern on computed tomography in five patients. Low-density periportal tissue, present throughout the liver, enhanced strongly after the administration of contrast medium. While rounded in cross section, the thickened periportal tissue produced linear and branching patterns when imaged in longitudinal section. In all cases, the sonographic features were typical of schistosomal periportal fibrosis. A lack of awareness of the distinctive features of periportal fibrosis may result in a mistaken diagnosis of hepatic metastases.

  8. CT and MR of pineal region tumors.

    PubMed

    Gouliamos, A D; Kalovidouris, A E; Kotoulas, G K; Athanasopoulou, A K; Kouvaris, J R; Trakadas, S J; Vlahos, L J; Papavasiliou, C G

    1994-01-01

    Magnetic Resonance (MR) imaging features of pineal region tumors were analyzed in 14 oncologic cases. The tumors were classified as germ-cell tumors, glial tumors, pineal parenchymal tumors, meningiomas, and cysts. They demonstrated different MR signal characteristics on precontrast scans and nodular or ring type enhancement with occasional central lucencies, except for benign cysts, which have not shown enhancement. MR images were useful in defining the relationship of the tumor to the posterior third ventricle, sylvian aqueduct, vein of Galen, and tentorium. Although CT can demonstrate in more evident fashion displacement of the original pineal calcification as well as tumor calcifications, MR imaging demonstrates different signal characteristics in germinomas and pineoblastomas which can be a useful adjunct in the evaluation and differential diagnosis of these tumors. PMID:8295504

  9. CT evaluation of primary benign retroperitoneal tumor.

    PubMed

    Hayasaka, K; Yamada, T; Saitoh, Y; Yoshikawa, D; Aburano, T; Hashimoto, H; Yachiku, S

    1994-01-01

    We studied CT patterns in 21 cases of primary benign retroperitoneal tumor including teratoma in nine cases, schwannoma in six, leiomyoma in three, lipoma in one, lymphangioma in one, and neurofibroma in one. The tumors were analyzed for size, internal homogeneity, CT density, calcification, border with neighboring organs, and contrast enhancement (CE). The mean diameter of the tumors was 10.2 (+/- 4.8) cm. Internal homogeneous distribution was observed in 33%, calcification in 43%, and well-defined border in 86%. The CT density and calcification were compared according to histology, and the results were as follows: teratoma showed fat density in 78%, water density in 100%, and calcification in 89%; schwannoma showed water density in 100% and septal CE in 33%; leiomyoma showed soft tissue density in 100%, CE in 100%, and water density in 33%; lipoma showed fat density and calcification; and lymphangioma and neurofibroma showed water density. Internal homogeneity, fat density, cyst formation, and calcification are considered to be important predictors of primary benign retroperitoneal tumor on CT.

  10. Primary Hepatic Carcinoid Tumor with Poor Outcome.

    PubMed

    Parkash, Om; Ayub, Adil; Naeem, Buria; Najam, Sehrish; Ahmed, Zubair; Jafri, Wasim; Hamid, Saeed

    2016-03-01

    Primary Hepatic Carcinoid Tumor (PHCT) represents an extremely rare clinical entity with only a few cases reported to date. These tumors are rarely associated with metastasis and surgical resection is usually curative. Herein, we report two cases of PHCT associated with poor outcomes due to late diagnosis. Both cases presented late with non-specific symptoms. One patient presented after a 2-week history of symptoms and the second case had a longstanding two years symptomatic interval during which he remained undiagnosed and not properly worked up. Both these cases were diagnosed with hepatic carcinoid tumor, which originates from neuroendocrine cells. Case 1 opted for palliative care and expired in one month’s time. Surgical resection was advised to the second case, but he left against medical advice. PMID:26975959

  11. Primary Hepatic Carcinoid Tumor with Poor Outcome.

    PubMed

    Parkash, Om; Ayub, Adil; Naeem, Buria; Najam, Sehrish; Ahmed, Zubair; Jafri, Wasim; Hamid, Saeed

    2016-03-01

    Primary Hepatic Carcinoid Tumor (PHCT) represents an extremely rare clinical entity with only a few cases reported to date. These tumors are rarely associated with metastasis and surgical resection is usually curative. Herein, we report two cases of PHCT associated with poor outcomes due to late diagnosis. Both cases presented late with non-specific symptoms. One patient presented after a 2-week history of symptoms and the second case had a longstanding two years symptomatic interval during which he remained undiagnosed and not properly worked up. Both these cases were diagnosed with hepatic carcinoid tumor, which originates from neuroendocrine cells. Case 1 opted for palliative care and expired in one month’s time. Surgical resection was advised to the second case, but he left against medical advice.

  12. Multidetector CT of hepatic artery pathologies.

    PubMed

    Karaosmanoglu, D; Erol, B; Karcaaltincaba, M

    2012-01-01

    The hepatic artery can be involved by a variety of pathology and diseases.Today MDCT enables high quality imaging of the hepatic artery using axial, MIP and volume rendered images. We illustrate MDCT findings of anatomical variations, aneurysm, dilatation, dissection, arteriovenous fistula, thrombosis and stenosis. Aneurysms can be saccular, fusiform and multiple and may develop due to atherosclerosis, vasculitis, trauma and biopsy. Dilatation of hepatic artery can be seen in portal hypertension, Osler-Weber-Rendu disease and hemangiomatosis. Hepatic artery can be occluded after trauma and transplantation. Dissection develops due to atherosclerosis, Marfan and Ehler Danlos syndromes and during pregnancy. Arteriovenous fistula can be congenital and acquired. We conclude that various hepatic artery pathologies can be confidently diagnosed by MDCT.

  13. Uncommon hepatic tumors: iconographic essay - Part 1*

    PubMed Central

    Pedrassa, Bruno Cheregati; da Rocha, Eduardo Lima; Kierszenbaum, Marcelo Longo; Bormann, Renata Lilian; Torres, Lucas Rios; D'Ippolito, Giuseppe

    2014-01-01

    Most malignant liver tumors are represented by hepatocellular carcinoma and cholangiocarcinoma; however a variety of other uncommon hepatic lesions might also be found. Common lesions such as hemangioma, focal nodular hyperplasia and metastases are well known and have already been extensively documented in the literature. The diagnosis of typical hepatic lesions may be done with some reliability by means of several imaging methods; on the other hand, uncommon lesions normally represent a diagnostic challenge for the radiologist. In this first part of the study, the authors will approach five uncommon liver tumors - angiosarcoma, angiomyolipoma, cystadenoma/biliary carcinoma, epithelioid hemangioendothelioma, and fibrolamellar hepatocellular carcinoma -, describing their main characteristics and image findings with focus on computed tomography and magnetic resonance imaging. PMID:25741106

  14. CT of Hepatic Sarcoidosis: Small Nodular Lesions Simulating Metastatic Disease

    PubMed Central

    Ufuk, Furkan; Herek, Duygu

    2015-01-01

    Summary Background Sarcoidosis is a multisystemic inflammatory disease of unknown origin. The lymphoid system and the lungs are the most commonly involved organs. The frequency of signs or symptoms of hepatic involvement is very low. Case Report We present a case of symptomatic granulomatous liver disease secondary to sarcoidosis, mimicking a metastatic disease on ultrasonography and CT. Conclusions Hepatic involvement in sarcoidosis might be a perplexing diagnostic problem. The decisive CT finding with respect to the differential diagnosis was the absence of a mass effect and intact vascular architecture around the lesions. PMID:25908950

  15. Hepatic perfusion abnormalities during CT angiography: Detection and interpretation

    SciTech Connect

    Freeny, P.C.; Marks, W.M.

    1986-06-01

    Twenty-seven perfusion abnormalities were detected in 17 of 50 patients who underwent computed tomographic angiography (CTA) of the liver. All but one of the perfusion abnormalities occurred in patients with primary or metastatic liver tumors. Perfusion abnormalities were lobar in nine cases, segmental in 11, and subsegmental in seven; 14 were hypoperfusion and 13 were hyperperfusion abnormalities. The causes for the abnormalities included nonperfusion of a replaced hepatic artery (n = 11), cirrhosis and nodular regeneration (n = 3), altered hepatic hemodynamics (e.g., siphoning, laminar flow) caused by tumor (n = 7), contrast media washout from a nonperfused vessel (n = 1), compression of adjacent hepatic parenchyma (n = 1), and unknown (n = 4). Differentiation of perfusion abnormalities from tumor usually can be made by comparing the morphology of the known tumor with the suspected perfusion abnormality, changes of each on delayed CTA scans, and review of initial angiograms and other imaging studies.

  16. Hepatic angiomyolipoma: differential diagnosis from other liver tumors in a special reference to vascular imaging - importance of early drainage vein.

    PubMed

    Yoshioka, Masato; Watanabe, Go; Uchinami, Hiroshi; Kudoh, Kazuhiro; Hiroshima, Yuko; Yoshioka, Toshiaki; Nanjo, Hiroshi; Funaoka, Masato; Yamamoto, Yuzo

    2015-12-01

    A 51-year-old female had been diagnosed with a hemangioma in the hepatic segment 6 (S6). After a 6-year follow-up, enlargement of the tumor was detected. The tumor was clearly enhanced in the arterial phase, and the enhancement remained in the portal phase on computed tomography (CT). Although the primary differential diagnosis on CT was hepatocellular carcinoma (HCC), we worried about the possibility of other vessel system tumors because the tumor remained to be enhanced at the portal phase for HCC and all tumor markers of HCC were negative. We performed angiography to determine the tumor nature and to seek other tumors. Angiography showed tumor stain at the hepatic S6 with an early obvious drainage vein from the tumor flowing through the right hepatic vein into the inferior vena cava. In addition to tumor stain and the drainage vein, there were many small poolings of contrast medium in the whole liver, which were suspected as dilatation of the hepatic peripheral artery. We suspected the tumor as a benign tumor such as hepatocellular adenoma or focal nodular hyperplasia, but the possibility of HCC could not be ruled out. Hepatic posterior sectionectomy was done to completely remove the drainage vein with the tumor. Intraoperative histological examination revealed the tumor as not malignant and not HCC. Later, immunohistochemical analysis uncovered that the tumor had high expression of HMB-45 and, therefore, the final diagnosis was angiomyolipoma. We think that detecting an early drainage vein from the tumor would be a key point for diagnosing hepatic angiomyolipoma. PMID:26943379

  17. Automated 3D vascular segmentation in CT hepatic venography

    NASA Astrophysics Data System (ADS)

    Fetita, Catalin; Lucidarme, Olivier; Preteux, Francoise

    2005-08-01

    In the framework of preoperative evaluation of the hepatic venous anatomy in living-donor liver transplantation or oncologic rejections, this paper proposes an automated approach for the 3D segmentation of the liver vascular structure from 3D CT hepatic venography data. The developed segmentation approach takes into account the specificities of anatomical structures in terms of spatial location, connectivity and morphometric properties. It implements basic and advanced morphological operators (closing, geodesic dilation, gray-level reconstruction, sup-constrained connection cost) in mono- and multi-resolution filtering schemes in order to achieve an automated 3D reconstruction of the opacified hepatic vessels. A thorough investigation of the venous anatomy including morphometric parameter estimation is then possible via computer-vision 3D rendering, interaction and navigation capabilities.

  18. Carbon dioxide contrast enhancement for C-arm CT utility for treatment planning during hepatic embolization procedures.

    PubMed

    Wong, Adrian A; Charalel, Resmi A; Louie, John D; Sze, Daniel Y

    2013-07-01

    A pilot study was performed to evaluate the use of carbon dioxide (CO2) as a contrast medium for C-arm computed tomography (CT). C-arm CT using CO2 was performed during embolization procedures in12 patients with hepatic malignancies and severe iodine allergy or high risk for nephrotoxicity. C-arm CT using gadolinium or iodinated contrast medium was performed for comparison. Of segmental arteries identified by conventional contrast enhancement, 96% were also seen with CO2 enhancement, but subsegmental arteries were not reliably depicted. CO2 enhancement identified 60% of tumors. Small, hypovascular, and infiltrative tumors were difficult to detect. CO2 is a promising alternative intraarterial contrast agent for C-arm CT.

  19. Low contrast medium and radiation dose for hepatic computed tomography perfusion of rabbit VX2 tumor

    PubMed Central

    Zhang, Cai-Yuan; Cui, Yan-Fen; Guo, Chen; Cai, Jing; Weng, Ya-Fang; Wang, Li-Jun; Wang, Deng-Bin

    2015-01-01

    AIM: To evaluate the feasibility of low contrast medium and radiation dose for hepatic computed tomography (CT) perfusion of rabbit VX2 tumor. METHODS: Eleven rabbits with hepatic VX2 tumor underwent perfusion CT scanning with a 24-h interval between a conventional tube potential (120 kVp) protocol with 350 mgI/mL contrast medium and filtered back projection, and a low tube potential (80 kVp) protocol with 270 mgI/mL contrast medium with iterative reconstruction. Correlation and agreement among perfusion parameters acquired by the conventional and low dose protocols were assessed for the viable tumor component as well as whole tumor. Image noise and tumor-to-liver contrast to noise ratio during arterial and portal venous phases were evaluated. RESULTS: A 38% reduction in contrast medium dose (360.1 ± 13.3 mgI/kg vs 583.5 ± 21.5 mgI/kg, P < 0.001) and a 73% decrease in radiation dose (1898.5 mGy • cm vs 6951.8 mGy • cm) were observed. Interestingly, there was a strong positive correlation in hepatic arterial perfusion (r = 0.907, P < 0.001; r = 0.879, P < 0.001), hepatic portal perfusion (r = 0.819, P = 0.002; r = 0.831, P = 0.002), and hepatic blood flow (r = 0.945, P < 0.001; r = 0.930, P < 0.001) as well as a moderate correlation in hepatic perfusion index (r = 0.736, P = 0.01; r = 0.636, P = 0.035) between the low dose protocol with iterative reconstruction and the conventional protocol for the viable tumor component and the whole tumor. These two imaging protocols provided a moderate but acceptable agreement for perfusion parameters and similar tumor-to-liver CNR during arterial and portal venous phases (5.63 ± 2.38 vs 6.16 ± 2.60, P = 0.814; 4.60 ± 1.27 vs 5.11 ± 1.74, P = 0.587). CONCLUSION: Compared with the conventional protocol, low contrast medium and radiation dose with iterative reconstruction has no significant influence on hepatic perfusion parameters for rabbits VX2 tumor. PMID:25954099

  20. Pattern of Retained Contrast on Immediate Postprocedure Computed tomography (CT) After Particle Embolization of Liver Tumors Predicts Subsequent Treatment Response

    SciTech Connect

    Wang Xiaodong Erinjeri, Joseph P.; Jia Xiaoyu Gonen, Mithat; Brown, Karen T. Sofocleous, Constantinos T. Getrajdman, George I. Brody, Lynn A. Thornton, Raymond H. Maybody, Majid Covey, Ann M. Siegelbaum, Robert H. Alago, William Solomon, Stephen B.

    2013-08-01

    PurposeTo determine if the pattern of retained contrast on immediate postprocedure computed tomography (CT) after particle embolization of hepatic tumors predicts modified Response Evaluation Criteria in Solid Tumors (mRECIST) response.Materials and MethodsThis study was approved by the Institutional Review Board with a waiver of authorization. One hundred four liver tumors were embolized with spherical embolic agents (Embospheres, Bead Block, LC Bead) and polyvinyl alcohol. Noncontrast CT was performed immediately after embolization to assess contrast retention in the targeted tumors, and treatment response was assessed by mRECIST criteria on follow-up CT (average time 9.0 {+-} 7.7 weeks after embolization). Tumor contrast retention (TCR) was determined based on change in Hounsfield units (HUs) of the index tumors between the preprocedure and immediate postprocedure scans; vascular contrast retention (VCR) was rated; and defects in contrast retention (DCR) were also documented. The morphology of residual enhancing tumor on follow-up CT was described as partial, circumferential, or total. Association between TCR variables and tumor response were assessed using multivariate logistic regression.ResultsOf 104 hepatic tumors, 51 (49 %) tumors had complete response (CR) by mRECIST criteria; 23 (22.1 %) had partial response (PR); 21 (20.2 %) had stable disease (SD); and 9 (8.7 %) had progressive disease (PD). By multivariate analysis, TCR, VCR, and tumor size are independent predictors of CR (p = 0.02, 0.05, and 0.005 respectively). In 75 tumors, DCR was found to be an independent predictor of failure to achieve complete response (p < 0.0001) by imaging criteria.ConclusionTCR, VCR, and DCR on immediate posttreatment CT are independent predictors of CR by mRECIST criteria.

  1. [Preliminary investigation on dynamic CT scan of intracranial tumors].

    PubMed

    Wu, E H

    1989-04-01

    74 patients with various intracranial tumors were studied by means of dynamic CT, among them 45 cases were confirmed by operation and pathology. In analyzing the time-density curve and the ratio of increase in CT number of the tumoral tissue to that in the arterial lumens (tissue-blood ratio, TBR), we found that: (1) Dynamic CT technique is safe and easy to perform suitable for out-patients; (2) The time-density curves in acoustic neurinoma, meningioma, glioma and metastatic tumors are different from each other because of difference in vascularity and the degree of B.B.B. breakdown. Meningioma curve shows a rapid rise to the peak followed by a subsequent plateau; (3) TBR at the peak time (TBRp) is useful as an index for tumor. Combined analysis of time-density curve and TBRp is helpful for tumor differentiation. PMID:2758930

  2. Double-low protocol for hepatic dynamic CT scan

    PubMed Central

    Zhang, Xiuli; Li, Shaodong; Liu, Wenlou; Huang, Ning; Li, Jingjing; Cheng, Li; Xu, Kai

    2016-01-01

    Abstract The radiation-induced carcinogenesis from computed tomography (CT) and iodine contrast agent induced nephropathy has attracted international attention. The reduction of the radiation dose and iodine intake in CT scan is always a direction for researchers to strive. The purpose of this study was to evaluate the feasibility of a “double-low” (i.e., low tube voltage and low-dose iodine contrast agent) scanning protocol for dynamic hepatic CT with the adaptive statistical iterative reconstruction (ASIR) in patients with a body mass index (BMI) of 18.5 to 27.9 kg/m2. A total of 128 consecutive patients with a BMI between 18.5 and 27.9 kg/m2 were randomly assigned into 3 groups according to tube voltage, iodine contrast agent, and reconstruction algorithms. Group A (the “double-low” protocol): 100 kVp tube voltage with 40% ASIR, iodixanol at 270 mg I/mL, group B: 120 kVp tube voltage with filtered back projection (FBP), iodixanol at 270 mg I/ mL, and group C: 120 kVp tube voltage with FBP, ioversol at 350 mg I/ mL. The volume CT dose index (CTDIvol) and effective dose (ED) in group A were lower than those in group B and C (all P < 0.01). The iodine intake in group A was decreased by approximately 26.5% than group C, whereas no statistical difference was observed between group A and B (P > 0.05). There was no significant difference of the CT values between group A and C (P > 0.05), which both showed higher CT values than that in group B (P < 0.001). However, no statistic difference was observed in the contrast-to-noise ratio (CNR), the signal-to-noise ratio (SNR), and image-quality scores among the 3 groups (all P > 0.05). Near-perfect consistency of the evaluation for group A, B, and C (Kenall's W = 0.921, 0.874, and 0.949, respectively) was obtained by the 4 readers with respect to the overall image quality. These results suggested that the “double-low” protocol with ASIR algorithm for multi-phase hepatic CT scan

  3. Evaluation of CT Perfusion Biomarkers of Tumor Hypoxia

    PubMed Central

    Qi, Qi; Yeung, Timothy Pok Chi; Lee, Ting-Yim; Bauman, Glenn; Crukley, Cathie; Morrison, Laura; Hoffman, Lisa; Yartsev, Slav

    2016-01-01

    Background Tumor hypoxia is associated with treatment resistance to cancer therapies. Hypoxia can be investigated by immunohistopathologic methods but such procedure is invasive. A non-invasive method to interrogate tumor hypoxia is an attractive option as such method can provide information before, during, and after treatment for personalized therapies. Our study evaluated the correlations between computed tomography (CT) perfusion parameters and immunohistopathologic measurement of tumor hypoxia. Methods Wistar rats, 18 controls and 19 treated with stereotactic radiosurgery (SRS), implanted with the C6 glioma tumor were imaged using CT perfusion on average every five days to monitor tumor growth. A final CT perfusion scan and the brain were obtained on average 14 days (8–22 days) after tumor implantation. Tumor hypoxia was detected immunohistopathologically with pimonidazole. The tumor, necrotic, and pimonidazole-positive areas on histology samples were measured. Percent necrotic area and percent hypoxic areas were calculated. Tumor volume (TV), blood flow (BF), blood volume (BV), and permeability-surface area product (PS) were obtained from the CT perfusion studies. Correlations between CT perfusion parameters and histological parameters were assessed by Spearman’s ρ correlation. A Bonferroni-corrected P value < 0.05 was considered significant. Results BF and BV showed significant correlations with percent hypoxic area ρ = -0.88, P < 0.001 and ρ = -0.81, P < 0.001, respectively, for control animals and ρ = -0.7, P < 0.001 and ρ = -0.6, P = 0.003, respectively, for all animals, while TV and BV were correlated (ρ = -0.64, P = 0.01 and ρ = -0.43, P = 0.043, respectively) with percent necrotic area. PS was not correlated with either percent necrotic or percent hypoxic areas. Conclusions Percent hypoxic area provided significant correlations with BF and BV, suggesting that CT perfusion parameters are potential non-invasive imaging biomarkers of tumor

  4. Primary hepatic carcinoid tumor: case report and literature review

    PubMed Central

    Camargo, Éden Sartor; Viveiros, Marcelo de Melo; Corrêa, Isaac José Felippe; Robles, Laercio; Rezende, Marcelo Bruno

    2014-01-01

    Primary hepatic carcinoid tumors are extremely rare neoplasms derived from hormone-producing neuroendocrine cells. It is difficult to make their diagnosis before biopsy, surgical resection or necropsy. A recent publication described only 94 cases of these tumors. There is no sex predilection and apparently it has no association with cirrhosis or preexisting hepatic disease. The most effective treatment is hepatectomy, and resection is determined by size and location of the lesions. PMID:25628206

  5. [CT in preoperative assessment of renal tumors?].

    PubMed

    Lanng, C; Bowall, P; Egeblad, M; Meyhoff, H H

    1992-04-13

    The value of CT-scanning as part of the preoperative morphological investigation of patients with renal tumours was calculated in a material of 28 patients. In eight patients, operative treatment was not found to be indicated. In the 20 patients in whom operation was undertaken, the operative and histological findings were compared with the findings on CT-scanning. In cases of disagreement, the CT-scanning findings were reassessed. It was found that interpretation of the CT-scan was accurate in 40% of the cases while minor disagreements were present in 25% but these did not have any significance for the indications for operation. In the remaining 35% considerable disagreement was found between the CT-scan and the operative or histological findings such as invasion of neighbouring organs, cysts interpreted as solid tumours with necrosis and as regards interpretation of the retroperitoneal glands. The present authors consider that CT-scanning provides an important supplement to the conventional morphological investigation of renal tumours with intravenous urography and radiography of the thorax. CT-scanning appears to be preferable to ultrasonic scanning in cases which are difficult to review and where expert interpretation of ultrasonic findings is not available. In addition, routine preoperative biopsy of the tumour guided by ultrasound is recommended together with peroperative biopsy for freeze microscopic examination prior to nephrectomy.

  6. A preoperative mathematic model for computed tomographic guided microwave ablation treatment of hepatic dome tumors

    PubMed Central

    Yang, Bin; Xue, Jing-Bing; Mo, Zhi-Qiang; Zhong, Zhi-Hui; Zhang, Tao; Zhang, Fu-Jun; Fan, Wei-Jun

    2016-01-01

    Purpose This study sought to prospectively evaluate the feasibility and safety of a preoperative mathematic model for computed tomographic(CT) guided microwave(MW) ablation treatment of hepatic dome tumors. Methods This mathematic model was a regular cylinder quantifying appropriate puncture routes from the bottom up. A total of 103 patients with hepatic dome tumors were enrolled and randomly divided into 2 groups based on whether this model was used or not: Group A (using the model; n = 43) versus Group B (not using the model; n = 60). All tumors were treated by CT-guided MW ablation and follow-up contrast CT were reviewed. Results The average number of times for successful puncture, average ablation time, and incidence of right shoulder pain were less in Group A than Group B (1.4 vs. 2.5, P = 0.001; 8.8 vs. 11.1 minutes, P = 0.003; and 4.7% vs. 20%, P = 0.039). The technical success rate was higher in Group A than Group B (97.7% vs. 85.0%, P = 0.032). There were no significant differences between the two groups in primary and secondary technique efficacy rates (97.7% vs. 88.3%, P = 0.081; 90.0% vs. 72.7%, P = 0.314). No major complications occurred in both groups. Conclusion The mathematic model of regular cylinder is feasible and safe for CT-guided MW ablation in treating hepatic dome tumors. PMID:27028994

  7. FDG-PET/CT in pediatric solid tumors.

    PubMed

    Franzius, C

    2010-08-01

    Positron emission tomography/computed tomography (PET/CT) has become an important imaging modality in the non-invasive evaluation and monitoring of children with known or suspected malignant diseases. In sarcoma patients, [18F]FDG (FDG) PET and FDG PET/CT is useful in staging, therapy monitoring, and detection of relapse. However, FDG PET has been proven to be less sensitive than chest CT in the detection of pulmonary metastases derived from sarcoma. This disadvantage has been overcome using a PET/CT scanner. In neuroblastoma patients, PET using FDG is indicated in MIBG-negative cases. Furthermore, there are specific PET tracers for tumors of the sympathetic nervous system, such as [11C]Hydroxyephedrine (HED) and [18F]-labeled dihydrophenylalanine (F-DOPA), which can be used for PET/CT imaging for detection of disease, staging and monitoring therapy. However, there are only few studies using specific PET tracers in neuroblastoma patients. In other pediatric malignancies including germ cell tumors and hepatoblastoma PET and PET/CT may be helpful in individual cases, but the literature in these entities is limited so far. Although publications on the additional value of the combined PET/CT compared to both stand-alone modalities are still limited in pediatrics, it can already be anticipated that the combination of morphological and functional information obtained by integrated PET/CT will improve the accuracy of staging and will change patient management in a significant number of pediatric patients.

  8. Hepatic Involvement of Histiocytic Sarcoma: CT and MRI Findings.

    PubMed

    Kubo, Takatoshi; Kiryu, Shigeru; Akai, Hiroyuki; Ota, Yasunori; Tojo, Arinobu; Yoshida, Hideo; Kato, Naoya; Nakano, Yoshiyasu; Ohtomo, Kuni

    2016-01-01

    Histiocytic sarcoma in the liver is an extremely rare hematological malignancy. Herein, we reported the case of a 68-year-old woman who presented with characteristic wedge-shaped abnormality bounded by hepatic veins on computed tomography and magnetic resonance imaging of the liver. In the wedge-shaped area, decreased portal flow and the deposition of iron were observed. These imaging findings are consistent with intrasinusoidal tumor cell infiltration. A liver biopsy was performed, and histiocytic sarcoma was confirmed histopathologically. PMID:27587965

  9. Hepatic Involvement of Histiocytic Sarcoma: CT and MRI Findings

    PubMed Central

    Kubo, Takatoshi; Akai, Hiroyuki; Ota, Yasunori; Tojo, Arinobu; Yoshida, Hideo; Kato, Naoya; Nakano, Yoshiyasu; Ohtomo, Kuni

    2016-01-01

    Histiocytic sarcoma in the liver is an extremely rare hematological malignancy. Herein, we reported the case of a 68-year-old woman who presented with characteristic wedge-shaped abnormality bounded by hepatic veins on computed tomography and magnetic resonance imaging of the liver. In the wedge-shaped area, decreased portal flow and the deposition of iron were observed. These imaging findings are consistent with intrasinusoidal tumor cell infiltration. A liver biopsy was performed, and histiocytic sarcoma was confirmed histopathologically. PMID:27587965

  10. Detection of Diffuse Infiltrative Primary Hepatic Lymphoma on FDG PET-CT: Hallmarks of Hepatic Superscan.

    PubMed

    Mahajan, Sonia; Kalra, Shefali; Chawla, Madhavi; Dougall, Pankaj

    2016-01-01

    Primary hepatic lymphoma (PHL) is an extremely rare entity with scarce information in evidence-based literature. Few case reports have described the role of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) in the diagnosing and staging of PHL. We report the case of a 78-year-old man with PHL who initially presented with weight loss and nonspecific fatigue. FDG PET-CT proved to be a beneficial tool in arriving at the diagnosis of this patient with nonspecific clinical presentation and also in the staging of PHL. Physiological uptake of FDG in the liver can be a potential cause of misinterpretation in such cases. Hence, knowing the imaging hallmarks can increase the accuracy in PET image interpretation. PMID:27134567

  11. Typical CT and MRI signs of hepatic epithelioid hemangioendothelioma

    PubMed Central

    GAN, LU; CHANG, RUIPING; JIN, HUALAN; YANG, LI

    2016-01-01

    To investigate the typical magnetic resonance imaging (MRI) and computed tomography (CT) features of hepatic epithelioid hemangioendothelioma (HEH), the CT and MRI findings of 14 histopathologically confirmed cases of HEH were retrospectively analyzed. Non-contrast and dynamic contrast-enhanced scans were conducted in all cases. A total of 229 lesions were detected in the 14 cases. All cases were classified as one of three types: (i) Solitary nodular type (1 case, 7%); (ii) multifocal nodular type (11 cases, 79%); or (iii) diffuse type (2 cases, 14%). The diameter of the lesions ranged from 5 to 105 mm. For the first two types (solitary and multifocal nodular types), the CT findings included low density lesions with clear margins on non-contrast scans, centripetal enhancement in arterial phase, and homogeneous enhancement in the portal venous and delay phases. The findings of non-contrast MRI scans for these two types included low signal intensity on T1-weighted images, heterogeneous high signal intensity on T2-weighted images, and heterogeneous high signal intensity on diffusion-weighted images. The lesions were predominantly located in submarginal areas. On contrast-enhanced MRI, the findings for the first two types included peripheral ring-like enhancement with a central low signal intensity (‘black target-like’ sign) and a central enhanced core surrounded by a low signal intensity halo (‘white target-like’ sign). The findings for the third HEH type (diffuse type) on CT and MRI scans included low density or heterogeneous signal intensity lesions involving regions of part or the whole liver, coalescent lesions (‘strip-like’ sign), and gradual enhancement along central vessels (‘lollipop’ sign). Collectively, these findings indicate that the ‘white target-like’ sign, ‘black target-like’ sign, ‘lollipop’ sign and ‘strip-like’ sign, in addition to capsular contraction and submarginal location, on CT and MRI imaging may have

  12. Mesenteric and splenic contributions to portal venous CT perfusion in hepatic diffuse disease

    PubMed Central

    Sun, Hongzan; Lu, Zaiming; Liang, Hongyuan; Xin, Jun; Gao, Yuying; Guo, Qiyong

    2014-01-01

    Aim: To investigate the changes and contributions of superior mesenteric venous perfusion (SMVP) and splenic venous perfusion (SpVP) to portal venous CT perfusion in canine model of hepatic diffuse disease. Materials and methods: By selective catheterization in superior mesenteric and splenic arteries respectively after CT perfusion scanning, SMVP and SpVP became available. Sixteen dogs were adopted and induced by carbon tetrachloride after data under normal conditions were collected. After 3, 6, 9 and 12 months from carbon tetrachloride intervention, liver biopsies by puncture or operation were performed after CT perfusion scanning. SMVP and SpVP under different pathologic conditions were compared and analyzed. Results: Three stages of hepatic diffuse lesions were defined according to pathologic changes, namely hepatitis, hepatic fibrosis, and cirrhosis. The number of dogs which survived from each stage was: 16 from normal, 12 from hepatitis, 10 from hepatic fibrosis and 4 from cirrhosis. During this progressive period, SpVP ml/(min·100 ml) declined slightly, but there were no significant differences between different stages (P > 0.05). SMVP ml/(min·100 ml) in stage of normal (64.1 ± 8.1) and hepatic fibrosis (44.4 ± 4.5), normal and cirrhosis (42.6 ± 5.4), hepatitis (61.3 ± 6.4) and hepatic fibrosis, hepatitis and cirrhosis was significantly different, but there was no significant difference of SMVP between normal and hepatitis (P = 0.326) or hepatic fibrosis and cirrhosis (P = 0.668). Conclusions: With our evidence of interventional CT perfusion, it is mesenteric, not splenic, perfusion that might coincide with hepatic portal venous perfusion during the progressive period of hepatic diffuse disease. PMID:25550855

  13. Treatment efficacy of radiofrequency ablation of 338 patients with hepatic malignant tumor and the relevant complications

    PubMed Central

    Chen, Min-Hua; Yang, Wei; Yan, Kun; Gao, Wen; Dai, Ying; Wang, Yan-Bin; Zhang, Xiao-Peng; Yin, Shan-Shan

    2005-01-01

    AIM: To investigate the treatment efficacy of radiofrequency ablation (RFA) of hepatic malignant tumor and the relevant complications. METHODS: A total of 338 patients with 763 hepatic tumors underwent ultrasound-guided RFA (565 procedures). There were 204 cases of hepatic cellular carcinoma (HCC) with 430 tumors, the mean largest diameter was 4.0 cm. Of them, 48 patients (23.5%) were in stages I-II (UICC Systems) and 156 (76.5%) in stages III-IV There were 134 cases of metastatic liver carcinoma (MLC), with 333 metastases in the liver, the mean diameter was 4.1 cm, the liver metastases of 96 patients (71.6%) came from gastrointestinal tract. Ninety-three percent of the 338 patients were treated using the relatively standard protocol. Crucial attention must be paid to monitor the abnormal changes in ultrasound images as well as the vital signs of the patients to find the possible hemorrhage and peripheral structures injury in time. The tumors were considered as ablated completely, if no viability was found on enhanced CT within 24 h or at 1 mo after RFA. These patients were followed up for 3-57 mo. RESULTS: The ablation success rate was 93.3% (401/430 tumors) for HCC and was 96.7% (322/333 tumors) for MLC. The local recurrence rate for HCC and MLC was 7.9% (34/430 tumors) and 10.5% (35/333 tumors), respectively. A total of 137 patients (40.5%) underwent 2-11 times of repeated ablations because of tumor recurrence or metastasis. The 1st, 2nd, and 3rd year survival rate was 84.6%, 66.6%, and 63.1%, respectively; the survival rate from 48 patients of I-II stage HCC was 93.7%, 80.4%, and 80.4%, respectively. The major complication rate in this study was 2.5% (14 of 565 procedures), which consisted of 5 hemorrhages, 1 colon perforation, 5 injuries of adjacent structures, 2 bile leakages, and 1 skin burn. CONCLUSION: RFA, as a minimally invasive local treatment, has become an effective and relatively safe alternative for the patients of hepatic malignant tumor, even of

  14. Primary hepatic neuroendocrine tumor: A case report and literature review

    PubMed Central

    Song, Jeong Eun; Kim, Byung Seok; Lee, Chang Hyeong

    2016-01-01

    Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare and difficult to distinguish from other liver tumors, such as hepatocellular carcinoma (HCC) and cholangiocarcinoma, based on medical imaging findings. A 70-year-old man was referred for evaluation of liver mass incidentally discovered on abdominal computed tomography. The characteristic finding from dynamic liver magnetic resonance imaging led to a diagnosis of HCC. The patient underwent right hepatectomy. Histopathological and immunohistochemical examination revealed grade 2 neuroendocrine tumor. The postoperative 24-h urinary excretion of 5-hydroxy-indolacetic acid was within the normal range. Further imaging investigations were performed. No other lesions were found making probable the diagnosis of PHNET. This case shows that the diagnosis of PHNET is a medical challenge, requiring differentiation of PHNETs other hepatic masses and exclusion of occult primary neuroendocrine tumors. The diagnosis of PHNET can be ascertained after long term follow-up to exclude another primary origin. PMID:27574614

  15. Impact of Multislice CT Angiography on Planning of Radiological Catheter Placement for Hepatic Arterial Infusion Chemotherapy

    SciTech Connect

    Sone, Miyuki Kato, Kenichi; Hirose, Atsuo; Nakasato, Tatsuhiko; Tomabechi, Makiko; Ehara, Shigeru; Hanari, Takao

    2008-01-15

    The objective of this study was to assess prospectively the role of multislice CT angiography (MSCTA) on planning of radiological catheter placement for hepatic arterial infusion chemotherapy (HAIC). Forty-six patients with malignant liver tumors planned for HAIC were included. In each patient, both MSCTA and intra-arterial digital subtraction angiography (DSA) were performed, except one patient who did not undergo DSA. Comparison of MSCTA and DSA images was performed for the remaining 45 patients. Detectability of anatomical variants of the hepatic artery, course of the celiac trunk, visualization scores of arterial branches and interobserver agreement, presence of arterial stenosis, and technical outcome were evaluated. Anatomical variations of the hepatic artery were detected in 19 of 45 patients (42%) on both modalities. The course of the celiac trunk was different in 12 patients. The visualization scores of celiac arterial branches on MSCTA/DSA were 3.0 {+-} 0/2.9 {+-} 0.2 in the celiac trunk, 3.0 {+-} 0/2.9 {+-} 0.3 in the common hepatic artery, 2.9 {+-} 0.2/2.9 {+-} 0.3 in the proper hepatic artery, 2.9 {+-} 0.3/2.9 {+-} 0.4 in the right hepatic artery, 2.8 {+-} 0.4/2.9 {+-} 0.4 in the left hepatic artery, 2.9 {+-} 0.2/2.9 {+-} 0.3 in the gastroduodenal artery, 2.1 {+-} 0.8/2.2 {+-} 0.9 in the right gastric artery, and 2.7 {+-} 0.8/2.6 {+-} 0.8 in the left gastric artery. No statistically significant differences exist between the two modalities. Interobserver agreement for MSCTA was equivalent to that for DSA. Two patients showed stenosis of the celiac trunk on both modalities. Based on these imaging findings, technical success was accomplished in all patients. In conclusion, MSCTA is accurate in assessing arterial anatomy and abnormalities. MSCTA can provide adequate information for planning of radiological catheter placement for HAIC.

  16. Intercostal Artery Supplying Hepatocellular Carcinoma: Demonstration of a Tumor Feeder by C-arm CT and Multidetector Row CT

    SciTech Connect

    Kim, Hyo-Cheol Chung, Jin Wook; Lee, In Joon; An, Sangbu; Seong, Nak Jong; Son, Kyu Ri; Jae, Hwan Jun; Park, Jae Hyung

    2011-02-15

    This study was designed to describe tumor feeders from the intercostal artery supplying hepatocellular carcinoma (HCC) on C-arm CT and multidetector row CT. From March 2008 to May 2009, C-arm CT of the intercostal artery was prospectively performed in 24 HCC patients. Two interventional radiologists, who performed C-arm CT, evaluated tumor feeders on C-arm CT and multidetector row CT scans by consensus. In total, 35 intercostal arteries were examined by C-arm CT. All tumor feeders except one showed a sharp upward turn at or near the costochondral junction. On axial C-arm CT images, all tumor feeders were observed as an enhancing dot in the upper intercostal space along the diaphragm. On multidetector CT scans, 17 tumor feeders were observed and 18 were not. Tumor feeders from the intercostal artery are observed as an enhancing dot along the diaphragm on C-arm CT and can be seen on multidetector row CT in approximately half of patients.

  17. Radiofrequency ablation of hepatic tumors: lessons learned from 3000 procedures.

    PubMed

    Rhim, Hyunchul; Lim, Hyo K; Kim, Young-sum; Choi, Dongil; Lee, Won Jae

    2008-10-01

    Radiofrequency ablation has been accepted as the most popular local ablative therapy for unresectable malignant hepatic tumors. For 9 years from April 1999, we performed 3000 radiofrequency ablation procedures for hepatic tumors in our institution. Our results on the safety (mortality, 0.15%/patient) and therapeutic efficacy (5-year survival rate, 58%) are similar to those of previous studies reported, supporting the growing evidence of a clear survival benefit, excellent results for local tumor control and improved quality of life. The most important lesson learned from our 3000 procedures is that the best planning, safe ablation and complete ablation are key factors for patient outcome. Furthermore, multimodality treatment is the best strategy for recurrent hepatocellular carcinoma encountered after any kind of first-line treatment.

  18. Image fusion for visualization of hepatic vasculature and tumors

    NASA Astrophysics Data System (ADS)

    Chou, Jin-Shin; Chen, Shiuh-Yung J.; Sudakoff, Gary S.; Hoffmann, Kenneth R.; Chen, Chin-Tu; Dachman, Abraham H.

    1995-05-01

    We have developed segmentation and simultaneous display techniques to facilitate the visualization of the three-dimensional spatial relationships between organ structures and organ vasculature. We concentrate on the visualization of the liver based on spiral computed tomography images. Surface-based 3-D rendering and maximal intensity projection algorithms are used for data visualization. To extract the liver in the serial of images accurately and efficiently, we have developed a user-friendly interactive program with a deformable-model segmentation. Surface rendering techniques are used to visualize the extracted structures, adjacent contours are aligned and fitted with a Bezier surface to yield a smooth surface. Visualization of the vascular structures, portal and hepatic veins, is achieved by applying a MIP technique to the extracted liver volume. To integrate the extracted structures they are surface-rendered and their MIP images are aligned and a color table is designed for simultaneous display of the combined liver/tumor and vasculature images. By combining the 3-D surface rendering and MIP techniques, portal veins, hepatic veins, and hepatic tumor can be inspected simultaneously and their spatial relationships can be more easily perceived. The proposed technique will be useful for visualization of both hepatic neoplasm and vasculature in surgical planning for tumor resection or living-donor liver transplantation.

  19. Hepatic Arterial Chemoembolization Using Drug-Eluting Beads in Gastrointestinal Neuroendocrine Tumor Metastatic to the Liver

    SciTech Connect

    Gaur, Shantanu K.; Friese, Jeremy L.; Sadow, Cheryl A.; Ayyagari, Rajasekhara; Binkert, Christoph A.; Schenker, Matthew P.; Kulke, Matthew; Baum, Richard

    2011-06-15

    Purpose: This study was designed to evaluate short (<3 months) and intermediate-term (>3 months) follow-up in patients with metastatic neuroendocrine tumor to the liver who underwent hepatic arterial chemoembolization with drug-eluting beads at a single institution. Methods: Institutional review board approval was obtained for this retrospective review. All patients who were treated with 100-300 or 300-500 {mu}m drug-eluting LC Beads (Biocompatibles, UK) preloaded with doxorubicin (range, 50-100 mg) for GI neuroendocrine tumor metastatic to the liver from June 2004 to June 2009 were included. CT and MRI were evaluated for progression using Response Evaluation Criteria In Solid Tumors (RECIST) or European Association for the Study of the Liver (EASL) criteria. Short-term (<3 months) and intermediate-term (>3 months) imaging response was determined and Kaplan-Meier survival curves were plotted. Results: Thirty-eight drug-eluting bead chemoembolization procedures were performed on 32 hepatic lobes, comprising 21 treatment cycles in 18 patients. All procedures were technically successful with two major complications (biliary injuries). At short-term follow-up (<3 months), 22 of 38 (58%) procedures and 10 of 21 (48%) treatment cycles produced an objective response (OR) with the remainder having stable disease (SD). At intermediate-term follow-up (mean, 445 days; range, 163-1247), 17 of 26 (65%) procedures and 8 of 14 (57%) treatment cycles produced an OR. Probability of progressing was approximately 52% at 1 year with a median time to progression of 419 days. Conclusions: Drug-eluting bead chemoembolization is a reasonable alternative to hepatic arterial embolization and chemoembolization for the treatment of metastatic neuroendocrine tumor to the liver.

  20. Non-Rigid Registration of Liver CT Images for CT-Guided Ablation of Liver Tumors

    PubMed Central

    Luu, Ha Manh; Klink, Camiel; Niessen, Wiro; Moelker, Adriaan; van Walsum, Theo

    2016-01-01

    CT-guided percutaneous ablation for liver cancer treatment is a relevant technique for patients not eligible for surgery and with tumors that are inconspicuous on US imaging. The lack of real-time imaging and the use of a limited amount of CT contrast agent make targeting the tumor with the needle challenging. In this study, we evaluate a registration framework that allows the integration of diagnostic pre-operative contrast enhanced CT images and intra-operative non-contrast enhanced CT images to improve image guidance in the intervention. The liver and tumor are segmented in the pre-operative contrast enhanced CT images. Next, the contrast enhanced image is registered to the intra-operative CT images in a two-stage approach. First, the contrast-enhanced diagnostic image is non-rigidly registered to a non-contrast enhanced image that is conventionally acquired at the start of the intervention. In case the initial registration is not sufficiently accurate, a refinement step is applied using non-rigid registration method with a local rigidity term. In the second stage, the intra-operative CT-images that are used to check the needle position, which often consist of only a few slices, are registered rigidly to the intra-operative image that was acquired at the start of the intervention. Subsequently, the diagnostic image is registered to the current intra-operative image, using both transformations, this allows the visualization of the tumor region extracted from pre-operative data in the intra-operative CT images containing needle. The method is evaluated on imaging data of 19 patients at the Erasmus MC. Quantitative evaluation is performed using the Dice metric, mean surface distance of the liver border and corresponding landmarks in the diagnostic and the intra-operative images. The registration of the diagnostic CT image to the initial intra-operative CT image did not require a refinement step in 13 cases. For those cases, the resulting registration had a Dice

  1. Non-Rigid Registration of Liver CT Images for CT-Guided Ablation of Liver Tumors.

    PubMed

    Luu, Ha Manh; Klink, Camiel; Niessen, Wiro; Moelker, Adriaan; Walsum, Theo van

    2016-01-01

    CT-guided percutaneous ablation for liver cancer treatment is a relevant technique for patients not eligible for surgery and with tumors that are inconspicuous on US imaging. The lack of real-time imaging and the use of a limited amount of CT contrast agent make targeting the tumor with the needle challenging. In this study, we evaluate a registration framework that allows the integration of diagnostic pre-operative contrast enhanced CT images and intra-operative non-contrast enhanced CT images to improve image guidance in the intervention. The liver and tumor are segmented in the pre-operative contrast enhanced CT images. Next, the contrast enhanced image is registered to the intra-operative CT images in a two-stage approach. First, the contrast-enhanced diagnostic image is non-rigidly registered to a non-contrast enhanced image that is conventionally acquired at the start of the intervention. In case the initial registration is not sufficiently accurate, a refinement step is applied using non-rigid registration method with a local rigidity term. In the second stage, the intra-operative CT-images that are used to check the needle position, which often consist of only a few slices, are registered rigidly to the intra-operative image that was acquired at the start of the intervention. Subsequently, the diagnostic image is registered to the current intra-operative image, using both transformations, this allows the visualization of the tumor region extracted from pre-operative data in the intra-operative CT images containing needle. The method is evaluated on imaging data of 19 patients at the Erasmus MC. Quantitative evaluation is performed using the Dice metric, mean surface distance of the liver border and corresponding landmarks in the diagnostic and the intra-operative images. The registration of the diagnostic CT image to the initial intra-operative CT image did not require a refinement step in 13 cases. For those cases, the resulting registration had a Dice

  2. Neuroendocrine tumor of the gallbladder with spectral CT.

    PubMed

    Du, Hai; Zhang, Haoliang; Xu, Yandong; Wang, Li

    2014-12-01

    Neuroendocrine tumors (NETs) are neoplasms that arise from neural crest argyrophil cells, and often occur to the elderly, female and patients with cholelithiasis. In this case, the female patient was 38 years old and admitted into the hospital for interrupted right upward abdominal pain for 2 years plus aggravated with nausea and anorexia for 1 week. Ultrasound showed gallbladder space-occupying lesions and spectral computed tomography (CT) suggested of retroperitoneal lymph node metastasis. The patient was diagnosed with gallbladder neuroendocrine carcinoma after the surgery.

  3. Pancreas tumor model in rabbit imaged by perfusion CT scans

    NASA Astrophysics Data System (ADS)

    Gunn, Jason; Tichauer, Kenneth; Moodie, Karen; Kane, Susan; Hoopes, Jack; Stewart, Errol E.; Hadway, Jennifer; Lee, Ting-Yim; Pereira, Stephen P.; Pogue, Brian W.

    2013-03-01

    The goal of this work was to develop and validate a pancreas tumor animal model to investigate the relationship between photodynamic therapy (PDT) effectiveness and photosensitizer drug delivery. More specifically, this work lays the foundation for investigating the utility of dynamic contrast enhanced blood perfusion imaging to be used to inform subsequent PDT. A VX2 carcinoma rabbit cell line was grown in the tail of the pancreas of three New Zealand White rabbits and approximately 3-4 weeks after implantation the rabbits were imaged on a CT scanner using a contrast enhanced perfusion protocol, providing parametric maps of blood flow, blood volume, mean transit time, and vascular permeability surface area product.

  4. Volumeteric treatment planning and image guidance for radiofrequency ablation of hepatic tumors

    NASA Astrophysics Data System (ADS)

    Cleary, Kevin R.; Tanaka, Daigo; Stewart, David; Wood, Bradford J.; Mocanu, Mihai L.; Levy, Elliot; Banovac, Filip; Lindisch, David; Roderick, Stephen; Tang, John; Chung, Ho Young

    2003-05-01

    This paper describes a computer program for volumetric treatment planning and image guidance during radiofrequency (RF) ablation of hepatic tumors. The procedure is performed by inserting an RF probe into the tumor under image guidance and generating heat to 'cook' a spherical region. If the tumor is too large to be ablated in a single burn, then multiple overlapping spherical burns are needed to encompass the entire target area. The computer program is designed to assist the physician in planning the sphere placement, as well as provide guidance in placing the probe using a magnetic tracking device. A pre-operative CT scan is routinely obtained before the procedure. On a slice by slice basis, the tumor, along with a 1 cm margin, is traced by the physician using the computer mouse. Once all of the images are traced, the program provides a three-dimensional rendering of the tumor. The minimum number of spheres necessary to cover the target lesion and the 1 cm margin are then computed by the program and displayed on the screen.

  5. [MRI and CT-scan in presumed benign ovarian tumors].

    PubMed

    Thomassin-Naggara, I; Bazot, M

    2013-12-01

    Radiological examinations are required for the assessment of complex or indeterminate ovarian masses, mainly using MRI and CT-scan. MRI provides better tissue characterization than Doppler ultrasound or CT-scan (LE2). Pelvic MRI is recommended in case of an indeterminate or complex ovarian ultrasonographic mass (grade B). The protocol of a pelvic MRI should include morphological T1 and T2 sequences (grade B). In case of solid portion, perfusion and diffusion sequences are recommended (grade C). In case of doubt about the diagnosis of ovarian origin, pelvic MRI is preferred over the CT-scan (grade C). MRI is the technique of choice for the difference between functional and organic ovarian lesion diagnosis (grade C). It can be useful in case of clinical diagnostic uncertainty between polycystic ovary syndrome and ovarian hyperstimulation and multilocular ovarian tumor syndrome (grade C). No MRI classification for ovarian masses is currently validated. The establishment of a presumption of risk of malignancy is required in a MRI report of adnexal mass with if possible a guidance on the histological diagnosis. In the absence of clinical or sonographic diagnosis, pelvic CT-scan is recommended in the context of acute painful pelvic mass in non-pregnant patients (grade C). It specifies the anomalies and allows the differential diagnosis with digestive and urinary diseases (LE4). Given the lack of data in the literature, the precautionary principle must be applied to the realization of a pelvic MRI in a pregnant patient. A risk-benefit balance should be evaluated case by case by the clinician and the radiologist and information should be given to the patient. In an emergency situation during pregnancy, pelvic MRI is an alternative to CT-scan for the exploration of acute pelvic pain in case of uncertain sonographic diagnosis (grade C).

  6. Bone Windows for Distinguishing Malignant from Benign Primary Bone Tumors on FDG PET/CT

    PubMed Central

    Costelloe, Colleen M.; Chuang, Hubert H.; Chasen, Beth A.; Pan, Tinsu; Fox, Patricia S.; Bassett, Roland L.; Madewell, John E.

    2013-01-01

    Objective. The default window setting on PET/CT workstations is soft tissue. This study investigates whether bone windowing and hybrid FDG PET/CT can help differentiate between malignant and benign primary bone tumors. Materials and methods. A database review included 98 patients with malignant (n=64) or benign primary bone (n=34) tumors. The reference standard was biopsy for malignancies and biopsy or >1 year imaging follow-up of benign tumors. Three radiologists and/or nuclear medicine physicians blinded to diagnosis and other imaging viewed the lesions on CT with bone windows (CT-BW) without and then with PET (PET/CT-BW), and separate PET-only images for malignancy or benignity. Three weeks later the tumors were viewed on CT with soft tissue windows (CT-STW) without and then with PET (PET/CT-STW). Results. Mean sensitivity and specificity for identifying malignancies included: CT-BW: 96%, 90%; CT-STW: 90%, 90%; PET/CT-BW: 95%, 85%, PET/CT-STW: 95%, 86% and PET-only: 96%, 75%, respectively. CT-BW demonstrated higher specificity than PET-only and PET/CT-BW (p=0.0005 and p=0.0103, respectively) and trended toward higher sensitivity than CT-STW (p=0.0759). Malignant primary bone tumors were more avid than benign lesions overall (p<0.0001) but the avidity of benign aggressive lesions (giant cell tumors and Langerhans Cell Histiocytosis) trended higher than the malignancies (p=0.08). Conclusion. Bone windows provided high specificity for distinguishing between malignant and benign primary bone tumors and are recommended when viewing FDG PET/CT. PMID:23983816

  7. Primary hepatic solitary fibrous tumor with histologically benign and malignant areas.

    PubMed

    Silvanto, Anna; Karanjia, Nariman D; Bagwan, Izhar N

    2015-12-01

    Extrapleural solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm, presenting most commonly in the intrathoracic sites but which has been reported at numerous extrathoracic locations. The majority of intra-thoracic SFTs are benign, but 10%-15% behave aggressively. We report a case of primary hepatic SFT with histologically benign and malignant areas. A 65-year-old man underwent an abdominal CT scan following a cerebrovascular accident, which demonstrated a sharply demarcated large liver mass with a heterogenous enhancing area and occupying most of the left lobe of the liver. Histological examination following a hemihepatectomy showed an SFT with morphological patterns ranging from benign to malignant areas, including pleomorphism, increased cellularity, herringbone pattern, necrosis and a raised mitotic count. On review of the literature, only an occasional case report with malignant areas in a hepatic SFT was identified. This case highlights that SFT should be included in the differential diagnosis of a hepatic spindle cell lesion, and that on rare occasions, malignant areas can occur in this already uncommon neoplasm. PMID:26663016

  8. Primary hepatic solitary fibrous tumor with histologically benign and malignant areas.

    PubMed

    Silvanto, Anna; Karanjia, Nariman D; Bagwan, Izhar N

    2015-12-01

    Extrapleural solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm, presenting most commonly in the intrathoracic sites but which has been reported at numerous extrathoracic locations. The majority of intra-thoracic SFTs are benign, but 10%-15% behave aggressively. We report a case of primary hepatic SFT with histologically benign and malignant areas. A 65-year-old man underwent an abdominal CT scan following a cerebrovascular accident, which demonstrated a sharply demarcated large liver mass with a heterogenous enhancing area and occupying most of the left lobe of the liver. Histological examination following a hemihepatectomy showed an SFT with morphological patterns ranging from benign to malignant areas, including pleomorphism, increased cellularity, herringbone pattern, necrosis and a raised mitotic count. On review of the literature, only an occasional case report with malignant areas in a hepatic SFT was identified. This case highlights that SFT should be included in the differential diagnosis of a hepatic spindle cell lesion, and that on rare occasions, malignant areas can occur in this already uncommon neoplasm.

  9. Detectability of hepatic tumors during 3D post-processed ultrafast cone-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Paul, Jijo; Vogl, Thomas J.; Chacko, Annamma

    2015-10-01

    To evaluate hepatic tumor detection using ultrafast cone-beam computed tomography (UCBCT) cross-sectional and 3D post-processed image datasets. 657 patients were examined using UCBCT during hepatic transarterial chemoembolization (TACE), and data were collected retrospectively from January 2012 to September 2014. Tumor detectability, diagnostic ability, detection accuracy and sensitivity were examined for different hepatic tumors using UCBCT cross-sectional, perfusion blood volume (PBV) and UCBCT-MRI (magnetic resonance imaging) fused image datasets. Appropriate statistical tests were used to compare collected sample data. Fused image data showed the significantly higher (all P  <  0.05) diagnostic ability for hepatic tumors compared to UCBCT or PBV image data. The detectability of small hepatic tumors (<5 mm) was significantly reduced (all P  <  0.05) using UCBCT cross-sectional images compared to MRI or fused image data; however, PBV improved tumor detectability using a color display. Fused image data produced 100% tumor sensitivity due to the simultaneous availability of MRI and UCBCT information during tumor diagnosis. Fused image data produced excellent hepatic tumor sensitivity, detectability and diagnostic ability compared to other datasets assessed. Fused image data is extremely reliable and useful compared to UCBCT cross-sectional or PBV image datasets to depict hepatic tumors during TACE. Partial anatomical visualization on cross-sectional images was compensated by fused image data during tumor diagnosis.

  10. Cone-Beam Computed Tomography (CBCT) Hepatic Arteriography in Chemoembolization for Hepatocellular Carcinoma: Performance Depicting Tumors and Tumor Feeders

    SciTech Connect

    Lee, In Joon; Chung, Jin Wook Yin, Yong Hu; Kim, Hyo-Cheol; Kim, Young Il; Jae, Hwan Jun; Park, Jae Hyung

    2015-10-15

    PurposeThis study was designed to analyze retrospectively the performance of cone-beam computed tomography (CBCT) hepatic arteriography in depicting tumors and their feeders and to investigate the related determining factors in chemoembolization for hepatocellular carcinoma (HCC).MethodsEighty-six patients with 142 tumors satisfying the imaging diagnosis criteria of HCC were included in this study. The performance of CBCT hepatic arteriography for chemoembolization per tumor and per patient was evaluated using maximum intensity projection images alone (MIP analysis) or MIP combined with multiplanar reformation images (MIP + MPR analysis) regarding the following three aspects: tumor depiction, confidence of tumor feeder detection, and trackability of tumor feeders. Tumor size, tumor enhancement, tumor location, number of feeders, diaphragmatic motion, portal vein enhancement, and hepatic artery to parenchyma enhancement ratio were regarded as potential determining factors.ResultsTumors were depicted in 125 (88.0 %) and 142 tumors (100 %) on MIP and MIP + MPR analysis, respectively. Imaging performances on MIP and MIP + MPR analysis were good enough to perform subsegmental chemoembolization without additional angiographic investigation in 88 (62.0 %) and 128 tumors (90.1 %) on per-tumor basis and in 43 (50 %) and 73 (84.9 %) on per-patient basis, respectively. Significant determining factors for performance in MIP + MPR analysis on per tumor basis were tumor size (p = 0.030), tumor enhancement (0.005), tumor location (p = 0.001), and diaphragmatic motion (p < 0.001).ConclusionsCBCT hepatic arteriography provided sufficient information for subsegmental chemoembolization by depicting tumors and their feeders in the vast majority of patients. Combined analysis of MIP and MPR images was essential to enhance the performance of CBCT hepatic arteriography.

  11. Changes in Hepatic Blood Flow During Transcatheter Arterial Infusion with Heated Saline in Hepatic VX2 Tumor

    SciTech Connect

    Cao Wei; Li Jing; Wu Zhiqun; Zhou Changxi; Liu Xi; Wan Yi; Duan Yunyou

    2013-06-15

    Purpose. This study evaluates the influence of transcatheter arterial infusion with heated saline on hepatic arterial and portal venous blood flows to tumor and normal hepatic tissues in a rabbit VX2 tumor model. Methods. All animal experiments were approved by the institutional animal care and use committee. Twenty rabbits with VX2 liver tumors were divided into the following two groups: (a) the treated group (n = 10), which received a 60 mL transarterial injection of 60 Degree-Sign C saline via the hepatic artery; (b) the control group (n = 10), which received a 60 mL injection of 37 Degree-Sign C saline via the hepatic artery. Using ultrasonography, the blood flows in both the portal vein and hepatic artery were measured, and the changes in the hemodynamic indices were recorded before and immediately after the injection. The changes in the tumor and normal liver tissues of the two groups were histopathologically examined by hematoxylin and eosin staining after the injection. Results. After the transcatheter arterial heated infusion, there was a decrease in the hepatic arterial blood flow to the tumor tissue, a significant decrease in the hepatic artery mean velocity (P < 0.05), and a significant increase in the resistance index (P < 0.05). On hematoxylin and eosin staining, there were no obvious signs of tissue destruction in the normal liver tissue or the tumor tissue after heated perfusion, and coagulated blood plasma was observed in the cavities of intratumoral blood vessels in the treated group. Conclusions. The changes in tumor blood flow in the rabbit VX2 tumor model were presumably caused by microthrombi in the tumor vessels, and the portal vein likely mediated the heat loss in normal liver tissue during the transarterial heated infusion.

  12. Hepatic arterial embolization in patients with neuroendocrine tumors

    PubMed Central

    2014-01-01

    Liver metastases occur in 46-93% of patients with neuroendocrine neoplasms (NENs). Presence and extension of liver metastases are considered important prognostic factors, as they may significantly impair the patient’s quality of life, because of either tumor bulk or hormonal hypersecretion. Therapies for NEN liver metastases include surgical resection, liver transplantation, chemotherapy and biotherapy. Surgery is the gold standard for curative therapy, but in most of NEN patients with liver metastases, when surgery can not be applied, minimally invasive therapeutic approaches are adopted. They include trans-arterial embolization (TAE), trans-arterial chemoembolization (TACE), radiofrequency thermal ablation and new emerging techniques. TAE is based on selective infusion of particles in the branch of the hepatic artery supplying the tumor lesions. The goal of TAE is to occlude tumor blood vessels resulting in ischemia and necrosis. Many reports have shown that TAE can reduce tumor size and hormone output, resulting in palliation of symptoms without the use of cytotoxic drugs, resulting in better tolerability. This review will focus on TAE performance and safety in NEN patients with liver metastases. PMID:24887262

  13. Atlas of hepatic tumors and focal lesions: Arteriographic and tomographic diagnosis

    SciTech Connect

    Gutierrez, O.; Schwartz, S.I.

    1984-01-01

    This book describes the diagnosis of liver tumors. Topics considered include general considerations, hepatocellular carcinoma, hepatoblastoma, cholangiocarcinoma, mesenchyomoma, sarcoma, hemangioma, hepatic cell adenoma, focal nodular hyperlasia (FNH), hamartoma, echinococcus cyst, abscess, AV fistula, hepatic artery aneurysm, metastatic carcinoma-colon, metastatic cholangiocarcinoma, metastatic melanoma, metastatic merkel cell and extrahepatic tumor.

  14. FDG-PET/CT and CT Findings of a Benign Solitary Fibrous Tumor of the Kidney; Correlation with Pathology.

    PubMed

    Nakajima, Reiko; Abe, Koichiro; Kondo, Tsunenori; Nagashima, Yoji; Kimura, Ken; Fukushima, Kenji; Momose, Mitsuru; Kondo, Chisato; Tanabe, Kazunari; Sakai, Shuji

    2015-01-01

    Herein, we report the F-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) findings of a benign solitary fibrous tumor (SFT) of the kidney. The patient was a 63-year-old woman with a mass in the right kidney (10×9.7 cm), incidentally found on CT images. The CT scan showed a lobulated tumor arising from the hilum of the right kidney. The tumor consisted of two components with different patterns of enhancement. Most of the tumor demonstrated moderate enhancement from the corticomedullary to nephrographic phase. A small nodular component at the caudal portion of the tumor showed avid enhancement in the corticomedullary phase and rapid washout in the nephrographic phase in contrast-enhanced CT. FDG-PET/CT was performed and showed weak FDG accumulation (SUVmax=2.30 and 1.91 in the main and small caudal components). Although renal cell carcinoma was preoperatively diagnosed, histopathological examination revealed renal SFT, with no malignant potential. Therefore, when a renal tumor with contrast-medium enhancement and low FDG accumulation is demonstrated, SFT should be considered as a differential diagnosis in addition to renal cell carcinoma. PMID:27408891

  15. FDG-PET/CT and CT Findings of a Benign Solitary Fibrous Tumor of the Kidney; Correlation with Pathology.

    PubMed

    Nakajima, Reiko; Abe, Koichiro; Kondo, Tsunenori; Nagashima, Yoji; Kimura, Ken; Fukushima, Kenji; Momose, Mitsuru; Kondo, Chisato; Tanabe, Kazunari; Sakai, Shuji

    2015-01-01

    Herein, we report the F-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) findings of a benign solitary fibrous tumor (SFT) of the kidney. The patient was a 63-year-old woman with a mass in the right kidney (10×9.7 cm), incidentally found on CT images. The CT scan showed a lobulated tumor arising from the hilum of the right kidney. The tumor consisted of two components with different patterns of enhancement. Most of the tumor demonstrated moderate enhancement from the corticomedullary to nephrographic phase. A small nodular component at the caudal portion of the tumor showed avid enhancement in the corticomedullary phase and rapid washout in the nephrographic phase in contrast-enhanced CT. FDG-PET/CT was performed and showed weak FDG accumulation (SUVmax=2.30 and 1.91 in the main and small caudal components). Although renal cell carcinoma was preoperatively diagnosed, histopathological examination revealed renal SFT, with no malignant potential. Therefore, when a renal tumor with contrast-medium enhancement and low FDG accumulation is demonstrated, SFT should be considered as a differential diagnosis in addition to renal cell carcinoma.

  16. FDG-PET/CT and CT Findings of a Benign Solitary Fibrous Tumor of the Kidney; Correlation with Pathology

    PubMed Central

    Nakajima, Reiko; Abe, Koichiro; Kondo, Tsunenori; Nagashima, Yoji; Kimura, Ken; Fukushima, Kenji; Momose, Mitsuru; Kondo, Chisato; Tanabe, Kazunari; Sakai, Shuji

    2015-01-01

    Herein, we report the F-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) findings of a benign solitary fibrous tumor (SFT) of the kidney. The patient was a 63-year-old woman with a mass in the right kidney (10×9.7 cm), incidentally found on CT images. The CT scan showed a lobulated tumor arising from the hilum of the right kidney. The tumor consisted of two components with different patterns of enhancement. Most of the tumor demonstrated moderate enhancement from the corticomedullary to nephrographic phase. A small nodular component at the caudal portion of the tumor showed avid enhancement in the corticomedullary phase and rapid washout in the nephrographic phase in contrast-enhanced CT. FDG-PET/CT was performed and showed weak FDG accumulation (SUVmax=2.30 and 1.91 in the main and small caudal components). Although renal cell carcinoma was preoperatively diagnosed, histopathological examination revealed renal SFT, with no malignant potential. Therefore, when a renal tumor with contrast-medium enhancement and low FDG accumulation is demonstrated, SFT should be considered as a differential diagnosis in addition to renal cell carcinoma. PMID:27408891

  17. Machine-learning based comparison of CT-perfusion maps and dual energy CT for pancreatic tumor detection

    NASA Astrophysics Data System (ADS)

    Goetz, Michael; Skornitzke, Stephan; Weber, Christian; Fritz, Franziska; Mayer, Philipp; Koell, Marco; Stiller, Wolfram; Maier-Hein, Klaus H.

    2016-03-01

    Perfusion CT is well-suited for diagnosis of pancreatic tumors but tends to be associated with a high radiation exposure. Dual-energy CT (DECT) might be an alternative to perfusion CT, offering correlating contrasts while being acquired at lower radiation doses. While previous studies compared intensities of Dual Energy iodine maps and CT-perfusion maps, no study has assessed the combined discriminative power of all information that can be generated from an acquisition of both functional imaging methods. We therefore propose the use of a machine learning algorithm for assessing the amount of information that becomes available by the combination of multiple images. For this, we train a classifier on both imaging methods, using a new approach that allows us to train only from small regions of interests (ROIs). This makes our study comparable to other - ROI-based analysis - and still allows comparing the ability of both classifiers to discriminate between healthy and tumorous tissue. We were able to train classifiers that yield DICE scores over 80% with both imaging methods. This indicates that Dual Energy Iodine maps might be used for diagnosis of pancreatic tumors instead of Perfusion CT, although the detection rate is lower. We also present tumor risk maps that visualize possible tumorous areas in an intuitive way and can be used during diagnosis as an additional information source.

  18. Imaging of Hepatic Ectopic Pregnancy by 18F-FDG PET/CT.

    PubMed

    Hao, Jingwen; Cheng, Zhen; Hu, Na; Xiao, Lizhi; Wang, Yunhua

    2016-09-01

    Hepatic ectopic pregnancy is an uncommon form of extrauterine pregnancy. A 31-year-old woman had acute abdominal pain and distention. Laboratory examination showed significantly increased serum β-human chorionic gonadotropin level. Both ultrasound and MRI identified a lesion located at the right lobe of the liver. FDG PET/CT was performed to determine whether the other causes of elevated β-human chorionic gonadotropin level, which showed an oval mass with mid peripherally increased FDG activity. After surgery, pathological results confirmed a diagnosis of hepatic ectopic pregnancy. PMID:27454601

  19. Clinical application of SPECT-CT with 99mTc-Tektrotyd in bronchial and thymic neuroendocrine tumors (NETs).

    PubMed

    Sergieva, Sonya; Robev, Bozhil; Dimcheva, Milena; Fakirova, Albena; Hristoskova, Radka

    2016-01-01

    Neuroendocrine tumors (NETs) of the thorax including bronchial and thymic tumors belong to foregut NETs. Limited loco-regional thoracic NETs can be resected with surgery, but in extensive metastatic disease the treatment is mainly palliative. A high incidence and density of somatostatin receptors (SSTR2, SSTR3, and SSTR5) are found in thoracic NETs. The purpose of this study was to evaluate the role of SPECT-CT somatostatin receptor scintigraphy (SRS) with 99mTc-Tektrotyd for imaging, staging and follow up of patients with bronchial and thymic neuroendocrine tumors. Forty-one patients with thoracic tumors with neuroendocrine differentiation were studied. Sixty-eight examinations including SPECT-CT studies of the neck and chest and/or abdomen and pelvis were carried out 2-4 hrs. post i.v. administration of aver-age 740 MBq activity dose of 99mTc-EDDA/HYNIC-TOC (Tektrotyd, Polatom). In all 41 investigated patients we obtained 81.25% (13/16), 88% (22/25) and 85.36% (35/41) of sensitivity, specificity and accuracy of this diagnostic approach, respectively. Somatostatin-receptor scintigraphy correctly identified all primary NETs located in the lungs and thymus. SPECT-CT studies with 99mTc-EDDA/HYNIC-TOC resulted in exact pre-surgical and pre-treatment N/M staging of bronchial and thymic NETs, except 2 cases with multiple hepatic metastases and 1 with massive suprarenal metastasis. It can be concluded that SPECT-CT with 99mTc-EDDA/HYNIC-TOC is a valuable tool for staging and follow-up of patients with thoracic NETs. PMID:27479885

  20. Selective internal radiation therapy of hepatic tumors: procedural implications of a patent hepatic falciform artery.

    PubMed

    Schelhorn, Juliane; Ertle, Judith; Schlaak, Joerg F; Mueller, Stefan; Bockisch, Andreas; Schlosser, Thomas; Lauenstein, Thomas

    2014-01-01

    Selective internal radiation therapy (SIRT) using 90-yttrium is a local therapy for unresectable liver malignancies. Non-targeted 90-yttrium diversion via a patent hepatic falciform artery (HFA) is seen as risk for periprocedural complications. Therefore, this study aimed to evaluate the impact of a patent HFA on SIRT. 606 patients with SIRT between 2006 and 2012 were evaluated retrospectively. SIRT preparation was performed by digital subtraction angiography including (99m)Tc-HSAM administration and subsequent SPECT/CT. Patients with an angiographically patent HFA were analyzed for procedural consequences and complications. 19 of 606 patients (3%) with an angiographically patent HFA were identified. Only 11 of these 19 patients received 90-yttrium in the hepatic vessel bed containing the HFA. Initial coil embolization of the HFA succeeded only in three of 11 patients. Out of the eight remaining patients four had no abdominal wall (99m)Tc-HSAM accumulation. The other four patients presented with an abdominal wall (99m)Tc-HSAM accumulation, for those a reattempt of HFA embolization was performed or ice packs were administered on the abdominal wall during SIRT. In summary, all patients tolerated SIRT well. A patent HFA should not be considered a SIRT contraindication. In patients with abdominal wall (99m)Tc-HSAM accumulation HFA embolization or ice pack administration seems to prevent complications. PMID:25332891

  1. 68Ga DOTA-TATE PET/CT allows tumor localization in patients with tumor-induced osteomalacia but negative 111In-octreotide SPECT/CT.

    PubMed

    Breer, Stefan; Brunkhorst, Thomas; Beil, F Timo; Peldschus, Kersten; Heiland, Max; Klutmann, Susanne; Barvencik, Florian; Zustin, Jozef; Gratz, Klaus-Friedrich; Amling, Michael

    2014-07-01

    Tumor-induced osteomalacia (TIO) is a paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia and low calcitriol levels as well as clinical symptoms like diffuse bone and muscle pain, fatigue fractures or increased fracture risk. Conventional imaging methods, however, often fail to detect the small tumors. Lately, tumor localization clearly improved by somatostatin-receptor (SSTR) imaging, such as octreotide scintigraphy or octreotide SPECT/CT. However, recent studies revealed that still a large number of tumors remained undetected by octreotide imaging. Hence, studies focused on different SSTR imaging methods such as 68Ga DOTA-NOC, 68Ga DOTA-TOC and 68Ga DOTA-TATE PET/CT with promising first results. Studies comparing different SSTR imaging methods for tumor localization in TIO are rare and thus little is known about diagnostic alternatives once a particular method failed to detect a tumor in patients with TIO. Here, we report the data of 5 consecutive patients suffering from TIO, who underwent both 111Indium-octreotide scintigraphy (111In-OCT) SPECT/CT as well as 68Ga DOTA-TATE PET/CT for tumor detection. While 111In-OCT SPECT/CT allowed tumor detection in only 1 of 5 patients, 68Ga DOTA-TATE PET/CT was able to localize the tumor in all patients. Afterwards, anatomical imaging of the region of interest was performed with CT and MRI. Thus, successful surgical resection of the tumor was achieved in all patients. Serum phosphate levels returned to normal and all patients reported relief of symptoms within weeks. Moreover, an iliac crest biopsy was obtained from every patient and revealed marked osteomalacia in all cases. Follow-up DXA revealed an increase in BMD of up to 34.5% 1-year postoperative, indicating remineralization. No recurrence was observed. In conclusion our data indicates that 68Ga DOTA-TATE PET/CT is an effective and promising diagnostic tool in the diagnosis of TIO, even in patients in whom 111In-OCT prior failed to detect

  2. 68Ga DOTA-TATE PET/CT allows tumor localization in patients with tumor-induced osteomalacia but negative 111In-octreotide SPECT/CT.

    PubMed

    Breer, Stefan; Brunkhorst, Thomas; Beil, F Timo; Peldschus, Kersten; Heiland, Max; Klutmann, Susanne; Barvencik, Florian; Zustin, Jozef; Gratz, Klaus-Friedrich; Amling, Michael

    2014-07-01

    Tumor-induced osteomalacia (TIO) is a paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia and low calcitriol levels as well as clinical symptoms like diffuse bone and muscle pain, fatigue fractures or increased fracture risk. Conventional imaging methods, however, often fail to detect the small tumors. Lately, tumor localization clearly improved by somatostatin-receptor (SSTR) imaging, such as octreotide scintigraphy or octreotide SPECT/CT. However, recent studies revealed that still a large number of tumors remained undetected by octreotide imaging. Hence, studies focused on different SSTR imaging methods such as 68Ga DOTA-NOC, 68Ga DOTA-TOC and 68Ga DOTA-TATE PET/CT with promising first results. Studies comparing different SSTR imaging methods for tumor localization in TIO are rare and thus little is known about diagnostic alternatives once a particular method failed to detect a tumor in patients with TIO. Here, we report the data of 5 consecutive patients suffering from TIO, who underwent both 111Indium-octreotide scintigraphy (111In-OCT) SPECT/CT as well as 68Ga DOTA-TATE PET/CT for tumor detection. While 111In-OCT SPECT/CT allowed tumor detection in only 1 of 5 patients, 68Ga DOTA-TATE PET/CT was able to localize the tumor in all patients. Afterwards, anatomical imaging of the region of interest was performed with CT and MRI. Thus, successful surgical resection of the tumor was achieved in all patients. Serum phosphate levels returned to normal and all patients reported relief of symptoms within weeks. Moreover, an iliac crest biopsy was obtained from every patient and revealed marked osteomalacia in all cases. Follow-up DXA revealed an increase in BMD of up to 34.5% 1-year postoperative, indicating remineralization. No recurrence was observed. In conclusion our data indicates that 68Ga DOTA-TATE PET/CT is an effective and promising diagnostic tool in the diagnosis of TIO, even in patients in whom 111In-OCT prior failed to detect

  3. Tumor

    MedlinePlus

    ... plants (aflatoxins) Excessive sunlight exposure Genetic problems Obesity Radiation exposure Viruses Types of tumors known to be caused by viruses are: Cervical cancer (human papillomavirus) Hepatocellular carcinoma (hepatitis B and hepatitis C ...

  4. Advanced 3D image processing techniques for liver and hepatic tumor location and volumetry

    NASA Astrophysics Data System (ADS)

    Chemouny, Stephane; Joyeux, Henri; Masson, Bruno; Borne, Frederic; Jaeger, Marc; Monga, Olivier

    1999-05-01

    To assist radiologists and physicians in diagnosing, and in treatment planning and evaluating in liver oncology, we have developed a fast and accurate segmentation of the liver and its lesions within CT-scan exams. The first step of our method is to reduce spatial resolution of CT images. This will have two effects: obtain near isotropic 3D data space and drastically decrease computational time for further processing. On a second step a 3D non-linear `edge- preserving' smoothing filtering is performed throughout the entire exam. On a third step the 3D regions coming out from the second step are homogeneous enough to allow a quite simple segmentation process, based on morphological operations, under supervisor control, ending up with accurate 3D regions of interest (ROI) of the liver and all the hepatic tumors. On a fourth step the ROIs are eventually set back into the original images, features like volume and location are immediately computed and displayed. The segmentation we get is as precise as a manual one but is much faster.

  5. Improving abdomen tumor low-dose CT images using a fast dictionary learning based processing

    NASA Astrophysics Data System (ADS)

    Chen, Yang; Yin, Xindao; Shi, Luyao; Shu, Huazhong; Luo, Limin; Coatrieux, Jean-Louis; Toumoulin, Christine

    2013-08-01

    In abdomen computed tomography (CT), repeated radiation exposures are often inevitable for cancer patients who receive surgery or radiotherapy guided by CT images. Low-dose scans should thus be considered in order to avoid the harm of accumulative x-ray radiation. This work is aimed at improving abdomen tumor CT images from low-dose scans by using a fast dictionary learning (DL) based processing. Stemming from sparse representation theory, the proposed patch-based DL approach allows effective suppression of both mottled noise and streak artifacts. The experiments carried out on clinical data show that the proposed method brings encouraging improvements in abdomen low-dose CT images with tumors.

  6. 68Ga DOTATATE PET/CT imaging of a solitary fibrous tumor of the nasopharynx.

    PubMed

    Parghane, Rahul Vithalrao; Agrawal, Kanhaiyalal; Mittal, Bhagwant Rai; Shukla, Jaya; Bhattacharya, Anish; Gupta, Ashok

    2014-08-01

    Solitary fibrous tumors (SFTs) are rare group of mesenchymal tumors that occurs predominantly in the pleura. The role of PET/CT imaging in characterizing the SFT is not well reported. Mesenchymal tumors may express somatostatin receptors. We hereby report a rare case of SFT of the nasopharynx showing Ga DOTATATE avidity.

  7. Contrast Agents for Quantitative MicroCT of Lung Tumors in Mice

    PubMed Central

    Lalwani, Kush; Giddabasappa, Anand; Li, Danan; Olson, Peter; Simmons, Brett; Shojaei, Farbod; Arsdale, Todd Van; Christensen, James; Jackson-Fisher, Amy; Wong, Anthony; Lappin, Patrick B; Eswaraka, Jeetendra

    2013-01-01

    The identification and quantitative evaluation of lung tumors in mouse models is challenging and an unmet need in preclinical arena. In this study, we developed a noninvasive contrast-enhanced microCTCT) method to longitudinally evaluate and quantitate lung tumors in mice. Commercially available μCT contrast agents were compared to determine the optimal agent for visualization of thoracic blood vessels and lung tumors in naïve mice and in non-small-cell lung cancer models. Compared with the saline control, iopamidol and iodinated lipid agents provided only marginal increases in contrast resolution. The inorganic nanoparticulate agent provided the best contrast and visualization of thoracic vascular structures; the density contrast was highest at 15 min after injection and was stable for more than 4 h. Differential contrast of the tumors, vascular structures, and thoracic air space by the nanoparticulate agent enabled identification of tumor margins and accurate quantification. μCT data correlated closely with traditional histologic measurements (Pearson correlation coefficient, 0.995). Treatment of ELM4–ALK mice with crizotinib yielded 65% reduction in tumor size and thus demonstrated the utility of quantitative μCT in longitudinal preclinical trials. Overall and among the 3 agents we tested, the inorganic nanoparticulate product was the best commercially available contrast agent for visualization of thoracic blood vessels and lung tumors. Contrast-enhanced μCT imaging is an excellent noninvasive method for longitudinal evaluation during preclinical lung tumor studies. PMID:24326223

  8. Esophageal carcinoma: CT findings

    SciTech Connect

    Quint, L.E.; Glazer, G.M.; Orringer, M.B.; Gross, B.H.

    1985-04-01

    Preoperative CT scans of 33 patients with esophageal cancer were reviewed to assess staging accuracy and define the role of CT in patients being considered for transhiatal blunt esophagectomy. Surgical and pathological verification was obtained in all cases. Only 13 tumors were staged correctly according to the TNM classification. In addition, CT was not useful in assessing resectability because of its low accuracy in evaluating aortic invasion and the fact that few patients had tracheobronchial or aortic invasion or hepatic metastases at presentation.

  9. SU-E-J-267: Change in Mean CT Intensity of Lung Tumors During Radiation Treatment

    SciTech Connect

    Mahon, R; Tennyson, N; Weiss, E; Hugo, G

    2015-06-15

    Purpose: To evaluate CT intensity change of lung tumors during radiation therapy. Methods: Repeated 4D CT images were acquired on a CT simulator during the course of therapy for 27 lung cancer patients on IRB approved protocols. All subjects received definitive radiation treatment ± chemotherapy. CT scans were completed prior to treatment, and 2–7 times during the treatment course. Primary tumor was delineated by an experienced Radiation Oncologist. Contours were thresholded between −100 HU and 200 HU to remove airways and bone. Correlations between the change in the mean tumor intensity and initial tumor intensity, SUVmax, and tumor volume change rate were investigated. Reproducibility was assessed by evaluating the variation in mean intensity over all phases in 4DCT, for a subgroup of 19 subjects. Results: Reproducibility of tumor intensity between phases as characterized by the root mean square of standard deviation across 19 subjects was 1.8 HU. Subjects had a mean initial tumor intensity of 16.5 ± 11.6 HU and an overall reduction in HU by 10.3 ± 8.5 HU. Evaluation of the changes in tumor intensity during treatment showed a decrease of 0.3 ± 0.3 HU/day for all subjects, except three. No significant correlation was found between change in HU/day and initial HU intensity (p=0.53), initial PET SUVmax (p=0.69), or initial tumor volume (p=0.70). The rate of tumor volume change was weakly correlated (R{sup 2}=0.05) with HU change (p=0.01). Conclusion: Most lung cancer subjects showed a marked trend of decreasing mean tumor CT intensity throughout radiotherapy, including early in the treatment course. Change in HU/day is not correlated with other potential early predictors for response, such as SUV and tumor volume change. This Result supports future studies to evaluate change in tumor intensity on CT as an early predictor of response.

  10. Soluble OX40L favors tumor rejection in CT26 colon carcinoma model.

    PubMed

    Serebrovskaya, Ekaterina O; Yuzhakova, Diana V; Ryumina, Alina P; Druzhkova, Irina N; Sharonov, George V; Kotlobay, Alexey A; Zagaynova, Elena V; Lukyanov, Sergey A; Shirmanova, Marina V

    2016-08-01

    OX40 receptor-expressing regulatory T cells (Tregs) populate tumors and suppress a variety of immune cells, posing a major obstacle for cancer immunotherapy. Different ways to functionally inactivate Tregs by triggering OX40 receptor have been suggested, including anti-OX40 antibodies and Fc:OX40L fusion proteins. To investigate whether the soluble extracellular domain of OX40L (OX40Lexo) is sufficient to enhance antitumor immune response, we generated an OX40Lexo-expressing CT26 colon carcinoma cell line and studied its tumorigenicity in immunocompetent BALB/c and T cell deficient nu/nu mice. We found that soluble OX40L expressed in CT26 colon carcinoma favors the induction of an antitumor response which is not limited just to cells co-expressing EGFP as an antigenic determinant, but also eliminates CT26 cells expressing another fluorescent protein, KillerRed. Tumor rejection required the presence of T lymphocytes, as indicated by the unhampered tumor growth in nu/nu mice. Subsequent re-challenge of tumor-free BALB/c mice with CT26 EGFP cells resulted in no tumor growth, which is indicative of the formation of immunological memory. Adoptive transfer of splenocytes from mice that successfully rejected CT26 OX40Lexo EGFP tumors to naïve mice conferred 100% resistance to subsequent challenge with the CT26 EGFP tumor. PMID:27203665

  11. Extrathoracic solitary fibrous tumor of the pelvic peritoneum with central malignant degeneration on CT and MRI.

    PubMed

    Vossough, Arastoo; Torigian, Drew A; Zhang, Paul J; Siegelman, Evan S; Banner, Marc P

    2005-11-01

    We describe a 61-year-old man who presented with an extrathoracic solitary fibrous tumor (SFT) of the pelvic peritoneum with central malignant degeneration as seen on computed tomography (CT), magnetic resonance imaging (MRI), and histopathology. When a central focus of heterogeneity and variable contrast enhancement are identified within a fibrous tumor of the pelvis on CT or MRI, malignant degeneration of an extrathoracic SFT, although rare, should be considered as a diagnostic possibility.

  12. Segmentation of hepatic artery in multi-phase liver CT using directional dilation and connectivity analysis

    NASA Astrophysics Data System (ADS)

    Wang, Lei; Schnurr, Alena-Kathrin; Zidowitz, Stephan; Georgii, Joachim; Zhao, Yue; Razavi, Mohammad; Schwier, Michael; Hahn, Horst K.; Hansen, Christian

    2016-03-01

    Segmentation of hepatic arteries in multi-phase computed tomography (CT) images is indispensable in liver surgery planning. During image acquisition, the hepatic artery is enhanced by the injection of contrast agent. The enhanced signals are often not stably acquired due to non-optimal contrast timing. Other vascular structure, such as hepatic vein or portal vein, can be enhanced as well in the arterial phase, which can adversely affect the segmentation results. Furthermore, the arteries might suffer from partial volume effects due to their small diameter. To overcome these difficulties, we propose a framework for robust hepatic artery segmentation requiring a minimal amount of user interaction. First, an efficient multi-scale Hessian-based vesselness filter is applied on the artery phase CT image, aiming to enhance vessel structures with specified diameter range. Second, the vesselness response is processed using a Bayesian classifier to identify the most probable vessel structures. Considering the vesselness filter normally performs not ideally on the vessel bifurcations or the segments corrupted by noise, two vessel-reconnection techniques are proposed. The first technique uses a directional morphological operator to dilate vessel segments along their centerline directions, attempting to fill the gap between broken vascular segments. The second technique analyzes the connectivity of vessel segments and reconnects disconnected segments and branches. Finally, a 3D vessel tree is reconstructed. The algorithm has been evaluated using 18 CT images of the liver. To quantitatively measure the similarities between segmented and reference vessel trees, the skeleton coverage and mean symmetric distance are calculated to quantify the agreement between reference and segmented vessel skeletons, resulting in an average of 0:55+/-0:27 and 12:7+/-7:9 mm (mean standard deviation), respectively.

  13. Pancreatic Cancer Tumor Size on CT Scan Versus Pathologic Specimen: Implications for Radiation Treatment Planning

    SciTech Connect

    Arvold, Nils D.; Niemierko, Andrzej; Mamon, Harvey J.; Hong, Theodore S.

    2011-08-01

    Purpose: Pancreatic cancer primary tumor size measurements are often discordant between computed tomography (CT) and pathologic specimen after resection. Dimensions of the primary tumor are increasingly relevant in an era of highly conformal radiotherapy. Methods and Materials: We retrospectively evaluated 97 consecutive patients with resected pancreatic cancer at two Boston hospitals. All patients had CT scans before surgical resection. Primary endpoints were maximum dimension (in millimeters) of the primary tumor in any direction as reported by the radiologist on CT and by the pathologist for the resected gross fresh specimen. Endoscopic ultrasound (EUS) findings were analyzed if available. Results: Of the patients, 87 (90%) had preoperative CT scans available for review and 46 (47%) had EUS. Among proximal tumors (n = 69), 40 (58%) had pathologic duodenal invasion, which was seen on CT in only 3 cases. The pathologic tumor size was a median of 7 mm larger compared with CT size for the same patient (range, -15 to 43 mm; p < 0.0001), with 73 patients (84%) having a primary tumor larger on pathology than CT. Endoscopic ultrasound was somewhat more accurate, with pathologic tumor size being a median of only 5 mm larger compared with EUS size (range, -15 to 35 mm; p = 0.0003). Conclusions: Computed tomography scans significantly under-represent pancreatic cancer tumor size compared with pathologic specimens in resectable cases. We propose a clinical target volume expansion formula for the primary tumor based on our data. The high rate of pathologic duodenal invasion suggests a risk of duodenal undercoverage with highly conformal radiotherapy.

  14. The importance of PET/CT in the evaluation of patients with Ewing tumors.

    PubMed

    Guimarães, Júlio Brandão; Rigo, Letícia; Lewin, Fabio; Emerick, André

    2015-01-01

    The effective evaluation for the treatment of patients with Ewing tumors depends on the accuracy in the determination of the primary tumor extent and the presence of metastatic disease. Currently, no universally accepted staging system is available to assess Ewing tumors. The present study aimed at discussing the use of PET/CT as a tool for staging, restaging and assessment of therapeutic response in patients with Ewing tumors. In spite of some limitations of PET/CT as compared with anatomical imaging methods, its relevance in the assessment of these patients is related to the capacity of the method to provide further physiological information, which often generates important clinical implications. Currently, the assessment of patients with Ewing tumor should comprise a study with PET/CT combined with other anatomical imaging modalities, such as radiography, computed tomography and magnetic resonance imaging.

  15. CT features of retroperitoneal solitary fibrous tumor: report of three cases and review of the literature.

    PubMed

    Sun, Jun; Yu, Xiang-rong; Shi, Bin-bin; Zheng, Jin; Wu, Jing-tao

    2014-01-01

    CT findings in three cases with solitary fibrous tumors (SFTs) confirmed by histopathology and immunohistochemistry were reviewed retrospectively, and compared with pathological results. The three tumors were large, well-defined, and smooth contour masses and SFT consisted of solid components of two different densities. On enhanced CT scans, tumors were strongly enhancing, the multiple vascular shadows were seen within the tumor in the arterial phase. There is progressive enhancement from the arterial to the venous phase, and the tumor capsule can be observed. Histologically, the tumors are composed of spindle cells within a background of collagen stroma, and showed a wide range of growth patterns, alternating hypercellular (tumor cell-rich) and hypocellular (collagen-rich) areas. The diagnosis is confirmed by characteristic positive immunohistochemical staining for CD34.

  16. Time courses of PIVKA-II and AFP levels after hepatic artery embolization and hepatic artery infusion against hepatocellular carcinoma: relation between the time course and tumor necrosis.

    PubMed

    Kishi, K; Sonomura, T; Mitsuzane, K; Nishida, N; Kimura, M; Satoh, M; Yamada, R; Kodama, N; Kinoshita, M; Tanaka, H

    1992-01-01

    We examined 35 untreated patients with unresectable hepatocellular carcinoma who exhibited positivity for both plasma PIVKA-II and serum AFP, and studied the weekly course of these markers from the pre-TAE or -HAI period to the third week of treatment. We correlated changes in these markers with the tumor necrosis rate and the time course on X-ray CT images. One week after TAE, the tumor necrosis rate and the time course of PIVKA-II showed a significant correlation (r = 0.7), while the correlation was between the time course of AFP and the tumor necrosis rate was insignificant (r = 0.2). At two and three weeks after TAE, both the time course of AFP and PIVKA-II showed significant correlations with the tumor necrosis rate. In 16 patients with tumor necrosis rates of not less than 90%, the mean of the actual half-life (AHL) of PIVKA-II was 3.2 days, the shortest was 1.83 days, and 75% of all AHLs clustered from two days to four days, while the mean and shortest AHLs of AFP were six days and 2.98 days, respectively, exhibiting a broader distribution. On the other hand, in three out of the nine cases of hepatocellular carcinoma complicated with portal tumor thrombi, PIVKA-II increased after HAI in spite of a reduction in tumor size. It was suggested that the PIVKA-II level requires careful interpretation in cases of portal vein obstruction after intensive hepatic arterial infusion of anticancer agents.

  17. A Functional CT Contrast Agent for In Vivo Imaging of Tumor Hypoxia.

    PubMed

    Shi, Hongyuan; Wang, Zhiming; Huang, Chusen; Gu, Xiaoli; Jia, Ti; Zhang, Amin; Wu, Zhiyuan; Zhu, Lan; Luo, Xianfu; Zhao, Xuesong; Jia, Nengqin; Miao, Fei

    2016-08-01

    Hypoxia, which has been well established as a key feature of the tumor microenvironment, significantly influences tumor behavior and treatment response. Therefore, imaging for tumor hypoxia in vivo is warranted. Although some imaging modalities for detecting tumor hypoxia have been developed, such as magnetic resonance imaging, positron emission tomography, and optical imaging, these technologies still have their own specific limitations. As computed tomography (CT) is one of the most useful imaging tools in terms of availability, efficiency, and convenience, the feasibility of using a hypoxia-sensitive nanoprobe (Au@BSA-NHA) for CT imaging of tumor hypoxia is investigated, with emphasis on identifying different levels of hypoxia in two xenografts. The nanoprobe is composed of Au nanoparticles and nitroimidazole moiety which can be electively reduced by nitroreductase under hypoxic condition. In vitro, Au@BSA-NHA attain the higher cellular uptake under hypoxic condition. Attractively, after in vivo administration, Au@BSA-NHA can not only monitor the tumor hypoxic environment with CT enhancement but also detect the hypoxic status by the degree of enhancement in two xenograft tumors with different hypoxic levels. The results demonstrate that Au@BSA-NHA may potentially be used as a sensitive CT imaging agent for detecting tumor hypoxia. PMID:27345304

  18. Hepatic Tumor Metastases Cause Enhanced PEGylated Liposome Uptake by Kupffer Cells.

    PubMed

    Ukawa, Masami; Fujiwara, Yukako; Ando, Hidenori; Shimizu, Taro; Ishida, Tatsuhiro

    2016-01-01

    Kupffer cells in livers bearing tumor metastases were found to have promoted tumor invasion and exacerbated the metastasis. This implies that the function of Kupffer cells might differ between animals bearing hepatic metastases and those that are healthy. Kupffer cells are considered responsible for the accumulation of liposomes in the liver. In this study, we hypothesized that the alteration in the function of Kupffer cells by hepatic metastasis would also affect the biodistribution of liposomes following intravenous administration. The hepatic accumulation and the blood concentration of PEGylated liposomes were compared between healthy mice and tumor-bearing mice. We noted that hepatic accumulation and elimination from the blood were significantly accelerated in tumor-bearing mice, indicating that our hypothesis was correct. In the tumor-bearing mice, the proportion of Kupffer cells taking up liposomes was significantly increased. Intravenous injection of oxaliplatin (l-OHP) containing PEGylated liposomes decreased the fraction of Kupffer cells, but this administration caused no injury to the hepatocytes. These results suggest that PEGylated liposomes containing l-OHP may have the potential to treat metastatic hepatic cancer-not only via the direct killing of the cancer cells but also via a reduction in tumor-supportive Kupffer cells. PMID:26830481

  19. Automatic co-segmentation of lung tumor based on random forest in PET-CT images

    NASA Astrophysics Data System (ADS)

    Jiang, Xueqing; Xiang, Dehui; Zhang, Bin; Zhu, Weifang; Shi, Fei; Chen, Xinjian

    2016-03-01

    In this paper, a fully automatic method is proposed to segment the lung tumor in clinical 3D PET-CT images. The proposed method effectively combines PET and CT information to make full use of the high contrast of PET images and superior spatial resolution of CT images. Our approach consists of three main parts: (1) initial segmentation, in which spines are removed in CT images and initial connected regions achieved by thresholding based segmentation in PET images; (2) coarse segmentation, in which monotonic downhill function is applied to rule out structures which have similar standardized uptake values (SUV) to the lung tumor but do not satisfy a monotonic property in PET images; (3) fine segmentation, random forests method is applied to accurately segment the lung tumor by extracting effective features from PET and CT images simultaneously. We validated our algorithm on a dataset which consists of 24 3D PET-CT images from different patients with non-small cell lung cancer (NSCLC). The average TPVF, FPVF and accuracy rate (ACC) were 83.65%, 0.05% and 99.93%, respectively. The correlation analysis shows our segmented lung tumor volumes has strong correlation ( average 0.985) with the ground truth 1 and ground truth 2 labeled by a clinical expert.

  20. Optimal Co-segmentation of Tumor in PET-CT Images with Context Information

    PubMed Central

    Song, Qi; Bai, Junjie; Han, Dongfeng; Bhatia, Sudershan; Sun, Wenqing; Rockey, William; Bayouth, John E.; Buatti, John M.

    2014-01-01

    PET-CT images have been widely used in clinical practice for radiotherapy treatment planning of the radiotherapy. Many existing segmentation approaches only work for a single imaging modality, which suffer from the low spatial resolution in PET or low contrast in CT. In this work we propose a novel method for the co-segmentation of the tumor in both PET and CT images, which makes use of advantages from each modality: the functionality information from PET and the anatomical structure information from CT. The approach formulates the segmentation problem as a minimization problem of a Markov Random Field (MRF) model, which encodes the information from both modalities. The optimization is solved using a graph-cut based method. Two sub-graphs are constructed for the segmentation of the PET and the CT images, respectively. To achieve consistent results in two modalities, an adaptive context cost is enforced by adding context arcs between the two subgraphs. An optimal solution can be obtained by solving a single maximum flow problem, which leads to simultaneous segmentation of the tumor volumes in both modalities. The proposed algorithm was validated in robust delineation of lung tumors on 23 PET-CT datasets and two head-and-neck cancer subjects. Both qualitative and quantitative results show significant improvement compared to the graph cut methods solely using PET or CT. PMID:23693127

  1. Automatic lung tumor segmentation on PET/CT images using fuzzy Markov random field model.

    PubMed

    Guo, Yu; Feng, Yuanming; Sun, Jian; Zhang, Ning; Lin, Wang; Sa, Yu; Wang, Ping

    2014-01-01

    The combination of positron emission tomography (PET) and CT images provides complementary functional and anatomical information of human tissues and it has been used for better tumor volume definition of lung cancer. This paper proposed a robust method for automatic lung tumor segmentation on PET/CT images. The new method is based on fuzzy Markov random field (MRF) model. The combination of PET and CT image information is achieved by using a proper joint posterior probability distribution of observed features in the fuzzy MRF model which performs better than the commonly used Gaussian joint distribution. In this study, the PET and CT simulation images of 7 non-small cell lung cancer (NSCLC) patients were used to evaluate the proposed method. Tumor segmentations with the proposed method and manual method by an experienced radiation oncologist on the fused images were performed, respectively. Segmentation results obtained with the two methods were similar and Dice's similarity coefficient (DSC) was 0.85 ± 0.013. It has been shown that effective and automatic segmentations can be achieved with this method for lung tumors which locate near other organs with similar intensities in PET and CT images, such as when the tumors extend into chest wall or mediastinum.

  2. Autoradiographic and histopathological studies of boric acid-mediated BNCT in hepatic VX2 tumor-bearing rabbits: Specific boron retention and damage in tumor and tumor vessels.

    PubMed

    Yang, C H; Lin, Y T; Hung, Y H; Liao, J W; Peir, J J; Liu, H M; Lin, Y L; Liu, Y M; Chen, Y W; Chuang, K S; Chou, F I

    2015-12-01

    Hepatoma is a malignant tumor that responds poorly to conventional therapies. Boron neutron capture therapy (BNCT) may provide a better way for hepatoma therapy. In this research, (10)B-enriched boric acid (BA, 99% (10)B) was used as the boron drug. A multifocal hepatic VX2 tumor-bearing rabbit model was used to study the mechanisms of BA-mediated BNCT. Autoradiography demonstrated that BA was selectively targeted to tumors and tumor vessels. Histopathological examination revealed the radiation damage to tumor-bearing liver was concentrated in the tumor regions during BNCT treatment. The selective killing of tumor cells and the destruction of the blood vessels in tumor masses may be responsible for the success of BA-mediated BNCT for liver tumors. PMID:26372198

  3. Autoradiographic and histopathological studies of boric acid-mediated BNCT in hepatic VX2 tumor-bearing rabbits: Specific boron retention and damage in tumor and tumor vessels.

    PubMed

    Yang, C H; Lin, Y T; Hung, Y H; Liao, J W; Peir, J J; Liu, H M; Lin, Y L; Liu, Y M; Chen, Y W; Chuang, K S; Chou, F I

    2015-12-01

    Hepatoma is a malignant tumor that responds poorly to conventional therapies. Boron neutron capture therapy (BNCT) may provide a better way for hepatoma therapy. In this research, (10)B-enriched boric acid (BA, 99% (10)B) was used as the boron drug. A multifocal hepatic VX2 tumor-bearing rabbit model was used to study the mechanisms of BA-mediated BNCT. Autoradiography demonstrated that BA was selectively targeted to tumors and tumor vessels. Histopathological examination revealed the radiation damage to tumor-bearing liver was concentrated in the tumor regions during BNCT treatment. The selective killing of tumor cells and the destruction of the blood vessels in tumor masses may be responsible for the success of BA-mediated BNCT for liver tumors.

  4. Follow-up segmentation of lung tumors in PET and CT data

    NASA Astrophysics Data System (ADS)

    Opfer, Roland; Kabus, Sven; Schneider, Torben; Carlsen, Ingwer C.; Renisch, Steffen; Sabczynski, Jörg

    2009-02-01

    Early response assessment of cancer therapy is a crucial component towards a more effective and patient individualized cancer therapy. Integrated PET/CT systems provide the opportunity to combine morphologic with functional information. We have developed algorithms which allow the user to track both tumor volume and standardized uptake value (SUV) measurements during the therapy from series of CT and PET images, respectively. To prepare for tumor volume estimation we have developed a new technique for a fast, flexible, and intuitive 3D definition of meshes. This initial surface is then automatically adapted by means of a model-based segmentation algorithm and propagated to each follow-up scan. If necessary, manual corrections can be added by the user. To determine SUV measurements a prioritized region growing algorithm is employed. For an improved workflow all algorithms are embedded in a PET/CT therapy monitoring software suite giving the clinician a unified and immediate access to all data sets. Whenever the user clicks on a tumor in a base-line scan, the courses of segmented tumor volumes and SUV measurements are automatically identified and displayed to the user as a graph plot. According to each course, the therapy progress can be classified as complete or partial response or as progressive or stable disease. We have tested our methods with series of PET/CT data from 9 lung cancer patients acquired at Princess Margaret Hospital in Toronto. Each patient underwent three PET/CT scans during a radiation therapy. Our results indicate that a combination of mean metabolic activity in the tumor with the PET-based tumor volume can lead to an earlier response detection than a purely volume based (CT diameter) or purely functional based (e.g. SUV max or SUV mean) response measures. The new software seems applicable for easy, faster, and reproducible quantification to routinely monitor tumor therapy.

  5. Imaging diagnosis-ultrasonographic and CT findings in a gray seal (Halichoerus grypus) with hepatic cirrhosis, pyelonephritis, and nephrolithiasis.

    PubMed

    de Swarte, Marie; Bryan, Jill; Zarelli, Micaela; Huuskonen, Vihelmiina; Schneeweiss, Wilfried; McAllister, Hester

    2013-01-01

    An immature gray seal was presented with lethargy, weight loss, vomiting and hematuria. Hepatic disease and urinary tract infection were suspected. Abdominal ultrasound showed hyperechoic structures with marked acoustic shadowing spread throughout both kidneys, but incomplete visualization of the liver. Abdominal CT showed mineral densities scattered throughout both kidneys and poor delineation of the liver. Due to the poor quality of life, the seal was euthanized. Postmortem examination showed ammonium urate nephroliths, pyelonephritis, and hepatic cirrhosis. This case report emphasizes the difficulty of characterizing liver disease with conventional 2D-ultrasound and CT in a deep-chested animal with minimal intra-abdominal fat. PMID:23578275

  6. Toward realistic radiofrequency ablation of hepatic tumors 3D simulation and planning

    NASA Astrophysics Data System (ADS)

    Villard, Caroline; Soler, Luc; Gangi, Afshin; Mutter, Didier; Marescaux, Jacques

    2004-05-01

    Radiofrequency ablation (RFA) has become an increasingly used technique in the treatment of patients with unresectable hepatic tumors. Evaluation of vascular architecture, post-RFA tissue necrosis prediction, and the choice of a suitable needle placement strategy using conventional radiological techniques remain difficult. In an attempt to enhance the safety of RFA, a 3D simulator and treatment planning tool, that simulates the necrosis of the treated area, and proposes an optimal placement for the needle, has been developed. From enhanced spiral CT scans with 2 mm cuts, 3D reconstructions of patients with liver metastases are automatically generated. Virtual needles can be added to the 3D scene, together with their corresponding zones of necrosis that are displayed as a meshed spheroids representing the 60° C isosurface. The simulator takes into account the cooling effect of local vessels greater than 3mm in diameter, making necrosis shapes more realistic. Using a voxel-based algorithm, RFA spheroids are deformed following the shape of the vessels, extended by an additional cooled area. This operation is performed in real-time, allowing updates while needle is adjusted. This allows to observe whether the considered needle placement strategy would burn the whole cancerous zone or not. Planned needle positioning can also be automatically generated by the software to produce complete destruction of the tumor with a 1 cm margin, with maximum respect of the healthy liver and of all major extrahepatic and intrahepatic structures to avoid. If he wishes, the radiologist can select on the skin an insertion window for the needle, focusing the research of the trajectory.

  7. The effect of housing temperature on the growth of CT26 tumor expressing fluorescent protein EGFP

    NASA Astrophysics Data System (ADS)

    Yuzhakova, Diana V.; Shirmanova, Marina V.; Lapkina, Irina V.; Serebrovskaya, Ekaterina O.; Lukyanov, Sergey A.; Zagaynova, Elena V.

    2016-04-01

    To date, the effect of housing temperature on tumor development in the immunocompetent mice has been studied on poorly immunogenic cancer models. Standard housing temperature 20-26°C was shown to cause chronic metabolic cold stress and promote tumor progression via suppression of the antitumor immune response, whereas a thermoneutral temperature 30-31°C was more preferable for normal metabolism of mice and inhibited tumor growth. Our work represents the first attempt to discover the potential effect of housing temperature on the development of highly immunogenic tumor. EGFP-expressing murine colon carcinoma CT26 generated in Balb/c mice was used as a tumor model. No statistically significant differences were shown in tumor incidences and growth rates at 20°C, 25°C and 30°C for non-modified CT26. Maintaining mice challenged with CT26-EGFP cells at 30°C led to complete inhibition of tumor development. In summary, we demonstrated that the housing temperature is important for the regulation of growth of highly immunogenic tumors in mice through antitumor immunity.

  8. Hepatic Arterial Embolization with Doxorubicin-Loaded Superabsorbent Polymer Microspheres in a Rabbit Liver Tumor Model

    SciTech Connect

    Gupta, Sanjay Wright, Kenneth C.; Ensor, Joe; Van Pelt, Carolyn S.; Dixon, Katherine A.; Kundra, Vikas

    2011-10-15

    Objectives: The pharmacokinetic profile after hepatic arterial embolization with superabsorbent microspheres (QuadraSpheres) loaded with doxorubicin was studied. Methods: Rabbits with hepatic VX2 tumors were treated with intra-arterial administration of QuadraSpheres loaded with doxorubicin, or transarterial chemoembolization (TACE) using doxorubicin, Lipiodol and Embospheres, or hepatic arterial infusion (HAI) of doxorubicin. Tumor specimens were evaluated by fluorescence microscopy, and plasma and tumor concentrations of doxorubicin were measured. Results: The peak plasma concentration of doxorubicin was lower in the QuadraSphere group (309.9 ng/ml) than in the HAI (673.4 ng/ml) or TACE (360.5 ng/ml) groups, suggesting higher tumor retention in the QuadraSphere group. Intratumoral doxorubicin levels declined to negligible levels at 1 and 3 days after treatment, respectively, in the HAI and TACE groups. In the QuadraSphere groups, intratumoral doxorubicin level declined after day 1, but was still detectable at 14 days after treatment and was higher than that in the other groups at 1, 3, and 7 days. Intratumoral doxorubicin fluorescence was detected at all time points in the QuadraSphere group, but only at 1 day after treatment in the TACE group. Conclusions: Hepatic arterial administration of doxorubicin-loaded QuadraSpheres enables the sustained release of doxorubicin to hepatic tumors.

  9. Investigation of 1377C/T polymorphism of the Toll-like receptor 3 among patients with chronic hepatitis B.

    PubMed

    Goktas, Emine Firat; Bulut, Cemal; Goktas, Mustafa Tugrul; Ozer, Erdem Kamil; Karaca, Ragip Ozgur; Kinikli, Sami; Demiroz, Ali Pekcan; Bozkurt, Atilla

    2016-07-01

    The immunopathogenesis of chronic hepatitis B (CHB) has not been clarified yet. Toll-like receptors (TLR) are a receptor family that initiates immunity with exogenous-endogenous ligands and plays a role in the pathogenesis of infections. In this study, we aimed to investigate the frequency of TLR 3 1377C/T (rs3775290) polymorphism and its role in patients with CHB. We included 50 healthy individuals as control group and 73 active and 43 inactive hepatitis B patients. All DNA samples were isolated from blood samples. For the detection of TLR 3 1377C/T single-nucleotide polymorphism, restriction fragment length polymorphism was used. A statistically significant difference was determined in Hepatitis B virus (HBV) DNA levels of CHB patients with the CC, CT, and TT genotypes (p = 0.013). The highest levels of HBV DNA were detected in individuals with TT genotypes. Additionally, the frequency of CC genotype was higher in the active CHB patients compared with that of the inactive CHB patients (p = 0.044). No statistically significant difference in TLR 3 1377C/T polymorphism was detected between healthy controls and the hepatitis B patients (p = 0.342). In conclusion, HBV DNA level was higher in the individuals with TT genotype, and CC genotype was more frequent in the active CHB patients. These results suggest a possible association between CHB and TLR 3 gene (1377C/T) polymorphism.

  10. Micro-CT molecular imaging of tumor angiogenesis using a magnetite nano-cluster probe.

    PubMed

    Liu, Ping; Li, Jing; Zhang, Chunfu; Xu, Lisa X

    2013-06-01

    Due to its high resolution, micro-CT is desirable for molecular imaging of tumor angiogenesis. However, the sensitivity of micro-CT to contrast agents is relatively low. Therefore, the purpose of this study is to develop high micro-CT sensitive molecular imaging probes for direct visualization and dynamic monitoring of tumor angiogenesis. To this end, Arg-Gly-Asp (RGD) peptides conjugated magnetite nano clusters (RGD-MNCs) were developed by assembling individual magnetite nano particles into clusters with amphiphilic (maleimide) methoxypoly(ethylene glycol)-b-poly(lactic acid) ((Mal)mPEG-PLA) copolymer and subsequently encoding RGD peptides onto the clusters for specific targeting alpha(v)beta3 integrin. The hydrodynamic size of RGD-MNCs was about 85 nm. To test its specificity, alpha(v)beta3 positive cells (H1299) were incubated with magnetite nano clusters (MNCs), RGD-MNCs or RGD-MNCs competition with free RGD peptides. Prussian Blue staining and inductively coupled plasma optical emission spectrometer (ICP-OES) measurements indicated that the cell uptake of RGD-MNCs was significantly more than that of MNCs, which could be inhibited by free RGD peptides. For detection of tumor angiogenesis, mice bearing H1299 tumors were injected intravenously with RGD-MNCs at the dose of 400 micro mol Fe/kg. Tumor angiogenic hot spots as well as individual angiogenic vessels could be clearly manifested by micro-CT imaging 12 h post injection, which was dynamically monitored with the extension of probe circulation time. Subsequent histological studies of tumor tissues verified that RGD-MNCs registered tumor angiogenic vessels. Our study demonstrated that RGD-MNC probes fabricated in this study could be used to effectively target alpha(v)beta3 integrin. Using high resolution micro-CT in combination with the probes, tumor angiogenesis could be studied dynamically.

  11. [Hemangioma, the most frequent hepatic tumor. Diagnosis with dynamic CAT].

    PubMed

    Cuevas Ibáñez, A; Santos Cores, J; Molina López-Nava, P; Fernández Iglesias, P; Bones Purkiss, J

    1994-08-01

    The sensitivity, specificity and predictive values of dynamic CAT with contrast piston-stroke performed at a single cut are described for the diagnosis of hepatic hemangiomas. We analyzed the correlation between the findings obtained through dynamic CAT and those obtained through echography, PAAF, analytic and clinical study of the patients with suspicion of hepatic hemangioma. The following values were obtained: sensitivity 92.3%; specificity 50%; VPP 88.8%; VPN 60%; and global diagnostic affectivity 84.37%. According to these results, we think that dynamic CAT is a highly reliable test for the diagnosis of hepatic hemangiomas.

  12. Hepatic arterial infusion chemotherapy for hepatocellular carcinoma with tumor thrombosis of the portal vein tumor thrombosis

    PubMed Central

    Lai, Yung-Chih; Shih, Cheng-Yen; Jeng, Chin-Ming; Yang, Sien-Sing; Hu, Jui-Ting; Sung, Yung-Chuan; Liu, Han-Ting; Hou, Shaw-Min; Wu, Chi-Hwa; Chen, Tzen-Kwan

    2003-01-01

    AIM: Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is associated with poor prognosis. The aim of this prospective study was to evaluate the efficacy of hepatic arterial infusion chemotherapy (HAIC) for patients with this disease. METHODS: Eighteen HCC patients with PVTT were treated with HAIC via a subcutaneously implanted injection port. A course of chemotherapy consisted of daily cisplatin (10 mg for one hour) followed by 5-fluorouracil (250 mg for five hours) for five continuous days within a given week. The patients were scheduled to receive four consecutive courses of HAIC. Responders were defined in whom either a complete or partial response was achieved, while non-responders were defined based on stable or progressive disease status. The prognostic factors associated with survival after treatment were analyzed. RESULTS: Six patients exhibited partial response to this form of HAIC (response rate = 33%). The 3, 6, 9, 12 and 18-month cumulative survival rates for the 18 patients were 83%, 72%, 50%, 28%, and 7%, respectively. Median survival times for the six responders and 12 non-responders were 15.0 (range, 11-18) and 7.5 (range, 1-13) months, respectively. It was demonstrated by both univariate and multivariate analyses that the therapeutic response and hepatic reserve function were significant prognostic factors. CONCLUSION: HAIC using low-dose cisplatin and 5-fluorouracil may be a useful alternative for the treatment of patients with advanced HCC complicated with PVTT. There may also be survival-related benefits associated with HAIC. PMID:14669309

  13. Infradiaphragmatic bronchogenic cyst with high CT numbers in a boy with primitive neuroectodermal tumor.

    PubMed

    Fischbach, R; Benz-Bohm, G; Berthold, F; Eidt, S; Schmidt, R

    1994-01-01

    Abdominal bronchogenic cysts are very rare with less than 20 published cases. We report the case of a retroperitoneal bronchogenic cyst in a 12-year-old boy, who initially presented with a primitive neuroectodermal tumor of the pelvis. Computed tomography (CT) showed a small, hyperdense nonenhancing mass adjacent to the right crus of the diaphragm. Follow-up CT after chemotherapy showed a decrease in CT attenuation of this mass, but a slight increase in size. At surgery the mass was loosely attached to the diaphragm and final pathology confirmed the diagnosis of a bronchogenic cyst.

  14. Nonalcoholic Hepatic Steatosis Is a Strong Predictor of High-Risk Coronary-Artery Plaques as Determined by Multidetector CT

    PubMed Central

    Osawa, Kazuhiro; Miyoshi, Toru; Yamauchi, Kentarou; Koyama, Yasushi; Nakamura, Kazufumi; Sato, Shuhei; Kanazawa, Susumu; Ito, Hiroshi

    2015-01-01

    Background Nonalcoholic fatty liver disease is associated with a risk of coronary artery disease (e.g., diabetes mellitus, dyslipidemia, metabolic syndrome). We evaluated whether nonalcoholic hepatic steatosis is associated with high-risk plaques as assessed by multidetector computed tomography (CT). Methods This retrospective study involved 414 participants suspected of having coronary artery disease. Nonalcoholic hepatic steatosis was defined as a liver-to-spleen fat ratio of <1.0 and the presence and appropriate characteristics of coronary-artery plaques as assessed by coronary CT angiography. High-risk plaques were identified, as were low-density plaques, positive remodeling, and spotty calcification. Results Compared with patients who did not have nonalcoholic hepatic steatosis, patients with nonalcoholic hepatic steatosis had more low-density plaques (21% vs. 44%, p<0.01), positive remodeling (41% vs. 58%, p = 0.01), and spotty calcification (12% vs. 36%, p<0.01). The number of high-risk plaques in patients with nonalcoholic hepatic steatosis was greater than in those without nonalcoholic hepatic steatosis (p<0.01). Patients with nonalcoholic hepatic steatosis were more likely to have high-risk plaques than were those with only an elevated level of visceral adipose tissue (≥86 cm2; 35% vs. 16%, p<0.01). Multivariate analyses that included nonalcoholic hepatic steatosis, amount of visceral adipose tissue, and the presence/absence of traditional risk factors demonstrated that nonalcoholic hepatic steatosis was an independent predictor of high-risk plaques (odds ratio: 4.60; 95% confidence interval: 1.94–9.07, p<0.01). Conclusions Diagnosis of nonalcoholic hepatic steatosis may be of value when assessing the risk of coronary artery disease. PMID:26125952

  15. Angiogenesis dependent characteristics of tumor observed on rabbit VX2 hepatic carcinoma

    PubMed Central

    Guan, Liming

    2015-01-01

    Objective: To evaluate angiogenesis dependent characteristics of carcinoma proliferation, metastasis and to found if there is tumor vascularity architecture defect. Methods: 36 rabbits were random divided into 2 groups: Experimental group: 18 rabbits liver were implanted with VX2 tumor by surgery operation; Control group: 18 experimental rabbits performed the same surgery operation without tumor implantation, the course of tumor growth and blood vessel invasion was observed by autopsy. One slide was used for hematoxylin-eosin (HE) staining, one slide was used for elastic fiber staining by Victoria blue and Ponceau’s histochemical staining, and one slide was used for vascular endothelial cell immunohistochemical staining with biotinylated-ulex europaeus agglutinin I (UEA I); all three slides were observed under an optical microscopic. One additional slide was systematically observed by electron microscopy. SPSS 19.0 software was used for the statistical analyses of the data. Results: The tumor grew acceleration after tumor angiogenesis, volume of original tumors was correlated with vascular caliber. The central tumor found necrosis without enough blood supply while tumor grew rapidly after tumor angiogenesis. The tumor infiltrated into liver blood sinus, blood vessels in hepatic interstitial tissue, the liver capsular vein and important organs metastasis such as lungs, kidneys, abdominal cavity caused rabbits died. The average vascular density count of 18 experimental rabbits under 400 times light microscope were 43.17 ± 8.68/vessels/High Power Field; Tumor vascular diameter all within 200 μm. Vascular elastic fiber staining presented tumor blood vessels internal, external elastic plate intact, vascular endothelial cells organelles of tumor were integrity without endothelial cells architecture defect found by pathologic observation. Conclusion: Proliferation and metastasis of rabbit VX2 hepatic carcinoma was correlated with tumor angiogenesis and no tumor

  16. Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

    PubMed Central

    Fonseca, Alexandre Zanchenko; Santin, Stephanie; Gomes, Luiz Guilherme Lisboa; Waisberg, Jaques; Ribeiro Jr., Marcelo Augusto Fontenelle

    2014-01-01

    Radiofrequency ablation (RFA) has become an important option in the therapy of primary and secondary hepatic tumors. Surgical resection is still the best treatment option, but only a few of these patients are candidates for surgery: multilobar disease, insufficient liver reserve that will lead to liver failure after resection, extra-hepatic disease, proximity to major bile ducts and vessels, and co-morbidities. RFA has a low mortality and morbidity rate and is considered to be safe. Thus, complications occur and vary widely in the literature. Complications are caused by thermal damage, direct needle injury, infection and the patient’s co-morbidities. Tumor type, type of approach, number of lesions, tumor localization, underlying hepatic disease, the physician’s experience, associated hepatic resection and lesion size have been described as factors significantly associated with complications. The physician in charge should promptly recognize high-risk patients more susceptible to complications, perform a close post procedure follow-up and manage them early and adequately if they occur. We aim to describe complications from RFA of hepatic tumors and their risk factors, as well as a few techniques to avoid them. This way, others can decrease their morbidity rates with better outcomes. PMID:24672640

  17. Tungsten oxide nanorods: an efficient nanoplatform for tumor CT imaging and photothermal therapy.

    PubMed

    Zhou, Zhiguo; Kong, Bin; Yu, Chao; Shi, Xiangyang; Wang, Mingwei; Liu, Wei; Sun, Yanan; Zhang, Yingjian; Yang, Hong; Yang, Shiping

    2014-01-13

    We report here a facile thermal decomposition approach to creating tungsten oxide nanorods (WO2.9 NRs) with a length of 13.1 ± 3.6 nm and a diameter of 4.4 ± 1.5 nm for tumor theranostic applications. The formed WO2.9 NRs were modified with methoxypoly(ethylene glycol) (PEG) carboxyl acid via ligand exchange to have good water dispersability and biocompatibility. With the high photothermal conversion efficiency irradiated by a 980 nm laser and the better X-ray attenuation property than clinically used computed tomography (CT) contrast agent Iohexol, the formed PEGylated WO2.9 NRs are able to inhibit the growth of the model cancer cells in vitro and the corresponding tumor model in vivo, and enable effective CT imaging of the tumor model in vivo. Our "killing two birds with one stone" strategy could be extended for fabricating other nanoplatforms for efficient tumor theranostic applications.

  18. CT-Guided Radiofrequency Ablation in Patients with Hepatic Metastases from Breast Cancer

    SciTech Connect

    Jakobs, Tobias F. Hoffmann, Ralf-Thorsten; Schrader, Angelika; Stemmler, Hans Joachim; Trumm, Christoph; Lubienski, Andreas; Murthy, Ravi; Helmberger, Thomas K.; Reiser, Maximilian F.

    2009-01-15

    The purpose of this study was to evaluate technical success, technique effectiveness, and survival following radiofrequency ablation for breast cancer liver metastases and to determine prognostic factors. Forty-three patients with 111 breast cancer liver metastases underwent CT-guided percutaneous radiofrequency (RF) ablation. Technical success and technique effectiveness was evaluated by performing serial CT scans. We assessed the prognostic value of hormone receptor status, overexpression of human epidermal growth factor receptor 2 (HER2), and presence of extrahepatic tumor spread. Survival rates were calculated using the Kaplan-Meier method. Technical success was achieved in 107 metastases (96%). Primary technique effectiveness was 96%. During follow-up local tumor progression was observed in 15 metastases, representing a secondary technique effectiveness of 86.5%. The overall time to progression to the liver was 10.5 months. The estimated overall median survival was 58.6 months. There was no significant difference in terms of survival probability with respect to hormone receptor status, HER2 overexpression, and presence of isolated bone metastases. Survival was significantly lower among patients with extrahepatic disease, with the exception of skeletal metastases. We conclude that CT-guided RF ablation of liver metastases from breast cancer can be performed with a high degree of technical success and technique effectiveness, providing promising survival rates in patients with no visceral extrahepatic disease. Solitary bone metastases did not negatively affect survival probability after RF ablation.

  19. 18 FDG-PET/CT: 21st century approach to leukemic tumors in 124 cases.

    PubMed

    Cunningham, Isabel; Kohno, Brigett

    2016-06-01

    Extramedullary tumors remain an obstacle to curing more acute leukemia patients. Their incidence is unknown because the presence of occult tumors that contribute to relapse is not routinely sought as in other cancers. No standard approach exists for treating tumors at most sites, apparent clinical response is typically followed by further tumors, and achievement of lengthy remission is uncommon. Body scanning with (18) FDG PET/CT now provides a means to identify the extent of occult tumors that enables directed tumor eradication and a way to evaluate tumor response. To evaluate its potential benefits, analysis was undertaken of 124 published cases scanned after apparent tumors were diagnosed. Clinical and radiologic exams underestimated extent of disease in over half of 100 cases. Among 70 cases that reported scans after various treatments, 70% achieved negative scans. Half relapsed subsequently but disease-free survivals up to 6 years were documented. These reported cases add to our knowledge of extramedullary leukemia in showing that further tumors are more likely than marrow relapse, clinical and radiologic evaluation of response is inadequate, intensive chemotherapy alone generally does not prevent progression and is associated with significant mortality, and tumor-directed plus systemic therapies appears the most effective approach, particularly to AML tumors. This analysis suggests this technology could increase our ability to eradicate all foci of leukemia, and identify tumors responsible for refractory, residual, and relapsed disease. PMID:26718745

  20. Hepatic resection or transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus

    PubMed Central

    Zheng, Ninggang; Wei, Xiaodong; Zhang, Dongzhi; Chai, Wenxiao; Che, Ming; Wang, Jiangye; Du, Binbin

    2016-01-01

    Abstract The role of hepatic resection in hepatocellular carcinoma (HCC) with accompanying portal vein tumor thrombus (PVTT) remains controversial. This study aimed to evaluate the surgical outcomes of hepatic resection compared with those of transarterial chemoembolization (TACE) in HCC patients. A retrospective study was conducted using the medical records of 230 HCC patients with portal vein invasion who underwent hepatic resection (96 patients) or TACE (134 patients). The baseline characteristics, tumor characteristics, clinicopathological parameters, and overall survival rates were compared between the 2 groups. The baseline and tumor characteristics were comparable between the hepatic resection and TACE groups. The overall complication rate was 35.4% in the hepatic resection group, which was significantly lower than that in the TACE group (73.0%, P <0.001). However, the serious complication rate (grade ≥3) in the hepatic resection group was 13.5%, which was significantly higher than that in the TACE group (P = 0.003). The cumulative overall survival rates at 1, 3, and 5 years in the hepatic resection group were 86.5%, 60.4%, and 33.3%, respectively. These rates were much higher than those in the TACE group (1-year: 77.6%; 3-year: 47.8%; and 5-year: 20.9%; P = 0.021). The long-term survival was notably better in the patients with types I and II PVTT than in the patients with types III and IV PVTT (P <0.05). The univariate and multivariate analyses indicated that types III and IV PVTT and TACE may have contributed to the poor overall survival following surgery. In HCC patients with PVTT and compensated liver function, hepatic resection is a safe and effective surgical protocol, particularly for patients with type I or II PVTT. PMID:27367992

  1. Automated lung tumor detection and quantification for respiratory gated PET/CT images

    NASA Astrophysics Data System (ADS)

    Wang, Jiali; del Valle, Misael; Franquiz, Juan; McGoron, Anthony

    2008-03-01

    Purpose: To develop and validate an automatic algorithm for the detection and functional assessment of lung tumors on three-dimensional respiratory gated PET/CT images. Method and Materials: First the algorithm will automatically segment lung regions in CT images, then identify and localize focal increases of activity in lung regions of PET images at each gated bin. Once the tumor voxels have been determined, an integration algorithm will include all the tumor counts collected at different bins within the respiratory cycle into one reference bin. Then the total activity (Bq), concentration (Bq/ml), functional volume (ml) and standard uptake values (SUV) are calculated for each tumor on PET images. Validation of the automatic algorithm was demonstrated by conducting experiments with the computerized 4D NCAT phantom and with a dynamic lung-chest phantom imaged using a GE PET/CT System at Baptist Hospital of Miami. Tumor variables to be controlled were: volume, total number of counts (activity), maximum and average number of counts. These values were the gold standard to which the results of the algorithm were compared. The tumor's motion was also controlled with different respiratory periods and amplitudes. Results: Validation, feasibility and robustness of the algorithm were demonstrated. With the algorithm, the best compromise between short PET scan time and reduced image noise can be achieved, while quantification and clinical analysis become faster and more precise.

  2. Primary hepatic signet ring cell neuroendocrine tumor: a case report with literature review.

    PubMed

    Zhu, Hongfa; Sun, Katherine; Ward, Stephen C; Schwartz, Myron; Thung, Swan N; Qin, Lihui

    2010-11-01

    Primary hepatic signet ring cell neuroendocrine tumor is extremely rare and is characterized by distinct intracytoplasmic hyaline vacuoles that are mucin negative and cytokeratin positive. The unique histological features may cause difficulty in diagnosis and delay patient care. Here the authors report a 49-year-old man with an incidental finding of a 2.7 cm liver mass in the absence of chronic liver disease. The resected tumor was grossly unencapsulated but well demarcated with friable tissue texture. Microscopically, the entire tumor consisted of sheets of monotonous cells separated by delicate microvasculature. The tumor cells had granular chromatin, inconspicuous nucleoli, and eosinophilic cytoplasm. Many of the tumor cells had eccentric, pale intracytoplasmic vacuoles resembling signet ring cells in adenocarcinoma. Immunohistochemical studies showed that the tumor cells were positive for neuroendocrine markers and that the intracytoplasmic vacuoles were negative for mucin but strongly positive for cytokeratins. Careful systemic search including OctreoScan scintigraphy (Mallinckrodt Medical, Inc., St. Louis, MO) and capsule endoscopy failed to reveal any other tumors. A diagnosis of primary hepatic signet ring cell neuroendocrine tumor was established. Ten months after surgery, the patient is well without any other detectable tumor on radiology. Serological neuroendocrine markers are also within normal limits.

  3. Intra- and extracranial solitary fibrous tumor of the trigeminal nerve: CT and MR imaging appearance.

    PubMed

    Motoori, K; Hanazawa, T; Yamakami, I; Sugimoto, A; Ito, H

    2010-02-01

    We describe a rare case of SFT existing along the mandibular division of the trigeminal nerve and extending down into the infratemporal fossa through the foramen ovale. The tumor showed heterogeneous hypointensity on T2-weighted images and marked enhancement on CT and MR images.

  4. CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

    PubMed Central

    Lin, ShaoChun; Li, XueHua; Feng, ShiTing; Peng, ZhenPeng; Huang, SiYun; Li, ZiPing

    2014-01-01

    Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement. PMID:25246826

  5. Contrast enhanced ultrasound in the evaluation and percutaneous treatment of hepatic and renal tumors.

    PubMed

    Meloni, Maria Franca; Smolock, Amanda; Cantisani, Vito; Bezzi, Mario; D'Ambrosio, Ferdinando; Proiti, Maria; Lee, Fred; Aiani, Luca; Calliada, Fabrizio; Ferraioli, Giovanna

    2015-09-01

    Image-guided percutaneous ablation techniques are increasingly being used for the treatment of malignant tumors of the liver and kidney. Contrast enhanced ultrasound (CEUS) is a real-time dynamic imaging technique that plays an important role in the pre-, intra-, and post-procedural management of these patients. This review will focus on the role of CEUS in the evaluation of patients undergoing treatment with percutaneous ablation for hepatic or renal tumors.

  6. Selective Internal Radiotherapy (SIRT) of Hepatic Tumors: How to Deal with the Cystic Artery

    SciTech Connect

    Theysohn, Jens M.; Mueller, Stefan; Schlaak, Joerg F.; Ertle, Judith; Schlosser, Thomas W.; Bockisch, Andreas; Lauenstein, Thomas C.

    2013-08-01

    PurposeSelective internal radiotherapy (SIRT) with the beta emitter yttrium-90 (Y90) is a rapidly developing therapy option for unresectable liver malignancies. Nontarget irradiation of the gallbladder is a complication of SIRT. Thus, we aimed to assess different strategies to avoid infusion of Y90 into the cystic artery (CA).MethodsAfter hepatic digital subtraction angiography and administration of technetium-99m-labeled human serum albumin ({sup 99}mTc-HSA), 295 patients with primary or secondary liver tumors underwent single-photon emission computed tomography/computed tomography (SPECT/CT). Different measures were taken before repeated Y90 mapping and SIRT to avoid unintended influx into the CA where necessary. Clinical symptoms, including pain, fever, or a positive Murphy sign, were assessed during patient follow-up.ResultsA significant {sup 99}mTc-HSA accumulation in the gallbladder wall (higher {sup 99}mTc-HSA uptake than in normal liver tissue) was seen in 20 patients. The following measures were taken to avoid unintended influx into the CA: temporary/permanent occlusion of the CA with gelfoam (n = 5)/microcoil (n = 1), induction of vasospasm with a microwire (n = 4), or altering catheter position (n = 10). Clinical signs of cholecystitis were observed in only one patient after temporary CA occlusion with gelfoam and were successfully treated by antibiotics. Cholecystectomy was not required for any patient.ConclusionIt is important to identify possible nontarget irradiation of the gallbladder. The risk for radiation-induced cholecystitis can be easily minimized by temporary or permanent CA embolization, vasospasm induction, or altering the catheter position.

  7. CT and MRI Findings in a Rare Case of Renal Primitive Neuroectodermal Tumor

    PubMed Central

    Akkaya, Zehra; Peker, Elif; Gulpinar, Basak; Karadag, Hale; Erden, Ayse

    2016-01-01

    Summary Background Primary renal primitive neuroectodermal tumor/extraskeletal Ewing’s sarcoma (PNET/EES) is a very rare renal tumor. Case Report We report a case of primary renal PNET/EES of the kidney in an adult patient and describe its computed tomography and magnetic resonance imaging findings, including diffusion weighted images along with a review of the current medical literature. Conclusions Although very rare, a relatively large renal mass which shows very infiltrative growth pattern on CT and MR imaging and striking diffusion restriction should raise the suspicion of a renal primitive neuroectodermal tumor, in a young adult. PMID:27635170

  8. Endolymphatic Sac Tumor Showing Increased Activity on 68Ga DOTATATE PET/CT.

    PubMed

    Papadakis, Georgios Z; Millo, Corina; Sadowski, Samira M; Bagci, Ulas; Patronas, Nicholas J

    2016-10-01

    Endolymphatic sac tumors (ELSTs) are rare tumors arising from the epithelium of the endolymphatic sac and duct that can be either sporadic or associated with von Hippel-Lindau (VHL) disease. We report a case of a VHL patient with histologically proven residual ELST who underwent Ga DOTATATE PET/CT showing increased activity (SUVmax, 6.29) by the ELST. The presented case of a VHL-associated ELST with increased Ga DOTATATE uptake indicates cell-surface expression of somatostatin receptors by this tumor, suggesting the potential application of somatostatin receptor imaging using Ga DOTA-conjugated peptides in the workup and management of these patients. PMID:27454593

  9. Lack of Correlation Between External Fiducial Positions and Internal Tumor Positions During Breath-Hold CT

    SciTech Connect

    Hunjan, Sandeep; Starkschall, George; Prado, Karl; Dong Lei; Balter, Peter

    2010-04-15

    Purpose: For thoracic tumors, if four-dimensional computed tomography (4DCT) is unavailable, the internal margin can be estimated by use of breath-hold (BH) CT scans acquired at end inspiration (EI) and end expiration (EE). By use of external surrogates for tumor position, BH accuracy is estimated by minimizing the difference between respiratory extrema BH and mean equivalent-phase free breathing (FB) positions. We tested the assumption that an external surrogate for BH accuracy correlates with internal tumor positional accuracy during BH CT. Methods and Materials: In 16 lung cancer patients, 4DCT images, as well as BH CT images at EI and EE, were acquired. Absolute differences between BH and mean equivalent-phase (FB) positions were calculated for both external fiducials and gross tumor volume (GTV) centroids as metrics of external and internal BH accuracy, respectively, and the results were correlated. Results: At EI, the absolute difference between mean FB and BH fiducial displacement correlated poorly with the absolute difference between FB and BH GTV centroid positions on CT images (R{sup 2} = 0.11). Similarly, at EE, the absolute difference between mean FB and BH fiducial displacements correlated poorly with the absolute difference between FB and BH GTV centroid positions on CT images (R{sup 2} = 0.18). Conclusions: External surrogates for tumor position are not an accurate metric of BH accuracy for lung cancer patients. This implies that care should be taken when using such an approach because an incorrect internal margin could be generated.

  10. CT-guided automated detection of lung tumors on PET images

    NASA Astrophysics Data System (ADS)

    Cui, Yunfeng; Zhao, Binsheng; Akhurst, Timothy J.; Yan, Jiayong; Schwartz, Lawrence H.

    2008-03-01

    The calculation of standardized uptake values (SUVs) in tumors on serial [ 18F]2-fluoro-2-deoxy-D-glucose ( 18F-FDG) positron emission tomography (PET) images is often used for the assessment of therapy response. We present a computerized method that automatically detects lung tumors on 18F-FDG PET/Computed Tomography (CT) images using both anatomic and metabolic information. First, on CT images, relevant organs, including lung, bone, liver and spleen, are automatically identified and segmented based on their locations and intensity distributions. Hot spots (SUV >= 1.5) on 18F-FDG PET images are then labeled using the connected component analysis. The resultant "hot objects" (geometrically connected hot spots in three dimensions) that fall into, reside at the edges or are in the vicinity of the lungs are considered as tumor candidates. To determine true lesions, further analyses are conducted, including reduction of tumor candidates by the masking out of hot objects within CT-determined normal organs, and analysis of candidate tumors' locations, intensity distributions and shapes on both CT and PET. The method was applied to 18F-FDG-PET/CT scans from 9 patients, on which 31 target lesions had been identified by a nuclear medicine radiologist during a Phase II lung cancer clinical trial. Out of 31 target lesions, 30 (97%) were detected by the computer method. However, sensitivity and specificity were not estimated because not all lesions had been marked up in the clinical trial. The method effectively excluded the hot spots caused by mediastinum, liver, spleen, skeletal muscle and bone metastasis.

  11. [Motion analysis of target in stereotactic radiotherapy of lung tumors using 320-row multidetector CT].

    PubMed

    Imae, Toshikazu; Haga, Akihiro; Nakagawa, Keiichi; Ino, Kenji; Tanaka, Kenichirou; Okano, Yukari; Sasaki, Katsutake; Saegusa, Shigeki; Shiraki, Takashi; Oritate, Takashi; Yano, Keiichi; Shinohara, Hiroyuki

    2011-01-01

    Multi-detector computed tomography (MDCT) has rapidly evolved and is increasingly used for treatment simulation of thoracic and abdominal radiotherapy. A 320-detector row CT scanner has recently become available that allows axial volumetric scanning of a 16-cm-long range in a patient without table movement. Current radiotherapy techniques require a generous margin around the presumed gross tumor volume (GTV) to account for uncertainties such as tumor motion and set up error. Motion analysis is useful to evaluate the internal margin of a moving target due to respiration and to improve therapeutic precision. The purpose of this study is to propose a method using phase-only correlation to automatically detect the target and to assess the motion of the target in numerical phantoms and patients. Free-breathing scans using 320-detector row CT were acquired for 4 patients with lung tumor(s). The proposed method was feasible for motion analysis of all numerical phantoms and patients. The results reproduced the facts that the motion of tumors in the patients varied in orbits during the respiratory cycle and exhibited hysteresis. The maximum distance between peak exhalation and inhalation increased as the tumors approached the diaphragm. The proposed method detected the three-dimensional position of the targets automatically and analyzed the trajectories. The tumor motion due to respiration differed by region and was greatest for the lower lobe. PMID:21471676

  12. Molecular imaging of brain tumors with 18F-DOPA PET and PET/CT.

    PubMed

    Calabria, Ferdinando; Chiaravalloti, Agostino; Di Pietro, Barbara; Grasso, Cristina; Schillaci, Orazio

    2012-06-01

    The objective of this study was to give an overview of the potential clinical utility of [18F]-L-dihydroxyphenylalanine (18F-DOPA) PET and PET/CT for imaging of brain tumors. Review articles and reference lists were used to supplement the search findings. 18F-DOPA has been investigated as a PET tracer for primary brain tumors, metastases of somatic cancer, and evaluation of relapse of pathology in patients with brain tumor after surgery and/or radiotherapy on the basis of enhanced cell proliferation. Available studies have provided encouraging preliminary results for diagnosis of brain tumors and relapse after surgery/radiotherapy. In the brain, excellent discrimination between tumor and normal tissue can be achieved because of the low physiological uptake of 18F-DOPA and the high ratio between tumor and normal hemispheric tissue. Information on evaluation of brain metastases is limited but encouraging. PET and PET/CT with 18F-DOPA are useful in diagnosing primary brain tumors and should be recommended in the diagnosis of relapse of disease after surgical treatment and/or radiotherapy. Semiquantitative analysis could improve diagnosis while correlative imaging with MRI is essential. Limits are due to low knowledge of potential pitfalls.

  13. Eosinophilic infiltration in the colon and liver mimicking primary colon cancer with hepatic metastases on (18)F-FDG PET/CT.

    PubMed

    Jo, Il; Won, Kyoung Sook; Choi, Byung Wook; Kim, Sung Hoon; Zeon, Seok Kil

    2013-06-01

    We describe the case of a 78-year-old man presenting with abdominal pain and a weight loss of 5 kg over 2 months. Colonoscopy and abdominal CT suggested colon cancer of hepatic flexure. F-FDG PET/CT scan showed moderate FDG uptake lesion at the hepatic flexure colon and multiple foci of FDG accumulation in the liver. These were considered as colon cancer with multiple hepatic metastases. However, the pathologic finding of colonoscopic biopsy and CT-guided liver biopsy showed only eosinophilic infiltration and no evidence of malignancy.

  14. Difficult diagnosis of a large cystic retroperitoneal tumor mimicking a hepatic origin.

    PubMed

    von Figura, G; Hartmann, D; Pauls, S; Barth, T F E; Adler, G; Henne-Bruns, D; Kulaksiz, H

    2010-11-01

    Schwannomas are rare tumors, usually benign, originating from the nerve sheath, and found only infrequently in the retroperitoneal space. We report on a 67-year-old woman who was initially misdiagnosed and treated for a liver hydatid cyst. After incomplete resection and recurrence of the tumor, we were able to diagnose a large retroperitoneal schwannoma that completely displaced the liver to the left abdomen. The patient underwent surgical resection of the schwannoma; pathological evaluation revealed a cystic tumor measuring 18.5 × 18 × 12.5 cm, with tumor cells staining strongly positive for S-100. Retroperitoneal schwannomas may mimic cystic hepatic tumors and should, therefore, be considered as a differential diagnosis in such cases. We describe the diagnostic modalities and difficulties in the approach of a cystic liver tumor.

  15. Nanosized multifunctional liposomes for tumor diagnosis and molecular imaging by SPECT/CT.

    PubMed

    Silindir, Mine; Erdoğan, Suna; Özer, A Yekta; Doğan, A Lale; Tuncel, Murat; Uğur, Ömer; Torchilin, Vladimir P

    2013-03-01

    Among currently used cancer imaging methods, nuclear medicine modalities provide metabolic information, whereas modalities in radiology provide anatomical information. However, different modalities, having different acquisition times in separate machines, decrease the specificity and accuracy of images. To solve this problem, hybrid imaging modalities were developed as a new era, especially in the cancer imaging field. With widespread usage of hybrid imaging modalities, specific contrast agents are essentially needed to use in both modalities, such as single-photon emission computed tomography/computed tomography (SPECT/CT). Liposomes are one of the most desirable drug delivery systems, depending on their suitable properties. The aim of this study was to develop a liposomal contrast agent for the diagnosis and molecular imaging of tumor by SPECT/CT. Liposomes were prepared nanosized, coated with polyethylene glycol to obtain long blood circulation, and modified with monoclonal antibody 2C5 for specific tumor targeting. Although DTPA-PE and DTPA-PLL-NGPE (polychelating amphilic polymers; PAPs) were loaded onto liposomes for stable radiolabeling for SPECT imaging, iopromide was encapsulated into liposomes for CT imaging. Liposomes [(DPPC:PEG(2000)-PE:Chol:DTPA-PE), (PL 90G:PEG(2000)-PE:Chol:DTPA-PE), (DPPC:PEG(2000)-PE:Chol:PAPs), (PL 90G:PEG(2000)-PE:Chol:PAPs), (60:0.9:39:0.1% mol ratio)] were characterized in terms of entrapment efficiency, particle size, physical stability, and release kinetics. Additionally, in vitro cell-binding studies were carried out on two tumor cell lines (MCF-7 and EL 4) by counting radioactivity. Tumor-specific antibody-modified liposomes were found to be effective multimodal contrast agents by designating almost 3-8 fold more uptake than nonmodified ones in different tumor cell lines. These results could be considered as an important step in the development of tumor-targeted SPECT/CT contrast agents for cancer imaging. PMID:23078019

  16. Hepatitis

    MedlinePlus

    ... Got Homework? Here's Help White House Lunch Recipes Hepatitis KidsHealth > For Kids > Hepatitis Print A A A ... an important digestive liquid called bile . What Is Hepatitis? Hepatitis is an inflammation (say: in-fluh-MAY- ...

  17. A prospective trial comparing FDG-PET/CT and CT to assess tumor response to cetuximab in patients with incurable squamous cell carcinoma of the head and neck

    PubMed Central

    Adkins, Douglas; Ley, Jessica; Dehdashti, Farrokh; Siegel, Marilyn J; Wildes, Tanya M; Michel, Loren; Trinkaus, Kathryn; Siegel, Barry A

    2014-01-01

    Computed tomography (CT), the standard method to assess tumor response to cetuximab in incurable squamous cell carcinoma of the head and neck (SCCHN), performs poorly as judged by the disparity between high disease control rate (46%) and short time to progression (TTP) (70 days). F-18 fluorodeoxyglucose positron emission tomography (FDG-PET)/CT is an alternative method to assess tumor response. The primary objective of this prospective trial was to evaluate the metabolic response of target lesions, assessed as the change in maximum standardized uptake value (SUVmax) on FDG-PET/CT before and after 8 weeks (cycle 1) of cetuximab. Secondary objectives were to compare tumor response by CT (RECIST 1.0) and FDG-PET/CT (EORTC criteria) following cycle 1, and determine TTP with continued cetuximab administration in patients with disease control by CT after cycle 1 but stratified for disease control or progression by FDG-PET/CT. Among 27 patients, the mean percent change of SUVmax of target lesions after cycle 1 was −21% (range: +72% to −81%); by FDG-PET/CT, partial response (PR)/stable disease (SD) occurred in 15 patients (56%) and progression in 12 (44%), whereas by CT, PR/SD occurred in 20 (74%) and progression in 7 (26%). FDG-PET/CT and CT assessments were discordant in 14 patients (P = 0.0029) and had low agreement (κ = 0.30; 95% confidence interval [CI]: 0.12, 0.48). With disease control by CT after cycle 1, median TTP was 166 days (CI: 86, 217) if the FDG-PET/CT showed disease control and 105 days (CI: 66, 159) if the FDG-PET/CT showed progression (P < 0.0001). Median TTP of the seven patients whose post cycle 1 CT showed progression compared to the 12 whose FDG-PET/CT showed progression were similar (53 [CI: 49, 56] vs. 61 [CI: 50, 105] days, respectively). FDG-PET/CT may be better than CT in assessing benefit of cetuximab in incurable SCCHN. PMID:25081631

  18. Retroperitoneal Bronchogenic Cyst Presenting Paraadrenal Tumor Incidentally Detected by (18)F-FDG PET/CT.

    PubMed

    Yoon, Ye Ri; Choi, Jiyoun; Lee, Sang Mi; Kim, Yeo Joo; Cho, Hyun Deuk; Lee, Jeong Won; Jeon, Youn Soo

    2015-03-01

    A follow-up (18)F-fluorodeoxyglucose ((18)F-FDG) PET/CT scan of a 57-year-old asymptomatic male who had undergone total thyroidectomy for thyroid cancer revealed a 5.0 × 4.0-cm, well-defined, ovoid-shaped mass around the left adrenal gland without definite FDG uptake. On the adrenal CT scan, the left paraadrenal tumor showed high attenuation on the precontrast scan without enhancement. The average Hounsfield unit (HU) was 58.1 on the precontrast scan and 58.4 on the postcontrast scan. The patient underwent laparoscopic adrenalectomy for resection of the left paraadrenal tumor. The final histopathologic examination revealed a bronchogenic cyst. Although retroperitoneal bronchogenic cysts are rare, they should be considered in the differential diagnosis of retroperitoneal cystic tumors. The preoperative diagnosis is difficult, but a contrast-enhanced CT scan or (18)F-FDG PET/CT scan may be useful for differentiating hyperattenuated cysts from other soft tissue masses.

  19. Marker-free lung tumor trajectory estimation from a cone beam CT sinogram

    NASA Astrophysics Data System (ADS)

    Hugo, Geoffrey D.; Liang, Jian; Yan, Di

    2010-05-01

    An algorithm was developed to estimate the 3D lung tumor position using the projection data forming a cone beam CT sinogram and a template registration method. A pre-existing respiration-correlated CT image was used to generate templates of the target, which were then registered to the individual cone beam CT projections, and estimates of the target position were made for each projection. The registration search region was constrained based on knowledge of the mean tumor position during the cone beam CT scan acquisition. Several template registration algorithms were compared, including correlation coefficient and robust methods such as block correlation, robust correlation coefficient and robust gradient correlation. Robust registration metrics were found to be less sensitive to occlusions such as overlying tissue and the treatment couch. The mean accuracy of the position estimation was 1.4 mm in phantom with a robust registration algorithm. In two research subjects with peripheral tumors, the mean position and mean target excursion were estimated to within 2.0 mm compared to the results obtained with a '4D' registration of 4D image volumes.

  20. Correlation between tumor size and blood volume in lung tumors: a prospective study on dual-energy gemstone spectral CT imaging.

    PubMed

    Aoki, Masahiko; Takai, Yoshihiro; Narita, Yuichiro; Hirose, Katsumi; Sato, Mariko; Akimoto, Hiroyoshi; Kawaguchi, Hideo; Hatayama, Yoshiomi; Miura, Hiroyuki; Ono, Shuichi

    2014-09-01

    The purpose of this study was to investigate the relationship between tumor size and blood volume for patients with lung tumors, using dual-energy computed tomography (DECT) and a gemstone spectral imaging (GSI) viewer. During the period from March 2011 to March 2013, 50 patients with 57 medically inoperable lung tumors underwent DECT before stereotactic body radiotherapy (SBRT) of 50-60 Gy in 5-6 fractions. DECT was taken for pretreatment evaluation. The region-of-interest for a given spatial placement of the tumors was set, and averages for CT value, water density and iodine density were compared with tumor size. The average values for iodine density in tumors of ≤ 2 cm, 2-3 cm, and >3 cm maximum diameter were 24.7, 19.6 and 16.0 (100 µg/cm(3)), respectively. The average value of the iodine density was significantly lower in larger tumors. No significant correlation was detected between tumor size and average CT value or between tumor size and average water density. Both the average water density and the average CT value were affected by the amount of air in the tumor, but the average iodine density was not affected by air in the tumor. The average water density and the average CT value were significantly correlated, but the average iodine density and the average CT value showed no significant correlation. The blood volume of tumors can be indicated by the average iodine density more accurately than it can by the average CT value. The average iodine density as assessed by DECT might be a non-invasive and quantitative assessment of the radio-resistance ascribable to the hypoxic cell population in a tumor.

  1. In vivo assessment of intratumoral aspirin injection to treat hepatic tumors

    PubMed Central

    Saad-Hossne, Rogério; Teixeira, Fábio Vieira; Denadai, Rafael

    2013-01-01

    AIM: To study the antineoplastic efficacy of 10% aspirin intralesional injection on VX2 hepatic tumors in a rabbit model. METHODS: Thirty-two male rabbits (age: 6-9 wk; body weight: 1700-2500 g) were inoculated with VX2 hepatic tumor cells (104 cells/rabbit) via supra-umbilical median laparotomy. On day 4 post-implantation, when the tumors were about 1 cm in diameter, the rabbits were randomly divided into the following groups (n = 8 each group) to assess early (24 h) and late (7 d) antineoplastic effects of intratumoral injection of 10% bicarbonate aspirin solution (experimental groups) in comparison to intratumoral injection of physiological saline solution (control groups): group 1, 24 h control; group 2, 24 h experimental; group 3, 7 d control; group 4, 7 d experimental. The serum biochemistry profile (measurements of glycemia, alkaline phosphatase, gamma-glutamyl transferase, aspartate aminotransferase, and alanine aminotransferase) and body weight measurements were obtained for all animals at the following time points: D0, before tumor implant; D4, day of treatment; D5, day of sacrifice for groups 1 and 2; D11, day of sacrifice for groups 3 and 4. Gross assessments of the abdominal and thoracic cavities were carried out upon sacrifice. The resected liver tissues, including hepatic tumors, were qualitatively (general morphology, signs of necrosis) and quantitatively (tumor area) assessed by histopathological analysis. RESULTS: Gross examination showed no alterations, besides the left hepatic lobe tumors, had occurred in the thoracic and abdominal cavities of any animal at any time point evaluated. However, the features of the tumor foci were distinctive between the groups. Compared to the control groups, which showed normal unabated tumor progression, the aspirin-treated groups showed imprecise but limited tumor boundaries and a general red-white coloration (indicating hemorrhaging) at 24 h post-treatment, and development of yellow-white areas of a cicatricial

  2. Comparison of DCE-CT models for quantitative evaluation of Ktrans in larynx tumors

    NASA Astrophysics Data System (ADS)

    Oosterbroek, J.; Bennink, E.; Philippens, M. E. P.; Raaijmakers, C. P. J.; Viergever, M. A.; de Jong, H. W. A. M.

    2015-05-01

    Dynamic contrast enhanced CT (DCE-CT) can be used to estimate blood perfusion and vessel permeability in tumors. Tumor induced angiogenesis is generally associated with disorganized microvasculature with increased permeability or leakage. Estimated vascular leakage (Ktrans) values and their reliability greatly depend on the perfusion model used. To identify the preferred model for larynx tumor analysis, several perfusion models frequently used for estimating permeability were compared in this study. DCE-CT scans were acquired for 16 larynx cancer patients. Larynx tumors were delineated based on whole-mount histopathology after laryngectomy. DCE-CT data within these delineated volumes were analyzed using the Patlak and Logan plots, the Extended Tofts Model (ETM), the Adiabatic Approximation to the Tissue Homogeneity model (AATH) and a variant of AATH with fixed transit time (AATHFT). Akaike’s Information Criterion (AIC) was used to identify the best fitting model. Ktrans values from all models were compared with this best fitting model. Correlation strength was tested with two-tailed Spearman’s rank correlation and further examined using Bland-Altman plots. AATHFT was found to be the best fitting model. The overall median of individual patient medians Ktrans estimates were 14.3, 15.1, 16.1, 2.6 and 22.5 mL/100 g min  -  1 for AATH, AATHFT, ETM, Patlak and Logan, respectively. Ktrans estimates for all models except Patlak were strongly correlated (P  <  0.001). Bland-Altman plots show large biases but no significant deviating trend for any model other than Patlak. AATHFT was found to be the preferred model among those tested for estimation of Ktrans in larynx tumors.

  3. CT and angiography of primary extradural juxtasellar tumors

    SciTech Connect

    Moore, T.; Ganti, S.R.; Mawad, M.E.; Hilal, S.K.

    1985-09-01

    The computed tomographic and angiographic features of 15 histologically proven primary extradural juxtasellar tumors were retrospectively reviewed. Five chordomas were characterized by prominent bone erosion and a significant posterior fossa component. Four trigeminal nerve neuromas each demonstrated bone erosion centered about Meckel's cave and moderate to marked contrast enhancement. Two cavernous sinus meningiomas revealed moderate contrast enhancement, expansion of the cavernous sinus, and moderate angiographic stain. Two cavernous hemangiomas of the cavernous sinus were intensely enhancing and demonstrated angiographic stain. Opacification of the sphenoid sinus with prominent bone destruction and lack of contrast enhancement was characteristic of a sphenoid sinus mucocele. The dural reflection could be directly visualized or indirectly inferred in each case.

  4. Tumor Uptake of Hollow Gold Nanospheres after Intravenous and Intra-arterial Injection: PET/CT Study in a Rabbit VX2 Liver Cancer Model

    PubMed Central

    Tian, Mei; Lu, Wei; Zhang, Rui; Xiong, Chiyi; Ensor, Joe; Nazario, Javier; Jackson, James; Shaw, Colette; Dixon, Katherine A.; Miller, Jennifer; Wright, Kenneth; Li, Chun; Gupta, Sanjay

    2014-01-01

    Purpose This study was designed to investigate the intratumoral uptake of hollow gold nanospheres (HAuNS) after hepatic intra-arterial (IA) and intravenous (IV) injection in a liver tumor model. Materials and Methods Fifteen VX2 tumor-bearing rabbits were randomized into five groups (N=3 in each group) that received either IV 64Cu-labeled PEG-HAuNS (IV-PEG-HAuNS), IA 64Cu-labeled PEG-HAuNS (IA-PEG-HAuNS), IV cyclic peptide (RGD)-conjugated 64Cu-labeled PEG-HAuNS (IV-RGD-PEG-HAuNS), IA RGD-conjugated 64Cu-labeled PEG-HAuNS (IA-RGD-PEG-HAuNS), or IA 64Cu-labeled PEG-HAuNS with lipiodol (IA-PEG-HAuNS-lipiodol). The animals underwent PET/CT 1 hour after injection, and uptake expressed as percentage of injected dose per gram of tissue (%ID/g) was measured in tumor and major organs. The animals were euthanized 24 hours after injection, and tissues were evaluated for radioactivity. Results At 1 hour after injection, animals in the IA-PEG-HAuNS-lipiodol group showed significantly higher tumor uptake (P < 0.001) and higher ratios of tumor-to-normal liver uptake (P < 0.001) than those in all other groups. The biodistribution of radioactivity 24 hours after injection showed that IA delivery of PEG-HAuNS with lipiodol resulted in the highest tumor uptake (0.33 %ID/g; P < 0.001) and tumor-to-normal liver ratio (P < 0.001) among all delivery methods. At 24 hours, the IA-RGD-PEG-HAuNS group showed higher tumor uptake than the IA-PEG-HAuNS group (0.20 %ID/g vs. 0.099 %ID/g; P < 0.001). Conclusion Adding iodized oil to IA-PEG-HAuNS maximizes nanoparticle delivery to hepatic tumors and therefore may be useful in targeted chemotherapy and photoablative therapy. PET/CT can be used to noninvasively monitor the biodistribution of radiolabeled HAuNS after IV or IA injection. PMID:23608932

  5. Hepatic cavernous hemangioma: diagnosis with /sup 99m/Tc-labeled red cells and single-photon emission CT

    SciTech Connect

    Brodsky, R.I.; Friedman, A.C.; Maurer, A.H.; Radecki, P.D.; Caroline, D.F.

    1987-01-01

    During the performance of high-resolution real-time abdominal sonography, small echogenic hepatic masses are frequently discovered. A second imaging test to confirm the suspected diagnosis of hemangioma is often required. Planar labeled red-cell imaging will often not detect hemangiomas smaller than 3 cm. We studied 14 patients with labeled red-cell scintigraphy and single-photon emission CT (SPECT). Six hemangiomas were diagnosed by SPECT that would have been missed by planar imaging alone. All six were smaller than 2.5 cm. With the addition of SPECT, labeled red-cell scintigraphy has specificity and sensitivity that make it at least as reliable as dynamic CT for the noninvasive diagnosis of hepatic cavernous hemangioma.

  6. Hepatic solitary fibrous tumor: report of a rare case.

    PubMed

    Patra, Sushma; Vij, Mukul; Venugopal, K; Rela, Mohamed

    2012-01-01

    Solitary fibrous tumor (SFT) of the liver is an extremely rare neoplasm of mesenchymal origin. In the English literature, less than 40 cases of SFTs of the liver have been reported. The present case concerns a 34-year-old female who presented to us with complaint of dyspepsia. On examination, there was hepatomegaly. On ultrasound examination, an SOL in the liver was detected. Large tumor measuring 14.5 × 10 × 8 cm was resected. Microscopic evaluation of the tumor showed a well-circumscribed, low to moderately cellular tumor demonstrating spindle- and fibroblast-like cells within the collagenous stroma. Immunohistochemistry revealed diffuse strong cytoplasmic immunopositivity of CD34, Bcl2, and vimentin. A diagnosis of a benign SFT was given. The patient remained well 4 years after surgery. SFT is a rare mesenchymal neoplasm that occasionally involves the liver in adult patients. Most SFTs are benign, but some may have malignant histological features. With less than 40 reported cases in the literature, little can be said regarding its natural history or the benefits of adjuvant radio chemotherapy. Complete surgical resection remains the cornerstone of its treatment.

  7. Anorectal giant condyloma acuminatum (Buschke-Loewenstein tumor): CT and radiographic manifestations

    SciTech Connect

    Balthazar, E.J.; Streiter, M.; Megibow, A.J.

    1984-03-01

    Giant condyloma acuminatum (Buschke-Loewenstein tumor) is an unusual variety of venereal wart characterized by a large size, cauliflower-like appearance, and locally invasive nature. CT examination of two patients with anorectal giant condylomata revealed the papillomatous and invasive nature of the lesion and the extent of tumor; there was infiltration of the subcutaneous tissue, perirectal fascial planes, and luminal narrowing with marked thickening of the rectal wall. The pathologic specimens showed benign histologic finding in one case and a mixed pattern with areas of malignant degeneration in the other. CT accurately demonstrated the exact location and extent of the lesions. The presence of malignant degeneration in this inherently invasive lesion can be established only on histologic examination.

  8. Head CT scan

    MedlinePlus

    Brain CT; Cranial CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial; CAT scan - brain ... conditions: Birth (congenital) defect of the head or brain Brain infection Brain tumor Buildup of fluid inside ...

  9. Texture Analysis of Preoperative CT Images for Prediction of Postoperative Hepatic Insufficiency: A Preliminary Study

    PubMed Central

    Simpson, Amber L; Adams, Lauryn B; Allen, Peter J; D’Angelica, Michael I; DeMatteo, Ronald P; Fong, Yuman; Kingham, T Peter; Leung, Universe; Miga, Michael I; Parada, E Patricia; Jarnagin, William R; Do, Richard K G

    2015-01-01

    Background Texture analysis is a promising method of analyzing imaging data to potentially enhance diagnostic capability. This approach involves automated measurement of pixel intensity variation that may offer further insight into disease progression than standard imaging techniques alone. We postulate that postoperative liver insufficiency, a major source of morbidity and mortality, correlates with preoperative heterogeneous parenchymal enhancement that can be quantified with texture analysis of cross-sectional imaging. Study Design A retrospective case-matched study (waiver of informed consent and HIPAA authorization, approved by the institutional review board) was performed comparing patients who underwent major hepatic resection and developed liver insufficiency (n=12) to a matched group of patients with no postoperative liver insufficiency (n=24) by procedure, remnant volume, and year of procedure. Texture analysis (with gray-level co-occurrence matrices) was used to quantify the heterogeneity of liver parenchyma on preoperative computed tomography (CT) scans. Statistical significance was evaluated using Wilcoxon’s signed rank and Pearson’s chi-squared tests. Results No statistically significant differences were found between study groups for preoperative patient demographics and clinical characteristics, with the exception of gender (p<0.05). Two texture features differed significantly between the groups: correlation (linear dependency of gray levels on neighboring pixels) and entropy (randomness of brightness variation) (p<0.05). Conclusions In this preliminary study, the texture of liver parenchyma on preoperative CT, was significantly more varied, less symmetric, and less homogeneous in patients with postoperative liver insufficiency; thus texture analysis has the potential to provide an additional means of preoperative risk stratification. PMID:25537305

  10. CT and MR imaging of the adrenal glands in cortisol-secreting tumors.

    PubMed

    Lumachi, Franco; Marchesi, Paolo; Miotto, Diego; Motta, Raffaella

    2011-09-01

    Cushing's syndrome (CS), first described by the neurosurgeon Harvey Cushing in the 1930s, is the result of chronic glucocorticoid excess. In patients with adreno-corticotropic hormone (ACTH)-dependent CS, bilateral hyperplasia of the adrenal cortex occurs, while in those with ACTH-independent primary CS, either adrenocortical tumors or primary adrenal hyperplasia can be observed. Cortisol-secreting adrenocortical tumors are more frequently adenomas, while adrenal carcinoma accounts for only 5% of cases. Unfortunately, no reliable endocrinological tests are available and no specific tumor markers exist to differentiate between benign and malignant adrenal tumors, so both computed tomography (CT) and magnetic resonance (MR) imaging studies are currently required to localize and define adrenal lesions. Additional information to conventional imaging can be obtained using ¹⁸F-fluoro-2-deoxyglucose (FDG)-positron emission tomography (PET)/CT, while percutaneous image-guided fine-needle aspiration cytology (FNAC) in some cases has shown a high accuracy in detecting malignancy and in confirming adrenal metastases. New PET tracers with selective affinity for the adrenal tissue are still under evaluation. Multidetector CT scan, with the combination of unenhanced and dynamic scans, represents the single most accurate modality for the detection and the characterization of adrenal adenomas. In these lesions, chemical-shift MR imaging produces a typical loss of signal intensity on out-of-phase breath-hold gradient-echo images in lipid-rich adenomas. For these lesions there is no difference between CT and MR imaging, while MR chemical shift imaging is very helpful in identifying the additional small group of adenomas where intracellular lipid content is minimal. PMID:21868539

  11. Assessment of tumor motion reproducibility with audio-visual coaching through successive 4D CT sessions.

    PubMed

    Goossens, Samuel; Senny, Frédéric; Lee, John A; Janssens, Guillaume; Geets, Xavier

    2014-01-04

    This study aimed to compare combined audio-visual coaching with audio coaching alone and assess their respective impact on the reproducibility of external breathing motion and, one step further, on the internal lung tumor motion itself, through successive sessions. Thirteen patients with NSCLC were enrolled in this study. The tumor motion was assessed by three to four successive 4D CT sessions, while the breathing signal was measured from magnetic sensors positioned on the epigastric region. For all sessions, the breathing was regularized with either audio coaching alone (AC, n = 5) or combined with a real-time visual feedback (A/VC, n = 8) when tolerated by the patients. Peak-to-peak amplitude, period and signal shape of both breathing and tumor motions were first measured. Then, the correlation between the respiratory signal and internal tumor motion over time was evaluated, as well as the residual tumor motion for a gated strategy. Although breathing and tumor motions were comparable between AC and AV/C groups, A/VC approach achieved better reproducibility through sessions than AC alone (mean tumor motion of 7.2 mm ± 1 vs. 8.6 mm ± 1.8 mm, and mean breathing motion of 14.9 mm ± 1.2 mm vs. 13.3mm ± 3.7 mm, respectively). High internal/external correlation reproducibility was achieved in the superior-inferior tumor motion direction for all patients. For the anterior posterior tumor motion direction, better correlation reproducibility has been observed when visual feedback has been used. For a displacement-based gating approach, A/VC might also be recommended, since it led to smaller residual tumor motion within clinically relevant duty cycles. This study suggests that combining real-time visual feedback with audio coaching might improve the reproducibility of key characteristics of the breathing pattern, and might thus be considered in the implementation of lung tumor radiotherapy.

  12. Carbon nanotube based respiratory gated micro-CT imaging of a murine model of lung tumors with optical imaging correlation

    NASA Astrophysics Data System (ADS)

    Burk, Laurel M.; Lee, Yueh Z.; Heathcote, Samuel; Wang, Ko-han; Kim, William Y.; Lu, Jianping; Zhou, Otto

    2011-03-01

    Current optical imaging techniques can successfully measure tumor load in murine models of lung carcinoma but lack structural detail. We demonstrate that respiratory gated micro-CT imaging of such models gives information about structure and correlates with tumor load measurements by optical methods. Four mice with multifocal, Kras-induced tumors expressing firefly luciferase were imaged against four controls using both optical imaging and respiratory gated micro-CT. CT images of anesthetized animals were acquired with a custom CNT-based system using 30 ms x-ray pulses during peak inspiration; respiration motion was tracked with a pressure sensor beneath each animal's abdomen. Optical imaging based on the Luc+ signal correlating with tumor load was performed on a Xenogen IVIS Kinetix. Micro-CT images were post-processed using Osirix, measuring lung volume with region growing. Diameters of the largest three tumors were measured. Relationships between tumor size, lung volumes, and optical signal were compared. CT images and optical signals were obtained for all animals at two time points. In all lobes of the Kras+ mice in all images, tumors were visible; the smallest to be readily identified measured approximately 300 microns diameter. CT-derived tumor volumes and optical signals related linearly, with r=0.94 for all animals. When derived for only tumor bearing animals, r=0.3. The trend of each individual animal's optical signal tracked correctly based on the CT volumes. Interestingly, lung volumes also correlated positively with optical imaging data and tumor volume burden, suggesting active remodeling.

  13. SU-E-I-58: Detecting Tumors with Extremely Low Contrast in CT Images

    SciTech Connect

    Sheng, K; Gou, S; Kupelian, P; Steiberg, M; Low, D

    2014-06-01

    Purpose: Tumors such as the prostate focal lesions and the brain metastases have extremely low CT contrast and MRI is usually used for target delineation. The target contours are propagated to the CT for treatment planning and patient positioning. We have employed an advanced denoising method eliminating the noise and allow magnification of subtle contrast of these focal lesions on CT. Methods: Five prostate and two brain metastasis patients with MRI T2, diffusion or dynamic contrast enhanced (DCE) images confirmed focal lesions were included. One brain patients had 5 metastases. A block matching 3D (BM3D) algorithm was adapted to reduce the noise of kVCT images used for treatment planning. The gray-level range of the resultant images was narrowed to magnify the tumor-normal tissue contrast. Results: For the prostate patients, denoised kVCT images showed focal regions at 5, 8,11-1, 2, and 8–10 oclock for the 5 patients, this is highly consistent to the radiologist confirmed focal lesions based on MRI at 5, 7, 11-1, 2 and 8–10 oclock in the axial plane. These CT focal regions matched well with the MRI focal lesions in the cranio-caudal position. The average increase in density compared to background prostate glands was 0.86%, which corresponds to ∼50% increase in cellularity and is lower than the average CT noise level of 2.4%. For the brain patients, denoised kVCT showed 5/6 metastases. The high CT-density region of a metastasis is 2-mm off from its corresponding elevated MRI perfusion center. Overall the detecting sensitivity was 91%. Conclusion: It has been preliminarily demonstrated that the higher tumor cellularity can be detected using kVCT. The low contrast-to-noise information requires advanced denoising to reveal. The finding is significant to radiotherapy by providing an additional tool to locate focal lesions for confirming MRI-CT registration and providing a highly accessible outcome assessment tool.

  14. Is There a Role for PET/CT Parameters to Characterize Benign, Malignant, and Metastatic Parotid Tumors?

    PubMed Central

    Kendi, Ayse Tuba Karagulle; Magliocca, Kelly R.; Corey, Amanda; Galt, James R.; Switchenko, Jeffrey; Wadsworth, J. Trad; El-Deiry, Mark W.; Schuster, David M.; Saba, Nabil F.; Hudgins, Patricia A.

    2016-01-01

    OBJECTIVE Assessment of benign and malignant lesions of the parotid gland, including metastatic lesions, is challenging with current imaging methods. Fluorine-18 FDG PET/CT is a noninvasive imaging modality that provides both anatomic and metabolic information. Semiquantitative data obtained from PET/CT, also known as PET/CT parameters, are maximum, mean, or peak standardized uptake values (SUVs); metabolic tumor volume; total lesion glycolysis; standardized added metabolic activity; and normalized standardized added metabolic activity. Our aim was to determine whether FDG PET/CT parameters can differentiate benign, malignant, and metastatic parotid tumors. MATERIALS AND METHODS Thirty-four patients with parotid neoplasms underwent PET/CT before parotidectomy; maximum SUV, mean SUV, peak SUV, total lesion glycolysis, metabolic tumor volume, standardized added metabolic activity, and normalized standardized added metabolic activity were calculated on a dedicated workstation. Univariate analyses were performed. A ROC analysis was used to determine the ability of PET/CT parameters to predict pathologically proven benign, malignant, and metastatic parotid gland neoplasms. RESULTS Fourteen patients had a benign or malignant primary parotid tumor. Twenty had metastases to the parotid gland. When the specificity was set to at least 85% for each parameter to identify cut points, the corresponding sensitivities ranged from 15% to 40%. Assessment of benign versus malignant lesions of parotid tumors, as well as metastasis from squamous cell carcinoma versus other metastatic causes, revealed that none of the PET/CT parameters has enough power to differentiate among these groups. CONCLUSION PET/CT parameters, including total lesion glycolysis, metabolic tumor volume, standardized added metabolic activity, and normalized standardized added metabolic activity, are not able to differentiate benign from malignant parotid tumors, primary parotid tumors from metastasis, or metastasis

  15. Tungsten Oxide Nanorods: An Efficient Nanoplatform for Tumor CT Imaging and Photothermal Therapy

    PubMed Central

    Zhou, Zhiguo; Kong, Bin; Yu, Chao; Shi, Xiangyang; Wang, Mingwei; Liu, Wei; Sun, Yanan; Zhang, Yingjian; Yang, Hong; Yang, Shiping

    2014-01-01

    We report here a facile thermal decomposition approach to creating tungsten oxide nanorods (WO2.9 NRs) with a length of 13.1 ± 3.6 nm and a diameter of 4.4 ± 1.5 nm for tumor theranostic applications. The formed WO2.9 NRs were modified with methoxypoly(ethylene glycol) (PEG) carboxyl acid via ligand exchange to have good water dispersability and biocompatibility. With the high photothermal conversion efficiency irradiated by a 980 nm laser and the better X-ray attenuation property than clinically used computed tomography (CT) contrast agent Iohexol, the formed PEGylated WO2.9 NRs are able to inhibit the growth of the model cancer cells in vitro and the corresponding tumor model in vivo, and enable effective CT imaging of the tumor model in vivo. Our “killing two birds with one stone” strategy could be extended for fabricating other nanoplatforms for efficient tumor theranostic applications. PMID:24413483

  16. Dynamic magnetic resonance monitoring of interstitial laser photocoagulation of hepatic metastases from a colorectal tumor

    NASA Astrophysics Data System (ADS)

    Roberts, Hugh R.; Paley, Martyn; Buonaccorsi, Giovanni A.; Clemence, Matthew; Friedman, Emma P.; Allen, Clare; Hall-Craggs, Margret A.; Lees, William R.; Bown, Stephen G.

    1994-12-01

    Interstitial laser photocoagulation (ILP) is becoming an established treatment for hepatic metastases. Per-procedural ultrasound does not accurately define the tissue coagulated and dynamic computed tomography, while an accurate form of assessment, must be delayed until 24 hours after therapy; it too is, therefore, no use for per-procedural confirmation of total tumor ablation. By virtue of its good contrast, spatial and temporal resolution and the fact that T1 weighted images are temperature sensitive magnetic resonance imaging (MRI) is, theoretically, applicable to the per-procedural guidance of ILP. Our ex vivo porcine, and in vivo rat liver experiments showed good imaging-pathological agreement. We have treated with ILP two patients suffering from hepatic metastases using MRI guidance. Four to eight 400 micrometers optical fibers were passed through the lesion down Teflon sheaths under local anaesthetic and intravenous sedation using ultrasound guidance. Sets of 400 second laser burns at 1.5 - 2.0 W per fiber were then performed, with a 1 cm fiber withdrawal between each set, until the entire tumor had been coagulated. Therapy was monitored with dynamic MRI using a T1 weighted FLASH sequence. MRI showed an enlarging bright rimmed low signal area which correlated with the region of devascularization seen on enhanced helical computed tomography at 24 hours. MRI can monitor ILP of hepatic metastases and confirm tumor ablation at the time of treatment.

  17. SU-E-QI-20: A Review of Advanced PET and CT Image Features for the Evaluation of Tumor Response

    SciTech Connect

    Lu, W

    2014-06-15

    Purpose: To review the literature in using quantitative PET and CT image features for the evaluation of tumor response. Methods: We reviewed and summarized more than fifty papers that use advanced, quantitative PET/CT image features for the evaluation of tumor response. We also discussed future works on extracting disease-specific features, combining multiple and complementary features in response modeling, delineating tumor in multimodality images, and exploring biological explanations of these advanced features. Results: Advanced PET image features considering spatial information, such as tumor volume, tumor shape, total glycolytic volume, histogram distance, and texture features (characterizing spatial distribution of FDG uptake) have been found more informative than the traditional SUVmax for the prediction of tumor response. Advanced CT features, including volumetric, attenuation, morphologic, structure, and texture descriptors, have also been found advantage over the traditional RECIST and WHO criteria in certain tumor types. Conclusions: Advanced, quantitative FDG PET/CT image features have been shown promising for the evaluation of tumor response. With the emerging multi-modality imaging performed at multiple time points for each patient, it becomes more important to analyze the serial images quantitatively, select and combine both complementary and contradictory information from various sources, for accurate and personalized evaluation of tumor response to therapy.

  18. Tumor Localization Using Cone-Beam CT Reduces Setup Margins in Conventionally Fractionated Radiotherapy for Lung Tumors

    SciTech Connect

    Yeung, Anamaria R.; Li, Jonathan G.; Shi Wenyin; Newlin, Heather E.; Chvetsov, Alexei; Liu, Chihray; Palta, Jatinder R.; Olivier, Kenneth

    2009-07-15

    Purpose: To determine whether setup margins can be reduced using cone-beam computed tomography (CBCT) to localize tumor in conventionally fractionated radiotherapy for lung tumors. Methods and Materials: A total of 22 lung cancer patients were treated with curative intent with conventionally fractionated radiotherapy using daily image guidance with CBCT. Of these, 13 lung cancer patients had sufficient CBCT scans for analysis (389 CBCT scans). The patients underwent treatment simulation in the BodyFix immobilization system using four-dimensional CT to account for respiratory motion. Daily alignment was first done according to skin tattoos, followed by CBCT. All 389 CBCT scans were retrospectively registered to the planning CT scans using automated soft-tissue and bony registration; the resulting couch shifts in three dimensions were recorded. Results: The daily alignment to skin tattoos with no image guidance resulted in systematic ({sigma}) and random ({sigma}) errors of 3.2-5.6 mm and 2.0-3.5 mm, respectively. The margin required to account for the setup error introduced by aligning to skin tattoos with no image guidance was approximately 1-1.6 cm. The difference in the couch shifts obtained from the bone and soft-tissue registration resulted in systematic ({sigma}) and random ({sigma}) errors of 1.5-4.1 mm and 1.8-5.3 mm, respectively. The margin required to account for the setup error introduced using bony anatomy as a surrogate for the target, instead of localizing the target itself, was 0.5-1.4 cm. Conclusion: Using daily CBCT soft-tissue registration to localize the tumor in conventionally fractionated radiotherapy reduced the required setup margin by up to approximately 1.5 cm compared with both no image guidance and image guidance using bony anatomy as a surrogate for the target.

  19. ⁶⁸Ga-DOTA-TOC-PET/CT detects heart metastases from ileal neuroendocrine tumors.

    PubMed

    Calissendorff, Jan; Sundin, Anders; Falhammar, Henrik

    2014-09-01

    Metastases from ileal neuroendocrine tumors (NETs) to the myocardium are rare and generally seen in patients with widespread metastatic NET disease. The objectives of this investigation were to describe the frequency of intracardiac metastases in ileal NET patients examined by (68)Ga-DOTA-TOC-PET/CT and to describe the cases in detail. All (68)Ga-DOTA-TOC-PET/CT examinations performed at the Karolinska University Hospital since 2010 until April 2012 were reviewed. In all, 128 out of 337 examinations were in patients with ileal NETs. Four patients had seven myocardiac metastases, yielding a frequency of 4.3 % in patients with ileal NETs. One patient had cardiac surgery while three were treated with somatostatin analogs. The cardiac metastases did not affect the patients' activity of daily life. (68)Ga-DOTA-TOC-PET/CT is an established imaging modality in identifying cardiac metastases in ileal NETs. Prospective studies are needed to confirm the true clinical value of (68)Ga-DOTA-TOC-PET/CT in detecting cardiac metastases in both ileal and non-ileal NETs.

  20. Topology polymorphism graph for lung tumor segmentation in PET-CT images

    NASA Astrophysics Data System (ADS)

    Cui, Hui; Wang, Xiuying; Zhou, Jianlong; Eberl, Stefan; Yin, Yong; Feng, Dagan; Fulham, Michael

    2015-06-01

    Accurate lung tumor segmentation is problematic when the tumor boundary or edge, which reflects the advancing edge of the tumor, is difficult to discern on chest CT or PET. We propose a ‘topo-poly’ graph model to improve identification of the tumor extent. Our model incorporates an intensity graph and a topology graph. The intensity graph provides the joint PET-CT foreground similarity to differentiate the tumor from surrounding tissues. The topology graph is defined on the basis of contour tree to reflect the inclusion and exclusion relationship of regions. By taking into account different topology relations, the edges in our model exhibit topological polymorphism. These polymorphic edges in turn affect the energy cost when crossing different topology regions under a random walk framework, and hence contribute to appropriate tumor delineation. We validated our method on 40 patients with non-small cell lung cancer where the tumors were manually delineated by a clinical expert. The studies were separated into an ‘isolated’ group (n = 20) where the lung tumor was located in the lung parenchyma and away from associated structures / tissues in the thorax and a ‘complex’ group (n = 20) where the tumor abutted / involved a variety of adjacent structures and had heterogeneous FDG uptake. The methods were validated using Dice’s similarity coefficient (DSC) to measure the spatial volume overlap and Hausdorff distance (HD) to compare shape similarity calculated as the maximum surface distance between the segmentation results and the manual delineations. Our method achieved an average DSC of 0.881  ±  0.046 and HD of 5.311  ±  3.022 mm for the isolated cases and DSC of 0.870  ±  0.038 and HD of 9.370  ±  3.169 mm for the complex cases. Student’s t-test showed that our model outperformed the other methods (p-values <0.05).

  1. Tumor necrosis factor alpha signaling in the development of experimental murine pre-hepatic portal hypertension

    PubMed Central

    Theodorakis, Nicholas G; Wang, Yining N; Wu, Jianmin; Maluccio, Mary A; Skill, Nicholas J

    2010-01-01

    The cytokine tumor necrosis factor alpha (TNFa) has previously been identified in the development of portal hypertension (PHT) by facilitating portal venous and systemic hyperemia. TNFa is reported to contribute to hyperemia via endothelial nitric oxide synthase (eNOS) induction and nitric oxide (NO) production. This study examines this hypothesis by utilizing TNFa receptor knockout mice and a murine model of pre-hepatic PHT. Plasma TNFa and NOx and tissue TNFa mRNA levels were determined in wild-type mice 0-7d post induction of pre-hepatic PHT by partial portal vein ligation (PVL). TNFa receptor knockout mice also received PVL or sham surgery and splenic pulp pressure, abdominal aortic flow and portal-systemic shunting were recorded 7d following. Portal pressure and systemic hyperemia developed rapidly following PVL. Plasma NOx was increased temporarily 2-3 days following PVL and returned to baseline by day 7. Circulating TNFa was below detectable limits of the ELISA used, as such no increase was observed. Hepatic and vascular TNFa mRNA levels were transiently changed after PVL otherwise there was no significant change. TNFa receptor targeted gene deletion did not ameliorate plasma NOx following PVL and had no effect on the development of PHT. TNFa receptor signaling plays no detectable role in the development of systemic hyperemia in the murine model of pre-hepatic PHT. Consequently, increased TNFa observed in intra-hepatic inflammatory models (CCl4) and in patients is probably related to inflammation associated with intra-hepatic pathology. Alternatively, TNFa may be signaling via a TNFa receptor independent mechanism. PMID:21383890

  2. Random Walk and Graph Cut for Co-Segmentation of Lung Tumor on PET-CT Images.

    PubMed

    Ju, Wei; Xiang, Dehui; Xiang, Deihui; Zhang, Bin; Wang, Lirong; Kopriva, Ivica; Chen, Xinjian

    2015-12-01

    Accurate lung tumor delineation plays an important role in radiotherapy treatment planning. Since the lung tumor has poor boundary in positron emission tomography (PET) images and low contrast in computed tomography (CT) images, segmentation of tumor in the PET and CT images is a challenging task. In this paper, we effectively integrate the two modalities by making fully use of the superior contrast of PET images and superior spatial resolution of CT images. Random walk and graph cut method is integrated to solve the segmentation problem, in which random walk is utilized as an initialization tool to provide object seeds for graph cut segmentation on the PET and CT images. The co-segmentation problem is formulated as an energy minimization problem which is solved by max-flow/min-cut method. A graph, including two sub-graphs and a special link, is constructed, in which one sub-graph is for the PET and another is for CT, and the special link encodes a context term which penalizes the difference of the tumor segmentation on the two modalities. To fully utilize the characteristics of PET and CT images, a novel energy representation is devised. For the PET, a downhill cost and a 3D derivative cost are proposed. For the CT, a shape penalty cost is integrated into the energy function which helps to constrain the tumor region during the segmentation. We validate our algorithm on a data set which consists of 18 PET-CT images. The experimental results indicate that the proposed method is superior to the graph cut method solely using the PET or CT is more accurate compared with the random walk method, random walk co-segmentation method, and non-improved graph cut method.

  3. ¹⁸F-FDG PET/CT and contrast enhanced CT in differential diagnosis between leiomyoma and gastrointestinal stromal tumor.

    PubMed

    Hirose, Yasumitus; Kaida, Hayato; Kawahara, Akihiko; Kurata, Seiji; Ishibashi, Masatoshi; Abe, Toshi

    2015-01-01

    In a 49 years old woman a large abdominal tumor was diagnosed by abdominal ultrasound. Dynamic contrast-enhanced computed tomography (CECT) showed a large tumor with minute calcification and poor contrast enhancement in the left abdominal cavity. The fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) scan showed low ¹⁸F-FDG uptake in the tumor. The SUV max (early image) was 1.90, and that of the delayed image was 2.86. A gastrointestinal stromal tumor (GIST) was suspected. Tumor resection revealed that it was a leiomyoma originating in the major curvature of the stomach. In conclusion, the findings of low ¹⁸F-FDG uptake on ¹⁸F-FDG PET and poor contrast enhancement on CECT in a gastric submucosal tumor suggested of a gastric leiomyoma rather than GIST. PMID:26574696

  4. Methodology for Registration of Shrinkage Tumors in Head-and-Neck CT Studies.

    PubMed

    Wang, Jianhua; Dai, Jianrong; Jing, Yongjie; Huo, Yanan; Niu, Tianye

    2015-01-01

    Tumor shrinkage occurs in many patients undergoing radiotherapy for head-and-neck (H&N) cancer. However, one-to-one correspondence is not always available between voxels of two image sets. This makes intensity-based deformable registration difficult and inaccurate. In this paper, we describe a novel method to increase the performance of the registration in presence of tumor shrinkage. The method combines an image modification procedure and a fast symmetric Demons algorithm to register CT images acquired at planning and posttreatment fractions. The image modification procedure modifies the image intensities of the primary tumor by calculating tumor cell survival rate using the linear quadratic (LQ) model according to the dose delivered to the tumor. A scale operation is used to deal with uncertainties in biological parameters. The method was tested in 10 patients with nasopharyngeal cancer (NPC). Registration accuracy was improved compared with that achieved using the symmetric Demons algorithm. The average Dice similarity coefficient (DSC) increased by 21%. This novel method is suitable for H&N adaptive radiation therapy. PMID:26089960

  5. Methodology for Registration of Shrinkage Tumors in Head-and-Neck CT Studies

    PubMed Central

    Wang, Jianhua; Dai, Jianrong; Jing, Yongjie; Huo, Yanan; Niu, Tianye

    2015-01-01

    Tumor shrinkage occurs in many patients undergoing radiotherapy for head-and-neck (H&N) cancer. However, one-to-one correspondence is not always available between voxels of two image sets. This makes intensity-based deformable registration difficult and inaccurate. In this paper, we describe a novel method to increase the performance of the registration in presence of tumor shrinkage. The method combines an image modification procedure and a fast symmetric Demons algorithm to register CT images acquired at planning and posttreatment fractions. The image modification procedure modifies the image intensities of the primary tumor by calculating tumor cell survival rate using the linear quadratic (LQ) model according to the dose delivered to the tumor. A scale operation is used to deal with uncertainties in biological parameters. The method was tested in 10 patients with nasopharyngeal cancer (NPC). Registration accuracy was improved compared with that achieved using the symmetric Demons algorithm. The average Dice similarity coefficient (DSC) increased by 21%. This novel method is suitable for H&N adaptive radiation therapy. PMID:26089960

  6. Effect of Salmonella treatment on an implanted tumor (CT26) in a mouse model.

    PubMed

    Yun, Misun; Pan, SangO; Jiang, Sheng-Nan; Nguyen, Vu Hong; Park, Seung-Hwan; Jung, Che-Hun; Kim, Hyung-Seok; Min, Jung-Joon; Choy, Hyon E; Hong, Yeongjin

    2012-06-01

    The use of bacteria has contributed to recent advances in targeted cancer therapy especially for its tumor-specific accumulation and proliferation. In this study, we investigated the molecular events following bacterial therapy using an attenuated Salmonella Typhimurium defective in ppGpp synthesis (ΔppGpp), by analyzing those proteins differentially expressed in tumor tissues from treated and untreated mice. CT26 murine colon cancer cells were implanted in BALB/c mice and allowed to form tumors. The tumor-bearing mice were treated with the attenuated Salmonella Typhimurium. Tumor tissues were analyzed by 2D-PAGE. Fourteen differentially expressed proteins were identified by mass spectrometry. The analysis revealed that cytoskeletal components, including vimentin, drebrin-like protein, and tropomyosin-alpha 3, were decreased while serum proteins related to heme or iron metabolism, including transferrin, hemopexin, and haptoglobin were increased. Subsequent studies revealed that the decrease in cytoskeletal components occurred at the transcriptional level and that the increase in heme and iron metabolism proteins occurred in liver. Most interestingly, the same pattern of increased expression of transferrin, hemopexin, and haptoglobin was observed following radiotherapy at the dosage of 14 Gy.

  7. Assessment of hepatic VX2 tumors with combined percutaneous transhepatic lymphosonography and contrast-enhanced ultrasonographic imaging

    PubMed Central

    Liu, Cun; Liang, Ping; Wang, Yang; Zhou, Pei; Li, Xin; Han, Zhi-Yu; Liu, Shao-Ping

    2008-01-01

    AIM: To evaluate the feasibility and efficacy of percutaneous transhepatic lymphosonography (PTL) as a novel method for the detection of tumor lymphangiogenesis in hepatic VX2 of rabbits and to evaluate combined PTL and routine contrast-enhanced ultrasonographic imaging for the diagnosis of liver cancer. METHODS: Ten rabbits with VX2 tumor were included in this study. SonoVue (0.1 mL/kg) was injected into each rabbit via an ear vein for contrast-enhanced ultrasonographic imaging, and 0.5 mL SonoVue was injected into the normal liver parenchyma near the VX2 tumor for PTL. Images and/or movie clips were stored for further analysis. RESULTS: Ultrasonographic imaging showed VX2 tumors ranging 5-19 mm in the liver of rabbits. The VX2 tumor was hyperechoic and hypoechoic to liver parenchyma at the early and later phase, respectively. The hepatic lymph vessels were visualized immediately after injection of contrast medium and continuously visualized with SonoVue® during PTL. The boundaries of VX2 tumors were hyperechoic to liver parenchyma and the tumors. There was a significant difference in the values for the boundaries of VX2 tumors after injection compared with the liver normal parenchyma and the tumor parenchyma during PTL. CONCLUSION: PTL is a novel method for the detection of tumor lymphangiogenesis in hepatic VX2 of rabbits. Combined PTL and contrast-enhanced ultrasonographic imaging can improve the diagnosis of liver cancer. PMID:18609718

  8. Improving recognition of hepatic perivascular epithelioid cell tumor: Case report and literature review

    PubMed Central

    Maebayashi, Toshiya; Abe, Katsumi; Aizawa, Takuya; Sakaguchi, Masakuni; Ishibashi, Naoya; Abe, Osamu; Takayama, Tadatoshi; Nakayama, Hisashi; Matsuoka, Shunichi; Nirei, Kazushige; Nakamura, Hitomi; Ogawa, Masahiro; Sugitani, Masahiko

    2015-01-01

    A 58-year-old man presented with the chief complaint of abdominal bloating and was incidentally found to have a liver tumor. As diagnostic imaging studies could not rule out malignancy, the patient underwent partial resection of segment 3 of the liver. The lesion pathologically showed eosinophilic proliferation, in addition to immunohistochemical positivity for human melanoma black 45 and Melan-A, thereby leading to the diagnosis of a hepatic perivascular epithelioid cell tumor (PEComa). A PEComa arising from the liver is relatively rare. Moreover, the name ‘PEComa’ has not yet been widely recognized, and the same disease entity has been called epithelioid angiomyolipoma (EAML), further diminishing the recognition of PEComa. In addition, PEComa imaging findings mimic those of malignant liver tumors, and clinically, this tumor tends to enlarge. Therefore, a PEComa is difficult to diagnose. We conducted a systematic review of PEComa and EAML cases and discuss the results, including findings useful for differentiating perivascular epithelioid cell tumors from malignant liver tumors. PMID:25954119

  9. [Image segmentation in tumor CT based on the improved C-V model].

    PubMed

    Zhang, Jianguo; Zhang, Rongguo; Xue, Fei; Liu, Kun

    2012-04-01

    Aiming at the shortcomings of slow convergence and inaccuracy segmentation in non-homogeneous images, improvements were made on the traditional C-V model in two aspects. Firstly, using a novel model based on local gradient, the initial contour of the C-V model was quickly moved near the target border, greatly reducing the evolution time. Secondly, combining the characteristics of GVF model from two directions to the target border, an adaptive velocity reconciling item was added for velocity equation of the C-V model to make the model converge to the true border. The segmentation experiments for liver tumors in CT showed that the proposed method could be effective.

  10. Renal Tumor Quantification and Classification in Contrast-Enhanced Abdominal CT

    PubMed Central

    Linguraru, Marius George; Yao, Jianhua; Gautam, Rabindra; Peterson, James; Li, Zhixi; Linehan, W. Marston; Summers, Ronald M.

    2008-01-01

    Kidney cancer occurs in both a hereditary (inherited) and sporadic (non-inherited) form. It is estimated that almost a quarter of a million people in the USA are living with kidney cancer and their number increases with 51,000 diagnosed with the disease every year. In clinical practice, the response to treatment is monitored by manual measurements of tumor size, which are 2D, do not reflect the 3D geometry and enhancement of tumors, and show high intra- and inter-operator variability. We propose a computer-assisted radiology tool to assess renal tumors in contrast-enhanced CT for the management of tumor diagnoses and responses to new treatments. The algorithm employs anisotropic diffusion (for smoothing), a combination of fast-marching and geodesic level-sets (for segmentation), and a novel statistical refinement step to adapt to the shape of the lesions. It also quantifies the 3D size, volume and enhancement of the lesion and allows serial management over time. Tumors are robustly segmented and the comparison between manual and semi-automated quantifications shows disparity within the limits of inter-observer variability. The analysis of lesion enhancement for tumor classification shows great separation between cysts, von Hippel-Lindau syndrome lesions and hereditary papillary renal carcinomas (HPRC) with p-values inferior to 0.004. The results on temporal evaluation of tumors from serial scans illustrate the potential of the method to become an important tool for disease monitoring, drug trials and noninvasive clinical surveillance. PMID:19492069

  11. Recovering 3D tumor locations from 2D bioluminescence images and registration with CT images

    NASA Astrophysics Data System (ADS)

    Huang, Xiaolei; Metaxas, Dimitris N.; Menon, Lata G.; Mayer-Kuckuk, Philipp; Bertino, Joseph R.; Banerjee, Debabrata

    2006-02-01

    In this paper, we introduce a novel and efficient algorithm for reconstructing the 3D locations of tumor sites from a set of 2D bioluminescence images which are taken by a same camera but after continually rotating the object by a small angle. Our approach requires a much simpler set up than those using multiple cameras, and the algorithmic steps in our framework are efficient and robust enough to facilitate its use in analyzing the repeated imaging of a same animal transplanted with gene marked cells. In order to visualize in 3D the structure of the tumor, we also co-register the BLI-reconstructed crude structure with detailed anatomical structure extracted from high-resolution microCT on a single platform. We present our method using both phantom studies and real studies on small animals.

  12. Deletion of tumor progression locus 2 attenuates alcohol-induced hepatic inflammation

    PubMed Central

    Stice, Camilla P.; Hussain, Sajid; Liu, Chun; Ausman, Lynne M.

    2016-01-01

    Background The pathogenesis of alcoholic liver disease (ALD) involves the interaction of several inflammatory signaling pathways. Tumor progression locus 2 (TPL2), also known as Cancer Osaka Thyroid (COT) and MAP3K8, is a serine-threonine kinase that functions as a critical regulator of inflammatory pathways by up-regulating production of inflammatory cytokines. The present study aims to fill the gap in knowledge regarding the involvement of TPL2 in the mechanism of alcohol-induced hepatic inflammation. Methods Male TPL2−/− knockout (TPL2KO) mice and TPL2+/+ wild-type (WT) mice were group pair-fed with Lieber-DeCarli liquid ethanol diet (EtOH diet, 27% energy from EtOH) or control diet (ctrl diet) for 4 weeks. Both histological and molecular biomarkers involved in the induction of hepatic inflammation by alcohol consumption were examined. Results Consumption of the EtOH diet in WT mice lead to a significant induction of TPL2 mRNA expression as compared with WT mice fed ctrl diet. A significant induction in inflammatory foci and steatosis was also observed in WT mice fed EtOH diet. The deletion of TPL2 significantly reduced inflammatory foci in the liver of mice consuming both ctrl and EtOH diets as compared to their respective WT controls. This reduction was associated with suppression of hepatic inflammatory gene expression of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) and macrophage marker F4/80. In addition, histological analysis of livers revealed that TPL2 deletion resulted in reduced steatosis in both ctrl (significant) and EtOH (non-significant) diet-fed mice as compared to their respective WT controls. Conclusions The demonstration that TPL2 deletion attenuates alcohol-induced hepatic inflammation provides evidence of a novel role for TPL2 in the pathogenesis of ALD. PMID:26904554

  13. Promising role of [18F] fluorocholine PET/CT vs [18F] fluorodeoxyglucose PET/CT in primary brain tumors-early experience.

    PubMed

    Lam, Winnie Wing-Chuen; Ng, David Chee-Eng; Wong, Wai Yin; Ong, Seng Chuan; Yu, Sidney Wing-Kwong; See, Siew Ju

    2011-02-01

    Primary brain tumors (PBT), in particular gliomas, are among the most difficult neoplasms to treat, necessitating good quality imaging to guide clinicians at many junctures. Current imaging modalities, including [18F] fluorodeoxyglucose (FDG) PET/CT, MRI and MR spectroscopy (MRS), have various limitations, particularly with regard to differentiating tumor from radiation induced necrosis (RIN) and from normal cerebral metabolic uptake. [18F] fluorocholine (FCH) is an analog of choline with potentially optimal imaging characteristics, as pharmacokinetic studies with FCH conducted in patients showed minimal FCH uptake by normal brain parenchyma, whereas high-grade tumors are known to have increased choline uptake. We present two cases of our early experience with FCH PET/CT for patients with PBT and discuss the potential use and comparative limitations of this imaging modality.

  14. Differential effects of arsenic trioxide on chemosensitization in human hepatic tumor and stellate cell lines

    PubMed Central

    2012-01-01

    Background Crosstalk between malignant hepatocytes and the surrounding peritumoral stroma is a key modulator of hepatocarcinogenesis and therapeutic resistance. To examine the chemotherapy resistance of these two cellular compartments in vitro, we evaluated a well-established hepatic tumor cell line, HepG2, and an adult hepatic stellate cell line, LX2. The aim was to compare the chemosensitization potential of arsenic trioxide (ATO) in combination with sorafenib or fluorouracil (5-FU), in both hepatic tumor cells and stromal cells. Methods Cytotoxicity of ATO, 5-FU, and sorafenib, alone and in combination against HepG2 cells and LX2 cells was measured by an automated high throughput cell-based proliferation assay. Changes in survival and apoptotic signaling pathways were analyzed by flow cytometry and western blot. Gene expression of the 5-FU metabolic enzyme, thymidylate synthase, was analyzed by real time PCR. Results Both HepG2 and LX2 cell lines were susceptible to single agent sorafenib and ATO at 24 hr (ATO IC50: 5.3 μM in LX2; 32.7 μM in HepG2; Sorafenib IC50: 11.8 μM in LX2; 9.9 μM in HepG2). In contrast, 5-FU cytotoxicity required higher concentrations and prolonged (48–72 hr) drug exposure. Concurrent ATO and 5-FU treatment of HepG2 cells was synergistic, leading to increased cytotoxicity due in part to modulation of thymidylate synthase levels by ATO. Concurrent ATO and sorafenib treatment showed a trend towards increased HepG2 cytotoxicity, possibly due to a significant decrease in MAPK activation in comparison to treatment with ATO alone. Conclusions ATO differentially sensitizes hepatic tumor cells and adult hepatic stellate cells to 5-FU and sorafenib. Given the importance of both of these cell types in hepatocarcinogenesis, these data have implications for the rational development of anti-cancer therapy combinations for the treatment of hepatocellular carcinoma (HCC). PMID:22963400

  15. Hepatitis

    MedlinePlus

    ... has been associated with drinking contaminated water. Hepatitis Viruses Type Transmission Prognosis A Fecal-oral (stool to ... risk for severe disease. Others A variety of viruses can affect the liver Signs and Symptoms Hepatitis ...

  16. Integrated imaging of hepatic tumors in childhood. Part II. Benign lesions (congenital, reparative, and inflammatory)

    SciTech Connect

    Miller, J.H.; Greenspan, B.S.

    1985-01-01

    The authors have encountered benign liver masses as frequently as malignant lesions in children with hepatomegaly. Lesions studied included abscesses, cavernous hemangioma/hemangioendothelioma, adenoma of glycogen storage disease, choledochal cysts, focal nodular hyperplasia, cystic hepatoblastoma, and hamartoma. An intergrated imaging protocol involving ultrasound, computed tomography, and scintigraphy proved to be more helpful than any one modality in establishing the benign or malignant nature of a hepatic neoplasm and the type of tumor, which is of particular importance when surgical exploration and/or biopsy is contraindicated.

  17. Calculating tumor trajectory and dose-of-the-day using cone-beam CT projections

    SciTech Connect

    Jones, Bernard L. Westerly, David; Miften, Moyed

    2015-02-15

    Purpose: Cone-beam CT (CBCT) projection images provide anatomical data in real-time over several respiratory cycles, forming a comprehensive picture of tumor movement. The authors developed and validated a method which uses these projections to determine the trajectory of and dose to highly mobile tumors during each fraction of treatment. Methods: CBCT images of a respiration phantom were acquired, the trajectory of which mimicked a lung tumor with high amplitude (up to 2.5 cm) and hysteresis. A template-matching algorithm was used to identify the location of a steel BB in each CBCT projection, and a Gaussian probability density function for the absolute BB position was calculated which best fit the observed trajectory of the BB in the imager geometry. Two modifications of the trajectory reconstruction were investigated: first, using respiratory phase information to refine the trajectory estimation (Phase), and second, using the Monte Carlo (MC) method to sample the estimated Gaussian tumor position distribution. The accuracies of the proposed methods were evaluated by comparing the known and calculated BB trajectories in phantom-simulated clinical scenarios using abdominal tumor volumes. Results: With all methods, the mean position of the BB was determined with accuracy better than 0.1 mm, and root-mean-square trajectory errors averaged 3.8% ± 1.1% of the marker amplitude. Dosimetric calculations using Phase methods were more accurate, with mean absolute error less than 0.5%, and with error less than 1% in the highest-noise trajectory. MC-based trajectories prevent the overestimation of dose, but when viewed in an absolute sense, add a small amount of dosimetric error (<0.1%). Conclusions: Marker trajectory and target dose-of-the-day were accurately calculated using CBCT projections. This technique provides a method to evaluate highly mobile tumors using ordinary CBCT data, and could facilitate better strategies to mitigate or compensate for motion during

  18. Accurate tracking of tumor volume change during radiotherapy by CT-CBCT registration with intensity correction

    NASA Astrophysics Data System (ADS)

    Park, Seyoun; Robinson, Adam; Quon, Harry; Kiess, Ana P.; Shen, Colette; Wong, John; Plishker, William; Shekhar, Raj; Lee, Junghoon

    2016-03-01

    In this paper, we propose a CT-CBCT registration method to accurately predict the tumor volume change based on daily cone-beam CTs (CBCTs) during radiotherapy. CBCT is commonly used to reduce patient setup error during radiotherapy, but its poor image quality impedes accurate monitoring of anatomical changes. Although physician's contours drawn on the planning CT can be automatically propagated to daily CBCTs by deformable image registration (DIR), artifacts in CBCT often cause undesirable errors. To improve the accuracy of the registration-based segmentation, we developed a DIR method that iteratively corrects CBCT intensities by local histogram matching. Three popular DIR algorithms (B-spline, demons, and optical flow) with the intensity correction were implemented on a graphics processing unit for efficient computation. We evaluated their performances on six head and neck (HN) cancer cases. For each case, four trained scientists manually contoured the nodal gross tumor volume (GTV) on the planning CT and every other fraction CBCTs to which the propagated GTV contours by DIR were compared. The performance was also compared with commercial image registration software based on conventional mutual information (MI), VelocityAI (Varian Medical Systems Inc.). The volume differences (mean±std in cc) between the average of the manual segmentations and automatic segmentations are 3.70+/-2.30 (B-spline), 1.25+/-1.78 (demons), 0.93+/-1.14 (optical flow), and 4.39+/-3.86 (VelocityAI). The proposed method significantly reduced the estimation error by 9% (B-spline), 38% (demons), and 51% (optical flow) over the results using VelocityAI. Although demonstrated only on HN nodal GTVs, the results imply that the proposed method can produce improved segmentation of other critical structures over conventional methods.

  19. Flat-Panel Cone-Beam Ct-Guided Radiofrequency Ablation of Very Small (≤1.5 cm) Liver Tumors: Technical Note on a Preliminary Experience

    SciTech Connect

    Cazzato, Roberto Luigi Buy, Xavier Alberti, Nicolas Fonck, Mariane; Grasso, Rosario Francesco; Palussière, Jean

    2015-02-15

    PurposeThe aim of the present study was to investigate the technical feasibility of flat-panel cone-beam CT (CBCT)-guided radiofrequency ablation (RFA) of very small (<1.5 cm) liver tumors.Materials and MethodsPatients included were candidates for hepatic percutaneous RFA as they had single biopsy-proven hepatic tumors sized ≤1.5 cm and poorly defined on ultrasonography. Following apnea induction, unenhanced CBCT scans were acquired and used to deploy the RF electrode with the aid of a virtual navigation system. If the tumor was not clearly identified on the unenhanced CBCT scan, a right retrograde arterial femoral access was established to carry out hepatic angiography and localize the tumor. Patients’ lesions and procedural variables were recorded and analyzed.ResultsThree patients (2 male and 1 female), aged 68, 76, and 87 years were included; 3 lesions (2 hepato-cellular carcinoma and 1 metastasis from colorectal cancer) were treated. One patient required hepatic angiography. Cycles of apnea used to acquire CBCT images and to deploy the electrode lasted <120 s. Mean fluoroscopic time needed to deploy the electrode was 36.6 ± 5.7 min. Mean overall procedural time was 66.0 ± 22.9 min. No peri- or post-procedural complications were noted. No cases of incomplete ablation were noted at 1-month follow-up.ConclusionPercutaneous CBCT-guided liver RFA with or without arterial hepatic angiography is technically feasible.

  20. Size effect of Au/PAMAM contrast agent on CT imaging of reticuloendothelial system and tumor tissue

    NASA Astrophysics Data System (ADS)

    Wang, Wei; Li, Jian; Liu, Ransheng; Zhang, Aixu; Yuan, Zhiyong

    2016-09-01

    Polyamidoamine (PAMAM)-entrapped Au nanoparticles were synthesized with distinct sizes to figure out the size effect of Au-based contrast agent on CT imaging of passively targeted tissues. Au/PAMAM nanoparticles were first synthesized with narrow distribution of particles size of 22.2 ± 3.1, 54.2 ± 3.7, and 104.9 ± 4.7 nm in diameters. Size effect leads no significant difference on X-ray attenuation when Au/PAMAM was ≤0.05 mol/L. For CT imaging of a tumor model, small Au/PAMAM were more easily internalized via endocytosis in the liver, leading to more obviously enhanced contrast. Similarly, contrast agents with small sizes were more effective in tumor imaging because of the enhanced permeability and retention effect. Overall, the particle size of Au/PAMAM heavily affected the efficiency of CT enhancement in imaging RES and tumors.

  1. Volume change determination of metastatic lung tumors in CT images using 3-D template matching

    NASA Astrophysics Data System (ADS)

    Ambrosini, Robert D.; Wang, Peng; O'Dell, Walter G.

    2009-02-01

    The ability of a clinician to properly detect changes in the size of lung nodules over time is a vital element to both the diagnosis of malignant growths and the monitoring of the response of cancerous lesions to therapy. We have developed a novel metastasis sizing algorithm based on 3-D template matching with spherical tumor appearance models that were created to match the expected geometry of the tumors of interest while accounting for potential spatial offsets of nodules in the slice thickness direction. The spherical template that best-fits the overall volume of each lung metastasis was determined through the optimization of the 3-D normalized cross-correlation coefficients (NCCC) calculated between the templates and the nodules. A total of 17 different lung metastases were extracted manually from real patient CT datasets and reconstructed in 3-D using spherical harmonics equations to generate simulated nodules for testing our algorithm. Each metastasis 3-D shape was then subjected to 10%, 25%, 50%, 75% and 90% scaling of its volume to allow for 5 possible volume change combinations relative to the original size per each reconstructed nodule and inserted back into CT datasets with appropriate blurring and noise addition. When plotted against the true volume change, the nodule volume changes calculated by our algorithm for these 85 data points exhibited a high degree of accuracy (slope = 0.9817, R2 = 0.9957). Our results demonstrate that the 3-D template matching method can be an effective, fast, and accurate tool for automated sizing of metastatic tumors.

  2. Whole-body (99m)Tc-octreotide scintigraphy with SPECT/CT to detect occult tumor inducing paraneoplastic osteomalacia.

    PubMed

    Rodrigues, Napoleão Ramalho; Calich, Ana Luisa; Etchebehere, Mauricio; Ichiki, Wilson Andre; Pereira, Fabio Payao; Amstalden, Elaine Maria Ingrid; de Sa Etchebehere, Elba Cristina

    2015-01-01

    A 32-year-old woman presented with progressive myalgia, bone pain, fatigue, insufficiency hip fractures, high urine phosphate, and low serum phosphate and vitamin D levels. These findings were suggestive of oncogenic osteomalacia. A whole-body Tc-octreotide scintigraphy with SPECT/CT showed uptake on a sclerotic intramedullary lesion in the left medial tibia plateau. MRI depicted a solid lesion. The lesion was surgically removed; the patient became asymptomatic, and follow-up laboratory results normalized. Histopathologic examination revealed a vascular hemangiopericytoma-like tumor, positive for somatostatin receptor (SSR-2). Whole-body Tc-octreotide scintigraphy with SPECT/CT may detect occult oncogenic osteomalacia tumors.

  3. Hepatic epithelioid angiomyolipoma is a rare and potentially severe but treatable tumor: A report of three cases and review of the literature

    PubMed Central

    LIU, WENTAO; MENG, ZIHUI; LIU, HONGYU; LI, WEI; WU, QIONG; ZHANG, XUEWEN; E, CHANGYONG

    2016-01-01

    Hepatic epithelioid angiomyolipoma (EAML) is a rare type of hepatic tumor. Due to a lack of adequate understanding about this tumor, hepatic EAML is often misdiagnosed as other diseases with similar clinical characteristics such as hepatic cancer. In the present study, 3 cases of hepatic EAML are reported, and the main clinicopathological features of this disease are presented, based on a literature search that included articles published in English between February 2000 and September 2014. A total of 24 hepatic EAML cases were considered, of which, 17 were females and 4 presented multiple liver lesions. Among the patients with single lesions, 2 underwent surgery and relapsed after 5 months and 9 years, respectively. Immunohistochemical staining was positive for human melanoma black-45 in the present 3 cases. The aim of the present study was to focus the attention of clinicians on this type of hepatic tumor in order to improve its diagnosis and treatment. PMID:27313680

  4. Assessment of contrast enhanced respiration managed cone-beam CT for image guided radiotherapy of intrahepatic tumors

    SciTech Connect

    Jensen, Nikolaj K. G.; Stewart, Errol; Lock, Michael; Fisher, Barbara; Kozak, Roman; Chen, Jeff; Lee, Ting-Yim; Wong, Eugene

    2014-05-15

    Purpose: Contrast enhancement and respiration management are widely used during image acquisition for radiotherapy treatment planning of liver tumors along with respiration management at the treatment unit. However, neither respiration management nor intravenous contrast is commonly used during cone-beam CT (CBCT) image acquisition for alignment prior to radiotherapy. In this study, the authors investigate the potential gains of injecting an iodinated contrast agent in combination with respiration management during CBCT acquisition for liver tumor radiotherapy. Methods: Five rabbits with implanted liver tumors were subjected to CBCT with and without motion management and contrast injection. The acquired CBCT images were registered to the planning CT to determine alignment accuracy and dosimetric impact. The authors developed a simulation tool for simulating contrast-enhanced CBCT images from dynamic contrast enhanced CT imaging (DCE-CT) to determine optimal contrast injection protocols. The tool was validated against contrast-enhanced CBCT of the rabbit subjects and was used for five human patients diagnosed with hepatocellular carcinoma. Results: In the rabbit experiment, when neither motion management nor contrast was used, tumor centroid misalignment between planning image and CBCT was 9.2 mm. This was reduced to 2.8 mm when both techniques were employed. Tumors were not visualized in clinical CBCT images of human subjects. Simulated contrast-enhanced CBCT was found to improve tumor contrast in all subjects. Different patients were found to require different contrast injections to maximize tumor contrast. Conclusions: Based on the authors’ animal study, respiration managed contrast enhanced CBCT improves IGRT significantly. Contrast enhanced CBCT benefits from patient specific tracer kinetics determined from DCE-CT.

  5. Peripheral primitive neuroectodermal tumor: Dynamic CT, MRI and clinicopathological characteristics - analysis of 36 cases and review of the literature

    PubMed Central

    Tan, Yan; Zhang, Hui; Ma, Guo-lin; Xiao, En-hua; Wang, Xiao-chun

    2014-01-01

    Background The peripheral primitive neuroectodermal tumor (pPNET) is a rare malignant tumor originating from neuroectoderm. The accurate diagnosis is essential for the treatment of pPNET. Methods we performed the largest cases of retrospective analysis thus far to review the unique computed tomography (CT), magnetic resonance imaging (MRI), and clinicopathological features of pPNET. The tumor location, morphological features, signal intensity, contrast enhancement characteristics, and involvement of local soft tissues of 36 pPNETs were assessed. Results Our results showed that there were more men (25/36) than women pPNETs patients. Unenhanced MRI (16 cases) showed that 14 cases were isointense and 2 cases were hypointense on T1WI. Nine cases were isointense and 7 were hyperintense on T2WI. Most pPNETs had heterogeneous signal intensity with small necrosis (CT: 31/36; MRI: 14/16) as well as heterogeneous enhancement (CT: 34/30; MRI: 15/16). The tumors usually had ill-defined borders and irregular shapes (CT: 30/36; MRI: 15/16). Pathologic exam showed small areas of necrosis in all tumors. Conclusions The diagnosis of pPNET should be suggested in young men when the imaging depicts a single large ill-defined solid mass with small area of necrosis, especially for those whose images show iso-intense on T1WI and T2WI and have heterogeneous enhancement. PMID:25587032

  6. Simultaneous detection of multiple elastic surfaces with application to tumor segmentation in CT images

    NASA Astrophysics Data System (ADS)

    Li, Kang; Jolly, Marie-Pierre

    2008-03-01

    We present a new semi-supervised method for segmenting multiple interrelated object boundaries with spherical topology in volumetric images. The core of our method is a novel graph-theoretic algorithm that simultaneously detects multiple surfaces under smoothness, distance, and elasticity constraints. The algorithm computes the global optimum of an objective function that incorporates boundary, regional and surface elasticity information. A single straight line drawn by the user in a cross-sectional slice is the sole user input, which roughly indicates the extent of the object. We employ a multi-seeded Dijkstra-based range competition algorithm to pre-segment the object on two orthogonal multiplanar reformatted (MPR) planes that pass through the input line. Based on the 2D pre-segmentation results, we estimate the object and background intensity histograms, and employ an adaptive mean-shift mode-seeking process on the object histogram to automatically determine the number of surface layers to be segmented. The final multiple-surface segmentation is performed in an ellipsoidal coordinate frame constructed by an automated ellipsoid fitting procedure. We apply our method to the segmentation of liver lesions with necrosis or calcification, and various other tumors in CT images. For liver tumor segmentation, our method can simultaneously delineate both tumor and necrosis boundaries. This capability is unprecedented and is valuable for cancer diagnosis, treatment planning, and evaluation.

  7. Bitargeted microemulsions based on coix seed ingredients for enhanced hepatic tumor delivery and synergistic therapy.

    PubMed

    Qu, Ding; Sun, Wenjie; Liu, Mingjian; Liu, Yuping; Zhou, Jing; Chen, Yan

    2016-04-30

    A hepatic tumor bitargeted microemulsions drug delivery system using coix seed oil and coix seed polysaccharide (CP) acting as anticancer components, as well as functional excipients, was developed for enhanced tumor-specific accumulation by CP-mediated enhancement on passive tumor targeting and modification of galactose stearate (tumor-targeted ligand). In the physicochemical characteristics studies, galactose stearate-modified coix seed multicomponent microemulsions containing 30% CP (w%) (Gal-C-MEs) had a well-defined spherical shape with a small size (47.63 ± 1.41 nm), a narrow polydispersity index (PDI, 0.101 ± 0.002), and a nearly neutral surface charge (-4.37 ± 1.76 mV). The half-maximal inhibitory concentration (IC50) of Gal-C-MEs against HepG2 cells was 70.2 μg/mL, which decreased by 1.8-fold in comparison with that of coix seed multicomponent microemulsions (C-MEs). The fluorescence intensity of fluorescein isothiocyanate (FITC)-loaded Gal-C-MEs (FITC-Gal-C-MEs) internalized by HepG2 cells was 1.8-fold higher than that of FITC-loaded C-MEs (FIT C-C-MEs), but the cellular uptake of the latter became reduce by 1.6-fold when the weight ratio of CP decreased up to 10%. In the cell apoptosis studies, C-MEs (containing 30% CP) did not show a significant difference with Gal-C-MEs, but exhibited 3.3-fold and 1.5-fold increase relative to C-MEs containing 10% CP and 20% CP, respectively. In the in vivo tumor targeting studies, Cy5-loaded Gal-C-MEs (Cy5-Gal-C-MEs), notably distributed in the tumor sites and still found even at 48 h post-administration, displayed the strongest capability of tumor tissue accumulation and retention among all the test groups. Most importantly, Gal-C-MEs had stronger inhibition of tumor growth, prolonged survival time and more effectively tumor cell apoptosis induction in comparison with C-MEs containing different amounts of CP, which further confirmed that a certain amount of CP and tumor-targeted ligand were of great importance to

  8. Glutamine Sensitivity Analysis Identifies the xCT Antiporter as a Common Triple Negative Breast Tumor Therapeutic Target

    PubMed Central

    Timmerman, Luika A.; Holton, Thomas; Yuneva, Mariia; Louie, Raymond J.; Padró, Mercè; Daemen, Anneleen; Hu, Min; Chan, Denise A.; Ethier, Stephen P.; van ‘t Veer, Laura J.; Polyak, Kornelia; McCormick, Frank; Gray, Joe W.

    2014-01-01

    SUMMARY A handful of tumor-derived cell lines form the mainstay of cancer therapeutic development, yielding drugs with impact typically measured as months to disease progression. To develop more effective breast cancer therapeutics and more readily understand their clinical impact, we constructed a functional metabolic portrait of 46 independently-derived breast cell lines. Our analysis of glutamine uptake and dependence identified a subset of triple negative samples that are glutamine auxotrophs. Ambient glutamine indirectly supports environmental cystine acquisition via the xCT antiporter, which is expressed on 1/3 of triple negative tumors in vivo. xCT inhibition with the clinically approved anti-inflammatory Sulfasalazine decreases tumor growth revealing a therapeutic target in breast tumors of poorest prognosis, and a lead compound for rapid, effective drug development. PMID:24094812

  9. Radiofrequency ablation of hepatic tumors: simulation, planning, and contribution of virtual reality and haptics.

    PubMed

    Villard, Caroline; Soler, Luc; Gangi, Afshin

    2005-08-01

    For radiofrequency ablation (RFA) of liver tumors, evaluation of vascular architecture, post-RFA necrosis prediction, and the choice of a suitable needle placement strategy using conventional radiological techniques remain difficult. In an attempt to enhance the safety of RFA, a 3D simulator, treatment planning, and training tool, that simulates the insertion of the needle, the necrosis of the treated area, and proposes an optimal needle placement, has been developed. The 3D scenes are automatically reconstructed from enhanced spiral CT scans. The simulator takes into account the cooling effect of local vessels greater than 3 mm in diameter, making necrosis shapes more realistic. Optimal needle positioning can be automatically generated by the software to produce complete destruction of the tumor, with maximum respect of the healthy liver and of all major structures to avoid. We also studied how the use of virtual reality and haptic devices are valuable to make simulation and training realistic and effective. PMID:16298844

  10. Freehand Two-Step CT-Guided Brain Tumor Biopsy: A Fast and Effective Interventional Procedure in Selected Patients

    SciTech Connect

    Thanos, Loukas Mylona, Sofia; Galani, Panagiota; Kalioras, Vasilios; Pomoni, Maria; Batakis, Nikolaos

    2006-04-15

    Purpose. To evaluate the efficacy and safety of CT-guided needle biopsy of brain lesions without a stereotactic device, and to determine the best possible indications for this technique. Methods. From February 2001 to February 2004, 20 patients (12 men, 8 women; age 61-82 years) underwent CT-guided brain lesion biopsy. The procedure started with a brain CT scan for lesion localization and for selection of the inlet for needle insertion. The patient was then transported to the operating room where cranioanatrisis was performed. Subsequently, the biopsy was performed under CT guidance using a 14G brain biopsy needle with a blind smooth end and lateral holes. At the end of the biopsy, the field was checked for possible complications with a CT scan. Results. Histopathologic results were: brain tumor in 16 patients (80%), inflammatory process in 3 (15%), and no conclusive diagnosis in 1 (5%). A repeat of the process was required in 2 patients. A minor complication of local hematoma was found in 1 patient (5%). There were no deaths or other serious complications.Conclusion. CT-guided biopsy is a reliable method for histopathologic diagnosis of brain lesions in selected cases. It is a simple, fast, effective, low-cost procedure with minimal complications, indicated especially for superficial and large tumors.

  11. ROI for outlining an entire tumor is a reliable approach for quantification of lung cancer tumor vascular parameters using CT perfusion

    PubMed Central

    Ma, Ensen; Ren, An; Gao, Baoxiang; Yang, Minxing; Zhao, Qichao; Wang, Wu; Li, Kefeng

    2016-01-01

    Objective To investigate the effect of position and size of tumor region of interest (ROI) on the estimation of lung cancer vascular parameters using 256-slice computed tomography (CT) perfusion. Methods After institutional review board approval and written informed consent, 16 men and 11 women with lung cancer were enrolled in this CT perfusion study. Perfusion, blood volume, and peak enhancement were determined for 60 or 120 mm2 circular ROIs placed at the edge, center, and around (outlining) the visible tumor. Average values were obtained by performing ROI analysis twice by the same observers without any procedural changes. Results Perfusion, blood volume, and peak enhancement measurements were substantially higher at the edge than at the center for both 60 and 120 mm2 ROIs (all P<0.05). Measurements varied substantially depending on the ROI size. Perfusion, blood volume, and peak enhancement for the ROIs outlining tumor were intermediate between those at the tumor edge and center. There were significant correlations between median values and interquartile ranges as follows; perfusion (12.51 [7.91–28.10] mL⋅min−1⋅100 mL−1), blood volume (29.31 [21.82–37.65] mL⋅100 g−1), peak enhancement (12.93 [2.42–22.50]) for the ROIs outlining the tumor, and microvascular density ([19.43±8.78] vessels/0.74 mm2), respectively (r values were 0.732, 0.590, and 0.544 respectively, all P<0.05). Conclusion Spatial and size selection of ROI significantly affects CT perfusion analysis. ROI outlining of entire tumor provides efficient and reliable measurements for clinical assessment of lung cancer using CT perfusion. PMID:27175083

  12. Inhibitory effect of tetrahydroswertianolin on tumor necrosis factor-alpha-dependent hepatic apoptosis in mice.

    PubMed

    Hase, K; Xiong, Q; Basnet, P; Namba, T; Kadota, S

    1999-06-15

    We investigated the effect of tetrahydroswertianolin (THS), a hepatoprotective agent from Swertia japonica, on tumor necrosis factor-alpha (TNF-alpha)-dependent hepatic apoptosis induced by D-galactosamine (D-GalN) (700 mg/kg, i.p.) and lipopolysaccharide (LPS) (10 microg/kg, i.p.) in mice. Apoptotic symptoms were observed at the initial stage of liver damage. By 5 hr after intoxication, hepatic DNA fragmentation had risen to 2123%, with the value in untreated mice set at 100%, without a significant elevation of serum alanine transaminase (ALT) activity. There was a parallel increase in hepatocytes undergoing chromatin condensation and apoptotic body formation. By 8 hr after intoxication, serum ALT activity had risen to 3707 U/L. Pretreatment with THS (50 mg/kg, p.o.) at 18 and 2 hr before intoxication significantly reduced DNA fragmentation to 821% of that in untreated mice and prevented the emergence of chromatin condensation and apoptotic body formation. A significant and dose-dependent reduction in serum ALT activity at 8 hr also was observed with THS pretreatment. These effects of THS were different from those observed from pretreatment with glycyrrhizin (GCR), which is a clinically used hepatoprotective agent with membrane-stabilizing activity. GCR pretreatment (100 mg/kg, p.o.) did not inhibit hepatic DNA fragmentation (1588% of untreated mice), although this compound significantly protected against serum ALT elevation (1463 U/L). These data suggest that an inhibitory effect on the progression of hepatic apoptosis prior to liver injury may be involved in the hepatoprotective mechanisms of THS, whereas it appears that GCR affects the processes after apoptosis. In a separate experiment, we found that the concentration of serum TNF-alpha rose to 2016 pg/mL at 1 hr after intoxication of mice with D-GalN and LPS, but this increase was suppressed by THS pretreatment (10, 50, or 200 mg/kg, p.o.) to 716, 454, or 406 pg/mL, respectively. Further study with a reverse

  13. Histopathological characteristics of glutamine synthetase-positive hepatic tumor lesions in a mouse model of spontaneous metabolic syndrome (TSOD mouse)

    PubMed Central

    Takahashi, Tetsuyuki; Nishida, Takeshi; Baba, Hayato; Hatta, Hideki; Imura, Johji; Sutoh, Mitsuko; Toyohara, Syunji; Hokao, Ryoji; Watanabe, Syunsuke; Ogawa, Hirohisa; Uehara, Hisanori; Tsuneyama, Koichi

    2016-01-01

    We previously reported that Tsumura-Suzuki obese diabetic (TSOD) mice, a polygenic model of spontaneous type 2 diabetes, is a valuable model of hepatic carcinogenesis via non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). One of the characteristics of tumors in these mice is the diffuse expression of glutamine synthetase (GS), which is a diagnostic marker for hepatocellular carcinoma (HCC). In this study, we performed detailed histopathological examinations and found that GS expression was diffusely positive in >70% of the hepatic tumors from 15-month-old male TSOD mice. Translocation of β-catenin into nuclei with enhanced membranous expression also occurred in GS-positive tumors. Small lesions (<1 mm) in GS-positive cases exhibited dysplastic nodules, with severe nuclear atypia, whereas large lesions (>3 mm) bore the characteristics of human HCC, exhibiting nuclear and structural atypia with invasive growth. By contrast, the majority of GS-negative tumors were hepatocellular adenomas with advanced fatty change and low nuclear grade. In GS-negative tumors, loss of liver fatty acid-binding protein expression was observed. These results suggest that the histological characteristics of GS-positive hepatic tumors in TSOD mice resemble human HCC; thus, this model may be a useful tool in translational research targeting the NAFLD/NASH-HCC sequence. PMID:27446562

  14. Vasculature segmentation for radio frequency ablation of non-resectable hepatic tumors

    NASA Astrophysics Data System (ADS)

    Hemler, Paul F.; McCreedy, Evan S.; Cheng, Ruida; Wood, Brad; McAuliffe, Matthew J.

    2006-03-01

    In Radio Frequency Ablation (RFA) procedures, hepatic tumor tissue is heated to a temperature where necrosis is insured. Unfortunately, recent results suggest that heating tumor tissue to necrosis is complicated because nearby major blood vessels provide a cooling effect. Therefore, it is fundamentally important for physicians to perform a careful analysis of the spatial relationship of diseased tissue to larger liver blood vessels. The liver contains many of these large vessels, which affect the RFA ablation shape and size. There are many sophisticated vasculature detection and segmentation techniques reported in the literature that identify continuous vessels as the diameter changes size and it transgresses through many bifurcation levels. However, the larger blood vessels near the treatment area are the only vessels required for proper RFA treatment plan formulation and analysis. With physician guidance and interaction, our system can segment those vessels which are most likely to affect the RFA ablations. We have found that our system provides the physician with therapeutic, geometric and spatial information necessary to accurately plan treatment of tumors near large blood vessels. The segmented liver vessels near the treatment region are also necessary for computing isolevel heating profiles used to evaluate different proposed treatment configurations.

  15. In vivo isolated liver perfusion technique in a rat hepatic metastasis model: 5-fluorouracil concentrations in tumor tissue.

    PubMed

    de Brauw, L M; van de Velde, C J; Tjaden, U R; de Bruijn, E A; Bell, A V; Hermans, J; Zwaveling, A

    1988-02-01

    An in vivo method of isolated rat liver perfusion was developed with true vascular isolation and recirculating perfusate. This new surgical technique to temporarily isolate the liver vascularly, and the perfusion procedure are described in depth. Twelve inbred WAG/RIJ rats were subjected to 25 min of normothermic liver perfusion without chemotherapy, and all rats survived the procedure. Hepatic functional and histological integrity were not significantly altered during perfusion. To determine the role of isolated liver perfusion (ILP) as a means of improved targeting of antitumor agents, 5-fluorouracil (5-FU) concentrations were monitored in hepatic tumor and liver tissues and in systemic plasma using high-performance liquid chromatography. Fifty-one rats with hepatic tumors of colonic origin were randomly assigned to one of three dosage groups (20, 40, or 80 mg/kg) receiving 5-FU by ILP, hepatic artery infusion (HAI), or jugular vein infusion (JVI). ILP resulted in significantly increased 5-FU concentrations in liver tissue. However, no significant differences were found in tumor tissue concentrations of 5-FU between the three treatment modalities. 5-FU concentrations in tumor tissue increased as a function of the dose with ILP, HAI, and JVI. ILP was associated with the lowest systemic drug concentrations. The low systemic 5-FU concentrations with ILP suggest a higher maximum tolerable dose. This mode of treatment deserves to be studied further in our model before conclusions can be drawn regarding its therapeutic potential. PMID:3339874

  16. False Suggestion of Malignant Transformation of Benign Bone Tumor by 18F-FDG PET/CT: A Potential Pitfall.

    PubMed

    Chen, Yu-Ren; Kuo, Yu-Cheng; Hsu, Cheng-Nan; Hsieh, Te-Chun; Kao, Chia-Hung

    2016-10-01

    A 68-year-old man underwent serial F-FDG PET/CT scan follow-up for lung cancer. Then 5.5 years after the initial F-FDG PET/CT scan, the presumed benign bone tumor in the left clavicle showed markedly increased FDG uptake during follow-up; in contrast, the Tc-MDP bone scan paradoxically exhibited no apparent interval change since last bone scan 5.5 years earlier. He underwent a CT-guided biopsy, and the pathological diagnosis was benign fibrous histiocytoma. The result was consistent with the lack of progression in Tc-MDP bone scan, whereas the F-FDG PET/CT scan gave a false-positive impression of malignant transformation. PMID:27556801

  17. Lattice Boltzmann method for fast patient-specific simulation of liver tumor ablation from CT images.

    PubMed

    Audigier, Chloé; Mansi, Tommaso; Delingette, Hervé; Rapaka, Saikiran; Mihalef, Viorel; Sharma, Puneet; Carnegie, Daniel; Boctor, Emad; Choti, Michael; Kamen, Ali; Comaniciu, Dorin; Ayache, Nicholas

    2013-01-01

    Radio-frequency ablation (RFA), the most widely used minimally invasive ablative therapy of liver cancer, is challenged by a lack of patient-specific planning. In particular, the presence of blood vessels and time-varying thermal diffusivity makes the prediction of the extent of the ablated tissue difficult. This may result in incomplete treatments and increased risk of recurrence. We propose a new model of the physical mechanisms involved in RFA of abdominal tumors based on Lattice Boltzmann Method to predict the extent of ablation given the probe location and the biological parameters. Our method relies on patient images, from which level set representations of liver geometry, tumor shape and vessels are extracted. Then a computational model of heat diffusion, cellular necrosis and blood flow through vessels and liver is solved to estimate the extent of ablated tissue. After quantitative verifications against an analytical solution, we apply our framework to 5 patients datasets which include pre- and post-operative CT images, yielding promising correlation between predicted and actual ablation extent (mean point to mesh errors of 8.7 mm). Implemented on graphics processing units, our method may enable RFA planning in clinical settings as it leads to near real-time computation: 1 minute of ablation is simulated in 1.14 minutes, which is almost 60x faster than standard finite element method.

  18. Lattice Boltzmann method for fast patient-specific simulation of liver tumor ablation from CT images.

    PubMed

    Audigier, Chloé; Mansi, Tommaso; Delingette, Hervé; Rapaka, Saikiran; Mihalef, Viorel; Sharma, Puneet; Carnegie, Daniel; Boctor, Emad; Choti, Michael; Kamen, Ali; Comaniciu, Dorin; Ayache, Nicholas

    2013-01-01

    Radio-frequency ablation (RFA), the most widely used minimally invasive ablative therapy of liver cancer, is challenged by a lack of patient-specific planning. In particular, the presence of blood vessels and time-varying thermal diffusivity makes the prediction of the extent of the ablated tissue difficult. This may result in incomplete treatments and increased risk of recurrence. We propose a new model of the physical mechanisms involved in RFA of abdominal tumors based on Lattice Boltzmann Method to predict the extent of ablation given the probe location and the biological parameters. Our method relies on patient images, from which level set representations of liver geometry, tumor shape and vessels are extracted. Then a computational model of heat diffusion, cellular necrosis and blood flow through vessels and liver is solved to estimate the extent of ablated tissue. After quantitative verifications against an analytical solution, we apply our framework to 5 patients datasets which include pre- and post-operative CT images, yielding promising correlation between predicted and actual ablation extent (mean point to mesh errors of 8.7 mm). Implemented on graphics processing units, our method may enable RFA planning in clinical settings as it leads to near real-time computation: 1 minute of ablation is simulated in 1.14 minutes, which is almost 60x faster than standard finite element method. PMID:24505777

  19. [Combination Chemotherapy Using Sorafenib and Hepatic Arterial Infusion with a Fine-Powder Formulation of Cisplatin for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis--A Case Report].

    PubMed

    Tsukamoto, Tadashi; Kanazawa, Akishige; Shimizu, Sadatoshi; Murata, Akihiro; Sakae, Masayuki; Kurihara, Shigeaki; Tashima, Tetsuzo; Deguchi, Sota; Nakai, Takashi; Kawasaki, Yasuko; Kioka, Kiyohide

    2015-11-01

    Sorafenib has been a standard therapy for advanced hepatocellular carcinoma (HCC) with portal vein thrombosis. Hepatic arterial infusion chemotherapy (HAIC) is still preferably performed in Japan because of its relatively good tumor-shrinking effect. We report a case of advanced multiple HCC with portal thrombus that responded to combination chemotherapy with sorafenib and repeat hepatic arterial infusion with a fine-powder formulation of cisplatin (IA-call®). A 57-year-old man presented for the treatment of HCC with alcoholic cirrhosis. Multiple HCC were found to be rapidly progressing with portal thrombosis. HAIC with IA-call® was performed, but the tumors progressed. TAE was performed 3 times thereafter and the main tumor shrunk to some extent. A month after the last TAE, the HCC was found to progress again, and oral sorafenib was administered. A reservoir and catheter were placed and HAIC with low-dose 5-fluorouracil and cisplatin was performed for 3 cycles following 1 HAIC cycle with epirubicin and mitomycin C, which was not effective. For 10 months after initial therapy, HAIC using IA-call® has been performed once for 6 weeks. After performing HAIC with IA-call® 5 times, the serum levels of HCC tumor markers AFP and PIVKA-Ⅱdecreased, and the tumors continued to shrink and were not stained on enhanced CT scan. The patient has been alive for 23 months after the initial therapy and has maintained stable disease. PMID:26805203

  20. Evaluating dynamic contrast-enhanced and photoacoustic CT to assess intra-tumor heterogeneity in xenograft mouse models

    NASA Astrophysics Data System (ADS)

    Stantz, Keith M.; Liu, Bo; Cao, Minsong; Reinecke, Dan; Dzemidzic, Mario; Liang, Yun; Kruger, Robert

    2006-03-01

    Purpose: To evaluate photoacoustic CT spectroscopy (PCT-S) and dynamic contrast-enhanced CT (DCE-CT) ability to measure parameters - oxygen saturation and vascular physiology - associated with the intra-tumor oxygenation status. Material and Methods: Breast (VEGF165 enhance MCF-7) and ovarian (SKOV3x) cancer cells were implanted into the fat pads and flanks of immune deficient mice and allowed to grow to a diameter of 8-15 mm. CT was used to determine physiological parameters by acquiring a sequence of scans over a 10 minute period after an i.v. injection of a radio-opaque contrast agent (Isovue). These time-dependent contrast-enhanced curves were fit to a two-compartmental model determining tumor perfusion, fractional plasma volume, permeability-surface area produce, and fractional interstitial volume on a voxel-by-voxel basis. After which, the tumors were imaged using photoacoustic CT (Optosonics, Inc., Indianapolis, IN 46202). The near infrared spectra (700-910 nm) within the vasculature was fit to linear combination of measured oxy- and deoxy-hemoglobin blood samples to obtain oxygen saturation levels (SaO II). Results: The PCT-S scanner was first calibrated using different samples of oxygenated blood, from which a statistical error ranging from 2.5-6.5% was measured and a plot of the hemoglobin dissociation curve was consistent with empirical formula. In vivo determination of tumor vasculature SaO II levels were measurably tracked, and spatially correlated to the periphery of the tumor. Tumor depend variations in SaO II - 0.32 (ovarian) and 0.60 (breast) - and in vascular physiology - perfusion, 1.03 and 0.063 mL/min/mL, and fractional plasma volume, 0.20 and 0.07 - were observed. Conclusion: Combined, PCT-S and CED-CT has the potential to measure intra-tumor levels of tumor oxygen saturation and vascular physiology, key parameters associated with hypoxia.

  1. Percutaneous CT-Guided Ablation in the Hepatic Dome: Artificially Induced Pneumothorax for Safe Transpleural Access

    PubMed Central

    Valle, Leonardo Guedes Moreira; Rochal, Rafael Dahmer; Rahal, Antônio; Garcia, Rodrigo Gobbo

    2015-01-01

    Ablative therapies have become a great alternative to surgical treatment of hepatic nodules. Some technical difficulties may negatively influence the effectiveness of this therapy, such as lesions located near the diaphragm. The transthoracic approach is commonly used to access these lesions. However, it is associated with an increased risk of complications, such as pneumothorax, hemothorax, alveolar bleeding, and others. We report a case of a radiofrequency ablation of a lesion in the hepatic dome, where an artificially induced pneumothorax was performed to guarantee a safe and effective access. The air was easily injected by a spinal needle and later aspirated by a single-lumen catheter. Induced pneumothorax shoud be considered in ablation of hepatic dome lesions, mainly when the transhepatic access is not appropriate. PMID:26713179

  2. Temporal change analysis for improved tumor detection in dedicated CT breast imaging using affine and free-form deformation

    NASA Astrophysics Data System (ADS)

    Dey, Joyoni; O'Connor, J. Michael; Chen, Yu; Glick, Stephen J.

    2008-03-01

    Preliminary evidence has suggested that computerized tomographic (CT) imaging of the breast using a cone-beam, flat-panel detector system dedicated solely to breast imaging has potential for improving detection and diagnosis of early-stage breast cancer. Hypothetically, a powerful mechanism for assisting in early stage breast cancer detection from annual screening breast CT studies would be to examine temporal changes in the breast from year-to-year. We hypothesize that 3D image registration could be used to automatically register breast CT volumes scanned at different times (e.g., yearly screening exams). This would allow radiologists to quickly visualize small changes in the breast that have developed during the period since the last screening CT scan, and use this information to improve the diagnostic accuracy of early-stage breast cancer detection. To test our hypothesis, fresh mastectomy specimens were imaged with a flat-panel CT system at different time points, after moving the specimen to emulate the re-positioning motion of the breast between yearly screening exams. Synthetic tumors were then digitally inserted into the second CT scan at a clinically realistic location (to emulate tumor growth from year-to-year). An affine and a spline-based 3D image registration algorithm was implemented and applied to the CT reconstructions of the specimens acquired at different times. Subtraction of registered image volumes was then performed to better analyze temporal change. Results from this study suggests that temporal change analysis in 3D breast CT can potentially be a powerful tool in improving the visualization of small lesion growth.

  3. Frequency of interleukin 28B rs12979860 C>T variants in Filipino patients chronically infected with hepatitis B virus.

    PubMed

    Baclig, Michael O; Reyes, Karen G; Mapua, Cynthia A; Gopez-Cervantes, Juliet; Natividad, Filipinas F

    2015-03-01

    Hepatitis B virus (HBV) is one of the most prevalent viral infections worldwide. Nearly 400 million individuals are chronic carriers of HBV. The aim of the present study was to determine the frequency of human interleukin 28B (IL28B) variants among treatment naive Filipino patients clinically diagnosed with chronic hepatitis B (CHB), and to compare the IL28B frequency distribution with various ethnic populations. Fifty-seven CHB patients and 43 normal controls were enrolled in this study. Real-time PCR was performed using the TaqMan genotyping assay for IL28B rs12979860. The allelic frequencies among normal controls were 0.94 and 0.06 for the IL28B rs12979860 C and T alleles, respectively. Eighty-eight percent were identified as homozygous for the IL28B C/C genotype and 12% were identified as heterozygous for the IL28B C/T genotype. Among CHB patients, the allelic frequencies were 0.90 for the IL28B C allele and 0.10 for the IL28B T allele. No IL28B T/T genotype was observed between the two groups. No significant difference in the distribution of IL28B genotypes was observed between normal controls and CHB patients. Allelic frequencies of IL28B among Filipinos were similar with other Asian populations but significantly different from Caucasians. The frequency of rs12979860 C>T variants among Filipino CHB patients has not yet been reported. These data provided new insight into the geographical frequency distribution of IL28B variants. Further studies are needed to determine the possible association between IL28B variants and response to pegylated-interferon-α plus ribavirin combination therapy among Filipino patients chronically infected with HBV.

  4. Automated detection and delineation of lung tumors in PET-CT volumes using a lung atlas and iterative mean-SUV threshold

    NASA Astrophysics Data System (ADS)

    Ballangan, Cherry; Wang, Xiuying; Eberl, Stefan; Fulham, Michael; Feng, Dagan

    2009-02-01

    Automated segmentation for the delineation of lung tumors with PET-CT is a challenging task. In PET images, primary lung tumors can have varying degrees of tracer uptake, which sometimes does not differ markedly from normal adjacent structures such as the mediastinum, heart and liver. In addition, separation of tumor from adjacent soft tissues and bone in the chest wall is problematic due to limited resolution. For CT, the tumor soft tissue density can be similar to that in the blood vessels and the chest wall; and although CT provides better boundary definition, exact tumor delineation is also difficult when the tumor density is similar to adjacent structures. We propose an innovative automated adaptive method to delineate lung tumors in PET-CT images in conjunction with a lung atlas in which an iterative mean-SUV (Standardized Uptake Value) threshold is used to gradually define the tumor region in PET. Tumor delineation in the CT data is performed using region growing and seeds obtained autonomously from the PET tumor regions. We evaluated our approach in 13 patients with non-small cell lung cancer (NSCLC) and found it could delineate tumors of different size, shape and location, even when when the NSCLC involved the chest wall.

  5. [Detection of tumors in the central zone of the prostate with 11C-Choline PET/CT].

    PubMed

    Garcia, J R; Soler, M; Moragas, M; Ponce, A; Moreno, C; Riera, E

    2014-01-01

    Prostate tumors originate 68% in the peripheral region and 24% in the transitional region where tumors originating in the central zone are rare (8%). However, diagnosis of the tumors in the central zone is important since they exhibit greater aggressiveness conditioned by their location and different biological behavior. Magnetic resonance imaging shows problems in identifying lesions in the central prostate zone, since this region has a heterogeneous signal, mainly after the primary treatment. Ultrasound guided sextant biopsy shows a negative result in 28% of prostate tumors. Therefore, it is advisable to repeat or even to perform saturation biopsies. We present two patients, one of them with suspected biochemical prostate cancer and one with biochemical recurrence after radical treatment. In both, (11)C-Choline PET/CT allowed detection of the tumor focus in the central zone of the prostate, with negative complementary diagnostic test and biopsies. PMID:24119550

  6. A Novel Markerless Technique to Evaluate Daily Lung Tumor Motion Based on Conventional Cone-Beam CT Projection Data

    SciTech Connect

    Yang Yin; Zhong Zichun; Guo Xiaohu; Wang Jing; Anderson, John; Solberg, Timothy; Mao Weihua

    2012-04-01

    Purpose: In this study, we present a novel markerless technique, based on cone beam computed tomography (CBCT) raw projection data, to evaluate lung tumor daily motion. Method and Materials: The markerless technique, which uses raw CBCT projection data and locates tumors directly on every projection, consists of three steps. First, the tumor contour on the planning CT is used to create digitally reconstructed radiographs (DRRs) at every projection angle. Two sets of DRRs are created: one showing only the tumor, and another with the complete anatomy without the tumor. Second, a rigid two-dimensional image registration is performed to register the DRR set without the tumor to the CBCT projections. After the registration, the projections are subtracted from the DRRs, resulting in a projection dataset containing primarily tumor. Finally, a second registration is performed between the subtracted projection and tumor-only DRR. The methodology was evaluated using a chest phantom containing a moving tumor, and retrospectively in 4 lung cancer patients treated by stereotactic body radiation therapy. Tumors detected on projection images were compared with those from three-dimensional (3D) and four-dimensional (4D) CBCT reconstruction results. Results: Results in both static and moving phantoms demonstrate that the accuracy is within 1 mm. The subsequent application to 22 sets of CBCT scan raw projection data of 4 lung cancer patients includes about 11,000 projections, with the detected tumor locations consistent with 3D and 4D CBCT reconstruction results. This technique reveals detailed lung tumor motion and provides additional information than conventional 4D images. Conclusion: This technique is capable of accurately characterizing lung tumor motion on a daily basis based on a conventional CBCT scan. It provides daily verification of the tumor motion to ensure that these motions are within prior estimation and covered by the treatment planning volume.

  7. The Transmediastinal, Intrapericardial Inferior Vena Cava Approach for Hepatectomy of a Large Liver Tumor Invading the Hepatic Vein Confluence.

    PubMed

    Tohyama, Taiji; Tamura, Kei; Takai, Akihiro; Hatano, Masahide; Kageyama, Shoichi; Inoue, Hitoshi; Watanabe, Jota; Takada, Yasutsugu

    2015-05-01

    We report the case of a large multilocular upper liver tumor invading the hepatic vein confluence in a 41-year-old male, and the safe resection of the tumor using a transmediastinal, intrapericardial inferior vena cava (IVC) approach. Several methods for exposing suprahepatic IVCs on the cranial side of the diaphragm have been reported. However, the approach to supradiaphragmatic IVCs varies, and there are currently no reports that provide a detailed description of the anatomical landmarks during the intrapericardial IVC approach. In the case reported herein, anatomic landmarks, including the prepericardial fat in the pericardial trigone, were confirmed during the transmediastinal, intrapericardial IVC approach. We believe that such anatomic landmarks are important to ensure a safe approach to the pericardium and the intrapericardial IVC through the anterior mediastinum. We think this case report is useful in elucidating the resection of large liver tumors invading the hepatic vein confluence.

  8. Adenovirus tumor targeting and hepatic untargeting by a coxsackie/adenovirus receptor ectodomain anti-carcinoembryonic antigen bispecific adapter.

    PubMed

    Li, Hua-Jung; Everts, Maaike; Pereboeva, Larisa; Komarova, Svetlana; Idan, Anat; Curiel, David T; Herschman, Harvey R

    2007-06-01

    Adenovirus vectors have a number of advantages for gene therapy. However, because of their lack of tumor tropism and their preference for liver infection following systemic administration, they cannot be used for systemic attack on metastatic disease. Many epithelial tumors (e.g., colon, lung, and breast) express carcinoembryonic antigen (CEA). To block the natural hepatic tropism of adenovirus and to "retarget" the virus to CEA-expressing tumors, we used a bispecific adapter protein (sCAR-MFE), which fuses the ectodomain of the coxsackie/adenovirus receptor (sCAR) with a single-chain anti-CEA antibody (MFE-23). sCAR-MFE untargets adenovirus-directed luciferase transgene expression in the liver by >90% following systemic vector administration. Moreover, sCAR-MFE can "retarget" adenovirus to CEA-positive epithelial tumor cells in cell culture, in s.c. tumor grafts, and in hepatic tumor grafts. The sCAR-MFE bispecific adapter should, therefore, be a powerful agent to retarget adenovirus vectors to epithelial tumor metastases.

  9. Comparison of manual vs. automated multimodality (CT-MRI) image registration for brain tumors

    SciTech Connect

    Sarkar, Abhirup; Santiago, Roberto J.; Smith, Ryan; Kassaee, Alireza . E-mail: Kassaee@xrt.upenn.edu

    2005-03-31

    Computed tomgoraphy-magnetic resonance imaging (CT-MRI) registrations are routinely used for target-volume delineation of brain tumors. We clinically use 2 software packages based on manual operation and 1 automated package with 2 different algorithms: chamfer matching using bony structures, and mutual information using intensity patterns. In all registration algorithms, a minimum of 3 pairs of identical anatomical and preferably noncoplanar landmarks is used on each of the 2 image sets. In manual registration, the program registers these points and links the image sets using a 3-dimensional (3D) transformation. In automated registration, the 3 landmarks are used as an initial starting point and further processing is done to complete the registration. Using our registration packages, registration of CT and MRI was performed on 10 patients. We scored the results of each registration set based on the amount of time spent, the accuracy reported by the software, and a final evaluation. We evaluated each software program by measuring the residual error between 'matched' points on the right and left globes and the posterior fossa for fused image slices. In general, manual registration showed higher misalignment between corresponding points compared to automated registration using intensity matching. This error had no directional dependence and was, most of the time, larger for a larger structure in both registration techniques. Automated algorithm based on intensity matching also gave the best results in terms of registration accuracy, irrespective of whether or not the initial landmarks were chosen carefully, when compared to that done using bone matching algorithm. Intensity-matching algorithm required the least amount of user-time and provided better accuracy.

  10. Hybrid gold-gadolinium nanoclusters for tumor-targeted NIRF/CT/MRI triple-modal imaging in vivo

    NASA Astrophysics Data System (ADS)

    Hu, De-Hong; Sheng, Zong-Hai; Zhang, Peng-Fei; Yang, Da-Zhi; Liu, Shu-Hui; Gong, Ping; Gao, Du-Yang; Fang, Sheng-Tao; Ma, Yi-Fan; Cai, Lin-Tao

    2013-01-01

    Multimodal imaging is highly desirable for accurate diagnosis because it can provide complementary information from each imaging modality. In this study, we prepared hybrid gold-gadolinium nanoclusters (NCs), which are ultrasmall, stable, biocompatible, and suitable for triple-modal NIRF/CT/MRI imaging. Upon intravenously injected, the hybrid NCs are effectively accumulated in tumor tissues and quickly clear by renal excretion, indicating their capacity of tumor targeting and low body residues. Notably, the ultrasmall hybrid NCs would penetrate into the solid tumor for capturing its heterostructure and do not induce potential toxicity in vivo. Hence, the well-defined hybrid gold-gadolinium NCs provide a versatile nanoprobe for cancer targeted imaging and diagnosis in vivo.Multimodal imaging is highly desirable for accurate diagnosis because it can provide complementary information from each imaging modality. In this study, we prepared hybrid gold-gadolinium nanoclusters (NCs), which are ultrasmall, stable, biocompatible, and suitable for triple-modal NIRF/CT/MRI imaging. Upon intravenously injected, the hybrid NCs are effectively accumulated in tumor tissues and quickly clear by renal excretion, indicating their capacity of tumor targeting and low body residues. Notably, the ultrasmall hybrid NCs would penetrate into the solid tumor for capturing its heterostructure and do not induce potential toxicity in vivo. Hence, the well-defined hybrid gold-gadolinium NCs provide a versatile nanoprobe for cancer targeted imaging and diagnosis in vivo. Electronic supplementary information (ESI) available. See DOI: 10.1039/c2nr33543c

  11. Hepatocellular carcinoma mouse models: Hepatitis B virus-associated hepatocarcinogenesis and haploinsufficient tumor suppressor genes

    PubMed Central

    Teng, Yuan-Chi; Shen, Zhao-Qing; Kao, Cheng-Heng; Tsai, Ting-Fen

    2016-01-01

    The multifactorial and multistage pathogenesis of hepatocellular carcinoma (HCC) has fascinated a wide spectrum of scientists for decades. While a number of major risk factors have been identified, their mechanistic roles in hepatocarcinogenesis still need to be elucidated. Many tumor suppressor genes (TSGs) have been identified as being involved in HCC. These TSGs can be classified into two groups depending on the situation with respect to allelic mutation/loss in the tumors: the recessive TSGs with two required mutated alleles and the haploinsufficient TSGs with one required mutated allele. Hepatitis B virus (HBV) is one of the most important risk factors associated with HCC. Although mice cannot be infected with HBV due to the narrow host range of HBV and the lack of a proper receptor, one advantage of mouse models for HBV/HCC research is the numerous and powerful genetic tools that help investigate the phenotypic effects of viral proteins and allow the dissection of the dose-dependent action of TSGs. Here, we mainly focus on the application of mouse models in relation to HBV-associated HCC and on TSGs that act either in a recessive or in a haploinsufficient manner. Discoveries obtained using mouse models will have a great impact on HCC translational medicine. PMID:26755878

  12. Case Report of Contrast-Enhanced Ultrasound Features of Primary Hepatic Neuroendocrine Tumor

    PubMed Central

    Li, Wei; Zhuang, Bo-wen; Wang, Zhu; Liao, Bing; Hong, Ling-yao; Xu, Ming; Lin, Xiao-na; Xie, Xiao-yan; Lu, Ming-de; Chen, Li-da; Wang, Wei

    2016-01-01

    Abstract Primary hepatic neuroendocrine tumors (PHNETs) are very rare and their clinical features and treatment outcomes are not well understood. It is difficult to reach a proper diagnosis before biopsy or resection. The aim of this study was to analyze the imaging features of PHNETs on contrast-enhanced ultrasound (CEUS). The clinical characteristics, CEUS findings, pathological features, treatment and prognosis of 6 patients with PHNET treated in our hospital were retrospectively analyzed. Most PHNETs occurred in middle-aged patients, and the most common clinical manifestation was right upper quadrant palpable mass and abdominal pain. Multiple small anechoic intralesional cavities occurred frequently in PHNET. Multilocular cystic with internal septation or monolocular with wall nodule could also be detected. On contrast-enhanced ultrasonography (CEUS), heterogeneous hyperenhancement in the arterial phase and wash-out hypoenhancement were observed in most patients, while computed tomography scanning yielded similar results. Diagnosis of PHNET was confirmed by immunohistochemical result and follow-up with the absence of extrahepatic primary sites. Five patients received surgical resection and 2 cases exhibited recurrence. Transcatheter arterial chemoembolization was performed in 1 patient with recurrence. Only 1 patient received conservative care. The median overall survival in 5 patients who underwent surgical treatment was 27 months (18–36 months). PHNET is a rare tumor, and its diagnosis is difficult. The CEUS features reported in this series may enrich the knowledge base for characterization of PHNET. PMID:27227910

  13. Complementary tumor vascularity imaging in a single PET-CT routine using FDG early dynamic blood flow and contrast-enhanced CT texture analysis

    NASA Astrophysics Data System (ADS)

    Carmi, Raz; Yefremov, Nikolay; Bernstine, Hanna; Groshar, David

    2014-03-01

    A feasibility study of improved PET-CT tumor imaging approach is presented. A single PET-CT routine includes three different techniques: 18F-FDG early dynamic blood flow intended for perfusion assessment; standard late 18F-FDG uptake; and high-resolution contrast-enhanced CT enabling tissue texture analysis. Both PET protocols utilize the same single standard radiotracer dose administration. Quantitative volumetric arterial perfusion maps are derived from the reconstructed dynamic PET images corresponding to successive acquisition time intervals of 3 seconds only. For achieving high accuracy, the analysis algorithm differentiates the first-pass arterial flow from other interfering dynamic effects, and a noise reduction scheme based on adaptive total-variation minimization aims to provide appreciable quantitative map in physical conditions of high noise and low spatial resolution. The CT texture analysis comprises a practical and robust method for generating volumetric tissue irregularity maps. A local map value is represented by the entropy function which is derived from a weighted co-occurrence matrix histogram of the corresponding image voxel three-dimensional vicinity. Unique entropy scaling scheme and parameter optimization process, as well as appropriate scaling for varying image noise levels and contrast agent concentrations, improve the results toward quantitative absolute measure with respect to diverse scanning conditions and key analysis parameters. Representative imaging results are demonstrated on several clinical cases involving different organs and cancer types. In these cases, significant tumor characterization relative to the normal surrounding tissues is seen on the quantitative maps of all three imaging techniques. This proof of concept can lead the way to a new practical diagnostic imaging application.

  14. Enhanced Ablation of High Intensity Focused Ultrasound with Microbubbles: An Experimental Study on Rabbit Hepatic VX2 Tumors

    SciTech Connect

    He Wei; Wang Wei Zhou Ping; Wang, Yixiang J.; Zhou Peng; Li Ruizhen; Wang Jinsheng; Ahuja, Anil T.

    2011-10-15

    Purpose: This study was designed to assess the enhanced effect of high intensity focused ultrasound (HIFU) ablation with microbubbles on rabbit hepatic VX2 tumors and to compare the detection sensitivity of CEUS and CECT to determine the residual viable tissue after ablation of HIFU. Methods: Forty rabbits with hepatic VX2 tumors were randomly separated into two groups (20 animals per group) before HIFU ablation. A bolus of 0.2 mL of saline or a microbubble-based ultrasound (US) contrast agent was injected intravenously to group I rabbits and group II rabbits, respectively. The HIFU ablation procedure was started 15 s after the injection. Tumors were examined with grayscale contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) immediately before and after HIFU ablation. Histopathologic assessment was performed immediately after treatment imaging. Results: Before ablation, intense contrast enhancement during arterial phase was observed at the whole tumors or the periphery of the tumors by CEUS and CECT. Lower HIFU energy was used in group II than in group I (P < 0.001). Histopathologic assessment revealed local residual viable tumor tissues due to incomplete ablation in 47.4% (9/19) of tumors in group I and 10% (2/20) of tumors in group II (P < 0.05). The concordance rate of CEUS (90.9%) with histopathology on residual tumor detection was higher than that of CECT (27.3%, P < 0.05). Conclusions: Introduction of the microbubble agent enhances HIFU therapeutic efficacy. CEUS proves to have high sensitivity in assessment of residual viable rabbit VX2 tumor after HIFU.

  15. Effective hepatic artery chemoembolization for advanced hepatocellular carcinoma with multiple tumor thrombi and pulmonary metastases: A case report

    PubMed Central

    Huang, De-Jia; Li, Yan-Hao; Luo, Yao-Chang; Huang, Jun-Zhen; He, Hai-Yuan

    2016-01-01

    Advanced hepatocellular carcinoma (HCC) with tumor thrombi invading the portal vein and extending into the right atrium (RA) through the hepatic vein is regarded as a terminal-stage condition. Intracardiac tumor thrombus and treatment via liver resection has been reported in the current literature, but results from this therapeutic approach remain unsatisfactory. The present study describes a rare case of HCC with metastatic portal vein, middle hepatic vein, inferior vena cava (IVC) and RA tumor thrombi, and pulmonary metastases. A 29-year-old woman was admitted to The First Affiliated Hospital of Guangxi Traditional Chinese Medical University (Nanning, China) subsequent to experiencing right upper quadrant abdominal pain. Following diagnosis, based on computed tomography analysis and laboratory data, the patient underwent an initial transcatheter arterial chemoembolization (TACE) treatment using fluorouracil (5-FU), pirarubicin, mitomycin C, Lipiodol and sodium alginate microball (KMG). At 1 month post-treatment, serum α-fetoprotein levels remained at >1,000 ng/ml. Subsequently, the patient underwent a second TACE treatment. At 1 month after the second treatment, the abdominal pain had been alleviated and the serum α-fetoprotein levels were reduced to <20 ng/ml. Imaging analysis indicated a marked reduction in tumor burden in the liver and the hepatic vein and IVC tumor thrombi. Furthermore, the portal vein and RA tumor thrombi, and the pulmonary metastases had disappeared. At 40 months after the second TACE therapy, the patient remains alive without any signs of recurrence. The present case demonstrates that the administration of TACE, using 5-FU, pirarubicin, mitomycin C, Lipiodol and KMG, functions as an effective treatment in cases of unresectable advanced HCC presenting with pulmonary metastases and extensive tumor thrombi in the IVC, the RA and one branch of the portal vein. PMID:27602147

  16. A pilot study of the prognostic significance of metabolic tumor size measurements in PET/CT imaging of lymphomas

    NASA Astrophysics Data System (ADS)

    Kallergi, Maria; Botsivali, Maria; Politis, Nikolaos; Menychtas, Dimitrios; Georgakopoulos, Alexandros; Chatziioannou, Sofia

    2015-03-01

    This study explores changes in metabolic tumor volume, metabolic tumor diameter, and maximum standardized uptake value (SUVmax), for earlier and more accurate identification of lymphomas' response to treatment using 18F- FDG PET/CT. Pre- and post-treatment PET/CT studies of 20 patients with Hodgkin disease (HL) and 7 patients with non- Hodgkin lymphoma (NHL) were retrospectively selected for this study. The diameter and volume of the metabolic tumor was determined by an in-house developed adaptive local thresholding technique based on a 50% threshold of the maximum pixel value within a region. Statistical analysis aimed at exploring associations between metabolic size measurements and SUVmax and the ability of the three biomarkers to predict the patients' response to treatment as defined by the four classes in the European Organization for Research and Treatment of Cancer (EORTC) guidelines. Results indicated moderate correlations between % change in metabolic tumor volume and % change in metabolic tumor maximum diameter (R=0.51) and between % change in maximum diameter and % change in SUVmax (R=0.52). The correlation between % change in tumor volume and % change in SUVmax was weak (R=0.24). The % change in metabolic tumor size, either volume or diameter, was a "very strong" predictor of response to treatment (R=0.89), stronger than SUVmax (R=0.63). In conclusion, metabolic tumor volume could have important prognostic value, possibly higher than maximum metabolic diameter or SUVmax that are currently the standard of practice. Volume measurements, however, should be based on robust and standardized segmentation methodologies to avoid variability. In addition, SUV-peak or lean body mass corrected SUV-peak may be a better PET biomarker than SUVmax when SUV-volume combinations are considered.

  17. Hepatitis B and C reactivation with tumor necrosis factor inhibitors: synopsis and interpretation of screening and prophylaxis recommendations.

    PubMed

    Fuchs, Inbal; Abu-Shakra, Mahmoud; Sikuler, Emanuel

    2013-06-01

    Information on reactivation of chronic viral hepatitis infection in patients who are candidates for tumor necrosis factor alpha inhibitors (TNFi) is in a constant state of flux. We retrieved the most updated guidelines (in English) of prominent rheumatological and gastroenterological professional socienties for the mangement of chronic hepatitis B (HBV) and hepatitis C virus (HCV) infection in the context of treatment with TNFi. Subsequently, the major areas of uncertainty and absence of consensus in the guidelines were located and a secondary search for additional studies addressing those areas was performed. Based on our search we formulated a personal interpretation applicable to health care settings with virological laboratories capable of performing viral load measurements, and health systems that can support use of potent nucleoside/tide analogues in well-defined patient populations. PMID:23882898

  18. Inhibition of cytokine-induced microvascular arrest of tumor cells by recombinant endostatin prevents experimental hepatic melanoma metastasis.

    PubMed

    Mendoza, Lorea; Valcárcel, María; Carrascal, Teresa; Egilegor, Eider; Salado, Clarisa; Sim, B Kim Lee; Vidal-Vanaclocha, Fernando

    2004-01-01

    We investigated effects of endostatin (ES) in the prometastatic microenvironment of inflammation occurring during the microvascular phase of cancer cell infiltration in the liver. We used a model of intrasplenic injection of B16 melanoma (B16M) cells leading to hepatic metastasis through vascular cell adhesion molecule-(VCAM-1)-mediated capillary arrest of cancer cells via interleukin-18 (IL-18)-dependent mechanism. We show that administration of 50 mg/kg recombinant human (rh) ES 30 min before B16M, plus repetition of same dose for 3 additional days decreased metastasis number by 60%. A single dose of rhES before B16M injection reduced hepatic microvascular retention of luciferase-transfected B16M by 40% and inhibited hepatic production of tumor necrosis factor alpha (TNF-alpha) and IL-18 and VCAM-1 expression by hepatic sinusoidal endothelia (HSE). Consistent with these data, rhES inhibited VCAM-1-dependent B16M cell adhesion to primary cultured HSE receiving B16M conditioned medium, and it abolished the HSE cell production of TNF-alpha and IL-18 induced by tumor-derived vascular endothelial cell growth factor (VEGF). rhES abrogated recombinant murine VEGF-induced tyrosine phosphorylation of KDR/flk-1 receptor in HSE cells, preventing the proinflammatory action of tumor-derived VEGF on HSE. rhES also abolished hepatic production of TNF-alpha, microvascular retention of luciferase-transfected B16M, and adhesion of B16M cells to isolated HSE cells, all of them induced in mice given 5 micro g/kg recombinant murine VEGF for 18 h. This capillary inflammation-deactivating capability constitutes a nonantiangiogenic antitumoral action of endostatin that decreases cancer cell arrest within liver microvasculature and prevents metastases promoted by proinflammatory cytokines induced by VEGF. PMID:14729638

  19. Size effect of Au/PAMAM contrast agent on CT imaging of reticuloendothelial system and tumor tissue.

    PubMed

    Wang, Wei; Li, Jian; Liu, Ransheng; Zhang, Aixu; Yuan, Zhiyong

    2016-12-01

    Polyamidoamine (PAMAM)-entrapped Au nanoparticles were synthesized with distinct sizes to figure out the size effect of Au-based contrast agent on CT imaging of passively targeted tissues. Au/PAMAM nanoparticles were first synthesized with narrow distribution of particles size of 22.2 ± 3.1, 54.2 ± 3.7, and 104.9 ± 4.7 nm in diameters. Size effect leads no significant difference on X-ray attenuation when Au/PAMAM was ≤0.05 mol/L. For CT imaging of a tumor model, small Au/PAMAM were more easily internalized via endocytosis in the liver, leading to more obviously enhanced contrast. Similarly, contrast agents with small sizes were more effective in tumor imaging because of the enhanced permeability and retention effect. Overall, the particle size of Au/PAMAM heavily affected the efficiency of CT enhancement in imaging RES and tumors. PMID:27671016

  20. Treatment of hepatic tumors by thermal versus mechanical effects of pulsed high intensity focused ultrasound in vivo

    NASA Astrophysics Data System (ADS)

    Peng, Song; Zhou, Ping; He, Wei; Liao, Manqiong; Chen, Lili; Ma, C.-M.

    2016-09-01

    The purpose of this study is to comparatively assess the thermal versus mechanical effects of pulsed high intensity focused ultrasound (HIFU) treatment on hepatic tumors in vivo. Forty-five rabbits with hepatic VX2 tumors were randomly separated into three groups (15 animals per group) before HIFU ablation. The total HIFU energy (in situ) of 1250 J was used for each tumor for three groups. In groups I and II, animals were treated with 1 MHz pulsed ultrasound at 1 Hz pulsed repetition frequency (PRF), 0.5 duty cycle (0.5 s on and 0.5 s off) and10 s duration for one spot sonication. For group II, in addition to HIFU treatment, microbubbles (SonoVue, Bracco, Milan, Italy) were injected via vein before sonication acting as a synergist. In group III, animals were treated with 1 MHz pulsed ultrasound at 10 Hz PRF, 0.1 duty cycle (0.1 s on and 0.9 s off) and 10 s duration for one sonication. The total treatment spots were calculated according to the tumor volume. Tumors were examined with contrast-enhanced computed tomography (CECT) immediately prior to and post HIFU treatment. Histopathologic assessment was performed 3 h after treatment. Our study showed that all animals tolerated the HIFU treatment well. Our data showed that mechanical HIFU could lead to controlled injury in rabbit hepatic tumors with different histological changes in comparison to thermal HIFU with or without microbubbles.

  1. Liver membrane proteome glycosylation changes in mice bearing an extra-hepatic tumor.

    PubMed

    Lee, Albert; Chick, Joel M; Kolarich, Daniel; Haynes, Paul A; Robertson, Graham R; Tsoli, Maria; Jankova, Lucy; Clarke, Stephen J; Packer, Nicolle H; Baker, Mark S

    2011-09-01

    Cancer is well known to be associated with alterations in membrane protein glycosylation (Bird, N. C., Mangnall, D., and Majeed, A. W. (2006) Biology of colorectal liver metastases: A review. J. Surg. Oncol. 94, 68-80; Dimitroff, C. J., Pera, P., Dall'Olio, F., Matta, K. L., Chandrasekaran, E. V., Lau, J. T., and Bernacki, R. J. (1999) Cell surface n-acetylneuraminic acid alpha2,3-galactoside-dependent intercellular adhesion of human colon cancer cells. Biochem. Biophys. Res. Commun. 256, 631-636; and Arcinas, A., Yen, T. Y., Kebebew, E., and Macher, B. A. (2009) Cell surface and secreted protein profiles of human thyroid cancer cell lines reveal distinct glycoprotein patterns. J. Proteome Res. 8, 3958-3968). Equally, it has been well established that tumor-associated inflammation through the release of pro-inflammatory cytokines is a common cause of reduced hepatic drug metabolism and increased toxicity in advanced cancer patients being treated with cytotoxic chemotherapies. However, little is known about the impact of bearing a tumor (and downstream effects like inflammation) on liver membrane protein glycosylation. In this study, proteomic and glycomic analyses were used in combination to determine whether liver membrane protein glycosylation was affected in mice bearing the Engelbreth-Holm Swarm sarcoma. Peptide IPG-IEF and label-free quantitation determined that many enzymes involved in the protein glycosylation pathway specifically; mannosidases (Man1a-I, Man1b-I and Man2a-I), mannoside N-acetylglucosaminyltransferases (Mgat-I and Mgat-II), galactosyltransferases (B3GalT-VII, B4GalT-I, B4GalT-III, C1GalT-I, C1GalT-II, and GalNT-I), and sialyltransferases (ST3Gal-I, ST6Gal-I, and ST6GalNAc-VI) were up-regulated in all livers of tumor-bearing mice (n = 3) compared with nontumor bearing controls (n = 3). In addition, many cell surface lectins: Sialoadhesin-1 (Siglec-1), C-type lectin family 4f (Kupffer cell receptor), and Galactose-binding lectin 9 (Galectin-9

  2. Graphics processing unit-accelerated non-rigid registration of MR images to CT images during CT-guided percutaneous liver tumor ablations

    PubMed Central

    Tokuda, Junichi; Plishker, William; Torabi, Meysam; Olubiyi, Olutayo I; Zaki, George; Tatli, Servet; Silverman, Stuart G.; Shekhar, Raj; Hata, Nobuhiko

    2015-01-01

    Rationale and Objectives Accuracy and speed are essential for the intraprocedural nonrigid MR-to-CT image registration in the assessment of tumor margins during CT-guided liver tumor ablations. While both accuracy and speed can be improved by limiting the registration to a region of interest (ROI), manual contouring of the ROI prolongs the registration process substantially. To achieve accurate and fast registration without the use of an ROI, we combined a nonrigid registration technique based on volume subdivision with hardware acceleration using a graphical processing unit (GPU). We compared the registration accuracy and processing time of GPU-accelerated volume subdivision-based nonrigid registration technique to the conventional nonrigid B-spline registration technique. Materials and Methods Fourteen image data sets of preprocedural MR and intraprocedural CT images for percutaneous CT-guided liver tumor ablations were obtained. Each set of images was registered using the GPU-accelerated volume subdivision technique and the B-spline technique. Manual contouring of ROI was used only for the B-spline technique. Registration accuracies (Dice Similarity Coefficient (DSC) and 95% Hausdorff Distance (HD)), and total processing time including contouring of ROIs and computation were compared using a paired Student’s t-test. Results Accuracy of the GPU-accelerated registrations and B-spline registrations, respectively were 88.3 ± 3.7% vs 89.3 ± 4.9% (p = 0.41) for DSC and 13.1 ± 5.2 mm vs 11.4 ± 6.3 mm (p = 0.15) for HD. Total processing time of the GPU-accelerated registration and B-spline registration techniques was 88 ± 14 s vs 557 ± 116 s (p < 0.000000002), respectively; there was no significant difference in computation time despite the difference in the complexity of the algorithms (p = 0.71). Conclusion The GPU-accelerated volume subdivision technique was as accurate as the B-spline technique and required significantly less processing time. The GPU

  3. Imaging Intratumoral Nanoparticle Uptake After Combining Nanoembolization with Various Ablative Therapies in Hepatic VX2 Rabbit Tumors.

    PubMed

    Tam, Alda L; Melancon, Marites P; Abdelsalam, Mohamed; Figueira, Tomas Appleton; Dixon, Katherine; McWatters, Amanda; Zhou, Min; Huang, Qian; Mawlawi, Osama; Dunner, Kenneth; Li, Chun; Gupta, Sanjay

    2016-02-01

    Combining image-guided therapy techniques for the treatment of liver cancers is a strategy that is being used to improve local tumor control rates. Here, we evaluate the intratumoral uptake of nanoparticles used in combination with radiofrequency ablation (RFA), irreversible electroporation (IRE), or laser induced thermal therapy (LITT). Eight rabbits with VX2 tumor in the liver underwent one of four treatments: (i) nanoembolization (NE) with radiolabeled, hollow gold nanoparticles loaded with doxorubicin (⁶⁴Cu-PEG-HAuNS-DOX); (ii) NE + RFA; (iii) NE + IRE; (iv) NE +LITT. Positron emission tomography/computed tomography (PET/CT) imaging was obtained 1-hr or 18-hrs after intervention. Tissue samples were collected for autoradiography and transmission electron microscopy (TEM) analysis. PET/CT imaging at 1-hr showed focal deposition of oil and nanoparticles in the tumor only after NE+ RFA but at 18-hrs, all animals had focal accumulation of oil and nanoparticles in the tumor region. Autoradiograph analysis demonstrated nanoparticle deposition in the tumor and in the ablated tissues adjacent to the tumor when NE was combined with ablation. TEM results showed the intracellular uptake of nanoparticles in tumor only after NE + IRE. Nanoparticles demonstrated a structural change, suggesting direct interaction, potentially leading to drug release, only after NE + LITT. The findings demonstrate that a combined NE and ablation treatment technique for liver tumors is feasible, resulting in deposition of nanoparticles in and around the tumor. Depending on the ablative energy applied, different effects are seen on nanoparticle localization and structure. These effects should be considered when designing nanoparticles for use in combination with ablation technologies. PMID:27305763

  4. Imaging Intratumoral Nanoparticle Uptake after Combining Nanoembolization with Various Ablative Therapies in Hepatic VX2 Rabbit Tumors

    PubMed Central

    Tam, Alda L; Melancon, Marites P.; Abdelsalam, Mohamed; Figueira, Tomas Appleton; Dixon, Katherine; McWatters, Amanda; Zhou, Min; Huang, Qian; Mawlawi, Osama; Dunner, Kenneth; Li, Chun; Gupta, Sanjay

    2016-01-01

    Combining image-guided therapy techniques for the treatment of liver cancers is a strategy that is being used to improve local tumor control rates. Here, we evaluate the intratumoral uptake of nanoparticles used in combination with radiofrequency ablation (RFA), irreversible electroporation (IRE), or laser induced thermal therapy (LITT). Eight rabbits with VX2 tumor in the liver underwent one of four treatments: (i) nanoembolization (NE) with radiolabeled, hollow gold nanoparticles loaded with doxorubicin (64Cu-PEG-HAuNS-DOX); (ii) NE+RFA; (iii) NE+IRE; (iv) NE+LITT. Positron emission tomography/computed tomography (PET/CT) imaging was obtained 1-hr or 18-hrs after intervention. Tissue samples were collected for autoradiography and transmission electron microscopy (TEM) analysis. PET/CT imaging at 1-hr showed focal deposition of oil and nanoparticles in the tumor only after NE+RFA but at 18-hrs, all animals had focal accumulation of oil and nanoparticles in the tumor region. Autoradiograph analysis demonstrated nanoparticle deposition in the tumor and in the ablated tissues adjacent to the tumor when NE was combined with ablation. TEM results showed the intracellular uptake of nanoparticles in tumor only after NE+IRE. Nanoparticles demonstrated a structural change, suggesting direct interaction, potentially leading to drug release, only after NE+LITT. The findings demonstrate that a combined NE and ablation treatment technique for liver tumors is feasible, resulting in deposition of nanoparticles in and around the tumor. Depending on the ablative energy applied, different effects are seen on nanoparticle localization and structure. These effects should be considered when designing nanoparticles for use in combination with ablation technologies. PMID:27305763

  5. Transarterial chemoembolization combined with sorafenib for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus

    PubMed Central

    Zhang, Yong-Fa; Wei, Wei; Wang, Jia-Hong; Xu, Li; Jian, Pei-En; Xiao, Cheng-Zuo; Zhong, Xiao-Ping; Shi, Ming; Guo, Rong-Ping

    2016-01-01

    Objective To compare the treatment outcomes of sorafenib plus transarterial chemoembolization (TACE) vs TACE alone in patients with hepatocellular carcinoma (HCC) and hepatic vein tumor thrombus (HVTT). Methods Twenty patients who were initially diagnosed with HCC and HVTT and received TACE combined with sorafenib during February 2009 to October 2013 were included in the study. To minimize selection bias, these patients were compared with 60 case-matched controls selected from a pool of 81 patients (in a 1:3 ratio) who received TACE alone during the same period. The primary end point was overall survival (OS). The secondary end points were time to progression, disease control rate, and adverse events. Results After a median follow-up period of 12.5 months (range, 1.03–44.23 months), the OS of the combined group was found to be significantly higher compared with the monotherapy group (14.9 vs 6.1 months, P=0.010). The time to progression was found to be significantly longer in the combined group (4.9 vs 2.4 months, P=0.016). Univariate and multivariate analyses revealed that the treatment allocation was an independent predictor of OS. Conclusion Sorafenib plus TACE was well tolerated and was more effective in treating patients with advanced HCC and HVTT. Future trials with prospective larger samples are required to validate these results. PMID:27471398

  6. Nuclear location-dependent role of peripheral benzodiazepine receptor (PBR) in hepatic tumoral cell lines proliferation.

    PubMed

    Corsi, L; Geminiani, E; Avallone, R; Baraldi, M

    2005-04-15

    PBR is involved in numerous biological functions, including steroid biosynthesis, mitochondrial oxidative phosphorylation and cell proliferation. The presence of PBR at the perinuclear/nuclear subcellular level has been demonstrated in aggressive breast cancer cell lines and human glioma cells where it seems to be involved in cell proliferation. In our study we investigated the presence of perinuclear/nuclear PBR in different hepatic tumor cell lines with regard to binding to [3H] PK 11195 and protein analysis. The results obtained by saturation binding experiments and scatchard analysis of perinuclear/nuclear PBR density in parallel with the results on the growth curves of the cell lines tested, indicate that the perinuclear/nuclear PBR density correlates inversely with cell doubling time. Moreover, the cell line with high perinuclear/nuclear PBR proliferated in response to PBR ligand, whereas that with low perinuclear/nuclear PBR did not. Our results reinforce the idea that the subcellular localisation of PBR defines its function and that this receptor could be a possible target for new strategies against cancer.

  7. Ultrastable polyethyleneimine-stabilized gold nanoparticles modified with polyethylene glycol for blood pool, lymph node and tumor CT imaging

    NASA Astrophysics Data System (ADS)

    Zhang, Yongxing; Wen, Shihui; Zhao, Lingzhou; Li, Du; Liu, Changcun; Jiang, Wenbin; Gao, Xiang; Gu, Wentao; Ma, Nan; Zhao, Jinhua; Shi, Xiangyang; Zhao, Qinghua

    2016-03-01

    Development of new long-circulating contrast agents for computed tomography (CT) imaging of different biological systems still remains a great challenge. Here, we report the design and synthesis of branched polyethyleneimine (PEI)-stabilized gold nanoparticles (Au PSNPs) modified with polyethylene glycol (PEG) for blood pool, lymph node, and tumor CT imaging. In this study, thiolated PEI was first synthesized and used as a stabilizing agent to form AuNPs. The formed Au PSNPs were then grafted with PEG monomethyl ether via PEI amine-enabled conjugation chemistry, followed by acetylation of the remaining PEI surface amines. The formed PEGylated Au PSNPs were characterized via different methods. We show that the PEGylated Au PSNPs with an Au core size of 5.1 nm have a relatively long half-decay time (7.8 h), and display a better X-ray attenuation property than conventionally used iodine-based CT contrast agents (e.g., Omnipaque), and are hemocompatible and cytocompatible in a given concentration range. These properties of the Au PSNPs afford their uses as a contrast agent for effective CT imaging of the blood pool and major organs of rats, lymph node of rabbits, and the xenografted tumor model of mice. Importantly, the PEGylated Au PSNPs could be excreted out of the body with time and also showed excellent in vivo stability. These findings suggest that the formed PEGylated Au PSNPs may be used as a promising contrast agent for CT imaging of different biological systems.Development of new long-circulating contrast agents for computed tomography (CT) imaging of different biological systems still remains a great challenge. Here, we report the design and synthesis of branched polyethyleneimine (PEI)-stabilized gold nanoparticles (Au PSNPs) modified with polyethylene glycol (PEG) for blood pool, lymph node, and tumor CT imaging. In this study, thiolated PEI was first synthesized and used as a stabilizing agent to form AuNPs. The formed Au PSNPs were then grafted with PEG

  8. Evaluation of thoracic tumors with (18)F-FMT and (18)F-FDG PET-CT: a clinicopathological study.

    PubMed

    Kaira, Kyoichi; Oriuchi, Noboru; Shimizu, Kimihiro; Ishikita, Tomohiro; Higuchi, Tetsuya; Imai, Hisao; Yanagitani, Noriko; Sunaga, Noriaki; Hisada, Takeshi; Ishizuka, Tamotsu; Kanai, Yoshikatsu; Endou, Hitoshi; Nakajima, Takashi; Endo, Keigo; Mori, Masatomo

    2009-03-01

    L-[3-(18)F]-alpha-methyltyrosine ((18)F-FMT) is an aminoacid tracer for positron emission tomography (PET). The aim of this study was to determine whether PET-CT with (18)F-FMT provides additional information for the preoperative diagnostic workup as compared with (18)F-FDG PET. PET-CT studies with (18)F-FMT and (18)F-FDG were performed as a part of the preoperative workup in 36 patients with histologically confirmed bronchial carcinoma, 6 patients with benign lesions and a patient with atypical carcinoid. Expression of L-type amino acid transporter 1 (LAT1), CD98, Ki-67 labeling index, VEGF, CD31 and CD34 of the resected tumors were analyzed by immunohistochemical staining, and correlated with the uptake of PET tracers. For the detection of pulmonary malignant tumors, (18)F-FMT PET exhibited a sensitivity of 84% whereas the sensitivity for (18)F-FDG PET was 89% (p = 0.736). (18)F-FMT PET-CT and (18)F-FDG PET-CT agreed with pathological staging in 85 and 68%, respectively (p = 0.151). (18)F-FMT uptake was closely correlated with LAT1, CD98, cell proliferation and angiogenesis. The specificity of (18)F-FMT PET for diagnosing thoracic tumors was higher than that of (18)F-FDG PET. Our results suggest that coexpression of LAT1 and CD98 in addition to cell proliferation and angiogenesis is relavant for the progression and metastasis of lung cancer.

  9. Diagnostic performance of gadoxetic acid (Primovist)-enhanced MR imaging versus CT during hepatic arteriography and portography for small hypervascular hepatocellular carcinoma.

    PubMed

    Yim, Sun Young; Park, Beom Jin; Um, Soon Ho; Han, Na Yeon; Sung, Deuk Jae; Cho, Sung Bum; Lee, Seung Hwa; Kim, Min Ju; Jung, Jin Yong; Kim, Jin Dong; Seo, Yeon Seok; Kim, Dong Sik; An, Hyonggin; Kim, Yun Hwan

    2016-09-01

    To compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with that of computed tomography (CT) during hepatic arteriography and arterial portography (CT HA/AP) for detecting hepatocellular carcinoma (HCC) from small hypervascular nodules.This retrospective study included 38 patients with 131 hypervascular nodules (≤2 cm) who had underwent MRI and CT HA/AP within a 2-week interval. Two observers analyzed MRI while other 2 observers analyzed CT HA/AP. Thereafter, MRI observers reviewed the CT HA/AP and magnetic resonance (MR) images again using both modalities. HCC was diagnosed by pathologic or imaging studies according to American Association for the Study of Liver Diseases (AASLD) criteria. Alternative free-response receiver operating characteristic (ROC) analysis was performed on a lesion-by-lesion basis. Diagnostic accuracy (area under the ROC curve [Az]), sensitivity, specificity, and positive and negative predictive values were calculated.The pooled Az was significantly higher for the combined modalities (0.946) than for MRI alone (0.9, P = 0.004), and for MRI than for CT HA/AP alone (0.827, P = 0.0154). Subgroup analysis for HCC ≤1 cm showed the sensitivity of the combined modalities (79.4%) was significantly higher than for MRI (52.9%) and CT HA/AP alone (50%) (both, P < 0.005). The specificity of the combined modalities was not different from MRI alone (98.8% vs. 97.3%, P = 0.5), but was significantly higher than for CT HA/AP alone (98.8% vs. 92.5%, P = 0.022).Hypervascular HCCs >1 to 2 cm can be diagnosed sufficiently by MRI. The combined modalities increased the diagnostic accuracy of HCCs ≤1 cm, compared with MRI or CT HA/AP alone. PMID:27684824

  10. Observer Performance in the Detection and Classification of Malignant Hepatic Nodules and Masses with CT Image-Space Denoising and Iterative Reconstruction

    PubMed Central

    Yu, Lifeng; Li, Zhoubo; Manduca, Armando; Blezek, Daniel J.; Hough, David M.; Venkatesh, Sudhakar K.; Brickner, Gregory C.; Cernigliaro, Joseph C.; Hara, Amy K.; Fidler, Jeff L.; Lake, David S.; Shiung, Maria; Lewis, David; Leng, Shuai; Augustine, Kurt E.; Carter, Rickey E.; Holmes, David R.; McCollough, Cynthia H.

    2015-01-01

    Purpose To determine if lower-dose computed tomographic (CT) scans obtained with adaptive image-based noise reduction (adaptive nonlocal means [ANLM]) or iterative reconstruction (sinogram-affirmed iterative reconstruction [SAFIRE]) result in reduced observer performance in the detection of malignant hepatic nodules and masses compared with routine-dose scans obtained with filtered back projection (FBP). Materials and Methods This study was approved by the institutional review board and was compliant with HIPAA. Informed consent was obtained from patients for the retrospective use of medical records for research purposes. CT projection data from 33 abdominal and 27 liver or pancreas CT examinations were collected (median volume CT dose index, 13.8 and 24.0 mGy, respectively). Hepatic malignancy was defined by progression or regression or with histopathologic findings. Lower-dose data were created by using a validated noise insertion method (10.4 mGy for abdominal CT and 14.6 mGy for liver or pancreas CT) and images reconstructed with FBP, ANLM, and SAFIRE. Four readers evaluated routine-dose FBP images and all lower-dose images, circumscribing liver lesions and selecting diagnosis. The jackknife free-response receiver operating characteristic figure of merit (FOM) was calculated on a per–malignant nodule or per-mass basis. Noninferiority was defined by the lower limit of the 95% confidence interval (CI) of the difference between lower-dose and routine-dose FOMs being less than −0.10. Results Twenty-nine patients had 62 malignant hepatic nodules and masses. Estimated FOM differences between lower-dose FBP and lower-dose ANLM versus routine-dose FBP were noninferior (difference: −0.041 [95% CI: −0.090, 0.009] and −0.003 [95% CI: −0.052, 0.047], respectively). In patients with dedicated liver scans, lower-dose ANLM images were noninferior (difference: +0.015 [95% CI: −0.077, 0.106]), whereas lower-dose FBP images were not (difference −0.049 [95% CI:

  11. Tumor Tracking Method Based on a Deformable 4D CT Breathing Motion Model Driven by an External Surface Surrogate

    SciTech Connect

    Fassi, Aurora; Schaerer, Joël; Fernandes, Mathieu; Riboldi, Marco; Sarrut, David; Baroni, Guido

    2014-01-01

    Purpose: To develop a tumor tracking method based on a surrogate-driven motion model, which provides noninvasive dynamic localization of extracranial targets for the compensation of respiration-induced intrafraction motion in high-precision radiation therapy. Methods and Materials: The proposed approach is based on a patient-specific breathing motion model, derived a priori from 4-dimensional planning computed tomography (CT) images. Model parameters (respiratory baseline, amplitude, and phase) are retrieved and updated at each treatment fraction according to in-room radiography acquisition and optical surface imaging. The baseline parameter is adapted to the interfraction variations obtained from the daily cone beam (CB) CT scan. The respiratory amplitude and phase are extracted from an external breathing surrogate, estimated from the displacement of the patient thoracoabdominal surface, acquired with a noninvasive surface imaging device. The developed method was tested on a database of 7 lung cancer patients, including the synchronized information on internal and external respiratory motion during a CBCT scan. Results: About 30 seconds of simultaneous acquisition of CBCT and optical surface images were analyzed for each patient. The tumor trajectories identified in CBCT projections were used as reference and compared with the target trajectories estimated from surface displacement with the a priori motion model. The resulting absolute differences between the reference and estimated tumor motion along the 2 image dimensions ranged between 0.7 and 2.4 mm; the measured phase shifts did not exceed 7% of the breathing cycle length. Conclusions: We investigated a tumor tracking method that integrates breathing motion information provided by the 4-dimensional planning CT with surface imaging at the time of treatment, representing an alternative approach to point-based external–internal correlation models. Although an in-room radiograph-based assessment of the

  12. SU-E-I-84: Accuracy Comparison of Multi-Modality Image-Based Volumes of Rodent Solid Tumors Using In-Air Micro-CT Image Volume

    SciTech Connect

    Lee, Y; Fullerton, G; Goins, B

    2015-06-15

    Purpose: Tumor volume is considered as a better predictor for therapy response monitoring and tumor staging over Response Evaluation Criteria In Solid Tumors (RECIST) or World Health Organization (WHO) criteria. In this study, the accuracy of subcutaneous rodent tumor volumes using preclinical magnetic resonance imaging (MRI), micro-computed tomography (micro-CT) and ultrasound (US) equipment and with an external caliper was compared using in-air micro-CT image volume of excised tumors determined as reference tumor volume in our prior study. Methods: MR, US and micro-CT images of subcutaneous SCC4 head and neck tumor xenografts were acquired 4, 6, 9, 11 and 13 days after tumor cell inoculation. Before MR and US scans, caliper measurements were made. After tumors were excised, in-air micro-CT imaging and ex vivo caliper measurements were performed. Tumor volumes were calculated using formula V = (π/6)*a*b*c where a, b and c are the maximum diameters in three perpendicular dimensions determined by the three image modalities and caliper, and compared with reference tumor volume by linear regression analysis as well as Bland-Altman plots. A one-way Analysis of Variance (ANOVA) test was also performed to compare volumes among caliper measurements. Results: The correlation coefficients (R2) of the regression lines for tumor volumes measured by the three imaging modalities and caliper were 0.9939, 0.9669, 0.9806, 0.9274, 0.9619 and 0.9819 for MRI, US and micro-CT, caliperbeforeMRI, caliperbeforeUS and ex vivo caliper respectively. In Bland-Altman plots, the average of tumor volume difference from reference tumor volume (bias) was significant for caliper and micro- CT, but not for MRI and US. Comparison of caliper measurements showed a significant difference (p < 0.05). Conclusion: Using the in-air micro-CT image volume, tumor volume measured by MRI was the most accurate among the three imaging modalities. In vivo caliper volume measurements showed unreliability while ex

  13. Computed tomography of infantile hepatic hemangioendothelioma

    SciTech Connect

    Lucaya, J.; Enriquez, G.; Amat, L.; Gonzalez-Rivero, M.A.

    1985-04-01

    Computed tomography (CT) was performed on five infants with hepatic hemangioendothelioma. Precontrast scans showed solitary or multiple, homogeneous, circumscribed areas with reduced attenuation values. Tiny tumoral calcifications were identified in two patients. Serial scans, after injection of a bolus of contrast material, showed early massive enhancement, which was either diffuse or peripheral. On delayed scans, multinocular tumors became isodense with surrounding liver, while all solitary ones showed varied degrees of centripetal enhancement and persistent central cleftlike unenhanced areas. The authors believe that these CT features are characteristic and obviate arteriographic confirmation.

  14. Down-regulation of the cancer/testis antigen 45 (CT45) is associated with altered tumor cell morphology, adhesion and migration

    PubMed Central

    2013-01-01

    Background Due to their restricted expression in male germ cells and certain tumors, cancer/testis (CT) antigens are regarded as promising targets for tumor therapy. CT45 is a recently identified nuclear CT antigen that was associated with a severe disease score in Hodgkin’s lymphoma and poor prognosis in multiple myeloma. As for many CT antigens, the biological function of CT45 in developing germ cells and in tumor cells is largely unknown. Methods CT45 expression was down-regulated in CT45-positive Hodgkin’s lymphoma (L428), fibrosarcoma (HT1080) and myeloma (U266B1) cells using RNA interference. An efficient CT45 knock-down was confirmed by immunofluorescence staining and/or Western blotting. These cellular systems allowed us to analyze the impact of CT45 down-regulation on proliferation, cell cycle progression, morphology, adhesion, migration and invasive capacity of tumor cells. Results Reduced levels of CT45 did not coincide with changes in cell cycle progression or proliferation. However, we observed alterations in cell adherence, morphology and migration/invasion after CT45 down-regulation. Significant changes in the distribution of cytoskeleton-associated proteins were detected by confocal imaging. Changes in cell adherence were recorded in real-time using the xCelligence system with control and siRNA-treated cells. Altered migratory and invasive capacity of CT45 siRNA-treated cells were visualized in 3D migration and invasion assays. Moreover, we found that CT45 down-regulation altered the level of the heterogeneous nuclear ribonucleoprotein syncrip (hnRNP-Q1) which is known to be involved in the control of focal adhesion formation and cell motility. Conclusions Providing first evidence of a cell biological function of CT45, we suggest that this cancer/testis antigen is involved in the modulation of cell morphology, cell adherence and cell motility. Enhanced motility and/or invasiveness of CT45-positive cells could contribute to the more severe

  15. Study of Aided Diagnosis of Hepatic Carcinoma Based on Artificial Neural Network Combined with Tumor Marker Group

    NASA Astrophysics Data System (ADS)

    Tan, Shanjuan; Feng, Feifei; Wu, Yongjun; Wu, Yiming

    To develop a computer-aided diagnostic scheme by using an artificial neural network (ANN) combined with tumor markers for diagnosis of hepatic carcinoma (HCC) as a clinical assistant method. 140 serum samples (50 malignant, 40 benign and 50 normal) were analyzed for α-fetoprotein (AFP), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), sialic acid (SA) and calcium (Ca). The five tumor marker values were then used as ANN inputs data. The result of ANN was compared with that of discriminant analysis by receiver operating characteristic (ROC) curve (AUC) analysis. The diagnostic accuracy of ANN and discriminant analysis among all samples of the test group was 95.5% and 79.3%, respectively. Analysis of multiple tumor markers based on ANN may be a better choice than the traditional statistical methods for differentiating HCC from benign or normal.

  16. Ga-68 DOTATOC PET/CT-Guided Biopsy and Cryoablation with Autoradiography of Biopsy Specimen for Treatment of Tumor-Induced Osteomalacia.

    PubMed

    Maybody, Majid; Grewal, Ravinder K; Healey, John H; Antonescu, Cristina R; Fanchon, Louise; Hwang, Sinchun; Carrasquillo, Jorge A; Kirov, Assen; Farooki, Azeez

    2016-09-01

    Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by small benign tumors of mesenchymal origin also known as phosphaturic mesenchymal tumors mixed connective tissue variant. Excellent prognosis is expected with eradication of the culprit tumor. These small tumors are notoriously difficult to localize with conventional imaging studies; this often leads to an extensive work up and prolonged morbidity. We report a patient with clinical diagnosis of TIO whose culprit tumor was localized with Ga-68 DOTATOC PET/CT and MRI. Biopsy and cryoablation were performed under Ga-68 DOTATOC PET/CT guidance. Autoradiography of the biopsy specimen was performed and showed in situ correlation between Ga-68 DOTATOC uptake and histopathology with millimeter resolution. PMID:27150801

  17. Simulation of dosimetric consequences of 4D-CT-based motion margin estimation for proton radiotherapy using patient tumor motion data

    NASA Astrophysics Data System (ADS)

    Koybasi, Ozhan; Mishra, Pankaj; St. James, Sara; Lewis, John H.; Seco, Joao

    2014-02-01

    For the radiation treatment of lung cancer patients, four-dimensional computed tomography (4D-CT) is a common practice used clinically to image tumor motion and subsequently determine the internal target volume (ITV) from the maximum intensity projection (MIP) images. ITV, which is derived from short pre-treatment 4D-CT scan (<6 s per couch position), may not adequately cover the extent of tumor motion during the treatment, particularly for patients that exhibit a large respiratory variability. Inaccurate tumor localization may result in under-dosage of the tumor or over-dosage of the surrounding tissues. The purpose of this study is therefore to assess the degree of tumor under-dosage in case of regular and irregular breathing for proton radiotherapy using ITV-based treatment planning. We place a spherical lesion into a modified XCAT phantom that is also capable of producing 4D images based on irregular breathing, and move the tumor according to real tumor motion data, which is acquired over multiple days by tracking gold fiducial markers implanted into the lung tumors of patients. We derive ITVs by taking the union of all tumor positions during 6 s of tumor motion in the phantom using the first day patient tumor tracking data. This is equivalent to ITVs generated clinically from cine-mode 4D-CT MIP images. The treatment plans created for different ITVs are then implemented on dynamic phantoms with tumor motion governed by real tumor tracking data from consecutive days. By comparing gross tumor volume dose distribution on days of ‘treatment’ with the ITV dose distribution, we evaluate the deviation of the actually delivered dose from the predicted dose. Our results have shown that the proton treatment planning on ITV derived from pre-treatment cine-mode 4D-CT can result in under-dosage (dose covering 95% of volume) of the tumor by up to 25.7% over 3 min of treatment for the patient with irregular respiratory motion. Tumor under-dosage is less significant for

  18. Tumor and normal tissue motion in the thorax during respiration: Analysis of volumetric and positional variations using 4D CT

    SciTech Connect

    Weiss, Elisabeth . E-mail: eweiss@mcvh-vcu.edu; Wijesooriya, Krishni; Dill, S. Vaughn; Keall, Paul J.

    2007-01-01

    Purpose: To investigate temporospatial variations of tumor and normal tissue during respiration in lung cancer patients. Methods and Materials: In 14 patients, gross tumor volume (GTV) and normal tissue structures were manually contoured on four-dimensional computed tomography (4D-CT) scans. Structures were evaluated for volume changes, centroid (center of mass) motion, and phase dependence of variations relative to inspiration. Only volumetrically complete structures were used for analysis (lung in 2, heart in 8, all other structures in >10 patients). Results: During respiration, the magnitude of contoured volumes varied up to 62.5% for GTVs, 25.5% for lungs, and 12.6% for hearts. The range of maximum three-dimensional centroid movement for individual patients was 1.3-24.0 mm for GTV, 2.4-7.9 mm for heart, 5.2-12.0 mm for lungs, 0.3-5.5 mm for skin markers, 2.9-10.0 mm for trachea, and 6.6-21.7 mm for diaphragm. During respiration, the centroid positions of normal structures varied relative to the centroid position of the respective GTV by 1.5-8.1 mm for heart, 2.9-9.3 mm for lungs, 1.2-9.2 mm for skin markers, 0.9-7.1 mm for trachea, and 2.7-16.4 mm for diaphragm. Conclusion: Using 4D-CT, volumetric changes, positional alterations as well as changes in the position of contoured structures relative to the GTV were observed with large variations between individual patients. Although the interpretation of 4D-CT data has considerable uncertainty because of 4D-CT artifacts, observer variations, and the limited acquisition time, the findings might have a significant impact on treatment planning.

  19. Comparison of diagnostic performance of CT and MRI for abdominal staging of pediatric renal tumors: a report from the Children's Oncology Group

    PubMed Central

    Servaes, Sabah; Naranjo, Arlene; Geller, James I.; Ehrlich, Peter F.; Gow, Kenneth W.; Perlman, Elizabeth J.; Dome, Jeffrey S.; Gratias, Eric; Mullen, Elizabeth A.

    2015-01-01

    Background CT and MRI are both used for abdominal staging of pediatric renal tumors. The diagnostic performance of the two modalities for local and regional staging of renal tumors has not been systematically evaluated. Objective To compare the diagnostic performance of CT and MRI for local staging of pediatric renal tumors. Materials and methods The study population was derived from the AREN03B2 study of the Children's Oncology Group. Baseline abdominal imaging performed with both CT and MRI within 30 days of nephrectomy was available for retrospective review in 82 renal tumor cases. Each case was evaluated for capsular penetration, lymph node metastasis, tumor thrombus, preoperative tumor rupture, and synchronous contralateral lesions. The surgical and pathological findings at central review were the reference standard. Results The sensitivity of CT and MRI for detecting capsular penetration was 68.6% and 62.9%, respectively (P=0.73), while specificity was 86.5% and 83.8% (P=1.0). The sensitivity of CT and MRI for detecting lymph node metastasis was 76.5% and 52.9% (P=0.22), and specificity was 90.4% and 92.3% (P=1.0). Synchronous contralateral lesions were identified by CT in 4/9 cases and by MRI in 7/9 cases. Conclusion CT and MRI have similar diagnostic performance for detection of lymph node metastasis and capsular penetration. MR detected more contralateral synchronous lesions; however these were present in a very small number of cases. Either modality can be used for initial loco–regional staging of pediatric renal tumors. PMID:25135711

  20. In vivo Tumor Grading of Prostate Cancer using Quantitative 111In-Capromab Pendetide SPECT/CT

    PubMed Central

    Seo, Youngho; Aparici, Carina Mari; Cooperberg, Matthew R.; Konety, Badrinath R.; Hawkins, Randall A.

    2010-01-01

    We have developed an in vivo antibody uptake quantification method using 111In-capromab pendetide single photon emission computed tomography combined with computed tomography (SPECT/CT) technology. Our goal is to evaluate this noninvasive antibody quantification method for potential prostate tumor grading. Methods Our phantom experiments focused on the robustness of an advanced iterative reconstruction algorithm that involves corrections for photon attenuation, scatter, and geometric blurring caused by radionuclide collimators. The conversion factors between image values and tracer concentrations (in Bq/ml) were calculated from uniform phantom filled with aqueous solution of 111InCl3 using the same acquisition protocol and reconstruction parameters as for patient studies. In addition, the spatial resolution of the reconstructed images was measured from a point source phantom. The measured spatial resolution was modeled into a point spread function (PSF), and the PSF was implemented in a deconvolution-based partial volume error (PVE) correction algorithm. The recovery capability to correctly estimate true tracer concentration values was tested using prostate-like and bladder-like lesion phantoms fitted in the modified NEMA/IEC body phantom. Patients with biopsy-proven prostate cancer (n=10) who underwent prostatectomy were prospectively enrolled in the preoperative SPECT/CT studies at the San Francisco VA Medical Center. The CT portion of SPECT/CT was used for CT-based attenuation map generation as well as an anatomical localization tool for clinical interpretation. Pathologic Gleason grades were compared with in vivo “antibody uptake value” (AUV) normalized by injected dose, effective half-life, and injection-scan time difference. AUVs were calculated in each lobe of prostate gland with cylindrical volumes of interest (VOIs) having dimensions of 1.5 cm both in diameter and height. Results Reconstructed SPECT images further corrected by the deconvolution

  1. A Novel Small-molecule Tumor Necrosis Factor α Inhibitor Attenuates Inflammation in a Hepatitis Mouse Model*

    PubMed Central

    Ma, Li; Gong, Haiyan; Zhu, Haiyan; Ji, Qing; Su, Pei; Liu, Peng; Cao, Shannan; Yao, Jianfeng; Jiang, Linlin; Han, Mingzhe; Ma, Xiaotong; Xiong, Dongsheng; Luo, Hongbo R.; Wang, Fei; Zhou, Jiaxi; Xu, Yuanfu

    2014-01-01

    Overexpression of tumor necrosis factor α (TNFα) is a hallmark of many inflammatory diseases, including rheumatoid arthritis, inflammatory bowel disease, and septic shock and hepatitis, making it a potential therapeutic target for clinical interventions. To explore chemical inhibitors against TNFα activity, we applied computer-aided drug design combined with in vitro and cell-based assays and identified a lead chemical compound, (E)-4-(2-(4-chloro-3-nitrophenyl) (named as C87 thereafter), which directly binds to TNFα, potently inhibits TNFα-induced cytotoxicity (IC50 = 8.73 μm) and effectively blocks TNFα-triggered signaling activities. Furthermore, by using a murine acute hepatitis model, we showed that C87 attenuates TNFα-induced inflammation, thereby markedly reducing injuries to the liver and improving animal survival. Thus, our results lead to a novel and highly specific small-molecule TNFα inhibitor, which can be potentially used to treat TNFα-mediated inflammatory diseases. PMID:24634219

  2. Semiautomatic technique for defining the internal gross tumor volume of lung tumors close to liver/spleen cupola by 4D-CT

    SciTech Connect

    Mancosu, Pietro; Sghedoni, Roberto; Bettinardi, Valentino; Aquilina, Mark Anthony; Navarria, Piera; Cattaneo, Giovanni Mauro; Di Muzio, Nadia; Cozzi, Luca; Scorsetti, Marta

    2010-09-15

    Purpose: It has been shown that in cases of lung tumors close to the liver cupola, the four dimensional (4D)-CT postprocessing maximum intensity projection (MIP) algorithm does not fully recover the radiotherapy internal gross tumor volume (IGTV). In this work, a semiautomatic technique was evaluated by which the residual IGTV that was not included into the IGTV by MIP algorithm was actually added. Methods: A moving phantom and five selected patients were considered. The various IGTVs produced by the semiautomatic approach were compared to those generated by 4D-CT manual contouring. Results: In all cases, the radiation oncologist qualitatively concurred with the semiautomatic IGTV. A quantitative difference in volume of 2.6% was found in the phantom study, whereas a mean difference of 0.1{+-}4.6% was obtained in the patient studies. Conclusions: A semiautomatic technique to include the residual part of IGTV covered by liver/spleen cupola when using MIP algorithm was validated on phantom and on selected patients, revealing the possibility of defining the IGTV for patients with lesions located near liver/spleen cupola by performing only the contours on the MIP series.

  3. Prognostic Value of the Sum of Metabolic Tumor Volume of Primary Tumor and Lymph Nodes Using 18F-FDG PET/CT in Patients With Cervical Cancer

    PubMed Central

    Hong, Jin Hwa; Min, Kyung Jin; Lee, Jae Kwan; So, Kyeong A; Jung, Un Suk; Kim, Sungeun; Eo, Jae Seon

    2016-01-01

    Abstract This is an observational study to determine the most relevant parameter of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for predicting recurrence in cervical cancer. Fifty-six patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIB-IVA cervical cancer who underwent pretreatment 18F-FDG PET/CT were enrolled. PET parameters including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of both primary tumor and pelvic and/or para-aortic lymph nodes were analyzed. SUVmax-S was defined as the sum of the SUVmax of primary tumor and the higher SUVmax of either pelvic or para-aortic lymph nodes. MTV-S was defined as the sum of the MTV of primary tumor and pelvic and para-aortic lymph nodes. TLG-S was calculated in the same way as MTV-S. We evaluated the relationship between these PET parameters and recurrence-free survival (RFS). Univariate analysis revealed that higher FIGO stage (hazard ratio [HR] = 5.61, 95% confidence interval [CI]: 1.68–18.68, P = 0.005), lymph node metastasis (HR = 3.42, 95% CI: 1.08–10.84, P = 0.037), MTV of primary tumor >47.81 cm3 (HR = 6.20, 95% CI: 1.35–28.48, P = 0.019), TLG of primary tumor >215.02 (HR = 11.82, 95% CI: 1.52–91.96, P = 0.018), MTV-S > 59.01 cm3 (HR = 8.24, 95% CI: 1.80–37.77, P = 0.007), and TLG-S > 224.15 (HR =  13.09, 95% CI: 1.68–101.89, P = 0.014) were associated with RFS. In multivariate analysis, FIGO stage (HR = 4.87, 95% CI: 1.38–17.18, P = 0.014) and MTV-S > 59.01 cm3 (HR = 7.37, 95% CI: 1.54–35.16, P = 0.012) were determined to be independent predictive factors for RFS. Our preliminary results reveal that MTV-S is an independent prognostic factor for RFS in patients with cervical cancer treated by definitive chemoradiotherapy. PMID:26945420

  4. In vivo characterization of tumor vasculature using iodine and gold nanoparticles and dual energy micro-CT

    NASA Astrophysics Data System (ADS)

    Clark, Darin P.; Ghaghada, Ketan; Moding, Everett J.; Kirsch, David G.; Badea, Cristian T.

    2013-03-01

    Tumor blood volume and vascular permeability are well established indicators of tumor angiogenesis and important predictors in cancer diagnosis, planning and treatment. In this work, we establish a novel preclinical imaging protocol which allows quantitative measurement of both metrics simultaneously. First, gold nanoparticles are injected and allowed to extravasate into the tumor, and then liposomal iodine nanoparticles are injected. Combining a previously optimized dual energy micro-CT scan using high-flux polychromatic x-ray sources (energies: 40 kVp, 80 kVp) with a novel post-reconstruction spectral filtration scheme, we are able to decompose the results into 3D iodine and gold maps, allowing simultaneous measurement of extravasated gold and intravascular iodine concentrations. Using a digital resolution phantom, the mean limits of detectability (mean CNR = 5) for each element are determined to be 2.3 mg mL-1 (18 mM) for iodine and 1.0 mg mL-1 (5.1 mM) for gold, well within the observed in vivo concentrations of each element (I: 0-24 mg mL-1, Au: 0-9 mg mL-1) and a factor of 10 improvement over the limits without post-reconstruction spectral filtration. Using a calibration phantom, these limits are validated and an optimal sensitivity matrix for performing decomposition using our micro-CT system is derived. Finally, using a primary mouse model of soft-tissue sarcoma, we demonstrate the in vivo application of the protocol to measure fractional blood volume and vascular permeability over the course of five days of active tumor growth.

  5. Assessment of Vascularity in Hepatic Alveolar Echinococcosis: Comparison of Quantified Dual-Energy CT with Histopathologic Parameters

    PubMed Central

    Jiang, Yi; Li, Jiaqi; Wang, Jing; Xiao, Hu; Li, Tingting; Liu, Hui; Liu, Wenya

    2016-01-01

    Purpose To investigate whether dual-energy computer tomography(DECT) could determine the angiographic vascularity of alveolar echinococcosis lesions by comparing the quantitative iodine concentration (IC) with the microvascular density (MVD). Material and Methods Twenty-five patients (16 men, 9 women; mean age, 40.9 ± 13.8 years) with confirmed hepatic alveolar echinococcosis (HAE) underwent DECT of the abdomen, consisting of arterial phase (AP), portal venous phase (PVP), and delayed phase (DP) scanning, in dual-source mode (100 kV/140 kV). Image data were processed with a DECT software algorithm that was designed for the evaluation of iodine distribution in the different layers (marginal zone, solid and cystic) of the lesions. The CT patterns of HAE lesions were classified into three types: solid type, pseudocystic type and ‘geographic map’ (mixed) type. The IC measurements in different layers and different types of lesions were statistically compared. MVD was examined using CD34 immunohistochemical staining of the resected HAE tissue and scored based on the percentage of positively stained cells and their intensity. Pearson’s correlation analysis was used to evaluate the potential correlation between DECT parameters and MVD. Results A total of 27 HAE lesions were evaluated, of which 9 were solid type, 3 were pseudocystic type and 15 were mixed type. The mean lesion size was 100.7 ± 47.3 mm. There was a significant difference in the IC measurements between different layers of HAE lesions during each scan phase (p < 0.001). The IC in the marginal zone was significantly higher than in the solid and cystic components in AP (2.15 mg/mL vs. 0.17 or 0.01 mg/mL), PVP (3.08 mg/mL vs. 0.1 or 0.02 mg/mL), and DP (2.93 mg/mL vs. 0.04 or 0.02 mg/mL). No significant difference was found among the different CT patterns of HAE lesions. Positive expression of CD34 in the marginal zones surrounding HAE lesions was found in 92.5% (25/27) of lesions, of which 18.5% (5

  6. TU-F-17A-05: Calculating Tumor Trajectory and Dose-Of-The-Day for Highly Mobile Tumors Using Cone-Beam CT Projections

    SciTech Connect

    Jones, B; Miften, M

    2014-06-15

    Purpose: Cone-beam CT (CBCT) projection images provide anatomical data in real-time over several respiratory cycles, forming a comprehensive picture of tumor movement. We developed a method using these projections to determine the trajectory and dose of highly mobile tumors during each fraction of treatment. Methods: CBCT images of a respiration phantom were acquired, where the trajectory mimicked a lung tumor with high amplitude (2.4 cm) and hysteresis. A template-matching algorithm was used to identify the location of a steel BB in each projection. A Gaussian probability density function for tumor position was calculated which best fit the observed trajectory of the BB in the imager geometry. Two methods to improve the accuracy of tumor track reconstruction were investigated: first, using respiratory phase information to refine the trajectory estimation, and second, using the Monte Carlo method to sample the estimated Gaussian tumor position distribution. 15 clinically-drawn abdominal/lung CTV volumes were used to evaluate the accuracy of the proposed methods by comparing the known and calculated BB trajectories. Results: With all methods, the mean position of the BB was determined with accuracy better than 0.1 mm, and root-mean-square (RMS) trajectory errors were lower than 5% of marker amplitude. Use of respiratory phase information decreased RMS errors by 30%, and decreased the fraction of large errors (>3 mm) by half. Mean dose to the clinical volumes was calculated with an average error of 0.1% and average absolute error of 0.3%. Dosimetric parameters D90/D95 were determined within 0.5% of maximum dose. Monte-Carlo sampling increased RMS trajectory and dosimetric errors slightly, but prevented over-estimation of dose in trajectories with high noise. Conclusions: Tumor trajectory and dose-of-the-day were accurately calculated using CBCT projections. This technique provides a widely-available method to evaluate highly-mobile tumors, and could facilitate better

  7. Detection of Corona Enhancement of Hypervascular Hepatocellular Carcinoma by C-Arm Dual-Phase Cone-Beam CT During Hepatic Arteriography

    SciTech Connect

    Miyayama, Shiro Yamashiro, Masashi; Okuda, Miho; Yoshie, Yuichi; Nakashima, Yoshiko; Ikeno, Hiroshi; Orito, Nobuaki; Matsui, Osamu

    2011-02-15

    The purpose of this study was to evaluate the detectability of corona enhancement around the hypervascular hepatocellular carcinoma (HCC) by dual-phase cone-beam computed tomography during hepatic arteriography (CBCTHA). Dual-phase CBCTHA was performed for 71 HCC lesions (mean {+-} SD 1.7 {+-} 0.9 cm), including seven presenting a nodule-in-nodule appearance and nine hypervascular pseudolesions. The first scan was performed during injection of 30-40 ml half-diluted contrast material at a rate of 1.5-2 ml/s through the hepatic artery. Scanning was initiated 7 s after the beginning of contrast material injection. The second scan was started 30 s after the end of the first scan. Detectability of corona enhancement on second-phase CBCTHA was evaluated. Thickness of corona enhancement was also analyzed as thin ({<=}2 mm) or thick (>2 mm). Corona enhancement was detected in 63 (88.7%) of 71 tumors (1.8 {+-} 0.9 cm), but it was not detected in eight tumors (1.0 {+-} 0.2 cm). Thin corona enhancement was seen in 18 tumors (1.2 {+-} 0.5 cm), and thick corona enhancement was seen in 45 tumors (2.0 {+-} 0.9 cm). There was a significant difference in tumor diameter between tumors with and those without corona enhancement (P = 0.0157) and between thin and thick corona enhancement (P = 0.001). In all seven early-stage tumors, corona enhancement was demonstrated around the hypervascular focus within the hypovascular tumor portion. None of the nine pseudolesions showed any corona enhancement. Dual-phase CBCTHA depicted corona enhancement in 88.7% of hypervascular HCC lesions. This technique may improve the diagnostic accuracy of HCC.

  8. Early prediction of tumor recurrence based on CT texture changes after stereotactic ablative radiotherapy (SABR) for lung cancer

    SciTech Connect

    Mattonen, Sarah A.; Palma, David A.; Haasbeek, Cornelis J. A.; Senan, Suresh; Ward, Aaron D.

    2014-03-15

    Purpose: Benign computed tomography (CT) changes due to radiation induced lung injury (RILI) are common following stereotactic ablative radiotherapy (SABR) and can be difficult to differentiate from tumor recurrence. The authors measured the ability of CT image texture analysis, compared to more traditional measures of response, to predict eventual cancer recurrence based on CT images acquired within 5 months of treatment. Methods: A total of 24 lesions from 22 patients treated with SABR were selected for this study: 13 with moderate to severe benign RILI, and 11 with recurrence. Three-dimensional (3D) consolidative and ground-glass opacity (GGO) changes were manually delineated on all follow-up CT scans. Two size measures of the consolidation regions (longest axial diameter and 3D volume) and nine appearance features of the GGO were calculated: 2 first-order features [mean density and standard deviation of density (first-order texture)], and 7 second-order texture features [energy, entropy, correlation, inverse difference moment (IDM), inertia, cluster shade, and cluster prominence]. For comparison, the corresponding response evaluation criteria in solid tumors measures were also taken for the consolidation regions. Prediction accuracy was determined using the area under the receiver operating characteristic curve (AUC) and two-fold cross validation (CV). Results: For this analysis, 46 diagnostic CT scans scheduled for approximately 3 and 6 months post-treatment were binned based on their recorded scan dates into 2–5 month and 5–8 month follow-up time ranges. At 2–5 months post-treatment, first-order texture, energy, and entropy provided AUCs of 0.79–0.81 using a linear classifier. On two-fold CV, first-order texture yielded 73% accuracy versus 76%–77% with the second-order features. The size measures of the consolidative region, longest axial diameter and 3D volume, gave two-fold CV accuracies of 60% and 57%, and AUCs of 0.72 and 0.65, respectively

  9. Active-target T1-weighted MR Imaging of Tiny Hepatic Tumor via RGD Modified Ultra-small Fe3O4 Nanoprobes

    PubMed Central

    Jia, Zhengyang; Song, Lina; Zang, Fengchao; Song, Jiacheng; Zhang, Wei; Yan, Changzhi; Xie, Jun; Ma, Zhanlong; Ma, Ming; Teng, Gaojun; Gu, Ning; Zhang, Yu

    2016-01-01

    Developing ultrasensitive contrast agents for the early detection of malignant tumors in liver is highly demanded. Constructing hepatic tumors specific targeting probes could provide more sensitive imaging information but still faces great challenges. Here we report a novel approach for the synthesis of ultra-small Fe3O4 nanoparticles conjugated with c(RGDyK) and their applications as active-target T1-weighted magnetic resonance imaging (MRI) contrast agent (T1-Fe3O4) for imaging tiny hepatic tumors in vivo. RGD-modified T1-Fe3O4 nanoprobes exhibited high r1 of 7.74 mM-1s-1 and ultralow r2/r1 of 2.8 at 3 T, reflecting their excellent T1 contrast effect at clinically relevant magnetic field. High targeting specificity together with favorable biocompatibility and strong ability to resist against non-specific uptake were evaluated through in vitro studies. Owing to the outstanding properties of tumor angiogenesis targeting with little phagocytosis in liver parenchyma, hepatic tumor as small as 2.2 mm was successfully detected via the T1 contrast enhancement of RGD-modified T1-Fe3O4. It is emphasized that this is the first report on active-target T1 imaging of hepatic tumors, which could not only significantly improve diagnostic sensitivity, but also provide post therapeutic assessments for patients with liver cancer. PMID:27570550

  10. Active-target T1-weighted MR Imaging of Tiny Hepatic Tumor via RGD Modified Ultra-small Fe3O4 Nanoprobes.

    PubMed

    Jia, Zhengyang; Song, Lina; Zang, Fengchao; Song, Jiacheng; Zhang, Wei; Yan, Changzhi; Xie, Jun; Ma, Zhanlong; Ma, Ming; Teng, Gaojun; Gu, Ning; Zhang, Yu

    2016-01-01

    Developing ultrasensitive contrast agents for the early detection of malignant tumors in liver is highly demanded. Constructing hepatic tumors specific targeting probes could provide more sensitive imaging information but still faces great challenges. Here we report a novel approach for the synthesis of ultra-small Fe3O4 nanoparticles conjugated with c(RGDyK) and their applications as active-target T1-weighted magnetic resonance imaging (MRI) contrast agent (T1-Fe3O4) for imaging tiny hepatic tumors in vivo. RGD-modified T1-Fe3O4 nanoprobes exhibited high r1 of 7.74 mM(-1)s(-1) and ultralow r2/r1 of 2.8 at 3 T, reflecting their excellent T1 contrast effect at clinically relevant magnetic field. High targeting specificity together with favorable biocompatibility and strong ability to resist against non-specific uptake were evaluated through in vitro studies. Owing to the outstanding properties of tumor angiogenesis targeting with little phagocytosis in liver parenchyma, hepatic tumor as small as 2.2 mm was successfully detected via the T1 contrast enhancement of RGD-modified T1-Fe3O4. It is emphasized that this is the first report on active-target T1 imaging of hepatic tumors, which could not only significantly improve diagnostic sensitivity, but also provide post therapeutic assessments for patients with liver cancer. PMID:27570550

  11. Evaluation of tumor localization in respiration motion-corrected cone-beam CT: Prospective study in lung

    SciTech Connect

    Dzyubak, Oleksandr; Kincaid, Russell; Hertanto, Agung; Hu, Yu-Chi; Pham, Hai; Yorke, Ellen; Zhang, Qinghui; Mageras, Gig S.; Rimner, Andreas

    2014-10-15

    Purpose: Target localization accuracy of cone-beam CT (CBCT) images used in radiation treatment of respiratory disease sites is affected by motion artifacts (blurring and streaking). The authors have previously reported on a method of respiratory motion correction in thoracic CBCT at end expiration (EE). The previous retrospective study was limited to examination of reducing motion artifacts in a small number of patient cases. They report here on a prospective study in a larger group of lung cancer patients to evaluate respiratory motion-corrected (RMC)-CBCT ability to improve lung tumor localization accuracy and reduce motion artifacts in Linac-mounted CBCT images. A second study goal examines whether the motion correction derived from a respiration-correlated CT (RCCT) at simulation yields similar tumor localization accuracy at treatment. Methods: In an IRB-approved study, 19 lung cancer patients (22 tumors) received a RCCT at simulation, and on one treatment day received a RCCT, a respiratory-gated CBCT at end expiration, and a 1-min CBCT. A respiration monitor of abdominal displacement was used during all scans. In addition to a CBCT reconstruction without motion correction, the motion correction method was applied to the same 1-min scan. Projection images were sorted into ten bins based on abdominal displacement, and each bin was reconstructed to produce ten intermediate CBCT images. Each intermediate CBCT was deformed to the end expiration state using a motion model derived from RCCT. The deformed intermediate CBCT images were then added to produce a final RMC-CBCT. In order to evaluate the second study goal, the CBCT was corrected in two ways, one using a model derived from the RCCT at simulation [RMC-CBCT(sim)], the other from the RCCT at treatment [RMC-CBCT(tx)]. Image evaluation compared uncorrected CBCT, RMC-CBCT(sim), and RMC-CBCT(tx). The gated CBCT at end expiration served as the criterion standard for comparison. Using automatic rigid image

  12. SU-E-J-190: Characterization of Radiation Induced CT Number Changes in Tumor and Normal Lung During Radiation Therapy for Lung Cancer

    SciTech Connect

    Yang, C; Liu, F; Tai, A; Gore, E; Johnstone, C; Li, X

    2014-06-01

    Purpose: To measure CT number (CTN) changes in tumor and normal lung as a function of radiation therapy (RT) dose during the course of RT delivery for lung cancer using daily IGRT CT images and single respiration phase CT images. Methods: 4D CT acquired during planning simulation and daily 3D CT acquired during daily IGRT for 10 lung cancer cases randomly selected in terms of age, caner type and stage, were analyzed using an in-house developed software tool. All patients were treated in 2 Gy fractions to primary tumors and involved nodal regions. Regions enclosed by a series of isodose surfaces in normal lung were delineated. The obtained contours along with target contours (GTVs) were populated to each singlephase planning CT and daily CT. CTN in term of Hounsfield Unit (HU) of each voxel in these delineated regions were collectively analyzed using histogram, mean, mode and linear correlation. Results: Respiration induced normal lung CTN change, as analyzed from single-phase planning CTs, ranged from 9 to 23 (±2) HU for the patients studied. Normal lung CTN change was as large as 50 (±12) HU over the entire treatment course, was dose and patient dependent and was measurable with dose changes as low as 1.5 Gy. For patients with obvious tumor volume regression, CTN within the GTV drops monotonically as much as 10 (±1) HU during the early fractions with a total dose of 20 Gy delivered. The GTV and CTN reductions are significantly correlated with correlation coefficient >0.95. Conclusion: Significant RT dose induced CTN changes in lung tissue and tumor region can be observed during even the early phase of RT delivery, and may potentially be used for early prediction of radiation response. Single respiration phase CT images have dramatically reduced statistical noise in ROIs, making daily dose response evaluation possible.

  13. Malignant extrarenal rhabdoid tumor of the spine: staging and evaluation of response to therapy with F-18 FDG PET/CT.

    PubMed

    Makis, William; Ciarallo, Anthony; Hickeson, Marc

    2011-07-01

    Malignant extrarenal rhabdoid tumor (ERRT) is a very rare type of soft-tissue sarcoma with a reported incidence of 0.3% of all soft-tissue sarcomas. Only 7 cases of spinal malignant ERRT have been reported in the literature, and to our knowledge, F-18 FDG PET/CT imaging for staging and evaluation of response to therapy for these tumors has not been previously described. This is a case of an 8-month-old boy with malignant ERRT of the spine, who was staged with F-18 FDG PET/CT, and had his tumor burden assessed with PET/CT after chemotherapy, which altered the subsequent chemotherapy regimen. PMID:21637073

  14. Malignant extrarenal rhabdoid tumor of the spine: staging and evaluation of response to therapy with F-18 FDG PET/CT.

    PubMed

    Makis, William; Ciarallo, Anthony; Hickeson, Marc

    2011-07-01

    Malignant extrarenal rhabdoid tumor (ERRT) is a very rare type of soft-tissue sarcoma with a reported incidence of 0.3% of all soft-tissue sarcomas. Only 7 cases of spinal malignant ERRT have been reported in the literature, and to our knowledge, F-18 FDG PET/CT imaging for staging and evaluation of response to therapy for these tumors has not been previously described. This is a case of an 8-month-old boy with malignant ERRT of the spine, who was staged with F-18 FDG PET/CT, and had his tumor burden assessed with PET/CT after chemotherapy, which altered the subsequent chemotherapy regimen.

  15. [Solitary fibrous tumor of the liver].

    PubMed

    Lehmann, C; Mourra, N; Tubiana, J-M; Arrivé, L

    2006-02-01

    Solitary fibrous tumor (SFT) is commonly found on serosal surfaces, and is rarely localized in the liver. There are benign and malignant variants of hepatic SFT. We report a new case of benign SFT. Our patient, a 63-year old woman, who has been followed for 5 years for an asymptomatic liver mass, was admitted for abdominal pain. Ultrasonography (US), CT, MR Imaging and angiography showed the liver mass with typical imaging features, situated in the right hepatic lobe with blood supply from the hepatic artery. Histopathological examination demonstrated a highly vascularized tumor, composed of short spindle cells alternating with hypocellular collagenous regions, with a hemangiopericytoma-like vascular pattern. The immunohistochemical staining was positive for CD 34. Tumor resection was performed. Follow-up 8 years after the resection showed no tumor recurrence or metastasis, thus confirming the initial diagnosis of benign SFT.

  16. Non-Hodgkin lymphoma diagnosed by a percutaneous trans-hepatic needle biopsy of portal vein tumor emboli.

    PubMed

    Ohyagi, Hideaki; Kume, Masaaki; Shinohara, Yoshinori; Takahashi, Satsuki; Saito, Masahiro; Zuguchi, Masashi; Enomoto, Yoshitaka; Saito, Ken; Hirayama, Katsu; Takahashi, Naoto

    2015-12-01

    A 58-year-old woman was admitted to our hospital for evaluation of left flank pain. Abdominal computed tomography showed a greatly enlarged splenic tumor with a massive portal vein tumor thrombosis (PVTT). We suspected non-Hodgkin lymphoma (NHL) based on the high values of serum soluble interleukin-2 receptor and lactate dehydrogenase. Because there was no superficial lymph node enlargement, ultrasound-guided percutaneous trans-hepatic needle biopsy was performed to obtain a pathological diagnosis of PVTT, instead of a splenectomy, after the patient had provided informed consent. This procedure was thought to be less invasive than splenectomy. Histologic examination revealed CD20-positive NHL. A complete response was achieved after six courses of R-CHOP and it was confirmed by splenectomy. A PVTT due to NHL is extremely rare as compared with that due to hepatocellular carcinoma, gastric cancer, and colon cancer. However, NHL should be considered in the differential diagnosis for a patient with a PVTT, because B cell-NHL tends to have a good prognosis when rituximab combined chemotherapy is administered. We suggest that a percutaneous trans-hepatic needle biopsy may be useful for diagnosing PVTT due to NHL. PMID:26725360

  17. Enhancement of p53 gene transfer efficiency in hepatic tumor mediated by transferrin receptor through trans-arterial delivery.

    PubMed

    Lu, Qin; Teng, Gao-Jun; Zhang, Yue; Niu, Huan-Zhang; Zhu, Guang-Yu; An, Yan-Li; Yu, Hui; Li, Guo-Zhao; Qiu, Ding-Hong; Wu, Chuan-Ging

    2008-02-01

    Transferrin-DNA complex mediated by transferrin receptor in combination with interventional trans-arterial injection into a target organ may be a duel-target-oriented delivery means to achieve an efficient gene therapy. In this study, transferrin receptor expression in normal human hepatocyte and two hepatocellular-carcinoma cells (Huh7/SK-Hep1) was determined. p53-LipofectAMINE with different amounts of transferrin was transfected into the cells and the gene transfection efficiency was evaluated. After VX2 rabbit hepatocarcinoma model was established, the transferrin-p53-LipofectAMINE complex was delivered into the hepatic artery via interventional techniques to analyze the therapeutic p53 gene transfer efficiency in vivo by Western blot, immunohistochemical/immunofluorescence staining analysis and survival time. The results were transferrin receptor expression in Huh7 and SK-Hep1 cells was higher than in normal hepatocyte. Transfection efficiency of p53 was increased in vitro in both Huh7 and SK-Hep1 cells with increasing transferrin in a dose-dependent manner. As compared to intravenous administration, interventional injection of p53-gene complex into hepatic tumor mediated by transferrin-receptor, could enhance the gene transfer efficiency in vivo as evaluated by Western blot, immunohistochemical/immunofluorenscence staining analyses and improved animal survival (H = 12.567, p = 0.0019). These findings show the transferrin-transferrin receptor system combined with interventional techniques enhanced p53-gene transfer to hepatic tumor and the duel-target-oriented gene delivery may be an effective approach for gene therapy. PMID:18347429

  18. Real-Time US-CT/MRI Image Fusion for Guidance of Thermal Ablation of Liver Tumors Undetectable with US: Results in 295 Cases

    SciTech Connect

    Mauri, Giovanni Cova, Luca; Beni, Stefano De; Ierace, Tiziana Tondolo, Tania Cerri, Anna; Goldberg, S. Nahum; Solbiati, Luigi

    2015-02-15

    PurposeThis study was designed to assess feasibility of US-CT/MRI fusion-guided ablation in liver tumors undetectable with US.MethodsFrom 2002 to 2012, 295 tumors (162 HCCs and 133 metastases; mean diameter 1.3 ± 0.6 cm, range 0.5–2.5 cm) detectable on contrast-enhanced CT/MRI, but completely undetectable with unenhanced US and either totally undetectable or incompletely conspicuous with contrast-enhanced US (CEUS), were treated in 215 sessions using either internally cooled radiofrequency or microwave with standard ablation protocols, guided by an image fusion system (Virtual Navigation System, Esaote S.p.A., Genova, Italy) that combines US with CT/ MRI images. Correct targeting and successful ablation of tumor were verified after 24 hours with CT or MRI.ResultsA total of 282 of 295 (95.6 %) tumors were correctly targeted with successful ablation achieved in 266 of 295 (90.2 %). Sixteen of 295 (5.4 %) tumors were correctly targeted, but unsuccessfully ablated, and 13 of 295 (4.4 %) tumors were unsuccessfully ablated due to inaccurate targeting. There were no perioperative deaths. Major complications were observed in 2 of the 215 treatments sessions (0.9 %).ConclusionsReal-time virtual navigation system with US-CT/MRI fusion imaging is precise for targeting and achieving successful ablation of target tumors undetectable with US alone. Therefore, a larger population could benefit from ultrasound guided ablation procedures.

  19. [The CT-stereotaxic neutron brachytherapy of brain tumors with californium sources on the ANET-B apparatus].

    PubMed

    Melikian, A G; Liass, F M; Shkol'nik, F G; Chekhonadskiĭ, V N; Elisiutin, G P; Golanov, A V; Kachkov, I A; Borodkin, S M; Lobanov, S A; Spasokukotskaia, O N

    1992-01-01

    A method for stereotaxic intratissue radiotherapy of brain tumors based on the findings of computed tomography is described. Radiosurgical implantation of sources with increased 252Cf content emitting mixed neutron + gamma-radiation was accomplished by means of an ANET-B apparatus by the afterloading method. Neutron irradiation is particularly effective in patients with malignant tumors possessing a large fraction of cells in a state of deep anoxia. Dosimetric planning was conducted by means of an original computer system. Devices and radiation-technical equipment for adaptation of the ANET-B apparatus for irradiation of neurosurgical patients are described. The indications for the use of this method and its place among the complex of measures for the treatment of patients with new growths of the brain are discussed. The first experience in using CT-stereotaxic neutron brachytherapy with californium sources on the ANET-B apparatus for the treatment of 6 patients with malignant glial tumors of the brain is dwelt on.

  20. Comparative Effects of CT Imaging Measurement on RECIST End Points and Tumor Growth Kinetics Modeling.

    PubMed

    Li, C H; Bies, R R; Wang, Y; Sharma, M R; Karovic, S; Werk, L; Edelman, M J; Miller, A A; Vokes, E E; Oto, A; Ratain, M J; Schwartz, L H; Maitland, M L

    2016-02-01

    Quantitative assessments of tumor burden and modeling of longitudinal growth could improve phase II oncology trials. To identify obstacles to wider use of quantitative measures we obtained recorded linear tumor measurements from three published lung cancer trials. Model-based parameters of tumor burden change were estimated and compared with similarly sized samples from separate trials. Time-to-tumor growth (TTG) was computed from measurements recorded on case report forms and a second radiologist blinded to the form data. Response Evaluation Criteria in Solid Tumors (RECIST)-based progression-free survival (PFS) measures were perfectly concordant between the original forms data and the blinded radiologist re-evaluation (intraclass correlation coefficient = 1), but these routine interrater differences in the identification and measurement of target lesions were associated with an average 18-week delay (range, -20 to 55 weeks) in TTG (intraclass correlation coefficient = 0.32). To exploit computational metrics for improving statistical power in small clinical trials will require increased precision of tumor burden assessments. PMID:26790562

  1. Assessing Tumor Response to Treatment in Patients with Lung Cancer Using Dynamic Contrast-Enhanced CT

    PubMed Central

    Strauch, Louise S.; Eriksen, Rie Ø.; Sandgaard, Michael; Kristensen, Thomas S.; Nielsen, Michael B.; Lauridsen, Carsten A.

    2016-01-01

    The aim of this study was to provide an overview of the literature available on dynamic contrast-enhanced computed tomography (DCE-CT) as a tool to evaluate treatment response in patients with lung cancer. This systematic review was compiled according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only original research articles concerning treatment response in patients with lung cancer assessed with DCE-CT were included. To assess the validity of each study we implemented Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). The initial search yielded 651 publications, and 16 articles were included in this study. The articles were divided into groups of treatment. In studies where patients were treated with systemic chemotherapy with or without anti-angiogenic drugs, four out of the seven studies found a significant decrease in permeability after treatment. Four out of five studies that measured blood flow post anti-angiogenic treatments found that blood flow was significantly decreased. DCE-CT may be a useful tool in assessing treatment response in patients with lung cancer. It seems that particularly permeability and blood flow are important perfusion values for predicting treatment outcome. However, the heterogeneity in scan protocols, scan parameters, and time between scans makes it difficult to compare the included studies. PMID:27455330

  2. Image-Guided Radiofrequency Ablation (RFA) of Unresectable Hepatic Tumors Using a Triple-Spiral-Shaped Electrode Needle: Initial Experience in 34 Patients

    SciTech Connect

    Thanos, Loukas; Poulou, Loukia S.; Ziakas, Panayiotis D.; Kelekis, Alexis D.; Pomoni, Maria; Kelekis, Dimitrios A.

    2010-02-15

    We evaluated the safety and efficacy of image-guided radiofrequency ablation (RFA) using a triple-spiral-shaped electrode needle for unresectable primary or metastatic hepatic tumors. Thirty-four patients with 46 index tumors were treated. Ablation zone, morbidity, and complications were assessed. The lesions were completely ablated with an ablative margin of about 1 cm. Five patients (14.7%) with a lesion larger than 4.5 cm had local tumor progression after 1 month and were retreated. Hemothorax, as a major complication, occurred in 1 of 34 patients (3.0%) or 1 of 46 lesions ablated (2.2%). RFA using this new electrode needle can be effective in the treatment of large unresectable hepatic tumors.

  3. Development of a K-edge micro CT for the study of tumor angiogenesis in small animals

    NASA Astrophysics Data System (ADS)

    Baldazzi, G.; Bollini, D.; Gambaccini, M.; Golfieri, R.; Lollini, P. L.; Margotti, A.; Masetti, S.; Nicoletti, G.; Pancaldi, G.; Roma, L.; Rossi, P. L.; Zuffa, M.

    2006-03-01

    A new micro scanner CT for small animals - based on a couple of parallel quasi-monochromatic X-ray beams with different energies selectable - is under development. The aim of the study is the in vivo imaging of the tumor neo-angiogenesis pattern in an earlier diagnostic phase and the analysis of cancer growth and metastasis development in different tumor types on mice. As previously demonstrated1, the imaging system based on dual energy quasi- monochromatic X-ray beams provides higher sensitivity in detecting low concentrations of iodine contrast medium if compared to traditional polychromatic X-ray equipment. The K-edge dual energy radiology is a realistic candidate to recognize tumor neo- angiogenesis process in a very earlier stage, in which conventional systems are very poor in sensitivity. Moreover, the capability to select the energy of quasi-monochromatic beams enables the use of the Multi-Energy Quasi-Monochromatic technique. Tuning properly the energies allows maximizing the difference between linear absorption coefficients of healthy and pathological tissues increasing the contrast of pathologies. In order to optimize the contrast with this technique, one should know the X-ray energy regions where the absorption of healthy and pathological tissues eventually differs and that for each type of tumor under study. For this reason, the systematic X-ray characterization of many types of healthy and neoplastic human and mice tissues is in progress. The goal of this work is to obtain a catalog of liner attenuation coefficients of a variety of pathological tissues for respect to the healthy ones, finding any energy windows of radiological differentiation. In this paper, the theoretical methods are presented with development works and preliminary results.

  4. Very low-dose adult whole-body tumor imaging with F-18 FDG PET/CT

    NASA Astrophysics Data System (ADS)

    Krol, Andrzej; Naveed, Muhammad; McGrath, Mary; Lisi, Michele; Lavalley, Cathy; Feiglin, David

    2015-03-01

    The aim of this study was to evaluate if effective radiation dose due to PET component in adult whole-body tumor imaging with time-of-flight F-18 FDG PET/CT could be significantly reduced. We retrospectively analyzed data for 10 patients with the body mass index ranging from 25 to 50. We simulated F-18 FDG dose reduction to 25% of the ACR recommended dose via reconstruction of simulated shorter acquisition time per bed position scans from the acquired list data. F-18 FDG whole-body scans were reconstructed using time-of-flight OSEM algorithm and advanced system modeling. Two groups of images were obtained: group A with a standard dose of F-18 FDG and standard reconstruction parameters and group B with simulated 25% dose and modified reconstruction parameters, respectively. Three nuclear medicine physicians blinded to the simulated activity independently reviewed the images and compared diagnostic quality of images. Based on the input from the physicians, we selected optimal modified reconstruction parameters for group B. In so obtained images, all the lesions observed in the group A were visible in the group B. The tumor SUV values were different in the group A, as compared to group B, respectively. However, no significant differences were reported in the final interpretation of the images from A and B groups. In conclusion, for a small number of patients, we have demonstrated that F-18 FDG dose reduction to 25% of the ACR recommended dose, accompanied by appropriate modification of the reconstruction parameters provided adequate diagnostic quality of PET images acquired on time-of-flight PET/CT.

  5. CT Perfusion Characteristics Identify Metastatic Sites in Liver.

    PubMed

    Wang, Yuan; Hobbs, Brian P; Ng, Chaan S

    2015-01-01

    Tissue perfusion plays a critical role in oncology because growth and migration of cancerous cells require proliferation of new blood vessels through the process of tumor angiogenesis. Computed tomography (CT) perfusion is an emerging functional imaging modality that measures tissue perfusion through dynamic CT scanning following intravenous administration of contrast medium. This noninvasive technique provides a quantitative basis for assessing tumor angiogenesis. CT perfusion has been utilized on a variety of organs including lung, prostate, liver, and brain, with promising results in cancer diagnosis, disease prognostication, prediction, and treatment monitoring. In this paper, we focus on assessing the extent to which CT perfusion characteristics can be used to discriminate liver metastases from neuroendocrine tumors from normal liver tissues. The neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow (BF), blood volume (BV), mean transit time (MTT), permeability (PS), and hepatic arterial fraction (HAF), for tumor and normal liver. The result reveals the potential of CT perfusion as a tool for constructing biomarkers from features of the hepatic vasculature for guiding cancer detection, prognostication, and treatment selection.

  6. FDG-PET/CT for detection of the unknown primary head and neck tumor.

    PubMed

    Johansen, J; Petersen, H; Godballe, C; Loft, A; Grau, C

    2011-10-01

    The benefit of FDG-PET in addition to standard work-up for carcinoma of unknown primary (CUP) and metastatic neck lesions has been widely described. However, most studies have been of retrospective nature with large heterogeneities in terms of workup standards and patient selection leaving several questions to be answered regarding the real value of PET in CUP. We here present an overview of the literature with focus on the current evidence of FDG-PET in detecting a primary in CUP and discuss the rationale of PET/CT in the diagnostic armamentarium of CUP. PMID:22019707

  7. TU-C-12A-11: Comparisons Between Cu-ATSM PET and DCE-CT Kinetic Parameters in Canine Sinonasal Tumors

    SciTech Connect

    La Fontaine, M; Bradshaw, T; Kubicek, L; Forrest, L; Jeraj, R

    2014-06-15

    Purpose: Regions of poor perfusion within tumors may be associated with higher hypoxic levels. This study aimed to test this hypothesis by comparing measurements of hypoxia from Cu-ATSM PET to vasculature kinetic parameters from DCE-CT kinetic analysis. Methods: Ten canine patients with sinonasal tumors received one Cu-ATSM PET/CT scan and three DCE-CT scans prior to treatment. Cu-ATSM PET/CT and DCE-CT scans were registered and resampled to matching voxel dimensions. Kinetic analysis was performed on DCE-CT scans and for each patient, the resulting kinetic parameter values from the three DCE-CT scans were averaged together. Cu-ATSM SUVs were spatially correlated (r{sub spatial}) on a voxel-to-voxel basis against the following DCE-CT kinetic parameters: transit time (t{sub 1}), blood flow (F), vasculature fraction (v{sub 1}), and permeability (PS). In addition, whole-tumor comparisons were performed by correlating (r{sub ROI}) the mean Cu-ATSM SUV (SUV{sub mean}) with median kinetic parameter values. Results: The spatial correlations (r{sub spatial}) were poor and ranged from -0.04 to 0.21 for all kinetic parameters. These low spatial correlations may be due to high variability in the DCE-CT kinetic parameter voxel values between scans. In our hypothesis, t{sub 1} was expected to have a positive correlation, while F was expected to have a negative correlation to hypoxia. However, in wholetumor analysis the opposite was found for both t{sub 1} (r{sub ROI} = -0.25) and F (r{sub ROI} = 0.56). PS and v{sub 1} may depict angiogenic responses to hypoxia and found positive correlations to Cu-ATSM SUV for PS (r{sub ROI} = 0.41), and v{sub 1} (r{sub ROI} = 0.57). Conclusion: Low spatial correlations were found between Cu-ATSM uptake and DCE-CT vasculature parameters, implying that poor perfusion is not associated with higher hypoxic regions. Across patients, the most hypoxic tumors tended to have higher blood flow values, which is contrary to our initial hypothesis. Funding

  8. (99m)Tc-Labeled Multifunctional Low-Generation Dendrimer-Entrapped Gold Nanoparticles for Targeted SPECT/CT Dual-Mode Imaging of Tumors.

    PubMed

    Li, Xin; Xiong, Zuogang; Xu, Xiaoying; Luo, Yu; Peng, Chen; Shen, Mingwu; Shi, Xiangyang

    2016-08-10

    Development of cost-effective and highly efficient nanoprobes for targeted tumor single-photon emission computed tomography (SPECT)/computed tomography (CT) dual-mode imaging remains a challenging task. Here, multifunctional dendrimer-entrapped gold nanoparticles (Au DENPs) modified with folic acid (FA) and labeled with (99m)Tc were synthesized for targeted dual-mode SPECT/CT imaging of tumors. Generation 2 (G2) poly(amidoamine) (PAMAM) dendrimers (G2-NH2) conjugated with cyclic diethylenetriamine pentaacetic anhydride (cDTPAA) via an amide linkage and FA via a spacer of polyethylene glycol (PEG) were used for templated synthesis of Au core NPs, followed by labeling of (99m)Tc via chelation. The thus created multifunctional Au DENPs were well-characterized. It is shown that particles with an average Au core diameter of 1.6 nm can be dispersed in water, display stability under different conditions, and are cytocompatible in the studied concentration range. Further results demonstrate that the multifunctional nanoprobe is able to be utilized for targeted SPECT/CT dual-mode imaging of cancer cells having FA receptor (FAR)-overexpression in vitro and the established subcutaneous tumor model in vivo within a time frame up to 4 h. The formed multifunctional Au DENPs synthesized using dendrimers of low-generation may be employed as an effective and economic nanoprobe for SPECT/CT imaging of different types of FAR-expressing tumors. PMID:27434031

  9. An efficient and simple co-culture method for isolating primary human hepatic cells: Potential application for tumor microenvironment research.

    PubMed

    Dong, Wei; Lu, Aiguo; Zhao, Jingkun; Yin, Shuai; Ou, Baochi; Feng, Hao

    2016-10-01

    Co-cultivation of non-parenchymal cells (NPCs) and tumor cells from the same donor is important for metastatic cancer research. This study aimed to optimize a protocol for liver NPC isolation. Two novel 3D organotypic co‑culture models for hepatocyte, endothelial cell (EC) and Kupffer cell (KC) isolation were used. Long‑term cell co‑culture, density gradient centrifugation and magnetic‑activated cell sorting (MACS) were established. ECs were isolated from the co‑culture system; the purity of the ECs was 92±1.2%. The island‑like shape of hepatocytes was noted in the 3D co‑culture system, and spindle cells were found in the rest space. Immunofluorescence analysis showed a net structure; the connective tissue was positively stained with VE‑cadherin or CD68, which were ECs and KCs/macrophages. KCs were enriched in this system and separated by using selective adherence to plastic. Clec4f+ KCs consisted of 87±6.3% of these cells. Heterogeneous endothelium populations were detected, including sinusoid ECs, microvascular ECs and hepatic lymphatic vessel epithelial cells. In addition, hepatic progenitor cells were isolated and differentiated into hepatoblasts. Dendritic cells (DCs), invariant natural killer T (iNKT) cells were further separated by density gradient centrifugation and magnetic bead sorting. In the present study, high protein expression levels of desmin and GFAP were observed in the hepatic stellate cells (HSCs). Most of the HSCs were α‑SMA‑positive cells, which underlined the identity of activated HSCs. Intrahepatic human biliary epithelial cells (hBECs) were semi‑purified by centrifugation on a Percoll gradient and were further immunopurified. In conclusion, we provide an efficient long‑term culture method to obtain liver NPCs in sufficient number and purity. PMID:27498714

  10. Effect of Sipjeondaebo-tang on cancer-induced anorexia and cachexia in CT-26 tumor-bearing mice.

    PubMed

    Choi, Youn Kyung; Jung, Ki Yong; Woo, Sang-Mi; Yun, Yee Jin; Jun, Chan-Yong; Park, Jong Hyeong; Shin, Yong Cheol; Cho, Sung-Gook; Ko, Seong-Gyu

    2014-01-01

    Cancer-associated anorexia and cachexia are a multifactorial condition described by a loss of body weight and muscle with anorexia, asthenia, and anemia. Moreover, they correlate with a high mortality rate, poor response to chemotherapy, poor performance status, and poor quality of life. Cancer cachexia is regulated by proinflammatory cytokines such as interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor- α (TNF- α). In addition, glucagon like peptide-1 (GIP-1), peptide YY (PYY), ghrelin, and leptin plays a crucial role in food intake. In this study, we investigated the therapeutic effects of one of the traditional herbal medicines, Sipjeondaebo-tang (Juzen-taiho-to in Japanese; SJDBT), on cancer anorexia and cachexia in a fundamental mouse cancer anorexia/cachexia model, CT-26 tumor-bearing mice. SJDBT was more significantly effective in a treatment model where it was treated after anorexia and cachexia than in a prevention model where it was treated before anorexia and cachexia on the basis of parameters such as weights of muscles and whole body and food intakes. Moreover, SJDBT inhibited a production of IL-6, MCP-1, PYY, and GLP-1 and ameliorated cancer-induced anemia. Therefore, our in vivo studies provide evidence on the role of SJDBT in cancer-associated anorexia and cachexia, thereby suggesting that SJDBT may be useful for treating cancer-associated anorexia and cachexia.

  11. Living donor liver transplantation: a life-saving option in emergency situations for diffuse hepatic neuroendocrine tumor metastasis.

    PubMed

    Yankol, Y; Mecit, N; Kanmaz, T; Acarli, K; Kalayoglu, M

    2015-03-01

    Liver metastasis is the main cause of death in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs), but only 10%-20% of metastasis in these cases is resectable at the time of diagnosis. In some cases, medical and interventional radiological treatments may not be effective. Liver transplantation, although controversial, may be an option. Worldwide organ-sharing systems do not provide exception points, but give recommendations for liver transplantation in cases of hepatic metastasis from GEP-NETs due to the issue of fair access to donor organs. Living donor liver transplantation is an option in select cases. Presented here are 2 cases in which living donor liver transplantation was performed in emergency situations as a life-saving procedure, with acceptable survival and without donor complications. PMID:25769585

  12. Delineation of Gross Tumor Volume (GTV) for Radiation Treatment Planning of Locally Advanced Rectal Cancer Using Information From MRI or FDG-PET/CT: A Prospective Study

    SciTech Connect

    Braendengen, Morten; Hansson, Karl; Radu, Calin; Siegbahn, Albert; Jacobsson, Hans; Glimelius, Bengt

    2011-11-15

    Purpose: Accurate delineation of target volumes is important to maximize radiation dose to the tumor and minimize it to nontumor tissue. Computed tomography (CT) and magnetic resonance imaging (MRI) are standard imaging modalities in rectal cancer. The aim was to explore whether functional imaging with F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET), combined with CT (FDG-PET/CT) gives additional information to standard pretreatment evaluation and changes the shape and size of the gross tumor volume (GTV). Methods and Materials: From 2007 to 2009, 77 consecutive patients with locally advanced rectal cancer were prospectively screened for inclusion in the study at two university hospitals in Sweden, and 68 patients were eligible. Standard GTV was delineated using information from clinical examination, CT, and MRI (GTV-MRI). Thereafter, a GTV-PET was defined in the fused PET-CT, and the target volume delineations were compared for total volume, overlap, and mismatch. Pathologic uptake suspect of metastases was also registered. Results: The median volume of GTV-MRI was larger than that of GTV-PET: 111 cm{sup 3} vs. 87 cm{sup 3} (p < 0.001). In many cases, the GTV-MRI contained the GTV defined on the PET/CT images as subvolumes, but when a GTV total was calculated after the addition of GTV-PET to GTV-MRI, the volume increased, with median 11% (range, 0.5-72%). New lesions were seen in 15% of the patients for whom PET/CT was used. Conclusions: FDG-PET/CT facilitates and adds important information to the standard delineation procedure of locally advanced rectal cancer, mostly resulting in a smaller GTV, but a larger total GTV using the union of GTV-MRI and GTV-PET. New lesions were sometimes seen, potentially changing the treatment strategy.

  13. Tumor Response and Survival Predicted by Post-Therapy FDG-PET/CT in Anal Cancer

    SciTech Connect

    Schwarz, Julie K.; Siegel, Barry A.; Dehdashti, Farrokh; Myerson, Robert J.; Fleshman, James W.; Grigsby, Perry W.

    2008-05-01

    Purpose: To evaluate the response to therapy for anal carcinoma using post-therapy imaging with positron emission tomography (PET)/computed tomography and F-18 fluorodeoxyglucose (FDG) and to compare the metabolic response with patient outcome. Patients and Methods: This was a prospective cohort study of 53 consecutive patients with anal cancer. All patients underwent pre- and post-treatment whole-body FDG-PET/computed tomography. Patients had been treated with external beam radiotherapy and concurrent chemotherapy. Whole-body FDG-PET was performed 0.9-5.4 months (mean, 2.1) after therapy completion. Results: The post-therapy PET scan did not show any abnormal FDG uptake (complete metabolic response) in 44 patients. Persistent abnormal FDG uptake (partial metabolic response) was found in the anal tumor in 9 patients. The 2-year cause-specific survival rate was 94% for patients with a complete vs. 39% for patients with a partial metabolic response in the anal tumor (p = 0.0008). The 2-year progression-free survival rate was 95% for patients with a complete vs. 22% for patients with a partial metabolic response in the anal tumor (p < 0.0001). A Cox proportional hazards model of survival outcome indicated that a complete metabolic response was the most significant predictor of progression-free survival in our patient population (p = 0.0003). Conclusions: A partial metabolic response in the anal tumor as determined by post-therapy FDG-PET is predictive of significantly decreased progression-free and cause-specific survival after chemoradiotherapy for anal cancer.

  14. CT of acquired cystic kidney disease and renal tumors in long-term dialysis patients

    SciTech Connect

    Levine, E.; Grantham, J.J.; Slusher, S.L.; Greathouse, J.L.; Krohn, B.P.

    1984-01-01

    The kidneys of long term dialysis patients frequently demonstrate multiple small acquired cysts and renal cell tumors on pathologic examination. The original kidneys of 30 long-term dialysis patients and six renal transplant patients were evaluated by computed tomography to determine the incidence of these abnormalities. Among dialysis patients, 43.3% had diffuse bilateral cysts, while 16.7% had occasional cysts (fewer than five per kidney), and 40% showed no renal cysts. Seven solid renal tumors were detected in four dialysis patients with renal cysts. Acquired cystic kidney disease tends to result in renal enlargement, is more common in patients who have been maintained on dialysis for prolonged periods, and may lead to spontaneous renal hemorrhage. The six transplant patients showed no evidence of renal cysts, and all had markedly shrunken kidneys. Acquired cystic disease and renal cell tumors in the original kidneys of dialysis patients may be due to biologically active substances that are not cleared effectively by dialysis but that are removed by normally functioning transplant kidneys.

  15. Enhanced Antitumor Effect of Tirapazamine Delivered Intraperitoneally to VX2 Liver Tumor-Bearing Rabbits Subjected to Transarterial Hepatic Embolization

    SciTech Connect

    Sonoda, Akinaga Nitta, Norihisa Ohta, Shinich Nitta-Seko, Ayumi Nagatani, Yukihiro Takahashi, Masashi Murata, Kiyoshi

    2011-12-15

    Purpose: We evaluated the effects of the combination of Tirapazamine (TPZ), activated preferentially under hypoxic conditions, and gelatin microspheres (GMS) on the tumor growth ratio in rabbits. Methods: We assigned 20 liver tumor-bearing Japanese white rabbits to 4 equal groups. Group 1 received 1 ml of saline intra-arterially (i.a.) and 20 ml of saline intraperitoneally (i.p.; saline group). Group 2 was injected with GMS i.a. and 20 ml saline i.p. (GMS group). Group 3 received 1 ml of saline i.a. and 300 mg/m{sup 2} of TPZ i.p. (TPZ group), and group 4 was treated with GMS i.a. and 300 mg/m{sup 2} of TPZ i.p. (GMS + TPZ group). The infusion of GMS was stopped when the blood flow stagnated. Before and 7 days after treatment, the liver tumor volumes were measured as the total number of pixels on 0.3Tesla (T) magnetic resonance imaging (MRI) scans. Results: The tumor growth ratio (mean {+-} standard deviation) of the saline, GMS, TPZ, and GMS + TPZ groups was 519.15 {+-} 93.78, 279.24 {+-} 91.83, 369.78 {+-} 95.73, and 119.87 {+-} 17.62, respectively. The difference between the GMS + TPZ group and the other groups was statistically significant (P < 0.05). Conclusions: Our results show that the combination of TPZ i.p. and GMS i.a. enhanced the antitumor effect of TPZ. This procedure may represent a new alternative treatment for patients with hepatic cell carcinoma.

  16. Analysis of the clinical value of 18F-FDG PET/CT in hepatic alveolar echinococcosis before and after autologous liver transplantation

    PubMed Central

    QIN, YONGDE; LI, XIAOHONG; ZHANG, QIZHOU; XIE, BIN; JI, XUEWEN; LI, YUBIN; YIBLAYAN, AMINA; WEN, HAO

    2016-01-01

    The aim of this study was to evaluate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in advanced liver alveolar echinococcosis (LAE) prior to and following autologous liver transplantation (ALT). The biodistribution of lesions in 8 patients was recorded using 18F-FDG PET/CT prior to and following surgery. The maximum standardized uptake value (SUVmax) of the lesions was also measured and compared with the pathological results. The overall hepatic peri-lesion SUVmax of the patients was 3.57±1.21, and the delayed SUVmax was 4.19±1.70. The diagnostic sensitivity of 18F-FDG PET/CT in LAE was 91.67%, with a specificity of 60.00% and accuracy of 82.35%. The positive predictive value was 84.62%, and the negative predictive value was 75.00%. SUVmax values of the surviving liver were 1.23±0.78 after 1 month, 1.15±0.67 after 3 months and 0.85±0.35 after 6 months. Compared with normal liver values (0.95±0.19), the 1-month SUVmax was significantly different. The SUVmax in 3 patients with high-lividity lesions was 2.05±0.72, and the delayed SUVmax was 3.15±0.83; 3 months after transplantation, the SUVmax was 1.85±0.62, and the delayed SUVmax was 2.95±0.79, revealing no significant difference. In conclusion, 18F-FDG PET/CT is effective for determining the biological boundary of LAE and shows important clinical value in determining the metabolic activities of the surviving liver following ALT. PMID:26889215

  17. Non-hepatic tumors change the activity of genes encoding copper trafficking proteins in the liver.

    PubMed

    Babich, Polina S; Skvortsov, Alexey N; Rusconi, Paolo; Tsymbalenko, Nadezhda V; Mutanen, Marja; Puchkova, Ludmila V; Broggini, Massimo

    2013-07-01

    To assess the statistical relationship between tumor growth and copper metabolism, we performed a metaanalysis of studies in which patients with neoplasms were characterized according to any of the copper status indexes (atomic copper serum concentration, serum oxidase activity, ceruloplasmin protein content). Our metaanalysis shows that in the majority of cases (more than 3100 patients), tumor growth positively correlates with the copper status indexes. Nude athymic CD-1 nu/nu mice with subcutaneous tumors of human origin, C57Bl/6J mice with murine melanoma and Apc(Min) mice with spontaneously developing adenomas throughout the intestinal tract were studied to experimentally determine the relationship between tumor progression, liver copper metabolism, and copper status indexes. We showed that the copper status indexes increased significantly during tumor growth. In the liver tissue of tumor-bearing mice, ceruloplasmin gene expression, as well as the expression of genes related to ceruloplasmin metallation (CTR1 and ATP7B), increased significantly. Moreover, the presence of an mRNA splice variant encoding a form of ceruloplasmin anchored to the plasma membrane by glycosylphosphatidyl inositol, which is atypical for hepatocytes, was also detected. The ATP7A copper transporter gene, which is normally expressed in the liver only during embryonic copper metabolism, was also activated. Depletion of holo-ceruloplasmin resulted in retardation of human HCT116 colon carcinoma cell growth in nude mice and induced DNA fragmentation in tumor cells. In addition, the concentration of cytochrome c increased significantly in the cytosol, while decreasing in the mitochondria. We discuss a possible trans-effect of developing tumors on copper metabolism in the liver.

  18. Non-hepatic tumors change the activity of genes encoding copper trafficking proteins in the liver

    PubMed Central

    Babich, Polina S.; Skvortsov, Alexey N; Rusconi, Paolo; Tsymbalenko, Nadezhda V.; Mutanen, Marja; Puchkova, Ludmila V.; Broggini, Massimo

    2013-01-01

    To assess the statistical relationship between tumor growth and copper metabolism, we performed a metaanalysis of studies in which patients with neoplasms were characterized according to any of the copper status indexes (atomic copper serum concentration, serum oxidase activity, ceruloplasmin protein content). Our metaanalysis shows that in the majority of cases (more than 3100 patients), tumor growth positively correlates with the copper status indexes. Nude athymic CD-1 nu/nu mice with subcutaneous tumors of human origin, C57Bl/6J mice with murine melanoma and ApcMin mice with spontaneously developing adenomas throughout the intestinal tract were studied to experimentally determine the relationship between tumor progression, liver copper metabolism, and copper status indexes. We showed that the copper status indexes increased significantly during tumor growth. In the liver tissue of tumor-bearing mice, ceruloplasmin gene expression, as well as the expression of genes related to ceruloplasmin metallation (CTR1 and ATP7B), increased significantly. Moreover, the presence of an mRNA splice variant encoding a form of ceruloplasmin anchored to the plasma membrane by glycosylphosphatidyl inositol, which is atypical for hepatocytes, was also detected. The ATP7A copper transporter gene, which is normally expressed in the liver only during embryonic copper metabolism, was also activated. Depletion of holo-ceruloplasmin resulted in retardation of human HCT116 colon carcinoma cell growth in nude mice and induced DNA fragmentation in tumor cells. In addition, the concentration of cytochrome c increased significantly in the cytosol, while decreasing in the mitochondria. We discuss a possible trans-effect of developing tumors on copper metabolism in the liver. PMID:23792645

  19. Serial megavoltage CT imaging during external beam radiotherapy for non-small-cell lung cancer: Observations on tumor regression during treatment

    SciTech Connect

    Kupelian, Patrick A. . E-mail: kupelian@orhs.org; Ramsey, Chester; Meeks, Sanford L.; Willoughby, Twyla R.; Forbes, Alan; Wagner, Thomas H.; Langen, Katja M.

    2005-11-15

    Purpose: The ability to obtain soft-tissue imaging in the treatment room, such as with megavoltage CT imaging, enables the observation of tumor regression during a course of external beam radiation therapy. In this current study, we report on the most extensive study looking at the rate of regression of non-small-cell lung cancers during a course of external beam radiotherapy by analyzing serial megavoltage CT images obtained on 10 patients. Methods and Materials: The analysis is performed on 10 patients treated with the Helical Tomotherapy Hi*Art device. All 10 patients had non-small-cell lung cancer. A total of 274 megavoltage CT sets were obtained on the 10 patients (average, 27 scans per patient; range, 9-35). All patients had at least a scan at beginning and at the end of treatment. The frequency of scanning was determined by the treating physician. The treatment was subsequently delivered with the Tomotherapy Hi*Art system. The gross tumor volumes (GTVs) were later contoured on each megavoltage CT scan, and tumor volumes were calculated. Although some patients were treated to draining nodal areas in addition to the primary tumor, only the primary GTVs were tracked. Response to treatment was quantified by the relative decrease in tumor volume over time, i.e., elapsed days from the first day of therapy. The individual GTVs ranged from 5.9 to 737.2 cc in volume at the start of treatment. In 6 of the 10 patients, dose recalculations were also performed to document potential variations in delivered doses within the tumors. The megavoltage CT scans were used, and the planned treatment was recalculated on the daily images. The hypothesis was that dose deposited in the target would increase throughout the course of radiotherapy because of tumor shrinkage and subsequent decreasing attenuation. Specifically, the dose received by 95% of the GTV (D{sub 95}) was monitored over time for each of the 6 patients treated at M.D. Anderson Cancer Center Orlando. Results

  20. Diode laser thermotherapy in the treatment of hepatic tumors in rabbits

    NASA Astrophysics Data System (ADS)

    Prudhomme, Michel; Pierredon, Marie-Ange; Tang, Jing; Lopez, Francois-Michel; Godlewski, Guilhem; Schoenenberger, Klaus; Rinck, Klauss; Delacretaz, Guy P.

    1996-01-01

    Laser induced thermotherapy (LITT) has been recently developed for treating deep seated tumors. Diode laser (830 nm) is suitable for LITT, because of its high penetration in tissue. The present animal experiment was conducted to evaluate the performance of a diode laser for treating liver tumors in rabbits. Fifty-two New Zealand rabbits were grafted in liver with a Vx2 tumor model. They were treated at a tumor size of 8 mm diameter. A laser energy of 1 350 J (power: 1.5 W; irradiation time 900 s) was delivered through a 300 micrometer fiber implanted in the center of the tumor. Our experiment was divided in two parts: (1) A survival study: we compared the medians survival between untreated tumors (Group A, n equals 21) and irradiated tumors (Group B, n equals 21), (2) An evaluation of LITT efficiency on day 7 (Group C, n equals 5) and at day 14 (Group D, n equals 5). We compared at day 7 and day 14 the radiologic data (ultrasonography and MRI realized before and after irradiation) to the microscopic examinations (haematoxylin eosine stain and picrosirius red F3BA). The results were a median survival not significantly different in group B (laser) than in group A (control) and an efficiency only at short time (on day 7). There was a good correlation between radiologic data and microscopic examinations in groups C and D. The picrosirius red F3BA estimated the extent of thermal damage. In conclusion, these disappointing results are due to an insufficient irradiation of peritumoral tissue and to the Vx2 aggressivity (undifferentiated). Using multiple optical fiber could improve the LITT efficiency. The correlation between radiological and microscopic findings would allow us to quantify the results of LITT.

  1. In vivo tumor-targeted dual-modal fluorescence/CT imaging using a nanoprobe co-loaded with an aggregation-induced emission dye and gold nanoparticles.

    PubMed

    Zhang, Jimei; Li, Chan; Zhang, Xu; Huo, Shuaidong; Jin, Shubin; An, Fei-Fei; Wang, Xiaodan; Xue, Xiangdong; Okeke, C I; Duan, Guiyun; Guo, Fengguang; Zhang, Xiaohong; Hao, Jifu; Wang, Paul C; Zhang, Jinchao; Liang, Xing-Jie

    2015-02-01

    As an intensely studied computed tomography (CT) contrast agent, gold nanoparticle has been suggested to be combined with fluorescence imaging modality to offset the low sensitivity of CT. However, the strong quenching of gold nanoparticle on fluorescent dyes requires complicated design and shielding to overcome. Herein, we report a unique nanoprobe (M-NPAPF-Au) co-loading an aggregation-induced emission (AIE) red dye and gold nanoparticles into DSPE-PEG(2000) micelles for dual-modal fluorescence/CT imaging. The nanoprobe was prepared based on a facile method of "one-pot ultrasonic emulsification". Surprisingly, in the micelles system, fluorescence dye (NPAPF) efficiently overcame the strong fluorescence quenching of shielding-free gold nanoparticles and retained the crucial AIE feature. In vivo studies demonstrated the nanoprobe had superior tumor-targeting ability, excellent fluorescence and CT imaging effects. The totality of present studies clearly indicates the significant potential application of M-NPAPF-Au as a dual-modal non-invasive fluorescence/X-ray CT nanoprobe for in vivo tumor-targeted imaging and diagnosis.

  2. Efficient Delivery of DOX to Nuclei of Hepatic Carcinoma Cells in the Subcutaneous Tumor Model Using pH-Sensitive Pullulan-DOX Conjugates.

    PubMed

    Li, Huanan; Cui, Yani; Sui, Junhui; Bian, Shaoquan; Sun, Yong; Liang, Jie; Fan, Yujiang; Zhang, Xingdong

    2015-07-29

    A series of pullulan-doxorubicin conjugates (Pu-DOXs) were investigated for effectively delivering DOX to nuclei of hepatic carcinoma cells in subcutaneous tumor model. These Pu-DOXs were prepared by conjugating DOX onto pullulan molecule via pH-responsive hydrazone bond using spacers with different alkane chain length. The highest drug loading content of Pu-DOXs went up to nearly 50%, and the diameter of Pu-DOX nanoparticles ranged from 50 to 170 nm, as measured by DLS and TEM. These Pu-DOX nanoparticles could rapidly release DOX in the acidic environment at pH = 5.0 while being kept relatively stable in neural conditions. The in vitro cell coculture experiments revealed that these Pu-DOX nanoparticles were selectively internalized by hepatic carcinoma cells through receptor-mediated endocytosis via asialoglycoprotein receptor on the hepatic carcinoma cell surface. DOX was rapidly released from Pu-DOX nanoparticles in acidic endosome/lysosome, diffused into cell nuclei due to its strong affinity to nucleic acid, inhibited the cell proliferation, and accelerated the cell apoptosis. In the nude mice subcutaneous hepatic carcinoma model, Pu-DOX nanoparticles efficiently accumulated in the tumor site through the enhanced permeation and retention effect. Then DOX was specifically internalized by hepatic carcinoma cells and rapidly diffused into the nuclei of cells. Compared with the control group in in vivo experiments, these Pu-DOX nanoparticles effectively inhibited solid tumor growth, prolonging the lifetime of the experimental animal. These pH sensitive nanoparticles might provide an important clinical implication for targeted hepatic carcinoma therapy with high efficiency and low systematic toxicity.

  3. Inhibition of microRNA-214 ameliorates hepatic fibrosis and tumor incidence in platelet-derived growth factor C transgenic mice

    PubMed Central

    Okada, Hikari; Honda, Masao; Campbell, Jean S; Takegoshi, Kai; Sakai, Yoshio; Yamashita, Taro; Shirasaki, Takayoshi; Takabatake, Riuta; Nakamura, Mikiko; Tanaka, Takuji; Kaneko, Shuichi

    2015-01-01

    Differentially regulated microRNA (miRNA) are associated with hepatic fibrosis; however, their potential usefulness for blocking hepatic fibrosis has not been exploited fully. We examined the expression of miRNA in the liver of a transgenic mouse model in which platelet-derived growth factor C (PDGF-C) is overexpressed (Pdgf-c Tg), resulting in hepatic fibrosis and steatosis and the eventual development of hepatocellular carcinoma (HCC). Robust induction of miR-214 correlated with fibrogenesis in the liver of Pdgf-c Tg mice, atherogenic high-fat diet-induced NASH mice, and patients with chronic hepatitis B or C. Pdgf-c Tg mice were injected with locked nucleic acid (LNA)-antimiR-214 via the tail vein using Invivofectamine 2.0 and the degree of hepatic fibrosis and tumor incidence were evaluated. Pdgf-c Tg mice treated with LNA-antimiR-214 showed a marked reduction in fibrosis and tumor incidence compared with saline or LNA-miR-control-injected control mice. In vitro, LNA-antimiR-214 significantly ameliorated TGF-β1-induced pro-fibrotic gene expression in Lx-2 cells. MiR-214 targets a negative regulator of EGFR signaling, Mig-6. Mimic-miR-214 decreased the expression of Mig-6 and increased the levels of EGF-mediated p-EGFR (Y1173 and Y845) and p-Met (Tyr1234/1235) in Huh-7 cells. Conversely, LNA-antimiR-214 repressed the expression of these genes. In conclusion, miR-214 appears to participate in the development of hepatic fibrosis by modulating the EGFR and TGF-β signaling pathways. LNA-antimiR-214 is a potential therapy for the prevention of hepatic fibrosis. PMID:26122702

  4. Is There an Additional Value of {sup 11}C-Choline PET-CT to T2-weighted MRI Images in the Localization of Intraprostatic Tumor Nodules?

    SciTech Connect

    Van den Bergh, Laura; Koole, Michel; Isebaert, Sofie; Joniau, Steven; Deroose, Christophe M.; Oyen, Raymond; Lerut, Evelyne; Budiharto, Tom; Mottaghy, Felix; Bormans, Guy; Van Poppel, Hendrik; Haustermans, Karin

    2012-08-01

    Purpose: To investigate the additional value of {sup 11}C-choline positron emission tomography (PET)-computed tomography (CT) to T2-weighted (T2w) magnetic resonance imaging (MRI) for localization of intraprostatic tumor nodules. Methods and Materials: Forty-nine prostate cancer patients underwent T2w MRI and {sup 11}C-choline PET-CT before radical prostatectomy and extended lymphadenectomy. Tumor regions were outlined on the whole-mount histopathology sections and on the T2w MR images. Tumor localization was recorded in the basal, middle, and apical part of the prostate by means of an octant grid. To analyze {sup 11}C-choline PET-CT images, the same grid was used to calculate the standardized uptake values (SUV) per octant, after rigid registration with the T2w MR images for anatomic reference. Results: In total, 1,176 octants were analyzed. Sensitivity, specificity, and accuracy of T2w MRI were 33.5%, 94.6%, and 70.2%, respectively. For {sup 11}C-choline PET-CT, the mean SUV{sub max} of malignant octants was significantly higher than the mean SUV{sub max} of benign octants (3.69 {+-} 1.29 vs. 3.06 {+-} 0.97, p < 0.0001) which was also true for mean SUV{sub mean} values (2.39 {+-} 0.77 vs. 1.94 {+-} 0.61, p < 0.0001). A positive correlation was observed between SUV{sub mean} and absolute tumor volume (Spearman r = 0.3003, p = 0.0362). No correlation was found between SUVs and prostate-specific antigen, T-stage or Gleason score. The highest accuracy (61.1%) was obtained with a SUV{sub max} cutoff of 2.70, resulting in a sensitivity of 77.4% and a specificity of 44.9%. When both modalities were combined (PET-CT or MRI positive), sensitivity levels increased as a function of SUV{sub max} but at the cost of specificity. When only considering suspect octants on {sup 11}C-choline PET-CT (SUV{sub max} {>=} 2.70) and T2w MRI, 84.7% of these segments were in agreement with the gold standard, compared with 80.5% for T2w MRI alone. Conclusions: The additional value of {sup

  5. Impact of PET - CT motion correction in minimizing the gross tumor volume in non-small cell lung cancer

    PubMed Central

    Masoomi, Michael A; McLean, Anne H; Bouchareb, Yassine; Ryder, Will; Robinson, Andy

    2013-01-01

    Objective(s): To investigate the impact of respiratory motion on localization, and quantification of lung lesions for the Gross Tumor Volume utilizing a fully automated Auto3Dreg program and dynamic NURBS-based cardiac-torso digitized phantom (NCAT). Methods: Respiratory motion may result in more than 30% underestimation of the SUV values of lung, liver and kidney tumor lesions. The motion correction technique adopted in this study was an image-based motion correction approach using, a voxel-intensity-based and a multi-resolution multi-optimization (MRMO) algorithm. The NCAT phantom was used to generate CT attenuation maps and activity distribution volumes for the lung regions. All the generated frames were co-registered to a reference frame using a time efficient scheme. Quantitative assessment including Region of Interest (ROI), image fidelity and image correlation techniques, as well as semi-quantitative line profile analysis and qualitatively overlaying non-motion and motion corrected image frames were performed. Results: The largest motion was observed in the Z-direction. The greatest translation was for the frame 3, end inspiration, and the smallest for the frame 5 which was closet frame to the reference frame at 67% expiration. Visual assessment of the lesion sizes, 20-60mm at 3 different locations, apex, mid and base of lung showed noticeable improvement for all the foci and their locations. The maximum improvements for the image fidelity were from 0.395 to 0.930 within the lesion volume of interest. The greatest improvement in activity concentration underestimation was 7.7% below the true activity for the 20 mm lesion in comparison to 34.4% below, prior to correction. The discrepancies in activity underestimation were reduced with increasing the lesion sizes. Overlaying activity distribution on the attenuation map showed improved localization of the PET metabolic information to the anatomical CT images. Conclusion: The respiratory motion correction for the

  6. Beam-specific planning target volumes incorporating 4D CT for pencil beam scanning proton therapy of thoracic tumors.

    PubMed

    Lin, Liyong; Kang, Minglei; Huang, Sheng; Mayer, Rulon; Thomas, Andrew; Solberg, Timothy D; McDonough, James E; Simone, Charles B

    2015-11-08

    The purpose of this study is to determine whether organ sparing and target coverage can be simultaneously maintained for pencil beam scanning (PBS) proton therapy treatment of thoracic tumors in the presence of motion, stopping power uncertainties, and patient setup variations. Ten consecutive patients that were previously treated with proton therapy to 66.6/1.8 Gy (RBE) using double scattering (DS) were replanned with PBS. Minimum and maximum intensity images from 4D CT were used to introduce flexible smearing in the determination of the beam specific PTV (BSPTV). Datasets from eight 4D CT phases, using ± 3% uncertainty in stopping power and ± 3 mm uncertainty in patient setup in each direction, were used to create 8 × 12 × 10 = 960 PBS plans for the evaluation of 10 patients. Plans were normalized to provide identical coverage between DS and PBS. The average lung V20, V5, and mean doses were reduced from 29.0%, 35.0%, and 16.4 Gy with DS to 24.6%, 30.6%, and 14.1 Gy with PBS, respectively. The average heart V30 and V45 were reduced from 10.4% and 7.5% in DS to 8.1% and 5.4% for PBS, respectively. Furthermore, the maximum spinal cord, esophagus, and heart doses were decreased from 37.1 Gy, 71.7 Gy, and 69.2 Gy with DS to 31.3 Gy, 67.9 Gy, and 64.6 Gy with PBS. The conformity index (CI), homogeneity index (HI), and global maximal dose were improved from 3.2, 0.08, 77.4 Gy with DS to 2.8, 0.04, and 72.1 Gy with PBS. All differences are statistically significant, with p-values <0.05, with the exception of the heart V45 (p = 0.146). PBS with BSPTV achieves better organ sparing and improves target coverage using a repainting method for the treatment of thoracic tumors. Incorporating motion-related uncertainties is essential.

  7. Beam-specific planning target volumes incorporating 4D CT for pencil beam scanning proton therapy of thoracic tumors.

    PubMed

    Lin, Liyong; Kang, Minglei; Huang, Sheng; Mayer, Rulon; Thomas, Andrew; Solberg, Timothy D; McDonough, James E; Simone, Charles B

    2015-01-01

    The purpose of this study is to determine whether organ sparing and target coverage can be simultaneously maintained for pencil beam scanning (PBS) proton therapy treatment of thoracic tumors in the presence of motion, stopping power uncertainties, and patient setup variations. Ten consecutive patients that were previously treated with proton therapy to 66.6/1.8 Gy (RBE) using double scattering (DS) were replanned with PBS. Minimum and maximum intensity images from 4D CT were used to introduce flexible smearing in the determination of the beam specific PTV (BSPTV). Datasets from eight 4D CT phases, using ± 3% uncertainty in stopping power and ± 3 mm uncertainty in patient setup in each direction, were used to create 8 × 12 × 10 = 960 PBS plans for the evaluation of 10 patients. Plans were normalized to provide identical coverage between DS and PBS. The average lung V20, V5, and mean doses were reduced from 29.0%, 35.0%, and 16.4 Gy with DS to 24.6%, 30.6%, and 14.1 Gy with PBS, respectively. The average heart V30 and V45 were reduced from 10.4% and 7.5% in DS to 8.1% and 5.4% for PBS, respectively. Furthermore, the maximum spinal cord, esophagus, and heart doses were decreased from 37.1 Gy, 71.7 Gy, and 69.2 Gy with DS to 31.3 Gy, 67.9 Gy, and 64.6 Gy with PBS. The conformity index (CI), homogeneity index (HI), and global maximal dose were improved from 3.2, 0.08, 77.4 Gy with DS to 2.8, 0.04, and 72.1 Gy with PBS. All differences are statistically significant, with p-values <0.05, with the exception of the heart V45 (p = 0.146). PBS with BSPTV achieves better organ sparing and improves target coverage using a repainting method for the treatment of thoracic tumors. Incorporating motion-related uncertainties is essential. PMID:26699580

  8. PET/CT Based In Vivo Evaluation of 64Cu Labelled Nanodiscs in Tumor Bearing Mice

    PubMed Central

    Huda, Pie; Binderup, Tina; Pedersen, Martin Cramer; Midtgaard, Søren Roi; Elema, Dennis Ringkjøbing; Kjær, Andreas; Jensen, Mikael; Arleth, Lise

    2015-01-01

    64Cu radiolabelled nanodiscs based on the 11 α-helix MSP1E3D1 protein and 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphatidylcholine lipids were, for the first time, followed in vivo by positron emission tomography for evaluating the biodistribution of nanodiscs. A cancer tumor bearing mouse model was used for the investigations, and it was found that the approximately 13 nm nanodiscs, due to their size, permeate deeply into cancer tissue. This makes them promising candidates for both drug delivery purposes and as advanced imaging agents. For the radiolabelling, a simple approach for 64Cu radiolabelling of proteins via a chelating agent, DOTA, was developed. The reaction was performed at sufficiently mild conditions to be compatible with labelling of the protein part of a lipid-protein particle while fully conserving the particle structure including the amphipathic protein fold. PMID:26132074

  9. Outcome Prediction After Surgery and Chemoradiation of Squamous Cell Carcinoma in the Oral Cavity, Oropharynx, and Hypopharynx: Use of Baseline Perfusion CT Microcirculatory Parameters vs. Tumor Volume

    SciTech Connect

    Bisdas, Sotirios; Nguyen, Shaun A.; Anand, Sharma K.; Glavina, Gordana; Day, Terry; Rumboldt, Zoran

    2009-04-01

    Purpose: To assess whether pretreatment perfusion computed tomography (PCT) may predict outcome in chemoradiated patients with oral cavity, oropharynx, and hypopharynx squamous cell carcinoma (SCCA) after surgical excision. Materials and Methods: Twenty-one patients with SCCA were examined before treatment. The primary site was oral cavity in 6, oropharynx in 7, and hypopharynx in 8 patients; there were 11 T2, 6 T3, and 4 T4 tumors. PCT was performed at the level of largest tumor diameter based on standard neck CT. The data were processed to obtain blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface area product (PS). Regions of interest were free-hand positioned on the lesions to obtain PCT measurements. Tumor volume was also calculated. Follow-up was performed with positron emission tomography (PET)/CT and endoscopy. Pearson correlation coefficient was used for comparison between the subgroups. A regression model was constructed to predict recurrence based on the following predictors: age, gender, tumor (T) and nodal (N) stage, tumor volume, and PCT parameters. Results: BF{sub mean}, BF{sub max}, BV{sub mean}, BV{sub max}, MTT{sub mean}, PS{sub mean}, and PS{sub max} were significantly different between patients with and without tumor recurrence (0.0001, p < 0.04). T stage, tumor volume, N stage, BF{sub max}, BV{sub max}, MTT{sub mean}, and radiation dose (p < 0.001) were independent predictors for recurrence. Cox proportional hazards model for tumor recurrence revealed significantly increased risk with high tumor volume (p = 0.00001, relative risk [RR] 7.4), low PS{sub mean} (p = 0.0001, RR 14.3), and low BF{sub max} (p = 0.002, RR 5.9). Conclusions: Our data suggest that PCT parameters have a prognostic role in patients with SCCA.

  10. Hepatic Resection as a Safe and Effective Treatment for Hepatocellular Carcinoma Involving a Single Large Tumor, Multiple Tumors, or Macrovascular Invasion

    PubMed Central

    Zhong, Jian-Hong; Rodríguez, A. Chapin; Ke, Yang; Wang, Yan-Yan; Wang, Lin; Li, Le-Qun

    2015-01-01

    Abstract This systematic review examined whether the available evidence justifies using hepatic resection (HR) during later stages of hepatocellular carcinoma (HCC), which contravenes treatment guidelines but is current practice at many medical centers. Official guidelines and retrospective studies recommend different roles for HR for patients with large/multinodular HCC or with HCC involving macrovascular invasion (MVI). Several databases were systematically searched for studies examining the safety and efficacy of HR for treating HCC involving a single large tumor (>5 cm) or multiple tumors, or for treating HCC involving MVI. We identified 50 studies involving 14 808 patients that investigated the use of HR to treat large/multinodular HCC, and 24 studies with 4389 patients that investigated HR to treat HCC with MVI. Median in-hospital mortality for patients with either type of HCC was significantly lower in Asian studies (2.7%) than in non-Asian studies (7.3%, P < 0.001). Median overall survival (OS) was significantly higher for all Asian patients with large/multinodular HCC than for all non-Asian patients at both 1 year (81% vs 65%, P < 0.001) and 5 years (42% vs 32%, P < 0.001). Similar results were obtained for median disease-free survival at 1 year (61% vs 50%, P < 0.001) and 5 years (26% vs 24%, P < 0.001). However, median OS was similar for Asian and non-Asian patients with HCC involving MVI at 1 year (50% vs 52%, P = 0.45) and 5 years (18% vs 14%, P = 0.94). There was an upward trend in 5-year OS in patients with either type of HCC. HR is reasonably safe and effective at treating large/multinodular HCC and HCC with MVI. The available evidence argues for expanding the indications for HR in official treatment guidelines. PMID:25621684

  11. SU-E-CAMPUS-I-06: Y90 PET/CT for the Instantaneous Determination of Both Target and Non-Target Absorbed Doses Following Hepatic Radioembolization

    SciTech Connect

    Pasciak, A; Kao, J

    2014-06-15

    Purpose The process of converting Yttrium-90 (Y90) PET/CT images into 3D absorbed dose maps will be explained. The simple methods presented will allow the medical physicst to analyze Y90 PET images following radioembolization and determine the absorbed dose to tumor, normal liver parenchyma and other areas of interest, without application of Monte-Carlo radiation transport or dose-point-kernel (DPK) convolution. Methods Absorbed dose can be computed from Y90 PET/CT images based on the premise that radioembolization is a permanent implant with a constant relative activity distribution after infusion. Many Y90 PET/CT publications have used DPK convolution to obtain 3D absorbed dose maps. However, this method requires specialized software limiting clinical utility. The Local Deposition method, an alternative to DPK convolution, can be used to obtain absorbed dose and requires no additional computer processing. Pixel values from regions of interest drawn on Y90 PET/CT images can be converted to absorbed dose (Gy) by multiplication with a scalar constant. Results There is evidence that suggests the Local Deposition method may actually be more accurate than DPK convolution and it has been successfully used in a recent Y90 PET/CT publication. We have analytically compared dose-volume-histograms (DVH) for phantom hot-spheres to determine the difference between the DPK and Local Deposition methods, as a function of PET scanner point-spread-function for Y90. We have found that for PET/CT systems with a FWHM greater than 3.0 mm when imaging Y90, the Local Deposition Method provides a more accurate representation of DVH, regardless of target size than DPK convolution. Conclusion Using the Local Deposition Method, post-radioembolization Y90 PET/CT images can be transformed into 3D absorbed dose maps of the liver. An interventional radiologist or a Medical Physicist can perform this transformation in a clinical setting, allowing for rapid prediction of treatment efficacy by

  12. Deletion of tumor progression locus 2 attenuates alcohol induced hepatic inflammation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    BACKGROUND: The pathogenesis of alcoholic liver disease (ALD) involves the interaction of several inflammatory signaling pathways. Tumor progression locus 2 (TPL2), also known as Cancer Osaka Thyroid (COT) and MAP3K8, is a serine threonine kinase that functions as a critical regulator of inflammator...

  13. Post-lumpectomy CT-guided tumor bed delineation for breast boost and partial breast irradiation: Can additional pre- and postoperative imaging reduce interobserver variability?

    PubMed Central

    DEN HARTOGH, MARISKA D.; PHILIPPENS, MARIELLE E.P.; VAN DAM, IRIS E.; KLEYNEN, CATHARINA E.; TERSTEEG, ROBBERT J.H.A.; KOTTE, ALEXIS N.T.J.; VAN VULPEN, MARCO; VAN ASSELEN, BRAM; VAN DEN BONGARD, DESIRÉE H.J.G.

    2015-01-01

    For breast boost radiotherapy or accelerated partial breast irradiation, the tumor bed (TB) is delineated by the radiation oncologist on a planning computed tomography (CT) scan. The aim of the present study was to investigate whether the interobserver variability (IOV) of the TB delineation is reduced by providing the radiation oncologist with additional magnetic resonance imaging (MRI) or CT scans. A total of 14 T1-T2 breast cancer patients underwent a standard planning CT in the supine treatment position following lumpectomy, as well as additional pre- and postoperative imaging in the same position. Post-lumpectomy TBs were independently delineated by four breast radiation oncologists on standard postoperative CT and on CT registered to an additional imaging modality. The additional imaging modalities used were postoperative MRI, preoperative contrast-enhanced (CE)-CT and preoperative CE-MRI. A cavity visualization score (CVS) was assigned to each standard postoperative CT by each observer. In addition, the conformity index (CI), volume and distance between centers of mass (dCOM) of the TB delineations were calculated. On CT, the median CI was 0.57, with a median volume of 22 cm3 and dCOM of 5.1 mm. The addition of postoperative MRI increased the median TB volume significantly to 28 cm3 (P<0.001), while the CI (P=0.176) and dCOM (P=0.110) were not affected. The addition of preoperative CT or MRI increased the TB volume to 26 and 25 cm3, respectively (both P<0.001), while the CI increased to 0.58 and 0.59 (both P<0.001) and the dCOM decreased to 4.7 mm (P=0.004) and 4.6 mm (P=0.001), respectively. In patients with CVS≤3, the median CI was 0.40 on CT, which was significantly increased by all additional imaging modalities, up to 0.52, and was accompanied by a median volume increase up to 6 cm3. In conclusion, the addition of postoperative MRI, preoperative CE-CT or preoperative CE-MRI did not result in a considerable reduction in the IOV in postoperative CT

  14. Variability of Gross Tumor Volume Delineation in Head-and-Neck Cancer Using PET/CT Fusion, Part II: The Impact of a Contouring Protocol

    SciTech Connect

    Berson, Anthony M. Stein, Nicholas F.; Riegel, Adam C.; Destian, Sylvie; Ng, Tracy; Tena, Lawrence B.; Mitnick, Robin J.; Heiba, Sherif

    2009-04-01

    The purpose of this study was to assess the efficacy of a gross tumor volume (GTV) contouring protocol on interobserver variability between 4 physicians in positron emission therapy/computed tomography (PET/CT) treatment planning of head-and-neck cancer. A GTV contouring protocol for PET/CT treatment planning was developed utilizing 4 stages: Preliminary contouring on CT alone, determination of appropriate PET windowing, accurate image registration, and modification of CT contouring with correctly formatted PET/CT display and rules for modality disagreement. Two neuroradiologists and 2 radiation oncologists (designated as A, B, C, and D, respectively) were given a tutorial of PET/CT coregistered imaging individualized to their skill level, which included a step-by-step explanation of the protocol with clinical examples. Opportunities for questions and hands-on practice were given. The physicians were asked to re-contour 16 head-and-neck patients from Part I on PET/CT fusion imaging. Differences in volume magnitude were analyzed for statistical significance by analysis of variance (ANOVA) and paired t-tests ({alpha} < 0.05). Volume overlap was analyzed for statistical significance using Wilcoxon signed-rank tests ({alpha} < 0.05). Volume overlap increased significantly from Part I to Part II (p < 0.05). One previously significant difference between physicians disappeared with the protocol in place. The mean fusion volume of Physician C, however, remained significantly larger than that of Physician D (p < 0.01). This result is unchanged from Part I. The multidisciplinary contouring protocol significantly improved the coincidence of GTVs contoured by multiple physicians. The magnitudes of the volumes showed marginal improvement in consistency. Developing an institutional contouring protocol for PET/CT treatment planning is highly recommended to reduce interobserver variability.

  15. Changes in the spectral index of skin-surface laser Doppler signals of nude mice following the injection of CT26 tumor cells.

    PubMed

    Liu, Ju-Chi; Hsiu, Hsin; Hsu, Yi-Ping; Tsai, Hung-Chi; Kuo, Chung-Hsien

    2016-01-01

    This study investigated microcirculatory-blood-flow responses in nude mice following the injection of CT26 tumor cells by analyzing the frequency content of skin blood-flow signals recorded on the skin surface. CT26 cells were injected subcutaneously (10^4/100 μl) into the right back flank of each 7-week-old mouse. Three-minute laser Doppler flowmetry (LDF) signals were measured in 60 nude mice. The data sequences were obtained at 1, 2, and 3 weeks after injecting CT26 cells. Mouse tissue samples were cut into sections and examined microscopically to determine the condition of cancer metastasis. Spectral analysis performed after 1 week revealed a significant decrease in the relative energy contribution of the endothelium-related frequency band, and significant increases in those of the myogenic and respiration-related frequency bands of the LDF signals in the metastasis group (n=12). To the best of our knowledge, this is the first study demonstrating the feasibility of evaluating metastasis in animal subjects based on changes in noninvasively measured LDF parameters. Changes in the LDF spectral indexes can be attributed to differences in the microcirculatory regulatory activities. The present measurements performed on the skin surface provide a noninvasive and real-time method for evaluating the microcirculatory responses induced by implanting CT26 tumor cells.

  16. Changes in the spectral index of skin-surface laser Doppler signals of nude mice following the injection of CT26 tumor cells.

    PubMed

    Liu, Ju-Chi; Hsiu, Hsin; Hsu, Yi-Ping; Tsai, Hung-Chi; Kuo, Chung-Hsien

    2016-01-01

    This study investigated microcirculatory-blood-flow responses in nude mice following the injection of CT26 tumor cells by analyzing the frequency content of skin blood-flow signals recorded on the skin surface. CT26 cells were injected subcutaneously (10^4/100 μl) into the right back flank of each 7-week-old mouse. Three-minute laser Doppler flowmetry (LDF) signals were measured in 60 nude mice. The data sequences were obtained at 1, 2, and 3 weeks after injecting CT26 cells. Mouse tissue samples were cut into sections and examined microscopically to determine the condition of cancer metastasis. Spectral analysis performed after 1 week revealed a significant decrease in the relative energy contribution of the endothelium-related frequency band, and significant increases in those of the myogenic and respiration-related frequency bands of the LDF signals in the metastasis group (n=12). To the best of our knowledge, this is the first study demonstrating the feasibility of evaluating metastasis in animal subjects based on changes in noninvasively measured LDF parameters. Changes in the LDF spectral indexes can be attributed to differences in the microcirculatory regulatory activities. The present measurements performed on the skin surface provide a noninvasive and real-time method for evaluating the microcirculatory responses induced by implanting CT26 tumor cells. PMID:27648367

  17. Changes in the spectral index of skin-surface laser Doppler signals of nude mice following the injection of CT26 tumor cells

    PubMed Central

    Liu, Ju-Chi; Hsiu, Hsin; Hsu, Yi-Ping; Tsai, Hung-Chi; Kuo, Chung-Hsien

    2016-01-01

    This study investigated microcirculatory-blood-flow responses in nude mice following the injection of CT26 tumor cells by analyzing the frequency content of skin blood-flow signals recorded on the skin surface. CT26 cells were injected subcutaneously (10^4/100 μl) into the right back flank of each 7-week-old mouse. Three-minute laser Doppler flowmetry (LDF) signals were measured in 60 nude mice. The data sequences were obtained at 1, 2, and 3 weeks after injecting CT26 cells. Mouse tissue samples were cut into sections and examined microscopically to determine the condition of cancer metastasis. Spectral analysis performed after 1 week revealed a significant decrease in the relative energy contribution of the endothelium-related frequency band, and significant increases in those of the myogenic and respiration-related frequency bands of the LDF signals in the metastasis group (n=12). To the best of our knowledge, this is the first study demonstrating the feasibility of evaluating metastasis in animal subjects based on changes in noninvasively measured LDF parameters. Changes in the LDF spectral indexes can be attributed to differences in the microcirculatory regulatory activities. The present measurements performed on the skin surface provide a noninvasive and real-time method for evaluating the microcirculatory responses induced by implanting CT26 tumor cells. PMID:27648367

  18. A quantitative evaluation of diffusion-weighted MR imaging of focal hepatic lesions by using an optimal b-value for differentiation of malignant and benign tumors

    NASA Astrophysics Data System (ADS)

    Lee, Jae-Seung; Im, In-Chul; Kang, Su-Man; Goo, Eun-Hoe; Kim, Kwang

    2013-12-01

    In this study, we aimed to determine an optimized b-value for the characterization of focal hepatic lesions (malignant and benign tumors) and to perform a quantitative analysis of the results. To achieve this, we obtained diffusion-weighted images (DWIs) from 30 focal hepatic disease patients (liver metastasis: 20 patients, and liver hemangioma: 10 patients) by using a 1.5 T MR system and varying the b-value from 0 through 200. The experimental results revealed that at a b-value of 50, the DWIs of the lesions showed high signal-to-noise ratios (SNRs; SN R liver_meta . = 229.83 ± 19.08, SNR liver_hema . = 241.66 ± 29.02), high contrast-to-noise ratios (CNRs; CN R liver_meta . = 39.66 ± 3.87, C N R liver_hema . = 142.55 ± 12.97) and low signal intensities of the apparent diffusion coefficients (ADCs; ADC liver_meta . = 1.40 × 10-3 ± 0.29, ADC liver_hema . = 2.55 × 10-3 ± 0.92). The focal hepatic lesions were clearly depicted, with DW images and ADC maps corresponding well. Thus, we could present an optimized b-value ( b = 50) for the characterization of focal hepatic lesions. Additionally, the ADC values of liver lesions were found to be useful in differentiating benign from malignant tumors.

  19. A polysaccharide from Ganoderma atrum inhibits tumor growth by induction of apoptosis and activation of immune response in CT26-bearing mice.

    PubMed

    Zhang, Shenshen; Nie, Shaoping; Huang, Danfei; Huang, Jianqin; Feng, Yanling; Xie, Mingyong

    2014-09-24

    Ganoderma atrum is one species of edible and pharmaceutical mushroom with various biological activities. Recently, a novel polysaccharide, PSG-1, was purified from G. atrum. The antitumor activity and its mechanism of action were studied. In vitro, PSG-1 has little effect on inhibiting proliferation of CT26 tumor cells. However, the tumor size was significantly decreased in PSG-1-treated mice. The results showed that PSG-1 induced apoptosis in CT26 cells. Moreover, the intracellular cyclic AMP (cAMP) level and protein kinase A (PKA) activity were markedly increased in PSG-1-treated mice. In contrast, the contents of cyclic GMP and DAG and the PKC activity were decreased. Similarly, the expression of PKA protein was upregulated, while PKC protein expression in PSG-1-treated group was lowered. Additionally, PSG-1 increased the immune organ index and serum biochemistry parameter. In general, PSG-1 enhances the antitumor immune response, induces apoptosis in CT26-bearing mice, and could be a safe and effective adjuvant for tumor therapy or functional food.

  20. Lack of anti-tumor activity by anti-VEGF treatments in hepatic hemangiomas.

    PubMed

    Lee, Minsu; Choi, Jin-Young; Lim, Joon Seok; Park, Mi-Suk; Kim, Myeong-Jin; Kim, Honsoul

    2016-04-01

    Recently, anti-vascular endothelial growth factor (anti-VEGF) agents have been described in the literature as a valid treatment option for symptomatic liver hemangiomas, but only limited evidence supports this notion. The purpose of this study was to elucidate whether or not the administration of anti-VEGF agents can reliably achieve a size reduction in liver hemangiomas. We examined patients with incidental hemangiomas who received anti-angiogenic agents for the treatment of other malignancies. Our study population consisted of 17 colorectal cancer patients and one lung cancer patient carrying 21 hemangiomas who received bevacizumab, and seven renal cell carcinoma patients carrying nine hepatic hemangiomas who received sunitinib. We have measured the liver hemangioma volume on both the pre-treatment and post-treatment computed tomography images and then calculated the volume alteration rates. No statistically significant difference (P = 0.365) in the volume of the liver hemangiomas was observed before (1.1-168.8 cm(3); mean ± SD 19.8 ± 39.7 cm(3)) or after (1.2-163.6 cm(3); 19.3 ± 38.0 cm(3)) bevacizumab treatment. The volume reduction rate ranged from -35.0 to 11.2 % (mean ± SD -1.3 ± 10.8 %). The sunitinib treatment group also showed no statistically significant difference (P = 0.889) in hemangioma volume before (1.2-6.5 cm(3); 3.0 ± 1.8 cm(3)) or after (1.2-6.0 cm(3); 3.0-1.7 cm(3)) treatment. The volume reduction rate ranged from -13.3 to 7.7 % (median: mean ± SD -2.5 ± 6.6 %). We did not observe liver hemangioma shrinkage after bevacizumab or sunitinib treatment. Our data do not support the application of anti-VEGF agents for the treatment of hepatic hemangiomas.

  1. Aflatoxin B1 and/or hepatitis B virus induced tumor spectrum in a genetically engineered hepatitis B virus expression and Trp53 haploinsufficient mouse model system for hepatocarcinogenesis.

    PubMed

    Cullen, John M; Brown, Danielle L; Kissling, Grace E; Foley, Julie F; Rizzo, Jennifer; Marion, Patricia L; Parron, Vandy I; French, John E

    2009-04-01

    The authors investigated the spectrum of tumors and Trp53 mutations in genetically engineered models using the FVB/N mouse that expressed the hepatitis B virus genome and/or carried a Trp53 null and wildtype allele and/or were exposed to aflatoxin B1. Liver tumor incidence was increased when all three risk factors were present. Without aflatoxin B1 exposure, neither Trp53 haploinsufficiency nor HBV expression affected liver tumor development. Liver tumor prevalence increased with aflatoxin B1 exposure (p < .001), as thirteen of fourteen mice with liver tumors were initiated with aflatoxin B1. Liver tumors were more frequent in males (12/190) than females (2/170). Seventy-three mice developed sarcomas. Trp53 haploinsufficiency was associated with increased sarcoma incidence in males and females (p < .001). In Trp53 haploinsufficient mice, the HBV transgene increased the risk of sarcoma in males and females (p < .001). Lymphoma was significantly increased in Trp53 haploinsufficient FVB/N mice. There was no loss of heterozygosity at the wildtype Trp53 locus in twenty-five sarcomas or four hepatocellular tumors examined. No mutations were identified in the mRNA (exons 2-11) of Trp53 in six liver neoplasms or twenty-four sarcomas. In this model system, HBV expression affected only hepatocellular neoplasia in association with both aflatoxin B1 initiation and p53 haploinsufficiency. PMID:19258306

  2. SU-E-I-100: Heterogeneity Studying for Primary and Lymphoma Tumors by Using Multi-Scale Image Texture Analysis with PET-CT Images

    SciTech Connect

    Li, Dengwang; Wang, Qinfen; Li, H; Chen, J

    2014-06-01

    Purpose: The purpose of this research is studying tumor heterogeneity of the primary and lymphoma by using multi-scale texture analysis with PET-CT images, where the tumor heterogeneity is expressed by texture features. Methods: Datasets were collected from 12 lung cancer patients, and both of primary and lymphoma tumors were detected with all these patients. All patients underwent whole-body 18F-FDG PET/CT scan before treatment.The regions of interest (ROI) of primary and lymphoma tumor were contoured by experienced clinical doctors. Then the ROI of primary and lymphoma tumor is extracted automatically by using Matlab software. According to the geometry size of contour structure, the images of tumor are decomposed by multi-scale method.Wavelet transform was performed on ROI structures within images by L layers sampling, and then wavelet sub-bands which have the same size of the original image are obtained. The number of sub-bands is 3L+1.The gray level co-occurrence matrix (GLCM) is calculated within different sub-bands, thenenergy, inertia, correlation and gray in-homogeneity were extracted from GLCM.Finally, heterogeneity statistical analysis was studied for primary and lymphoma tumor using the texture features. Results: Energy, inertia, correlation and gray in-homogeneity are calculated with our experiments for heterogeneity statistical analysis.Energy for primary and lymphomatumor is equal with the same patient, while gray in-homogeneity and inertia of primaryare 2.59595±0.00855, 0.6439±0.0007 respectively. Gray in-homogeneity and inertia of lymphoma are 2.60115±0.00635, 0.64435±0.00055 respectively. The experiments showed that the volume of lymphoma is smaller than primary tumor, but thegray in-homogeneity and inertia were higher than primary tumor with the same patient, and the correlation with lymphoma tumors is zero, while the correlation with primary tumor isslightly strong. Conclusion: This studying showed that there were effective heterogeneity

  3. Dual oncogenic and tumor suppressor roles of the promyelocytic leukemia gene in hepatocarcinogenesis associated with hepatitis B virus surface antigen.

    PubMed

    Chung, Yih-Lin; Wu, Mei-Ling

    2016-05-10

    Proteasome-mediated degradation of promyelocytic leukemia tumor suppressor (PML) is upregulated in many viral infections and cancers. We previously showed that PML knockdown promotes early-onset hepatocellular carcinoma (HCC) in hepatitis B virus surface antigen (HBsAg)-transgenic mice. Here we report the effects of PML restoration on late-onset HBsAg-induced HCC. We compared protein expression patterns, genetic mutations and the effects of pharmacologically targeting PML in wild-type, PML-/-, PML+/+HBsAgtg/o and PML-/-HBsAgtg/o mice. PML-/- mice exhibited somatic mutations in DNA repair genes and developed severe steatosis and proliferative disorders, but not HCC. PML-/-HBsAgtg/o mice exhibited early mutations in cancer driver genes and developed hyperplasia, fatty livers and indolent adipose-like HCC. In PML+/+HBsAg-transgenic mice, HBsAg expression declined over time, and HBsAg-associated PML suppression was concomitantly relieved. Nevertheless, these mice accumulated mutations in genes contributing to oxidative stress pathways and developed aggressive late-onset angiogenic trabecular HCC. PML inhibition using non-toxic doses of arsenic trioxide selectively killed long-term HBsAg-affected liver cells in PML+/+HBsAgtg/o mice with falling HBsAg and rising PML levels, but not normal liver cells or early-onset HCC cells in PML-/-HBsAgtg/0 mice. These findings suggest dual roles for PML as a tumor-suppressor lost in early-onset HBsAg-induced hepatocarcinogenesis and as an oncogenic promoter in late-onset HBsAg-related HCC progression. PMID:27058621

  4. Dual oncogenic and tumor suppressor roles of the promyelocytic leukemia gene in hepatocarcinogenesis associated with hepatitis B virus surface antigen

    PubMed Central

    Chung, Yih-Lin; Wu, Mei-Ling

    2016-01-01

    Proteasome-mediated degradation of promyelocytic leukemia tumor suppressor (PML) is upregulated in many viral infections and cancers. We previously showed that PML knockdown promotes early-onset hepatocellular carcinoma (HCC) in hepatitis B virus surface antigen (HBsAg)-transgenic mice. Here we report the effects of PML restoration on late-onset HBsAg-induced HCC. We compared protein expression patterns, genetic mutations and the effects of pharmacologically targeting PML in wild-type, PML−/−, PML+/+HBsAgtg/o and PML−/−HBsAgtg/o mice. PML−/− mice exhibited somatic mutations in DNA repair genes and developed severe steatosis and proliferative disorders, but not HCC. PML−/−HBsAgtg/o mice exhibited early mutations in cancer driver genes and developed hyperplasia, fatty livers and indolent adipose-like HCC. In PML+/+HBsAg-transgenic mice, HBsAg expression declined over time, and HBsAg-associated PML suppression was concomitantly relieved. Nevertheless, these mice accumulated mutations in genes contributing to oxidative stress pathways and developed aggressive late-onset angiogenic trabecular HCC. PML inhibition using non-toxic doses of arsenic trioxide selectively killed long-term HBsAg-affected liver cells in PML+/+HBsAgtg/o mice with falling HBsAg and rising PML levels, but not normal liver cells or early-onset HCC cells in PML−/−HBsAgtg/0 mice. These findings suggest dual roles for PML as a tumor-suppressor lost in early-onset HBsAg-induced hepatocarcinogenesis and as an oncogenic promoter in late-onset HBsAg-related HCC progression. PMID:27058621

  5. [Treatment of hepatocellular carcinoma--partial hepatic resection under hand-assisted laparoscopic surgery and local ablation therapy with ethanol and radio frequency].

    PubMed

    Doi, Koichi; Beppu, Toru; Ishiko, Takatoshi; Ishimoto, Takatsugu; Hayashi, Hiromitsu; Hirota, Masahiko; Ogawa, Michio

    2002-11-01

    A 76-year old female patient with chronic B type hepatitis had HCC expanding into the extra-hepatic space. In July 2001, we safely performed partial hepatic resection under hand-assisted laparoscopic surgery (HALS). Three months after the treatment, computed tomography of the liver revealed HCC close to the first branch of right portal vein and bile duct. Although we performed transcatheter arterial chemoembolization (TACE) for the tumor, this treatment was not effective. So we treated percutaneous ethanol injection therapy (PEIT) for the tumor area neighboring Glisson's capsule and radiofrequency ablation therapy (RFA) for the tumor. After this treatment the tumor showed no viability on dynamic CT, and there was no liver infarction or damage to the bile duct. Four months after the final treatment, enhanced CT revealed no viable lesion, and serum alpha-fetoprotein level was declining toward the normal range. We conclude that selection of an applicable treatment and approach is of importance for safe and effective therapy.

  6. CT-Based Evaluation of Tumor Volume After Intra-Arterial Chemotherapy of Locally Advanced Carcinoma of the Oral Cavity: Comparison with Clinical Remission Rates

    SciTech Connect

    Rohde, Stefan Turowski, Bernd; Berkefeld, Joachim; Kovacs, Adorjan F.

    2007-02-15

    Purpose. To assess the volume of locally advanced tumors of the oral cavity and the oropharynx before and after intra-arterial (i.a.) chemotherapy by means of computed tomography and to compare these data with clinically determined treatment response of the same patient population. Methods. Eighty-eight patients with histologically proven, advanced carcinoma of the oral cavity and/or the oropharynx (local tumor stages T3/4) received neoadjuvant i.a. chemotherapy with cisplatin as part of a multimodal therapeutic regimen, comprising (1) local chemotherapy, (2) surgery, and (3) combined radio-chemotherapy. Three weeks after the intervention, residual disease was evaluated radiologically by measurement of the tumor volume and clinically by inspection and palpation of the primary tumor according to WHO criteria. Results. Comparison of treatment response according to radiological and clinical criteria respectively revealed complete remission in 5% vs. 8% (p < 0.05), partial remission in 30% vs. 31%, stable disease in 61% vs. 58%, and tumor progression in 5% vs. 2%. Conclusion. Radiological volumetry and clinical evaluation found comparable response rates after local chemotherapy. However, in patients with good response after local treatment, volumetric measurement with CT may help to distinguish between partial and complete remission. Thus, radiological tumor volumetry provides precise and differentiated information about tumor response and should be used as an additional tool in treatment monitoring after local chemotherapy.

  7. Quantification of Local Tumor Response to Fractionated Radiation Therapy for Non-Hodgkin Lymphoma Using Weekly {sup 18}F-FDG PET/CT Imaging

    SciTech Connect

    Keller, Harald; Goda, Jayant Sastri; Vines, Douglass C.; Lockwood, Gina M.Math.; Tsang, Richard

    2010-03-01

    Purpose: To quantify, in a feasibility study, metabolic and volumetric response to fractionated radiation therapy (RT) using weekly {sup 18}F fluoro-deoxyglucose positron emission tomography (PET) imaging for 10 non-Hodgkin lymphoma (NHL) patients, and to correlate them to clinical outcome. Methods and Materials: Ten patients with chemotherapy-refractory NHL planned for radical RT were prospectively entered into a research study. PET/computed tomography (CT) scans were acquired before RT, and repeated weekly during the 3- to 4-week course of RT, and at 1 and 3 months after therapy. Gross tumor volumes were contoured on CT scans and the corresponding maximum standardized uptake values (SUV{sub max}) determined in the coregistered PET images. The clinical outcomes of interest were local tumor response at 3 months post-RT and local tumor status at last follow-up or time of death. Results: {sup 18}F fluoro-deoxyglucose uptake from inflammation was rarely observed. The responses showed a large variability between patients. SUV{sub max} decreased consistently with a median of -2.1% per Gy (range, -3.3 to -0.7) and the median of the volumetric response was -2.2% per Gy (range, -2.8 to +0.5). Initial SUV{sub max} was not correlated with local control, whereas smaller initial tumor volume was, with smaller tumors more likely to achieve local control. The responses after treatment were also correlated to local control, but not the responses during treatment. Conclusions: Radiation does not confound the FDG uptake in the NHL tumor and normal tissues. Only smaller initial tumor volume and metabolic and volumetric response after completion of radiation therapy significantly correlated with eventual local control.

  8. The LATS2 tumor suppressor inhibits SREBP and suppresses hepatic cholesterol accumulation

    PubMed Central

    Aylon, Yael; Gershoni, Anat; Rotkopf, Ron; Biton, Inbal E.; Porat, Ziv; Koh, Anna P.; Sun, Xiaochen; Lee, Youngmin; Fiel, Maria-Isabel; Hoshida, Yujin; Friedman, Scott L.; Johnson, Randy L.; Oren, Moshe

    2016-01-01

    The Hippo signaling pathway is a major regulator of organ size. In the liver, Hippo pathway deregulation promotes hyperplasia and hepatocellular carcinoma primarily through hyperactivation of its downstream effector, YAP. The LATS2 tumor suppressor is a core member of the Hippo pathway. A screen for LATS2-interacting proteins in liver-derived cells identified the transcription factor SREBP2, master regulator of cholesterol homeostasis. LATS2 down-regulation caused SREBP activation and accumulation of excessive cholesterol. Likewise, mice harboring liver-specific Lats2 conditional knockout (Lats2-CKO) displayed constitutive SREBP activation and overexpressed SREBP target genes and developed spontaneous fatty liver disease. Interestingly, the impact of LATS2 depletion on SREBP-mediated transcription was clearly distinct from that of YAP overexpression. When challenged with excess dietary cholesterol, Lats2-CKO mice manifested more severe liver damage than wild-type mice. Surprisingly, apoptosis, inflammation, and fibrosis were actually attenuated relative to wild-type mice, in association with impaired p53 activation. Subsequently, Lats2-CKO mice failed to recover effectively from cholesterol-induced damage upon return to a normal diet. Additionally, decreased LATS2 mRNA in association with increased SREBP target gene expression was observed in a subset of human nonalcoholic fatty liver disease cases. Together, these findings further highlight the tight links between tumor suppressors and metabolic homeostasis. PMID:27013235

  9. Defining vascular signatures of benign hepatic masses: role of MDCT with 3D rendering.

    PubMed

    Ahmed, Sameer; Johnson, Pamela T; Fishman, Elliot K

    2013-08-01

    Multidetector CT (MDCT) provides new opportunities for hepatic tumor characterization. By coupling high-resolution isotropic datasets with advanced post-processing tools, maps of tumor vascularity can be generated to elucidate characteristic findings. This two-part review describes a range of benign and malignant liver masses, with emphasis on IV contrast-enhanced MDCT features and vascular signatures that can be identified on 3D vascular mapping.

  10. [Pneumothorax during laparoscopic percutaneous transthoracic radiofrequency ablation for liver tumors of the hepatic dome: a case report].

    PubMed

    Abe, Eiji; Abe, Mari

    2007-10-01

    A 69-year-old man with hepatoma was scheduled for laparoscopic percutaneous transthoracic radiofrequency ablation (RFA) under general anesthesia. His history and physical examination were unremarkable. Anesthesia was induced with propofol and maintained with oxygen-air, sevoflurane and fentanyl. After pneumoperitoneum was introduced, percutaneous RFA needle was inserted into the hepatoma crossing the thoracic cavity and diaphragm several times. Sixty-five minutes after the start of pneumoperitoneum, breathing sounds gradually decreased over the right side of the chest. Because his oxygenation and hemodynamics were stable, the operation was continued with pneumoperitoneum. At the end of surgery, breathing sounds were hardly audible over the right side of the chest. Postoperative chest X-ray showed right pneumothorax. Following thoracentesis, the patient was successfully extubated. During laparoscopic percutaneous transthoracic radiofrequency ablation for liver tumors in the hepatic dome, pneumothorax can occur easily due to passage of peritoneal gas through lesion of the diaphragm caused by RFA needle. We anesthesiologist should recognize the risk of this operation.

  11. An evaluation of the variability of tumor-shape definition derived by experienced observers from CT images of supraglottic carcinomas (ACRIN protocol 6658)

    SciTech Connect

    Cooper, Jay S. . E-mail: jcooper@maimonidesmed.org; Mukherji, Suresh K.; Toledano, Alicia Y.; Beldon, Clifford; Schmalfuss, Ilona M.; Amdur, Robert; Sailer, Scott; Loevner, Laurie A.; Kousouboris, Phil; Ang, K. Kian; Cormack, Jean; Sicks, JoRean M.S.

    2007-03-15

    Purpose: Accurate target definition is considered essential for sophisticated, image-guided radiation therapy; however, relatively little information has been reported that measures our ability to identify the precise shape of targets accurately. We decided to assess the manner in which eight 'experts' interpreted the size and shape of tumors based on 'real-life' contrast-enhanced computed tomographic (CT) scans. Methods and Materials: Four neuroradiologists and four radiation oncologists (the authors) with considerable experience and presumed expertise in treating head-and-neck tumors independently contoured, slice-by-slice, his/her interpretation of the precise gross tumor volume (GTV) on each of 20 sets of CT scans taken from 20 patients who previously were enrolled in Radiation Therapy Oncology Group protocol 91-11. Results: The average proportion of overlap (i.e., the degree of agreement) was 0.532 (95% confidence interval 0.457 to 0.606). There was a slight tendency for the proportion of overlap to increase with increasing average GTV. Conclusions: Our work suggests that estimation of tumor shape currently is imprecise, even for experienced physicians. In consequence, there appears to be a practical limit to the current trend of smaller fields and tighter margins.

  12. Visualization of microvascular proliferation as a tumor infiltration structure in rat glioma specimens using the diffraction-enhanced imaging in-plane CT technique

    NASA Astrophysics Data System (ADS)

    Seo, Seung-Jun; Sunaguchi, Naoki; Yuasa, Tetsuya; Huo, Qingkai; Ando, Masami; Choi, Gi-Hwan; Kim, Hong-Tae; Kim, Ki-Hong; Jeong, Eun-Ju; Chang, Won-Seok; Kim, Jong-Ki

    2012-03-01

    In order to study potent microenvironments of malignant gliomas with a high- resolution x-ray imaging technique, an injection orthotopic glioma model was made using the Sprague-Dawley rat. Total brain tissue, taken out as an ex vivo model, was examined with diffraction-enhanced imaging (DEI) computed tomography (CT) acquired with a 35 keV monochromatic x-ray. In the convolution-reconstructed 2D/3D images with a spatial resolution of 12.5 × 12.5 × 25 µm, distinction among necrosis, typical ring-shaped viable tumors, edemas and healthy tissues was clearly observed near the frontal lobe in front of the rat's caudate nucleus. Multiple microvascular proliferations (MVPs) were observed surrounding peritumoral edemas as a tumor infiltration structure. Typical dimensions of tubular MVPs were 130 (diameter) ×250 (length) µm with a partial sprout structure revealed in the 3D reconstructed image. Hyperplasia of cells around vessel walls was revealed with tumor cell infiltration along the perivascular space in microscopic observations of mild MVP during histological analysis. In conclusion, DEI-CT is capable of imaging potent tumor-infiltrating MVP structures surrounding high-grade gliomas.

  13. Survival outcomes of hepatic resection compared with transarterial chemoembolization or sorafenib for hepatocellular carcinoma with portal vein tumor thrombosis

    PubMed Central

    Lee, Jung Min; Jang, Byoung Kuk; Lee, Yoo Jin; Choi, Wang Yong; Choi, Sei Myong; Chung, Woo Jin; Hwang, Jae Seok; Kang, Koo Jeong; Kim, Young Hwan; Chauhan, Anil Kumar; Park, Soo Young; Tak, Won Young; Kweon, Young Oh; Kim, Byung Seok; Lee, Chang Hyeong

    2016-01-01

    Background/Aims: Treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remains controversial. We compared the outcomes of hepatic resection (HR), transarterial chemoembolization (TACE), and sorafenib therapy as treatments for HCC with PVTT. Methods: Patients diagnosed as HCC with PVTT between January 2000 and December 2011 who received treatment with sorafenib, HR, or TACE were included. Patients with main PVTT, superior mesenteric vein tumor thrombosis, or Child-Turcotte-Pugh (CTP) class C were excluded. The records of 172 patients were analyzed retrospectively. HR, TACE, and sorafenib treatment were performed is 40, 80, and 52 patients respectively. PVTT was classified as either involving the segmental branch (type I) or extending to involve the right or left portal vein (type II). Results: The median survival time was significantly longer in the HR group (19.9 months) than in the TACE and sorafenib groups (6.6 and 6.2 months, respectively; both p<0.001), and did not differ significantly between the latter two groups (p=0.698). Among patients with CTP class A, type I PVTT or unilobar-involved HCC, the median survival time was longer in the HR group than in the TACE and sorafenib groups (p=0.006). In univariate analyses, the initial treatment method, tumor size, PVTT type, involved lobe, CTP class, and presence of cirrhosis or ascites were correlated with overall survival. The significant prognostic factors for overall survival in Cox proportional-hazards regression analysis were initial treatment method (HR vs. TACE: hazard ratio=1.750, p=0.036; HR vs. sorafenib: hazard ratio=2.262, p=0.006), involved lobe (hazard ratio=1.705, p=0.008), PVTT type (hazard ratio=1.617, p=0.013), and CTP class (hazard ratio=1.712, p=0.012). Conclusions: Compared with TACE or sorafenib, HR may prolong the survival of patients with HCC in cases of CTP class A, type I PVTT or unilobar-involved HCC. PMID:27044767

  14. Optical Imaging of Mesenchymal Epithelial Transition Factor (MET) for Enhanced Detection and Characterization of Primary and Metastatic Hepatic Tumors

    PubMed Central

    Esfahani, Shadi A.; Heidari, Pedram; Kim, Sun A.; Ogino, Shuji; Mahmood, Umar

    2016-01-01

    specific and can be blocked when co-injected with unlabeled peptide; for instance the epifluorescence TBR is reduced from 13.5 ± 1.2 to 1.7 ± 0.3 (p < 0.05) in HT-29 and from 5.3 ± 0.8 to 1.4 ± 0.2 (p < 0.05) in Huh-7 xenografts after co-injection with unlabeled peptides. Biodistribution studies showed predominantly renal clearance of the probe. Conclusion: Optical imaging of MET resulted in high TBR in animal models of primary and metastatic hepatic tumors suggesting its utility for procedural guidance. PMID:27698938

  15. Optical Imaging of Mesenchymal Epithelial Transition Factor (MET) for Enhanced Detection and Characterization of Primary and Metastatic Hepatic Tumors

    PubMed Central

    Esfahani, Shadi A.; Heidari, Pedram; Kim, Sun A.; Ogino, Shuji; Mahmood, Umar

    2016-01-01

    specific and can be blocked when co-injected with unlabeled peptide; for instance the epifluorescence TBR is reduced from 13.5 ± 1.2 to 1.7 ± 0.3 (p < 0.05) in HT-29 and from 5.3 ± 0.8 to 1.4 ± 0.2 (p < 0.05) in Huh-7 xenografts after co-injection with unlabeled peptides. Biodistribution studies showed predominantly renal clearance of the probe. Conclusion: Optical imaging of MET resulted in high TBR in animal models of primary and metastatic hepatic tumors suggesting its utility for procedural guidance.

  16. Systemic Agonistic Anti-CD40 Treatment of Tumor-Bearing Mice Modulates Hepatic Myeloid-Suppressive Cells and Causes Immune-Mediated Liver Damage.

    PubMed

    Medina-Echeverz, José; Ma, Chi; Duffy, Austin G; Eggert, Tobias; Hawk, Nga; Kleiner, David E; Korangy, Firouzeh; Greten, Tim F

    2015-05-01

    Immune-stimulatory mAbs are currently being evaluated as antitumor agents. Although overall toxicity from these agents appears to be moderate, liver toxicities have been reported and are not completely understood. We studied the effect of systemic CD40 antibody treatment on myeloid cells in the spleen and liver. Naïve and tumor-bearing mice were treated systemically with agonistic anti-CD40 antibody. Immune cell subsets in the liver and spleen, serum transaminases, and liver histologies were analyzed after antibody administration. Nox2(-/-), Cd40(-/-), and bone marrow chimeric mice were used to study the mechanism by which agonistic anti-CD40 mediates its effects in vivo. Suppressor function of murine and human tumor-induced myeloid-derived suppressor cells (MDSC) was studied upon CD40 ligation. Agonistic CD40 antibody caused liver damage within 24 hours after injection in two unrelated tumor models and mice strains. Using bone marrow chimeras, we demonstrate that CD40 antibody-induced hepatitis in tumor-bearing mice was dependent on the presence of CD40-expressing hematopoietic cells. Agonistic CD40 ligation-dependent liver damage was induced by the generation of reactive oxygen species. Furthermore, agonistic CD40 antibody resulted in increased CD80-positive and CD40-positive liver CD11b(+)Gr-1(+) immature myeloid cells. CD40 ligation on tumor-induced murine and human CD14(+)HLA-DR(low) peripheral blood mononuclear cells from patients with cancer reduced their immune suppressor function. Collectively, agonistic CD40 antibody treatment activated tumor-induced myeloid cells, caused myeloid-dependent hepatotoxicity, and ameliorated the suppressor function of murine and human MDSC. Collectively, our data suggest that CD40 may mature immunosuppressive myeloid cells and thereby cause liver damage in mice with an accumulation of tumor-induced hepatic MDSC. PMID:25637366

  17. Systemic Agonistic Anti-CD40 Treatment of Tumor-Bearing Mice Modulates Hepatic Myeloid-Suppressive Cells and Causes Immune-Mediated Liver Damage.

    PubMed

    Medina-Echeverz, José; Ma, Chi; Duffy, Austin G; Eggert, Tobias; Hawk, Nga; Kleiner, David E; Korangy, Firouzeh; Greten, Tim F

    2015-05-01

    Immune-stimulatory mAbs are currently being evaluated as antitumor agents. Although overall toxicity from these agents appears to be moderate, liver toxicities have been reported and are not completely understood. We studied the effect of systemic CD40 antibody treatment on myeloid cells in the spleen and liver. Naïve and tumor-bearing mice were treated systemically with agonistic anti-CD40 antibody. Immune cell subsets in the liver and spleen, serum transaminases, and liver histologies were analyzed after antibody administration. Nox2(-/-), Cd40(-/-), and bone marrow chimeric mice were used to study the mechanism by which agonistic anti-CD40 mediates its effects in vivo. Suppressor function of murine and human tumor-induced myeloid-derived suppressor cells (MDSC) was studied upon CD40 ligation. Agonistic CD40 antibody caused liver damage within 24 hours after injection in two unrelated tumor models and mice strains. Using bone marrow chimeras, we demonstrate that CD40 antibody-induced hepatitis in tumor-bearing mice was dependent on the presence of CD40-expressing hematopoietic cells. Agonistic CD40 ligation-dependent liver damage was induced by the generation of reactive oxygen species. Furthermore, agonistic CD40 antibody resulted in increased CD80-positive and CD40-positive liver CD11b(+)Gr-1(+) immature myeloid cells. CD40 ligation on tumor-induced murine and human CD14(+)HLA-DR(low) peripheral blood mononuclear cells from patients with cancer reduced their immune suppressor function. Collectively, agonistic CD40 antibody treatment activated tumor-induced myeloid cells, caused myeloid-dependent hepatotoxicity, and ameliorated the suppressor function of murine and human MDSC. Collectively, our data suggest that CD40 may mature immunosuppressive myeloid cells and thereby cause liver damage in mice with an accumulation of tumor-induced hepatic MDSC.

  18. Hepatic SirT1-Dependent Gain-of-Function of Stearoyl-CoA Desaturase-1 Conveys Dysmetabolic and Tumor Progression Functions

    PubMed Central

    Qiang, Li; Kon, Ning; Zhao, Wenhui; Jiang, Le; Knight, Colette M.; Welch, Carrie; Pajvani, Utpal

    2015-01-01

    SUMMARY Obesity is associated with higher incidence of cancer but the predisposing mechanisms remain poorly understood. The NAD+–dependent deacetylase SirT1 orchestrates metabolism, cellular survival, and growth. To date, there is no unifying mechanism to explain the metabolic and tumor-related effects of SirT1. In this work, we demonstrate that genetic ablation of the endogenous inhibitor of SirT1, Deleted-in-Breast-Cancer-1 (Dbc1), unexpectedly results in obesity and insulin-resistance. Dbc1 deficiency promoted SirT1-dependent gain-of-function of stearoyl-coenzyme A desaturase 1 (Scd1), increasing plasma and tissue levels of unsaturated fatty acids. The metabolic abnormalities in Dbc1−/− mice were reversed by ablation of hepatic SirT1 or by inhibition of Scd1 activity. Furthermore, loss of Dbc1 impaired master tumor suppressor p53 activation and treatment of Scd1 inhibitor extended survival of tumorigenic TP53−/− mice by decreasing tumor-related death. Together, our findings illustrate a shared mechanism of obesity and tumor progression through hepatic SirT1 gain-of-function in a metabolic control step, with potential therapeutic implications. PMID:26074075

  19. [A case of multiple tumors].

    PubMed

    Chikazawa, H; Shibata, J; Murata, H; Yoshida, K; Fujiyama, S; Satoh, T; Kako, H; Takano, S; Misumi, A; Akagi, M

    1990-05-01

    A 54-year-old man was admitted to our clinic for a further examination of rectal and liver tumors, after which a rectal cancer, a hepatocellular carcinoma (HCC), a hemangioma of the liver a retroperitoneal cyst, and a submucosal tumor of the stomach (SMT) were diagnosed by means of a colonoscopy, a gastroscopy, and US, CT, and angiography, these tests also revealing elevated CEA and AFP levels. A hepatic subsegmentectomy and a Miles's operation, as well as an enucleation of other liver tumors and an SMT, were performed and a retroperitoneal cyst was removed. The histopathological finding of the rectal cancer was a moderately differentiated adenocarcinoma, while the liver tumors were determined as being an HCC of the trabecular type, adenomatas revealing hyperplasia, a hemangioma, and the SMT showing a benign leiomyoblastoma.

  20. Au Nanocage Functionalized with Ultra-small Fe3O4 Nanoparticles for Targeting T1–T2Dual MRI and CT Imaging of Tumor

    NASA Astrophysics Data System (ADS)

    Wang, Guannan; Gao, Wei; Zhang, Xuanjun; Mei, Xifan

    2016-06-01

    Diagnostic approaches based on multimodal imaging of clinical noninvasive imaging (eg. MRI/CT scanner) are highly developed in recent years for accurate selection of the therapeutic regimens in critical diseases. Therefore, it is highly demanded in the development of appropriate all-in-one multimodal contrast agents (MCAs) for the MRI/CT multimodal imaging. Here a novel ideal MCAs (F-AuNC@Fe3O4) were engineered by assemble Au nanocages (Au NC) and ultra-small iron oxide nanoparticles (Fe3O4) for simultaneous T1–T2dual MRI and CT contrast imaging. In this system, the Au nanocages offer facile thiol modification and strong X-ray attenuation property for CT imaging. The ultra-small Fe3O4 nanoparticles, as excellent contrast agent, is able to provide great enhanced signal of T1- and T2-weighted MRI (r1 = 6.263 mM‑1 s‑1, r2 = 28.117 mM‑1 s‑1) due to their ultra-refined size. After functionalization, the present MCAs nanoparticles exhibited small average size, low aggregation and excellent biocompatible. In vitro and In vivo studies revealed that the MCAs show long-term circulation time, renal clearance properties and outstanding capability of selective accumulation in tumor tissues for simultaneous CT imaging and T1- and T2-weighted MRI. Taken together, these results show that as-prepared MCAs are excellent candidates as MRI/CT multimodal imaging contrast agents.

  1. Au Nanocage Functionalized with Ultra-small Fe3O4 Nanoparticles for Targeting T1–T2Dual MRI and CT Imaging of Tumor

    PubMed Central

    Wang, Guannan; Gao, Wei; Zhang, Xuanjun; Mei, Xifan

    2016-01-01

    Diagnostic approaches based on multimodal imaging of clinical noninvasive imaging (eg. MRI/CT scanner) are highly developed in recent years for accurate selection of the therapeutic regimens in critical diseases. Therefore, it is highly demanded in the development of appropriate all-in-one multimodal contrast agents (MCAs) for the MRI/CT multimodal imaging. Here a novel ideal MCAs (F-AuNC@Fe3O4) were engineered by assemble Au nanocages (Au NC) and ultra-small iron oxide nanoparticles (Fe3O4) for simultaneous T1–T2dual MRI and CT contrast imaging. In this system, the Au nanocages offer facile thiol modification and strong X-ray attenuation property for CT imaging. The ultra-small Fe3O4 nanoparticles, as excellent contrast agent, is able to provide great enhanced signal of T1- and T2-weighted MRI (r1 = 6.263 mM−1 s−1, r2 = 28.117 mM−1 s−1) due to their ultra-refined size. After functionalization, the present MCAs nanoparticles exhibited small average size, low aggregation and excellent biocompatible. In vitro and In vivo studies revealed that the MCAs show long-term circulation time, renal clearance properties and outstanding capability of selective accumulation in tumor tissues for simultaneous CT imaging and T1- and T2-weighted MRI. Taken together, these results show that as-prepared MCAs are excellent candidates as MRI/CT multimodal imaging contrast agents. PMID:27312564

  2. Brain metastases detectability of routine whole body (18)F-FDG PET and low dose CT scanning in 2502 asymptomatic patients with solid extracranial tumors.

    PubMed

    Bochev, Pavel; Klisarova, Aneliya; Kaprelyan, Ara; Chaushev, Borislav; Dancheva, Zhivka

    2012-01-01

    As fluorine-18-fluorodesoxyglucose positron emission tomography/computed tomography ( (18)F-FDG PET/CT) is gaining wider availability, more and more patients with malignancies undergo whole body PET/CT, mostly to assess tumor spread in the rest of the body, but not in the brain. Brain is a common site of metastatic spread in patients with solid extracranial tumors. Gold standard in the diagnosis of brain metastases remains magnetic resonance imaging (MRI). However MRI is not routinely indicated and is not available for all cancer patients. Fluorine-18-FDG PET is considered as having poor sensitivity in detecting brain metastases, but this may not be true for PET/CT. The aim of our study was to assess the value of (18)F-FDG PET/CT in the detection of brain metastases found by whole body scan including the brain, in patients with solid extracranial neoplasms. A total of 2502 patients with solid extracranial neoplasms were studied. All patients underwent a routine whole body (18)F-FDG PET/CT scan with the whole brain included in the scanned field. Patients with known or suspected brain metastases were preliminary excluded from the study. Hypermetabolic and ring-like brain lesions on the PET scan were considered as metastases. Lesions with CT characteristics of brain metastases were regarded as such irrespective of their metabolic pattern. Lesions in doubt were verified by MRI during first testing or on follow-up or by operation. Our results showed that brain lesions, indicative of and verified to be metastases were detected in 25 out of the 2502 patients (1%), with lung cancer being the most common primary. Twenty three out of these 25 patients had no neurological symptoms by the time of the scan. The detection rate of brain metastases was relatively low, but information was obtained with a minimum increase of radiation burden. In conclusion, whole body (18)F-FDG PET/CT detected brain metastases in 1% of the patients if brain was included in the scanned field. Brain

  3. [Study on targeting drug delivery system--the characteristics of methotrexate microsphere and experimental treatment of hepatic tumor in rats by arterial embolization].

    PubMed

    Chen, Q H; Lu, W G; Ge, Q H; Sheng, Q; Zhang, Y; Xie, X H; Wang, Y; Wu, M C; Zhang, X H

    1991-01-01

    Preparation of methotrexate microsphere (MTX-ms) by emulsion-freezing technique was introduced and the experimental results proved that MTX entrapped in the microspheres exhibited good stabilities towards temperature, cobalt-60 radiation and light. The dissolution and inflation rate of the microspheres in pH 7.4 buffer solution at different times measured by Coulter counter was presented. Antitumor activity of MTX-ms after hepatic arterial embolization was examined in a model of liver tumor in Wistar rats. The group of rats treated with MTX-ms showed a rather significant reduction in tumor growth and more extended tumor necrosis as compared with the other groups, e.g. normal saline solution, MTX solution, placebo gelatin-ms and the results demonstrate that the effect of arterial chemoembolization used by MTX-ms is superior to that of the groups either using arterial chemotherapy or arterial embolization alone in treating rat liver cancer.

  4. Apoptosis induced by tumor necrosis factor-alpha in rat hepatocyte cell lines expressing hepatitis B virus.

    PubMed Central

    Guilhot, S.; Miller, T.; Cornman, G.; Isom, H. C.

    1996-01-01

    Three well differentiated SV40-immortalized rat hepatocyte cell lines, CWSV1, CWSV2, and CWSV14, and Hepatitis B Virus (HBV)-producing cell lines derived from them were examined for sensitivity to tumor necrosis factor (TNF)-alpha. CWSV1, CWSV2, and CWSV14 cells were co-transfected with a DNA construct containing a dimer of the HBV genome and the neo gene and selected in G418 to generate stable cell lines. Characterization of these cell lines indicated that they contain integrated HBV DNA, contain low molecular weight HBV DNA compatible with the presence of HBV replication intermediates, express HBV transcripts, and produce HBV proteins. The viability of CWSV1, CWSV2, and CWSV2 cells was not significantly altered when they were treated with TNF-alpha at concentrations as high as 20,000 U/ml. The HBV-expressing CWSV1 cell line, SV1di36, and the HBV-expressing CWSV14 cell line, SV14di208, were also not killed when treated with TNF-alpha. However, the HBV-expressing CWSV2 cell line, SV2di366, was extensively killed when treated with TNF-alpha at concentrations ranging from 200 to 20,000 U/ml. Analysis of several different HBV-producing CWSV2 cell lines indicated that TNF-alpha killing depended upon the level of HBV expression. The TNF-alpha-induced cell killing in high HBV-producing CWSV2 cell lines was accompanied by the presence of an oligonucleosomal DNA ladder characteristic of apoptosis. Images Figure 2 Figure 3 Figure 4 Figure 6 Figure 9 Figure 10 Figure 11 PMID:8774135

  5. A Method to Estimate Mean Position, Motion Magnitude, Motion Correlation, and Trajectory of a Tumor From Cone-Beam CT Projections for Image-Guided Radiotherapy

    SciTech Connect

    Poulsen, Per Rugaard Cho, Byungchul; Keall, Paul J.

    2008-12-01

    Purpose: To develop a probability-based method for estimating the mean position, motion magnitude, and trajectory of a tumor using cone-beam CT (CBCT) projections. Method and Materials: CBCT acquisition was simulated for more than 80 hours of patient-measured trajectories for thoracic/abdominal tumors and prostate. The trajectories were divided into 60-second segments for which CBCT was simulated by projecting the tumor position onto a rotating imager. Tumor (surrogate) visibility on all projections was assumed. The mean and standard deviation of the tumor position and motion correlation along the three axes were determined with maximum likelihood estimation based on the projection data, assuming a Gaussian spatial distribution. The unknown position component along the imager axis was approximated by its expectation value, determined by the Gaussian distribution. Transformation of the resulting three-dimensional position to patient coordinates provided the estimated trajectory. Two trajectories were experimentally investigated by CBCT acquisition of a phantom. Results: The root-mean-square error of the estimated mean position was 0.05 mm. The root-mean-square error of the trajectories was <1 mm in 99.1% of the thorax/abdomen cases and in 99.7% of the prostate cases. The experimental trajectory estimation agreed with the actual phantom trajectory within 0.44 mm in any direction. Clinical applicability was demonstrated by estimating the tumor trajectory for a pancreas cancer case. Conclusions: A method for estimation of mean position, motion magnitude, and trajectory of a tumor from CBCT projections has been developed. The accuracy was typically much better than 1 mm. The method is applicable to motion-inclusive, respiratory-gated, and tumor-tracking radiotherapy.

  6. Hormone-sensitive hepatic Na/sup +/-pump: evidence for regulation by diacylglycerol and tumor promoters

    SciTech Connect

    Lynch, C.J.; Wilson, P.B.; Blackmore, P.F.; Exton, J.H.

    1986-11-05

    Ouabain-sensitive /sup 86/Rb/sup +/ uptake by isolated rat hepatocytes was studied to elucidate how Ca/sup 2 +/-mobilizing hormones stimulate the Na/sup +/-pump. Stimulation of this uptake was observed with concentrations of vasopressin ((8-arginine)vasopressin, AVP), angiotensin II, and norepinephrine which elicited Ca/sup 2 +/ mobilization and phosphorylase activation. These results suggested that changes in cytosolic Ca/sup 2 +/, mediated by inositol trisphosphate, might trigger sodium pump stimulation by AVP. However, in hepatocytes incubated in Ca/sup 2 +/-free Krebs-Henseleit buffer, Na/sup +/-pump activity was not altered over 15 min by either 1.5 mM EGTA or 1.5 mM Ca/sup 2 +/. Furthermore, incubation of cells in 5 mM EGTA for 15-30 min drastically impaired the ability of AVP to increase cytosolic Ca/sup 2 +/, but only modestly attenuated AVP-stimulated Na/sup +/-pump activity. Two tumor promoters, phorbol myristate acetate (PMA) and mezerein, stimulated Na/sup +//K/sup +/-ATPase-mediated transport activity. Similarly, addition of synthetic diacylglycerols or of exogenous phospholipase C from Clostridium perfringens to increase endogenous diacylglycerol levels also resulted in a stimulation of the Na/sup +/-pump in the absence of changes in cytosolic or total cellular Ca/sup 2 +/ levels. Stimulation of the Na/sup +/-pump by the combination of maximal concentrations of PMA and AVP did not produce an additive response, and both agents displayed a transient time course, suggesting that the two agents share a common mechanism. Stimulation of the Na/sup +/-pump by AVP and PMA was not blocked by amiloride analogs which inhibit Na/sup +//H/sup +/ exchange, but these compounds blocked the action of insulin. These data suggest that the elevated Na/sup +//K/sup +/-ATPase-mediated transport activity observed in hepatocytes following exposure to Ca/sup 2 +/-mobilizing hormones is a consequence of stimulated diacylglycerol formation and may involve protein kinase C.

  7. Changes in Skeletal Tumor Activity on (18)F-choline PET/CT in Patients Receiving (223)Radium Radionuclide Therapy for Metastatic Prostate Cancer.

    PubMed

    Miyazaki, Kyle S; Kuang, Yu; Kwee, Sandi A

    2015-06-01

    Radium-223 dichloride is an alpha-emitting radiopharmaceutical shown to prolong survival in patients with castrate-resistant prostate cancer (CRPC) and symptomatic skeletal metastases. This report describes in two patients the acute changes in bone metastatic activity detected by F-18 choline PET/CT imaging midway during treatment with radium-223 dichloride. In addition to visual and standardized uptake value analysis, changes in the whole-body tumor burden were quantified by measuring the difference in net metabolically active tumor volume (MATV) and total lesion activity (TLA) between pre- and mid-treatment PET scans. After the third dose of radium-223 dichloride, near-total disappearance of abnormal skeletal activity was observed in one case (net MATV change from 260.7 to 0.8 cc; net TLA change from 510.7 to 2.1), while a heterogeneous tumor response was observed in the other (net MATV change from 272.2 to 241.3 cc; net TLA change from 987.1 to 779.4). Corresponding normalization and persistent elevation in serum alkaline phosphatase levels were observed in these cases, respectively. Further research is needed to determine the predictive value of serial F-18 choline PET/CT imaging in patients receiving radium-223 dichloride for CRPC.

  8. 18F-FMISO PET/CT Visualization of Tumor Hypoxia in Patients with Chordoma of the Mobile and Sacrococcygeal Spine

    PubMed Central

    Cheney, Matthew D.; Chen, Yen-Lin; Lim, Ruth; Winrich, Barbara K.; Grosu, Anca L.; Trofimov, Alexei V.; Depauw, Nicolas; Shih, Helen A.; Schwab, Joseph H.; Hornicek, Francis J.; DeLaney, Thomas F.

    2014-01-01

    Summary Local recurrence (LR) rates in chordoma patients following surgery ± radiation therapy (RT) or definitive RT are high. Tumor hypoxia is associated with radioresistance and LR. In this prospective study, [18F]-FMISO-PET/CT detected hypoxic tumor sub-volumes in 60% of patients with chordoma of the mobile and sacrococcygeal spine, the majority of which were sufficiently large to allow an RT boost. Further study of hypoxia-directed, dose-escalated RT, particularly in patients at high risk for LR, is warranted. Purpose/Objectives Local recurrence (LR) rates in chordoma patients following surgery ± radiation therapy (RT) or definitive RT are high. Tumor hypoxia is associated with radioresistance and LR. [18F] fluoromisonidazole positron emission tomography/computed tomography (FMISO-PET/CT) can visualize skull base chordoma hypoxic sub-volumes (HSV) and feasibility of hypoxia-directed RT dose-escalation has been demonstrated in head and neck cancer. This study investigates FMISO-PET/CT detection of targetable HSVs in chordoma of the mobile or sacrococcygeal spine. Methods and Materials A prospective, pilot study of 20 patients with primary or locally recurrent chordoma of the mobile or sacrococcygeal spine treated with proton or combined proton/photon RT ± surgery was completed. FMISO-PET/CT was performed prior to RT and after 19.8-34.2 GyRBE (relative biologic effectiveness). Gross tumor volumes (GTV) were delineated and HSVs defined including voxels with standardized uptake values ≥ 1.4 times the muscle mean. Clinical characteristics and treatments received were compared between patients with and without HSVs. Results FMISO-PET/CT detected HSVs in 12 (60%; 12/20) patients. Baseline and interval HSV spatial concordance varied (0-94%). Eight HSVs were sufficiently large (≥ 5cc) to potentially allow an intensity modulated proton therapy boost. Patients with HSVs had significantly larger GTVs (median =410.0 cc vs. 63.4 cc; p=0.02) and were significantly more

  9. Increasing the Accuracy of Volume and ADC Delineation for Heterogeneous Tumor on Diffusion-Weighted MRI: Correlation with PET/CT

    SciTech Connect

    Gong, Nan-Jie; Wong, Chun-Sing; Chu, Yiu-Ching; Guo, Hua; Huang, Bingsheng; Chan, Queenie

    2013-10-01

    Purpose: To improve the accuracy of volume and apparent diffusion coefficient (ADC) measurements in diffusion-weighted magnetic resonance imaging (MRI), we proposed a method based on thresholding both the b0 images and the ADC maps. Methods and Materials: In 21 heterogeneous lesions from patients with metastatic gastrointestinal stromal tumors (GIST), gross lesion were manually contoured, and corresponding volumes and ADCs were denoted as gross tumor volume (GTV) and gross ADC (ADC{sub g}), respectively. Using a k-means clustering algorithm, the probable high-cellularity tumor tissues were selected based on b0 images and ADC maps. ADC and volume of the tissues selected using the proposed method were denoted as thresholded ADC (ADC{sub thr}) and high-cellularity tumor volume (HCTV), respectively. The metabolic tumor volume (MTV) in positron emission tomography (PET)/computed tomography (CT) was measured using 40% maximum standard uptake value (SUV{sub max}) as the lower threshold, and corresponding mean SUV (SUV{sub mean}) was also measured. Results: HCTV had excellent concordance with MTV according to Pearson's correlation (r=0.984, P<.001) and linear regression (slope = 1.085, intercept = −4.731). In contrast, GTV overestimated the volume and differed significantly from MTV (P=.005). ADC{sub thr} correlated significantly and strongly with SUV{sub mean} (r=−0.807, P<.001) and SUV{sub max} (r=−0.843, P<.001); both were stronger than those of ADC{sub g}. Conclusions: The proposed lesion-adaptive semiautomatic method can help segment high-cellularity tissues that match hypermetabolic tissues in PET/CT and enables more accurate volume and ADC delineation on diffusion-weighted MR images of GIST.

  10. Paternal B Vitamin Intake Is a Determinant of Growth, Hepatic Lipid Metabolism and Intestinal Tumor Volume in Female Apc1638N Mouse Offspring

    PubMed Central

    Sabet, Julia A.; Park, Lara K.; Iyer, Lakshmanan K.; Tai, Albert K.; Koh, Gar Yee; Pfalzer, Anna C.; Parnell, Laurence D.; Mason, Joel B.; Liu, Zhenhua; Byun, Alexander J.; Crott, Jimmy W.

    2016-01-01

    Background The importance of maternal nutrition to offspring health and risk of disease is well established. Emerging evidence suggests paternal diet may affect offspring health as well. Objective In the current study we sought to determine whether modulating pre-conception paternal B vitamin intake alters intestinal tumor formation in offspring. Additionally, we sought to identify potential mechanisms for the observed weight differential among offspring by profiling hepatic gene expression and lipid content. Methods Male Apc1638N mice (prone to intestinal tumor formation) were fed diets containing replete (control, CTRL), mildly deficient (DEF), or supplemental (SUPP) quantities of vitamins B2, B6, B12, and folate for 8 weeks before mating with control-fed wild type females. Wild type offspring were euthanized at weaning and hepatic gene expression profiled. Apc1638N offspring were fed a replete diet and euthanized at 28 weeks of age to assess tumor burden. Results No differences in intestinal tumor incidence or burden were found between male Apc1638N offspring of different paternal diet groups. Although in female Apc1638N offspring there were no differences in tumor incidence or multiplicity, a stepwise increase in tumor volume with increasing paternal B vitamin intake was observed. Interestingly, female offspring of SUPP and DEF fathers had a significantly lower body weight than those of CTRL fed fathers. Moreover, hepatic trigylcerides and cholesterol were elevated 3-fold in adult female offspring of SUPP fathers. Weanling offspring of the same fathers displayed altered expression of several key lipid-metabolism genes. Hundreds of differentially methylated regions were identified in the paternal sperm in response to DEF and SUPP diets. Aside from a few genes including Igf2, there was a striking lack of overlap between these genes differentially methylated in sperm and differentially expressed in offspring. Conclusions In this animal model, modulation of

  11. [Multidetector CT and magnetic resonance imaging features of solitary fibrous tumors in the pelvis and the relevant pathologic basis changes].

    PubMed

    Li, Xueming; Ren, Jing; Zhou, Peng; Cao, Ying; Cheng, Zhuzhong; Yu, Jianqun; Xu, Guohui

    2015-02-01

    In order to investigate the features of multidetector CT (MDCT) and magnetic resonance imaging (MRI) as well as the corresponding pathogic basis of solitary fibrous tumor (SFT) in the pelvis, we collected the clinical data of 13 patients with pathologically confirmed SFT in pelvis, and retrospectively reviewed the MDCT and MRI appearances. Of these enrolled patients, 6 received MDCT scans, 5 underwent MRI scans, and 2 underwent both MDCT and MRI examinations. Shown on the MDCT and MRI, the maximum diameters of the masses ranged from 4.0 to 25.2 cm (averaged 11.8 cm). Six masses were lobulated, and seven were round or oval. In addition, all masses were well-defined and displaced the adjacent structures to some degrees. On the computed tomography, all masses were of isodensity on unenhanced scans in general, among which five masses were demonstrated with hypodense areas. On the MRI T1-weighted image, all lesions were isointense, of which patchy hypointense areas were detected in 3 cases and radial hypointense areas were in 3 cases, and the other one was presented with homogenous intensity. On T2-weighted images, most of the lesions were mixed hyperintense, of which 3 cases were of heterogenous hyperintesity, radial hypointense areas were detected in 3 patients, and the other one was homogenously intense. On enhanced computed tomography and MRI, large supplying vessels were found in 4 cases; 12 cases showed moderate to conspicuous enhancement, and the other one was presented with mild homogenous enhancement. Of the patients with moderate to conspicuous enhancement, patchy areas of non-enhancement were detected in 7 cases, radial areas of progressive enhancement were detected in 3 cases, and the remained 2 cases showed homogenous enhancement. On pathology, the radial area presented as progressive enhancement was fibrosis. During the follow-ups after surgery, 2 patients had local recurrence and 1 had metastasis to liver. In conclusion, the SFT in the pelvis are commonly

  12. [Multidetector CT and magnetic resonance imaging features of solitary fibrous tumors in the pelvis and the relevant pathologic basis changes].

    PubMed

    Li, Xueming; Ren, Jing; Zhou, Peng; Cao, Ying; Cheng, Zhuzhong; Yu, Jianqun; Xu, Guohui

    2015-02-01

    In order to investigate the features of multidetector CT (MDCT) and magnetic resonance imaging (MRI) as well as the corresponding pathogic basis of solitary fibrous tumor (SFT) in the pelvis, we collected the clinical data of 13 patients with pathologically confirmed SFT in pelvis, and retrospectively reviewed the MDCT and MRI appearances. Of these enrolled patients, 6 received MDCT scans, 5 underwent MRI scans, and 2 underwent both MDCT and MRI examinations. Shown on the MDCT and MRI, the maximum diameters of the masses ranged from 4.0 to 25.2 cm (averaged 11.8 cm). Six masses were lobulated, and seven were round or oval. In addition, all masses were well-defined and displaced the adjacent structures to some degrees. On the computed tomography, all masses were of isodensity on unenhanced scans in general, among which five masses were demonstrated with hypodense areas. On the MRI T1-weighted image, all lesions were isointense, of which patchy hypointense areas were detected in 3 cases and radial hypointense areas were in 3 cases, and the other one was presented with homogenous intensity. On T2-weighted images, most of the lesions were mixed hyperintense, of which 3 cases were of heterogenous hyperintesity, radial hypointense areas were detected in 3 patients, and the other one was homogenously intense. On enhanced computed tomography and MRI, large supplying vessels were found in 4 cases; 12 cases showed moderate to conspicuous enhancement, and the other one was presented with mild homogenous enhancement. Of the patients with moderate to conspicuous enhancement, patchy areas of non-enhancement were detected in 7 cases, radial areas of progressive enhancement were detected in 3 cases, and the remained 2 cases showed homogenous enhancement. On pathology, the radial area presented as progressive enhancement was fibrosis. During the follow-ups after surgery, 2 patients had local recurrence and 1 had metastasis to liver. In conclusion, the SFT in the pelvis are commonly

  13. Automated Voxel-Based Analysis of Volumetric Dynamic Contrast-Enhanced CT Data Improves Measurement of Serial Changes in Tumor Vascular Biomarkers

    SciTech Connect

    Coolens, Catherine; Driscoll, Brandon; Chung, Caroline; Shek, Tina; Gorjizadeh, Alborz; Ménard, Cynthia; Jaffray, David

    2015-01-01

    Objectives: Development of perfusion imaging as a biomarker requires more robust methodologies for quantification of tumor physiology that allow assessment of volumetric tumor heterogeneity over time. This study proposes a parametric method for automatically analyzing perfused tissue from volumetric dynamic contrast-enhanced (DCE) computed tomography (CT) scans and assesses whether this 4-dimensional (4D) DCE approach is more robust and accurate than conventional, region-of-interest (ROI)-based CT methods in quantifying tumor perfusion with preliminary evaluation in metastatic brain cancer. Methods and Materials: Functional parameter reproducibility and analysis of sensitivity to imaging resolution and arterial input function were evaluated in image sets acquired from a 320-slice CT with a controlled flow phantom and patients with brain metastases, whose treatments were planned for stereotactic radiation surgery and who consented to a research ethics board-approved prospective imaging biomarker study. A voxel-based temporal dynamic analysis (TDA) methodology was used at baseline, at day 7, and at day 20 after treatment. The ability to detect changes in kinetic parameter maps in clinical data sets was investigated for both 4D TDA and conventional 2D ROI-based analysis methods. Results: A total of 7 brain metastases in 3 patients were evaluated over the 3 time points. The 4D TDA method showed improved spatial efficacy and accuracy of perfusion parameters compared to ROI-based DCE analysis (P<.005), with a reproducibility error of less than 2% when tested with DCE phantom data. Clinically, changes in transfer constant from the blood plasma into the extracellular extravascular space (K{sub trans}) were seen when using TDA, with substantially smaller errors than the 2D method on both day 7 post radiation surgery (±13%; P<.05) and by day 20 (±12%; P<.04). Standard methods showed a decrease in K{sub trans} but with large uncertainty (111.6 ± 150.5) %. Conclusions

  14. Experimental validation of heterogeneity-corrected dose-volume prescription on respiratory-averaged CT images in stereotactic body radiotherapy for moving tumors

    SciTech Connect

    Nakamura, Mitsuhiro; Miyabe, Yuki; Matsuo, Yukinori; Kamomae, Takeshi; Nakata, Manabu; Yano, Shinsuke; Sawada, Akira; Mizowaki, Takashi; Hiraoka, Masahiro

    2012-04-01

    The purpose of this study was to experimentally assess the validity of heterogeneity-corrected dose-volume prescription on respiratory-averaged computed tomography (RACT) images in stereotactic body radiotherapy (SBRT) for moving tumors. Four-dimensional computed tomography (CT) data were acquired while a dynamic anthropomorphic thorax phantom with a solitary target moved. Motion pattern was based on cos (t) with a constant respiration period of 4.0 sec along the longitudinal axis of the CT couch. The extent of motion (A{sub 1}) was set in the range of 0.0-12.0 mm at 3.0-mm intervals. Treatment planning with the heterogeneity-corrected dose-volume prescription was designed on RACT images. A new commercially available Monte Carlo algorithm of well-commissioned 6-MV photon beam was used for dose calculation. Dosimetric effects of intrafractional tumor motion were then investigated experimentally under the same conditions as 4D CT simulation using the dynamic anthropomorphic thorax phantom, films, and an ionization chamber. The passing rate of {gamma} index was 98.18%, with the criteria of 3 mm/3%. The dose error between the planned and the measured isocenter dose in moving condition was within {+-} 0.7%. From the dose area histograms on the film, the mean {+-} standard deviation of the dose covering 100% of the cross section of the target was 102.32 {+-} 1.20% (range, 100.59-103.49%). By contrast, the irradiated areas receiving more than 95% dose for A{sub 1} = 12 mm were 1.46 and 1.33 times larger than those for A{sub 1} = 0 mm in the coronal and sagittal planes, respectively. This phantom study demonstrated that the cross section of the target received 100% dose under moving conditions in both the coronal and sagittal planes, suggesting that the heterogeneity-corrected dose-volume prescription on RACT images is acceptable in SBRT for moving tumors.

  15. Reproducibility of 'Intelligent' Contouring of Gross Tumor Volume in Non-Small-Cell Lung Cancer on PET/CT Images Using a Standardized Visual Method

    SciTech Connect

    Bayne, Michael; Hicks, Rodney J.; Everitt, Sarah; Fimmell, Natalie

    2010-07-15

    Purpose: Positron emission tomography/computed tomography (PET/CT) is increasingly used for delineating gross tumor volume (GTV) in non-small-cell lung cancer (NSCLC). The methodology for contouring tumor margins remains controversial. We developed a rigorous visual protocol for contouring GTV that uses all available clinical information and studied its reproducibility in patients from a prospective PET/CT planning trial. Methods and Materials: Planning PET/CT scans from 6 consecutive patients were selected. Six 'observers' (two radiation oncologists, two nuclear medicine physicians, and two radiologists) contoured GTVs for each patient using a predefined protocol and subsequently recontoured 2 patients. For the estimated GTVs and axial distances, least-squares means for each observer and for each case were calculated and compared, using the F test and pairwise t-tests. In five cases, tumor margins were also autocontoured using standardized uptake value (SUV) cutoffs of 2.5 and 3.5 and 40% SUV{sub max}. Results: The magnitude of variation between observers was small relative to the mean (coefficient of variation [CV] = 3%), and the total variation (intraclass correlation coefficient [ICC] = 3%). For estimation of superior/inferior (SI), left/right (LR), and anterior/posterior (AP) borders of the GTV, differences between observers were also small (AP, CV = 2%, ICC = 0.4%; LR, CV = 6%, ICC = 2%; SI, CV 4%, ICC = 2%). GTVs autocontoured generated using SUV 2.5, 3.5, and 40% SUV{sub max} differed widely in each case. An SUV contour of 2.5 was most closely correlated with the mean GTV defined by the human observers. Conclusions: Observer variation contributed little to total variation in the GTV and axial distances. A visual contouring protocol gave reproducible results for contouring GTV in NSCLC.

  16. Can calcified pulmonary metastases detected by (18)F-FDG PET/CT suggest the primary tumor?

    PubMed

    Hong, Chae Moon; Ahn, Byeong Cheol

    2016-01-01

    Many calcified nodules are encountered on the (18)F-FDG PET/CT scan and even though most of them are benign, the possibility of calcified pulmonary metastases (CPM) should be considered. The CT portion can often differentiate benign diseases due to their morphology. Measuring SUVmax is very important. Understanding the mechanism of calcification in malignant metastatic pulmonary lesions may be useful to suggest their origin. PMID:27035906

  17. Hepatic hemangioma: atypical appearance

    SciTech Connect

    Mikulis, D.J.; Costello, P.; Clouse, M.E.

    1985-07-01

    Recent reports indicate that computed tomography (CT) after bolus injection of contrast material is diagnostically specific for hemangioma, replacing the need for angiography in a high percentage of patients. The authors report a unique hepatic hemangioma that showed early diffuse intense opacification by angiography and contrast-enhanced CT.

  18. Impact of Reconstruction Algorithms on CT Radiomic Features of Pulmonary Tumors: Analysis of Intra- and Inter-Reader Variability and Inter-Reconstruction Algorithm Variability

    PubMed Central

    Kim, Hyungjin; Park, Chang Min; Lee, Myunghee; Park, Sang Joon; Song, Yong Sub; Lee, Jong Hyuk; Hwang, Eui Jin; Goo, Jin Mo

    2016-01-01

    Purpose To identify the impact of reconstruction algorithms on CT radiomic features of pulmonary tumors and to reveal and compare the intra- and inter-reader and inter-reconstruction algorithm variability of each feature. Methods Forty-two patients (M:F = 19:23; mean age, 60.43±10.56 years) with 42 pulmonary tumors (22.56±8.51mm) underwent contrast-enhanced CT scans, which were reconstructed with filtered back projection and commercial iterative reconstruction algorithm (level 3 and 5). Two readers independently segmented the whole tumor volume. Fifteen radiomic features were extracted and compared among reconstruction algorithms. Intra- and inter-reader variability and inter-reconstruction algorithm variability were calculated using coefficients of variation (CVs) and then compared. Results Among the 15 features, 5 first-order tumor intensity features and 4 gray level co-occurrence matrix (GLCM)-based features showed significant differences (p<0.05) among reconstruction algorithms. As for the variability, effective diameter, sphericity, entropy, and GLCM entropy were the most robust features (CV≤5%). Inter-reader variability was larger than intra-reader or inter-reconstruction algorithm variability in 9 features. However, for entropy, homogeneity, and 4 GLCM-based features, inter-reconstruction algorithm variability was significantly greater than inter-reader variability (p<0.013). Conclusions Most of the radiomic features were significantly affected by the reconstruction algorithms. Inter-reconstruction algorithm variability was greater than inter-reader variability for entropy, homogeneity, and GLCM-based features. PMID:27741289

  19. FDG PET/CT and MR imaging of CD34-negative soft-tissue solitary fibrous tumor with NAB2-STAT6 fusion gene.

    PubMed

    Nishio, Jun; Iwasaki, Hiroshi; Aoki, Mikiko; Nabeshima, Kazuki; Naito, Masatoshi

    2015-02-01

    Extrapleural solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm of intermediate biological potential. Herein, we describe the radiological, histological, immunohistochemical and molecular genetic features of an SFT arising in the left thigh of a 55-year-old woman. Magnetic resonance imaging exhibited a well-defined mass with intermediate signal intensity on T1-weighted sequences and heterogeneous high signal intensity on T2-weighted sequences. Contrast-enhanced T1-weighted sequences showed strong homogeneous enhancement of the mass. A prominent vascular pedicle was visible. Integrated positron-emission tomography (PET)/computed tomographic (CT) scan demonstrated a moderate 18F-fluorodeoxyglucose (FDG) uptake (maximum standardized uptake value, 4.45) in the mass. Following an open biopsy, wide excision of the tumor was performed. Histologically, the tumor was composed of a proliferation of spindle cells in a fibrous stroma with focal hyalinization. Thin-walled branching hemangiopericytoma-like vessels were observed. Immunohistochemically, the tumor cells were diffusely positive for signal transducer and activator of transcription 6 (STAT6) but negative for CD34. The MIB-1 labeling index was less than 5%. Subsequent reverse transcriptase-polymerase chain reaction analysis identified a nerve growth factor inducible-A binding protein 2-STAT6 gene fusion. Our case supports the utility of STAT6 immunohistochemistry as an adjunct in the diagnosis of soft-tissue SFT with loss of CD34 positivity. To the best of our knowledge, this is the first report showing the FDG PET/CT findings of soft-tissue SFT.

  20. FDG PET/CT and MR imaging of CD34-negative soft-tissue solitary fibrous tumor with NAB2-STAT6 fusion gene.

    PubMed

    Nishio, Jun; Iwasaki, Hiroshi; Aoki, Mikiko; Nabeshima, Kazuki; Naito, Masatoshi

    2015-02-01

    Extrapleural solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm of intermediate biological potential. Herein, we describe the radiological, histological, immunohistochemical and molecular genetic features of an SFT arising in the left thigh of a 55-year-old woman. Magnetic resonance imaging exhibited a well-defined mass with intermediate signal intensity on T1-weighted sequences and heterogeneous high signal intensity on T2-weighted sequences. Contrast-enhanced T1-weighted sequences showed strong homogeneous enhancement of the mass. A prominent vascular pedicle was visible. Integrated positron-emission tomography (PET)/computed tomographic (CT) scan demonstrated a moderate 18F-fluorodeoxyglucose (FDG) uptake (maximum standardized uptake value, 4.45) in the mass. Following an open biopsy, wide excision of the tumor was performed. Histologically, the tumor was composed of a proliferation of spindle cells in a fibrous stroma with focal hyalinization. Thin-walled branching hemangiopericytoma-like vessels were observed. Immunohistochemically, the tumor cells were diffusely positive for signal transducer and activator of transcription 6 (STAT6) but negative for CD34. The MIB-1 labeling index was less than 5%. Subsequent reverse transcriptase-polymerase chain reaction analysis identified a nerve growth factor inducible-A binding protein 2-STAT6 gene fusion. Our case supports the utility of STAT6 immunohistochemistry as an adjunct in the diagnosis of soft-tissue SFT with loss of CD34 positivity. To the best of our knowledge, this is the first report showing the FDG PET/CT findings of soft-tissue SFT. PMID:25667482

  1. Impact of 68Ga-DOTATATE PET/CT on the Management of Neuroendocrine Tumors: The Referring Physician’s Perspective

    PubMed Central

    Herrmann, Ken; Czernin, Johannes; Wolin, Edward M.; Gupta, Pawan; Barrio, Martin; Gutierrez, Antonio; Schiepers, Christiaan; Mosessian, Sherly; Phelps, Michael E.; Allen-Auerbach, Martin S.

    2016-01-01

    Somatostatin receptor imaging with 68Ga-DOTATATE PET/CT (DOTATATE) is increasingly used for managing patients with neuroendocrine tumors. The objective of this study was to determine referring physicians’ perspectives on the impact of DOTATATE on the management of neuroendocrine tumors. Methods A set of 2 questionnaires (pre-PET and post-PET) was sent to the referring physicians of 100 consecutive patients with known or suspected neuroendocrine tumors, who were evaluated with DOTATATE. Questionnaires on 88 patients were returned (response rate, 88%). Referring physicians categorized the DOTATATE findings on the basis of the written PET reports as negative, positive, or equivocal for disease. The likelihood for metastatic disease was scored as low, moderate, or high. The intended management before and changes as a consequence of the PET study were indicated. Results The indications for PET/CT were initial and subsequent treatment strategy assessments in 14% and 86% of patients, respectively. Referring physicians reported that DOTATATE led to a change in suspicion for metastatic disease in 21 patients (24%; increased and decreased suspicion in 9 [10%] and 12 [14%] patients, respectively). Intended management changes were reported in 53 of 88 (60%) patients. Twenty patients (23%) scheduled to undergo chemotherapy were switched to treatments without chemotherapy, and 6 (7%) were switched from watch-and-wait to other treatment strategies. Conversely, 5 patients (6%) were switched from their initial treatment strategy to watch-and-wait. Conclusion This survey of referring physicians demonstrates a substantial impact of DOTATATE on the intended management of patients with neuroendocrine tumors. PMID:25500825

  2. Human Dosimetry and Preliminary Tumor Distribution of (superscript)18F-Fluoropaclitaxel in Healthy Volunteers and Newly Diagnosed Breast Cancer Patients Using PET/CT

    SciTech Connect

    Kurdziel, K.A.; Logan, J.; Kurdziel, K.A.; Kalen, J.D.; Hirsch, J.I.; Wilson, J.D.; Bear, H.D.; Logan, J.; McCumisky, J.; Moorman-Sykes, K.; Adler, S.; Choyke, P.L.

    2011-08-17

    {sup 18}F-fluoropaclitaxel is a radiolabeled form of paclitaxel, a widely used chemotherapy agent. Preclinical data suggest that {sup 18}F-fluoropaclitaxel may be a reasonable surrogate for measuring the uptake of paclitaxel. As a substrate of P-glycoprotein, a drug efflux pump associated with multidrug resistance, {sup 18}F-fluoropaclitaxel may also be useful in identifying multidrug resistance and predicting tumor response for drugs other than paclitaxel. After informed consent was obtained, 3 healthy volunteers and 3 patients with untreated breast cancer (neoadjuvant chemotherapy candidates, tumor size > 2 cm) received an intravenous infusion of {sup 18}F-fluoropaclitaxel and then underwent PET/CT. Healthy volunteers underwent serial whole-body imaging over an approximately 3-h interval, and organ {sup 18}F residence times were determined from the time-activity curves uncorrected for decay to determine dosimetry. Radiation dose estimates were calculated using OLINDA/EXM software. For breast cancer patients, dynamic imaging of the primary tumor was performed for 60 min, followed by static whole-body scans at 1 and 2 h after injection. Dosimetry calculations showed that the gallbladder received the highest dose (229.50 {mu}Gy/MBq [0.849 rad/mCi]), followed by the small and large intestines (161.26 {mu}Gy/MBq [0.597 rad/mCi] and 184.59 {mu}Gy/MBq [0.683 rad/mCi]). The resultant effective dose was 28.79 {mu}Gy/MBq (0.107 rem/mCi). At approximately 1 h after injection, an average of 42% of the decay-corrected activity was in the gastrointestinal system, with a mean of 0.01% in the tumor. All 3 breast cancer patients showed retention of {sup 18}F-fluoropaclitaxel and ultimately demonstrated a complete pathologic response (no invasive cancer in the breast or axillary nodes) to chemotherapy that included a taxane (either paclitaxel or docetaxel) at surgical resection. The tumor-to-background ratio increased with time to a maximum of 7.7 at 20 min. This study

  3. Tumor necrosis factor-α -G308A polymorphism is associated with liver pathological changes in hepatitis C virus patients

    PubMed Central

    Bader El Din, Noha G; Farouk, Sally; El-Shenawy, Reem; Ibrahim, Marwa K; Dawood, Reham M; Elhady, Mostafa M; Salem, Ahmed M; Zayed, Naglaa; Khairy, Ahmed; El Awady, Mostafa K

    2016-01-01

    AIM To investigate the association of tumor necrosis factor alpha (TNFα) -G308A polymorphism with different liver pathological changes in treatment-naïve Egyptian patients infected with hepatitis C virus (HCV) genotype 4. METHODS This study included 180 subjects, composed of 120 treatment-naïve chronic HCV patients with different fibrosis grades (F0-F4) and 60 healthy controls. The TNFα -G308A region was amplified by PCR and the different genotypes were detected by restriction fragment length polymorphism analysis. The TNFα protein was detected by enzyme-linked immunosorbent assay. The influence of different TNFα -G308A genotypes on TNFα expression and liver disease progression were statistically analyzed. The OR and 95%CI were calculated to assess the relative risk confidence. RESULTS Current data showed that the TNFα -G308A SNP frequency was significantly different between controls and HCV infected patients (P = 0.001). Both the AA genotype and A allele were significantly higher in late fibrosis patients (F2-F4, n = 60) than in early fibrosis patients (F0-F1, n = 60) (P = 0.05, 0.04 respectively). Moreover, the GA or AA genotypes increased the TNFα serum level greater than the GG genotype (P = 0.002). The results showed a clear association between severe liver pathological conditions (inflammation, steatosis and fibrosis) and (GA + AA) genotypes (P = 0.035, 0.03, 0.04 respectively). The stepwise logistic regression analysis showed that the TNFα genotypes (GA + AA) were significantly associated with liver inflammation (OR = 3.776, 95%CI: 1.399-10.194, P = 0.009), severe steatosis (OR = 4.49, 95%CI: 1.441-14.0, P = 0.010) and fibrosis progression (OR = 2.84, 95%CI: 1.080-7.472, P = 0.034). Also, the A allele was an independent risk factor for liver inflammation (P = 0.003), steatosis (P = 0.003) and fibrosis (P = 0.014). CONCLUSION TNFα SNP at nucleotide -308 represents an important genetic marker that can be used for the prognosis of different liver

  4. Tumor necrosis factor-α -G308A polymorphism is associated with liver pathological changes in hepatitis C virus patients

    PubMed Central

    Bader El Din, Noha G; Farouk, Sally; El-Shenawy, Reem; Ibrahim, Marwa K; Dawood, Reham M; Elhady, Mostafa M; Salem, Ahmed M; Zayed, Naglaa; Khairy, Ahmed; El Awady, Mostafa K

    2016-01-01

    AIM To investigate the association of tumor necrosis factor alpha (TNFα) -G308A polymorphism with different liver pathological changes in treatment-naïve Egyptian patients infected with hepatitis C virus (HCV) genotype 4. METHODS This study included 180 subjects, composed of 120 treatment-naïve chronic HCV patients with different fibrosis grades (F0-F4) and 60 healthy controls. The TNFα -G308A region was amplified by PCR and the different genotypes were detected by restriction fragment length polymorphism analysis. The TNFα protein was detected by enzyme-linked immunosorbent assay. The influence of different TNFα -G308A genotypes on TNFα expression and liver disease progression were statistically analyzed. The OR and 95%CI were calculated to assess the relative risk confidence. RESULTS Current data showed that the TNFα -G308A SNP frequency was significantly different between controls and HCV infected patients (P = 0.001). Both the AA genotype and A allele were significantly higher in late fibrosis patients (F2-F4, n = 60) than in early fibrosis patients (F0-F1, n = 60) (P = 0.05, 0.04 respectively). Moreover, the GA or AA genotypes increased the TNFα serum level greater than the GG genotype (P = 0.002). The results showed a clear association between severe liver pathological conditions (inflammation, steatosis and fibrosis) and (GA + AA) genotypes (P = 0.035, 0.03, 0.04 respectively). The stepwise logistic regression analysis showed that the TNFα genotypes (GA + AA) were significantly associated with liver inflammation (OR = 3.776, 95%CI: 1.399-10.194, P = 0.009), severe steatosis (OR = 4.49, 95%CI: 1.441-14.0, P = 0.010) and fibrosis progression (OR = 2.84, 95%CI: 1.080-7.472, P = 0.034). Also, the A allele was an independent risk factor for liver inflammation (P = 0.003), steatosis (P = 0.003) and fibrosis (P = 0.014). CONCLUSION TNFα SNP at nucleotide -308 represents an important genetic marker that can be used for the prognosis of different liver

  5. Comparison of {sup 18}F-Fluorothymidine and {sup 18}F-Fluorodeoxyglucose PET/CT in Delineating Gross Tumor Volume by Optimal Threshold in Patients With Squamous Cell Carcinoma of Thoracic Esophagus

    SciTech Connect

    Han Dali; Yu Jinming; Yu Yonghua; Zhang Guifang; Zhong Xiaojun; Lu Jie; Yin Yong; Fu Zheng; Mu Dianbin; Zhang Baijiang; He Wei; Huo Zhijun; Liu Xijun; Kong Lei; Zhao Shuqiang; Sun Xiangyu

    2010-03-15

    Purpose: To determine the optimal method of using {sup 18}F-fluorothymidine (FLT) positron emission tomography (PET)/computed tomography (CT) simulation to delineate the gross tumor volume (GTV) in esophageal squamous cell carcinoma verified by pathologic examination and compare the results with those using {sup 18}F-fluorodeoxyglucose (FDG) PET/CT. Methods and Materials: A total of 22 patients were enrolled and underwent both FLT and FDG PET/CT. The GTVs with biologic information were delineated using seven different methods in FLT PET/CT and three different methods in FDG PET/CT. The results were compared with the pathologic gross tumor length, and the optimal threshold was obtained. Next, we compared the simulation plans using the optimal threshold of FLT and FDG PET/CT. The radiation dose was prescribed as 60 Gy in 30 fractions with a precise radiotherapy technique. Results: The mean +- standard deviation pathologic gross tumor length was 4.94 +- 2.21 cm. On FLT PET/CT, the length of the standardized uptake value 1.4 was 4.91 +- 2.43 cm. On FDG PET/CT, the length of the standardized uptake value 2.5 was 5.10 +- 2.18 cm, both of which seemed more approximate to the pathologic gross tumor length. The differences in the bilateral lung volume receiving >=20 Gy, heart volume receiving >=40 Gy, and the maximal dose received by spinal cord between FLT and FDG were not significant. However, the values for mean lung dose, bilateral lung volume receiving >=5, >=10, >=30, >=40, and >=50 Gy, mean heart dose, and heart volume receiving >=30 Gy using FLT PET/CT-based planning were significant lower than those using FDG PET/CT. Conclusion: A standardized uptake value cutoff of 1.4 on FLT PET/CT and one of 2.5 on FDG PET/CT provided the closest estimation of GTV length. Finally, FLT PET/CT-based treatment planning provided potential benefits to the lungs and heart.

  6. Gastrodin stimulates anticancer immune response and represses transplanted H22 hepatic ascitic tumor cell growth: Involvement of NF-κB signaling activation in CD4 + T cells

    SciTech Connect

    Shu, Guangwen; Yang, Tianming; Wang, Chaoyuan; Su, Hanwen; Xiang, Meixian

    2013-06-15

    Gastrodia elata Blume (G. elata) is a famous restorative food in East Asia. It can be used as an auxiliary reagent in hepatocellular carcinoma (HCC) treatment. Previous studies unveiled that G. elata exhibited immunomodulatory activities. To explore the active ingredients contributing to its immunomodulatory activities, gastrodin, vanillin, and parishin B were purified from G. elata and their anti-HCC effects were assessed in vivo. Among these compounds, only gastrodin was capable of repressing transplanted H22 ascitic hepatic tumor cell growth in vivo with low toxicity. Further investigations were designed to explore the effects of gastrodin on the immune system of tumor-bearing mice and potential molecular mechanisms underlying these effects. Our data showed that gastrodin ameliorated tumor cell transplantation-induced activation of endogenous pro-apoptotic pathway in CD4 + T cells and abnormalities in serum cytokine profiles in host animals. These events enhanced cytotoxic activities of natural killer and CD8 + T cells against H22 hepatic cancer cells. Gastrodin administration specifically upregulated mRNA levels of several nuclear factor κB (NF-κB) responsive genes in CD4 + T cells but not in CD8 + T cells. Chromatin immunoprecipitation assay showed that gastrodin increased the association of NF-κB p65 subunit to the promoter regions of IL-2 and Bcl-2 encoding genes in CD4 + T cells. Our investigations demonstrated that gastrodin is the main active ingredient contributing to the anticancer immunomodulatory properties of G. elata. Promoting NF-κB-mediated gene transcription in CD4 + T cells is implicated in its immunomodulatory activity. - Highlights: • Gastrodin stimulates anticancer immune response. • Gastrodin represses tumor transplantation-induced CD4 + T cell apoptosis. • Gastrodin activates NF-κB activity in CD4 + T cells.

  7. WE-E-17A-05: Complementary Prognostic Value of CT and 18F-FDG PET Non-Small Cell Lung Cancer Tumor Heterogeneity Features Quantified Through Texture Analysis

    SciTech Connect

    Desseroit, M; Cheze Le Rest, C; Tixier, F; Majdoub, M; Visvikis, D; Hatt, M; Guillevin, R; Perdrisot, R

    2014-06-15

    Purpose: Previous studies have shown that CT or 18F-FDG PET intratumor heterogeneity features computed using texture analysis may have prognostic value in Non-Small Cell Lung Cancer (NSCLC), but have been mostly investigated separately. The purpose of this study was to evaluate the potential added value with respect to prognosis regarding the combination of non-enhanced CT and 18F-FDG PET heterogeneity textural features on primary NSCLC tumors. Methods: One hundred patients with non-metastatic NSCLC (stage I–III), treated with surgery and/or (chemo)radiotherapy, that underwent staging 18F-FDG PET/CT images, were retrospectively included. Morphological tumor volumes were semi-automatically delineated on non-enhanced CT using 3D SlicerTM. Metabolically active tumor volumes (MATV) were automatically delineated on PET using the Fuzzy Locally Adaptive Bayesian (FLAB) method. Intratumoral tissue density and FDG uptake heterogeneities were quantified using texture parameters calculated from co-occurrence, difference, and run-length matrices. In addition to these textural features, first order histogram-derived metrics were computed on the whole morphological CT tumor volume, as well as on sub-volumes corresponding to fine, medium or coarse textures determined through various levels of LoG-filtering. Association with survival regarding all extracted features was assessed using Cox regression for both univariate and multivariate analysis. Results: Several PET and CT heterogeneity features were prognostic factors of overall survival in the univariate analysis. CT histogram-derived kurtosis and uniformity, as well as Low Grey-level High Run Emphasis (LGHRE), and PET local entropy were independent prognostic factors. Combined with stage and MATV, they led to a powerful prognostic model (p<0.0001), with median survival of 49 vs. 12.6 months and a hazard ratio of 3.5. Conclusion: Intratumoral heterogeneity quantified through textural features extracted from both CT and FDG PET

  8. Tumor Burden Analysis on Computed Tomography by Automated Liver and Tumor Segmentation

    PubMed Central

    Linguraru, Marius George; Richbourg, William J.; Liu, Jianfei; Watt, Jeremy M.; Pamulapati, Vivek; Wang, Shijun; Summers, Ronald M.

    2013-01-01

    The paper presents the automated computation of hepatic tumor burden from abdominal CT images of diseased populations with images with inconsistent enhancement. The automated segmentation of livers is addressed first. A novel three-dimensional (3D) affine invariant shape parameterization is employed to compare local shape across organs. By generating a regular sampling of the organ's surface, this parameterization can be effectively used to compare features of a set of closed 3D surfaces point-to-point, while avoiding common problems with the parameterization of concave surfaces. From an initial segmentation of the livers, the areas of atypical local shape are determined using training sets. A geodesic active contour corrects locally the segmentations of the livers in abnormal images. Graph cuts segment the hepatic tumors using shape and enhancement constraints. Liver segmentation errors are reduced significantly and all tumors are detected. Finally, support vector machines and feature selection are employed to reduce the number of false tumor detections. The tumor detection true position fraction of 100% is achieved at 2.3 false positives/case and the tumor burden is estimated with 0.9% error. Results from the test data demonstrate the method's robustness to analyze livers from difficult clinical cases to allow the temporal monitoring of patients with hepatic cancer. PMID:22893379

  9. High total metabolic tumor volume in PET/CT predicts worse prognosis in diffuse large B cell lymphoma patients with bone marrow involvement in rituximab era.

    PubMed

    Song, Moo-Kon; Yang, Deok-Hwan; Lee, Gyeong-Won; Lim, Sung-Nam; Shin, Seunghyeon; Pak, Kyoung June; Kwon, Seong Young; Shim, Hye Kyung; Choi, Bong-Hoi; Kim, In-Suk; Shin, Dong-Hoon; Kim, Seong-Geun; Oh, So-Yeon

    2016-03-01

    Bone marrow involvement (BMI) in diffuse large B cell lymphoma (DLBCL) was naively regarded as an adverse clinical factor. However, it has been unknown which factor would separate clinical outcomes in DLBCL patients with BMI. Recently, metabolic tumor volume (MTV) on positron emission tomography/computed tomography (PET/CT) was suggested to predict prognosis in several lymphoma types. Therefore, we investigated whether MTV would separate the outcomes in DLBCL patients with BMI. MTV on PET/CT was defined as an initial tumor burden as target lesion ≥ standard uptake value, 2.5 in 107 patients with BMI. Intramedullary (IM) MTV was defined as extent of BMI and total MTV was as whole tumor burden. 260.5 cm(3) and 601.2 cm(3) were ideal cut-off values for dividing high and low MTV status in the IM and total lymphoma lesions in Receiver Operating Curve analysis. High risk NCCN-IPI (p<0.001, p<0.001), bulky disease (p=0.011, p=0.005), concordant subtype (p=0.025, p=0.029), high IM MTV status (p<0.001, p<0.001), high total MTV status (p<0.001, p<0.001), and ≥ 2CAs in BM (p=0.037, p=0.033) were significantly associated with progression-free survival (PFS) and overall survival (OS) than other groups. In multivariate analysis, high risk NCCN-IPI (PFS, p=0.006; OS, p=0.013), concordant subtype (PFS, p=0.005; OS, p=0.007), and high total MTV status (PFS, p<0.001; OS, p<0.001) had independent clinical impacts. MTV had prognostic significances for survivals in DLBCL with BMI. PMID:26851438

  10. Multimodal Imaging of Nanocomposite Microspheres for Transcatheter Intra-Arterial Drug Delivery to Liver Tumors

    NASA Astrophysics Data System (ADS)

    Kim, Dong-Hyun; Li, Weiguo; Chen, Jeane; Zhang, Zhuoli; Green, Richard M.; Huang, Sui; Larson, Andrew C.

    2016-07-01

    A modern multi-functional drug carrier is critically needed to improve the efficacy of image-guided catheter-directed approaches for the treatment of hepatic malignancies. For this purpose, a nanocomposite microsphere platform was developed for selective intra-arterial transcatheter drug delivery to liver tumors. In our study, continuous microfluidic methods were used to fabricate drug-loaded multimodal MRI/CT visible microspheres that included both gold nanorods and magnetic clusters. The resulting hydrophilic, deformable, and non-aggregated microspheres were mono-disperse and roughly 25 um in size. Sustained drug release and strong MRI T2 and CT contrast effects were achieved with the embedded magnetic nano-clusters and radiopaque gold nanorods. The microspheres were successfully infused through catheters selectively placed within the hepatic artery in rodent models and subsequent distribution in the targeted liver tissues and hepatic tumors confirmed with MRI and CT imaging. These multimodal nanocomposite drug carriers should be ideal for selective intra-arterial catheter-directed administration to liver tumors while permitting MRI/CT visualization for patient-specific confirmation of tumor-targeted delivery.

  11. Multimodal Imaging of Nanocomposite Microspheres for Transcatheter Intra-Arterial Drug Delivery to Liver Tumors

    PubMed Central

    Kim, Dong-Hyun; Li, Weiguo; Chen, Jeane; Zhang, Zhuoli; Green, Richard M.; Huang, Sui; Larson, Andrew C.

    2016-01-01

    A modern multi-functional drug carrier is critically needed to improve the efficacy of image-guided catheter-directed approaches for the treatment of hepatic malignancies. For this purpose, a nanocomposite microsphere platform was developed for selective intra-arterial transcatheter drug delivery to liver tumors. In our study, continuous microfluidic methods were used to fabricate drug-loaded multimodal MRI/CT visible microspheres that included both gold nanorods and magnetic clusters. The resulting hydrophilic, deformable, and non-aggregated microspheres were mono-disperse and roughly 25 um in size. Sustained drug release and strong MRI T2 and CT contrast effects were achieved with the embedded magnetic nano-clusters and radiopaque gold nanorods. The microspheres were successfully infused through catheters selectively placed within the hepatic artery in rodent models and subsequent distribution in the targeted liver tissues and hepatic tumors confirmed with MRI and CT imaging. These multimodal nanocomposite drug carriers should be ideal for selective intra-arterial catheter-directed administration to liver tumors while permitting MRI/CT visualization for patient-specific confirmation of tumor-targeted delivery. PMID:27405824

  12. Contrast medium accumulation and washout in canine brain tumors and irradiated normal brain: a CT study of kinetics

    SciTech Connect

    Fike, J.R.; Cann, C.E.

    1984-04-01

    Kinetics of an iodinated contrast medium were evaluated quantitatively as a function of time up to one hour after intravenous infusion in the brains of dogs with experimentally induced radiation damage and dogs with spontaneous brain tumor. Radiation damage was characterized by an increase in iodine accumulation soon after the infusion, while tumor concentration of iodine either showed no change or decreased with time. These results suggest that contrast kinetic studies may be useful in differentiating radiation damage to normal brain tissue from a malignant brain tumor.

  13. SU-E-J-79: Internal Tumor Volume Motion and Volume Size Assessment Using 4D CT Lung Data

    SciTech Connect

    Jurkovic, I; Stathakis, S; Li, Y; Patel, A; Vincent, J; Papanikolaou, N; Mavroidis, P

    2014-06-01

    Purpose: To assess internal tumor volume change through breathing cycle and associated tumor motion using the 4DCT data. Methods: Respiration induced volume change through breathing cycle and associated motion was analyzed for nine patients that were scanned during the different respiratory phases. The examined datasets were the maximum and average intensity projections (MIP and AIP) and the 10 phases of the respiratory cycle. The internal target volume (ITV) was delineated on each of the phases and the planning target volume (PTV) was then created by adding setup margins to the ITV. Tumor motion through the phases was assessed using the acquired 4DCT dataset, which was then used to determine if the margins used for the ITV creation successfully encompassed the tumor in three dimensions. Results: Results showed that GTV motion along the superior inferior axes was the largest in all the cases independent of the tumor location and/or size or the use of abdomen compression. The extent of the tumor motion was found to be connected with the size of the GTV. The smallest GTVs exhibited largest motion vector independent of the tumor location. The motion vector size varied through the phases depending on the tumor size and location and it was smallest for phases 20 and 30. The smaller the volume of the delineated GTV, the greater its volume difference through the different respiratory phases was. The average GTV volume change was largest for the phases 60 and 70. Conclusion: Even if GTV is delineated using both AIP and MIP datasets, its motion extent will exceed the used margins especially for the very small GTV volumes. When the GTV size is less than 10 cc it is recommended to use fusion of the GTVs through all the phases to create the planning ITV.

  14. Comparative Oncology: Evaluation of 2-Deoxy-2-[18F]fluoro-D-glucose (FDG) Positron Emission Tomography/Computed Tomography (PET/CT) for the Staging of Dogs with Malignant Tumors

    PubMed Central

    Beer, Ambros J.; Brühschwein, Andreas; Kreutzmann, Nina; Laberke, Silja; Wergin, Melanie C.; Meyer-Lindenberg, Andrea; Brandl, Johanna; von Thaden, Anne-Kathrin; Farrell, Eliane

    2015-01-01

    Introduction 2-Deoxy-2-[18F]fluoro-D-glucose PET/CT is a well-established imaging method for staging, restaging and therapy-control in human medicine. In veterinary medicine, this imaging method could prove to be an attractive and innovative alternative to conventional imaging in order to improve staging and restaging. The aim of this study was both to evaluate the effectiveness of this image-guided method in canine patients with spontaneously occurring cancer as well as to illustrate the dog as a well-suited animal model for comparative oncology. Methods Ten dogs with various malignant tumors were included in the study and underwent a whole body FDG PET/CT. One patient has a second PET-CT 5 months after the first study. Patients were diagnosed with histiocytic sarcoma (n = 1), malignant lymphoma (n = 2), mammary carcinoma (n = 4), sertoli cell tumor (n = 1), gastrointestinal stromal tumor (GIST) (n = 1) and lung tumor (n = 1). PET/CT data were analyzed with the help of a 5-point scale in consideration of the patients’ medical histories. Results In seven of the ten dogs, the treatment protocol and prognosis were significantly changed due to the results of FDG PET/CT. In the patients with lymphoma (n = 2) tumor extent could be defined on PET/CT because of increased FDG uptake in multiple lymph nodes. This led to the recommendation for a therapeutic polychemotherapy as a treatment. In one of the dogs with mammary carcinoma (n = 4) and in the patient with the lung tumor (n = 1), surgery was cancelled due to the discovery of multiple metastasis. Consequently no treatment was recommended. Conclusion FDG PET/CT offers additional information in canine patients with malignant disease with a potential improvement of staging and restaging. The encouraging data of this clinical study highlights the possibility to further improve innovative diagnostic and staging methods with regard to comparative oncology. In the future, performing PET/CT not only for staging but also in

  15. Computed Tomography (CT) -- Head

    MedlinePlus

    ... further information please consult the ACR Manual on Contrast Media and its references. The risk of serious allergic ... Angiography (CTA) Stroke Brain Tumors Computer Tomography (CT) Safety During Pregnancy Head and Neck Cancer X-ray, ...

  16. Inhibition of hereditary hepatitis and liver tumor development in Long-Evans cinnamon rats by the copper-chelating agent trientine dihydrochloride.

    PubMed

    Sone, K; Maeda, M; Wakabayashi, K; Takeichi, N; Mori, M; Sugimura, T; Nagao, M

    1996-04-01

    Trientine dihydrochloride (trientine) is an alternative medicinal copper chelating agent for patients with Wilson's disease of penicillamine intolerance. We examined the effects of trientine on the spontaneous development of hepatitis and hepatic tumors, by its short-term and long-term administration to Long-Evans cinnamon (LEC) rats with an accumulation of copper in the liver, as animal models of Wilson's disease. Male rats were given trientine in their drinking water at 1500 ppm for 18 weeks, from 6 weeks to 24 weeks of age in short-term experiment, and 1500 ppm for 27 weeks then 750 ppm for 52 weeks, from 8 to 87 weeks of age in the long-term experiment. Development of hepatitis was observed in the control LEC rats at 18 weeks of age. They had high levels of plasma transaminases (glutamic oxaloacetic transaminase [GOT], glutamic pyruvic transaminase [GPT]), and on pathological examination, hepatocyte destruction was observed. Histological findings revealed that short-term administration of trientine inhibited the development of hepatitis remarkably. The plasma GOT and GPT levels of treated animals were only slightly higher than those of normal LEA (Long-Evans with agouti coat color) rats, a sibling line of LEC rats. Copper levels in the liver were decreased by a maximum of 50 percent. In the long-term administration of trientine, the incidence of hepatic cell carcinoma (HCC) in the treated rats was 67 percent that of the untreated LEC rats, and the number of HCCs per rat in the treated group was 0.7 +/- 0.5, being significantly lower as compared with 4.7 +/- 3.5 in the untreated rats. Additionally, the development of cholangiofibrosis in LEC rats was completely prevented by long-term administration of the agent. The copper level in the liver of treated rats was reduced by 33 percent at 87 weeks of age. Development of HCC in LEC rats might be partly, but not totally, because of copper accumulation. No effects on the levels of copper, iron, or zinc in the liver of

  17. Tumor-promoting/progressing role of additional chromosome instability in hepatic carcinogenesis in Sgo1 (Shugoshin 1) haploinsufficient mice.

    PubMed

    Yamada, Hiroshi Y; Zhang, Yuting; Reddy, Arun; Mohammed, Altaf; Lightfoot, Stan; Dai, Wei; Rao, Chinthalapally V

    2015-04-01

    A major etiological risk factor for hepatocellular carcinoma (HCC) is infection by Hepatitis viruses, especially hepatitis B virus and hepatitis C virus. Hepatitis B virus and hepatitis C virus do not cause aggressive activation of an oncogenic pathway, but they transactivate a broad array of genes, cause chronic inflammation, and, through interference with mitotic processes, lead to mitotic error-induced chromosome instability (ME-CIN). However, how ME-CIN is involved in the development of HCC remains unclear. Delineating the effect of ME-CIN on HCC development should help in identifying measures to combat HCC. In this study, we used ME-CIN model mice haploinsufficient in Shugoshin 1 (Sgo1(-/+)) to assess the role of ME-CIN in HCC development. Treatment with the carcinogen azoxymethane caused Sgo1(-/+) ME-CIN model mice to develop HCCs within 6 months, whereas control mice developed no HCC (P < 0.003). The HCC development was associated with expression of early HCC markers (glutamine synthetase, glypican 3, heat shock protein 70, and the serum marker alpha fetoprotein), although without fibrosis. ME-CIN preceded the expression of HCC markers, suggesting that ME-CIN is an important early event in HCC development. In 12-month-old untreated Sgo1 mice, persistent DNA damage, altered gene expression, and spontaneous HCCs were observed. Sgo1 protein accumulated in response to DNA damage in vitro. Overall, Sgo1(-/+)-mediated ME-CIN strongly promoted/progressed development of HCC in the presence of an initiator carcinogen, and it had a mild initiator effect by itself. Use of the ME-CIN model mice should help in identifying drugs to counteract the effects of ME-CIN and should accelerate anti-HCC drug development. PMID:25740822

  18. Usefulness of standardized uptake value normalized by individual CT-based lean body mass in application of PET response criteria in solid tumors (PERCIST).

    PubMed

    Narita, Atsushi; Shiomi, Susumu; Katayama, Yutaka; Yamanaga, Takashi; Daisaki, Hiromitsu; Hamada, Kazuo; Watanabe, Yasuyoshi

    2016-07-01

    Our aim in this study was to verify the usefulness of the standardized uptake value (SUV) normalized by individual CT-based lean body mass (LBMCT) in application of PET response criteria in solid tumors (PERCIST).We retrospectively investigated 14 patients (4 male and 10 female) with malignant lymphoma who were undergoing chemotherapy. (18)F-FDG PET/CT examinations were performed before and after chemotherapy. The LBMCT was calculated by estimation of fat weight from CT data (from skull base to pelvis). The mean ± standard deviation (SD) and the Bland-Altman plot were used for comparison among body weight, LBMCT, and LBM derived from a predictive equation (LBMPE). Indices for FDG uptake in the liver were: SUV, SUV based on LBMPE (SULPE), and SUV based on LBMCT (SULCT). Overall differences between the uptake values were analyzed by one-way ANOVA. If the ANOVA showed significance, differences between uptake values were investigated further by use of the Tukey-Kramer test. The mean values of body weight, LBMPE, and LBMCT were: 55.4 ± 14.9 (39.0-112.0), 43.0 ± 10.5 (31.3-75.2), and 35.3 ± 9.8 (23.4-75.8) kg, respectively. There was a wide dispersion between LBMPE and LBMCT (differences, 7.6 ± 3.6 kg; 95 % CI, 6.42-8.85). LBMPE was higher than LBMCT in all the cases except in Case 11. The mean uptake values significantly differed among SUV, SULPE, and SULCT (F = 68.3, p < 0.05). Whereas SULPE deviated from PERCIST criteria in seven patients, SULCT satisfied the criteria except in one case. These results suggest that liver SULCT is useful for application of PERCIST. PMID:26873140

  19. A new catheter for tumor targeting with radioactive microspheres in representative hepatic artery systems. Part I: impact of catheter presence on local blood flow and microsphere delivery.

    PubMed

    Kleinstreuer, C; Basciano, C A; Childress, E M; Kennedy, A S

    2012-05-01

    Building on previous studies in which the transport and targeting of (90)Y microspheres for liver tumor treatment were numerically analyzed based on medical data sets, this two-part paper discusses the influence of an anchored, radially adjustable catheter on local blood flow and microsphere delivery in an idealized hepatic artery system (Part I). In Part II a patient-inspired case study with necessary conditions for optimal targeting of radioactive microspheres (i.e., yttrium 90) onto liver tumors is presented. A new concept of optimal catheter positioning is introduced for selective targeting of two daughter-vessel exits potentially connected to liver tumors. Assuming laminar flow in rigid blood vessels with an anchored catheter in three controlled positions, the transient three-dimensional (3D) transport phenomena were simulated employing user-enhanced engineering software. The catheter position as well as injection speed and delivery function may influence fluid flow and particle transport. Although the local influences of the catheter may not be negligible, unique cross-sectional particle release zones exist, with which selectively the new controlled targeting methodology would allow optimal microsphere delivery. The insight gained from this analysis paves the way for improved design and testing of a smart microcatheter (SMC) system as well as new investigations leading to even more successful treatment with (90)Y microspheres or combined internal radiation and chemotherapy.

  20. Oncogenic signaling pathways and origins of tumor-initiating stem-like cells of hepatocellular carcinomas induced by hepatitis C virus, alcohol and/or obesity.

    PubMed

    Chen, Chia-Lin; Tsukamoto, Hidekazu; Machida, Keigo

    2014-07-01

    This review article discusses the importance and oncogenic signaling pathways of tumor-initiating cells (TICs) in several etiologies of hepatocellular carcinomas (HCCs) induced by hepatitis C virus (HCV), alcohol, obesity and/or chemicals. Stem cells may be present in cancer tissue, and a hierarchy of cells is formed, as is the case for normal tissue. Tumor formation, growth and propagation are maintained by a small proportion of cells with stem cell-like properties. TICs are present in alcohol-fed HCV transgenic mice, diethylnitrosamine/phenobarbital-treated mice (chemical carcinogenesis) and Spnb2 +/- mice (defective TGF-β signal). Alcohol/obesity-associated endotoxemia induces the stem cell marker Nanog through TLR4 signaling to generate TICs and liver tumors in several HCC models. The oncogenic pathway (such as the STAT3 and TLR4-NANOG pathway) and mechanism of generation of TICs of HCCs associated with HCV, alcohol and obesity are discussed. Understanding the molecular stemness signaling and cellular hierarchy and defining key TIC-specific genes will accelerate the development of novel biomarkers and treatment strategies. This review highlights recent advances in understanding the pathogenesis of liver TICs and discusses unanswered questions about the concept of liver TICs. (This project was supported by NIH grants 1R01AA018857 and P50AA11999).

  1. Hepatitis B - children

    MedlinePlus

    ... tests detect liver damage and the risk for liver cancer from chronic hepatitis B: Albumin level Liver function tests Prothrombin time Liver biopsy Abdominal ultrasound Liver cancer tumor markers such as alpha fetoprotein The provider ...

  2. [Method of radiotherapy planning for head and neck tumors using simulated CT images and radiographic data, developed at the Gustave Roussy Institute].

    PubMed

    Bridier, A; Diaz, J C; Kafrouni, H; Leclerc, A; Barrois, M M; Rivet, P; Wibault, P; Bourhis, J; Eschwège, F

    2001-06-01

    The paper deals with the recent improvements introduced in the most usual method applied in the Institut Gustave Roussy radiotherapy department for obtaining the anatomical data of patients treated for head and neck tumors. For each of these patients, five to seven transverses slices and a lateral radiographic film are taken from a Mecaserto simulator-CT. The anatomical representation of the patient sagittal plane is carried out from the digitalisation of the radiographic film on a Vidar Vxr-12 Plus film scanner and integrated into the Dosigray dose calculation programme in order to be used as a support for the laying out of the dose distribution in reference to the treatment. The sagittal anatomical representation obtained from the radiographic film digitalisation is compared with the one resulting from the interpolation between a limited number of irregularly-spaced transverse slices taken on the simulator-CT. The method using the simulator-scanner transverse slices and the radiographic film digitalisation represents an interesting alternative for obtaining an anatomy simulation representative of the patient in hospitals where a scanner is not available full-time for the needs of the radiotherapy process. PMID:11446081

  3. Dynamic contrast-enhanced x-ray CT measurement of cerebral blood volume in a rabbit tumor model

    NASA Astrophysics Data System (ADS)

    Cenic, Aleksa; Lee, Ting-Yim; Craen, Rosemary A.; Gelb, Adrian W.

    1998-07-01

    Cerebral blood volume (CBV) is a major determinant of intracranial pressure (ICP). Hyperventilation is commonly employed to reduce raised ICP (e.g. in brain tumour patients) presumably through its effect on CBV. With the advent of slip- ring CT scanners, dynamic contrast-enhanced imaging allows for the measurement of CBV with high spatial resolution. Using a two-compartment model to characterize the distribution of X- ray contrast agent in the brain, we have developed a non- equilibrium CT method to measure CBV in normal and pathological regions. We used our method to investigate the effect of hyperventilation on CBV during propofol anaesthesia in rabbits with implanted brain tumours. Eight New Zealand White rabbits with implanted VX2 carcinoma brain tumours were studied. For each rabbit, regional CBV measurements were initially made at normocapnia (PaCO2 40 mmHg) and then at hyperventilation (PaCO2 25 mmHg) during propofol anaesthesia. The head was positioned such that a coronal image through the brain incorporated a significant cross-section of the brain tumour as well as a radial artery in a forelimb. Images at the rate of 1 per second were acquired for 2 minutes as Omnipaque 300 (1.5 ml/kg rabbit weight) was injected via a peripheral vein. In these CT images, regions of interest in the brain tissue (e.g. tumour, contra-lateral normal, and peri-tumoural) and the radial artery were drawn. For each region, the mean CT number in pre-contrast images was subtracted from the mean CT number in post-contrast images to produce either the tissue contrast concentration curve, or the arterial contrast concentration curve. Using our non- equilibrium analysis method based on a two-compartment model, regional CBV values were determined from the measured contrast concentration curves. From our study, the mean CBV values [+/- SD] in the tumour, peri-tumoural, and contra-lateral normal regions during normocapnia were: 5.47 plus or minus 1.97, 3.28 plus or minus 1.01, and 1

  4. What is changing in indications and treatment of hepatic hemangiomas. A review.

    PubMed

    Toro, Adriana; Mahfouz, Ahmed-Emad; Ardiri, Annalisa; Malaguarnera, Michele; Malaguarnera, Giulia; Loria, Francesco; Bertino, Gaetano; Di Carlo, Isidoro

    2014-01-01

    Hepatic cavernous hemangioma accounts for 73% of all benign liver tumors with a frequency of 0.4-7.3% at autopsy and is the second most common tumor seen in the liver after metastases. Patients affected by hemangioma usually have their tumor diagnosed by ultrasound abdominal examination for a not well defined pain, but pain persist after treatment of the hemangioma. The causes of pain can be various gastrointestinal pathologies including cholelithiasis and peptic ulcer disease.The malignant trasformation is practically inexistent. Different imaging modalities are used to diagnosis liver hemangioma including ultrasonography, computed tomography (CT), magnetic resonance (MR) imaging, and less frequently scintigraphy, positronemission tomography combined with CT (PET/CT) and angiography. Imaging-guided biopsy of hemangioma is usually not resorted to except in extremely atypical cases. The right indications for surgery remain rupture, intratumoral bleeding, Kasabach-Merritt syndrome and organ or vessels compression (gastric outlet obstruction, Budd-Chiari syndrome, etc.) represents the valid indication for surgery and at the same time they are all complications of the tumor itself. The size of the tumor do not represent a valid indication for treatment. Liver hemangiomas, when indication exist, have to be treated firstly by surgery (hepatic resection or enucleation, open, laproscopic or robotic), but in the recent years other therapies like liver transplantation, radiofrequency ablation, radiotherapy, trans-arterial embolization, and chemotherapy have been applied. PMID:24927603

  5. Tumor Heterogeneity in Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Advanced Gastric Cancer Assessed by CT Texture Analysis: Association with Survival after Trastuzumab Treatment

    PubMed Central

    Yoon, Sung Hyun; Lee, Yoon Jin; Park, Jihoon; Kim, Jin Won; Lee, Hye Seung; Kim, Bohyoung

    2016-01-01

    Background Image texture analysis is a noninvasive technique for quantifying intratumoral heterogeneity, with derived texture features reported to be closely related to the treatment outcome of tumors. Gastric cancer is one of the most common tumors and the third leading cause of cancer-related deaths worldwide. Although trastuzumab is associated with a survival gain among patients with human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer, optimal patient selection is challenging. The purpose of this study was to determine whether CT texture features of HER2-positive gastric cancer were related to the survival rate after trastuzumab treatment. Methods and Findings Patients diagnosed with HER2-positive advanced gastric cancer from February 2007 to August 2014 were retrospectively selected. Using in-house built software, histogram features (kurtosis and skewness) and gray-level co-occurrence matrices (GLCM) features (angular second moment [ASM], contrast, entropy, variance, and correlation) were derived from the CT images of HER2-positive advanced gastric cancer in 26 patients. All the patients were followed up for more than 6 months, with no confirmed deaths. The patients were dichotomized into a good and poor survival group based on cutoff points of overall survival of 12 months. A receiver-operating characteristics (ROC) analysis was performed to test the ability of each texture parameter to identify the good survival group. Kaplan–Meier curves for patients above and below each threshold were constructed. Using a threshold of >265.8480 for contrast, >488.3150 for variance, and ≤0.1319×10−3. for correlation, all of the area under the ROC curves showed fair accuracy (>0.7). Kaplan–Meier analysis showed statistically significant survival difference between two groups according to optimal cutoff values of contrast, variance, correlation and ASM. However, as this study had a small number of patients, a further study with a larger

  6. Association between two common polymorphisms (single nucleotide polymorphism -250G/A and -514C/T) of the hepatic lipase gene and coronary artery disease in type 2 diabetic patients

    PubMed Central

    Mohammadzadeh, Ghorban; Ghaffari, Mohammad-Ali; Bazyar, Mohammad; Kheirollah, Alireza

    2016-01-01

    Background: Variations in the hepatic lipase (HL) gene are the potential candidate for coronary artery disease (CAD) especially in type 2 diabetes mellitus (T2DM) in diverse populations. We assessed the association of -514C/T and -250G/A polymorphisms in HL (LIPC) gene with CAD risk in Iranian population with type 2 diabetes. Materials and Methods: We evaluated 322 type 2 diabetic patients, 166 patients with normal angiograms as controls and 156 patients those identified with CAD undergoing their first coronary angiography as CAD cases. Genotyping of -514C/T and -250G/A polymorphisms in the promoter of the LIPC gene were studied by polymerase chain reaction (PCR)-restriction fragment length polymorphism technique. Results: Genotype distributions in CAD cases (73.7%, 20.5%, and 5.8% for −250G/A) and (62.2%, 32.7%, and 5.1% for -514C/T) were significantly different from those in controls (60.8%, 37.4%, and 1.8% for -250G/A) and (51.2%, 48.2%, and 0.6% for -514C/T). CAD cases had lower A-allele frequency than controls (0.131 vs. 0.196, P = 0.028). The odds ratio for the presence of -250 (GG + GA) genotype and A allele in CAD cases were 2.206 (95% confidence interval [CI] =1.33–3.65, P = 0.002) and 1.609 (95% CI = 1.051 −2.463, P = 0.029) respectively. Haplotype analysis demonstrated a significant association between especially LIPC double mutant (−250 A/-514 T) haplotype and presence of CAD. Conclusion: Our findings indicated that -250 G/A polymorphism rather than -514 C/T polymorphism of LIPC gene is more associated with the increased risk of CAD particularly in women with T2DM. PMID:27014654

  7. Vitamin D and Tumor Necrosis Factor-Alpha Receptor Gene Polymorphisms in Various Hepatitis B Clinical Conditions in Turkey

    PubMed Central

    Tuncbilek, Semra; Aydin, Kemalettin; Hizel, Kenan

    2013-01-01

    Background The aim is to define the role of single nucleotide polymorphism on the progress of hepatitis B virus (HBV) infection. We evaluated polymorphisms of TNF-α-308, Vitamin D receptor Apa I and Taq I gene in patients with HBV infection. Methods All subjects included were older than 18 years old. Sixty three patients had chronic HBV infection, 61 were HBsAg positive carriers and 59 were positive for anti-HBs and anti-HBc. Gene polymorphisms were evaluated by Amplification Refractory Mutation System PCR. For patients with chronic hepatitis, viral load, ALT levels, and histopathological evaluation of the liver were also compared. Results Gender distribution was not different among groups; however, anti-HBs positive patients were significantly older than the other patients. ALT levels and viral load were significantly higher in chronic hepatitis group than the asymptomatic carriers group. Vitamin D receptor Apa I gene and Taq I gene and TNF-α -308 gene variant alleles were not different in all three groups. Variant alleles of three genes were not different in subgroups of chronic hepatitis patients formed according to ALT levels, viral load, histological activity index, and fibrosis score. Conclusions Role of single nucleotide polymorphism in clinical status of various HBV infection states was not shown in this study. Considering the other studies performed with this aim, which strengthens the notion that ethnicity is an important factor, future studies with more patients from different ethnic groups may help to clear the role of polymorphisms in the clinical progress of HBV infection.

  8. Daily injection of tumor necrosis factor-{alpha} increases hepatic triglycerides and alters transcript abundance of metabolic genes in lactating dairy cattle.

    PubMed

    Bradford, Barry J; Mamedova, Laman K; Minton, J Ernest; Drouillard, James S; Johnson, Bradley J

    2009-08-01

    To determine whether inflammation can induce bovine fatty liver, we administered recombinant bovine tumor necrosis factor-alpha (rbTNF) to late-lactation Holstein cows. Cows (n = 5/treatment) were blocked by feed intake and parity and randomly assigned within block to control (CON; saline), rbTNF at 2 microg/(kg.d), or pair-fed control (saline, intake matched) treatments. Treatments were administered once daily by subcutaneous injection for 7 d. Plasma samples were collected daily for analysis of glucose and FFA and a liver biopsy was collected on d 7 for triglyceride (TG) and quantitative RT-PCR analyses. Data were analyzed using treatment contrasts to assess effects of tumor necrosis factor-alpha (TNFalpha) and decreased feed intake. By d 7, feed intake of both rbTNF and pair-fed cows was approximately 15% less than CON (P < 0.01). Administration of rbTNF resulted in greater hepatic TNFalpha mRNA and protein abundance and 103% higher liver TG content (P < 0.05) without affecting the plasma FFA concentration. Hepatic carnitine palmitoyltransferase 1 transcript abundance tended to be lower (P = 0.09) and transcript abundance of fatty acid translocase and 1-acyl-glycerol-3-phosphate acyltransferase was higher (both P < 0.05) after rbTNF treatment, consistent with increased FFA uptake and storage as TG. Transcript abundance of glucose-6-phosphatase (P < 0.05) and phosphoenolpyruvate carboxykinase 1 (P = 0.09), genes important for gluconeogenesis, was lower for rbTNF-treated cows. These findings indicate that TNFalpha promotes liver TG accumulation and suggest that inflammatory pathways may also be responsible for decreased glucose production in cows with fatty liver.

  9. Efficacy of 68Ga-DOTATOC Positron Emission Tomography (PET) CT in Children and Young Adults With Brain Tumors

    ClinicalTrials.gov

    2016-09-07

    Acoustic Schwannoma; Adult Anaplastic Astrocytoma; Adult Anaplastic Ependymoma; Adult Anaplastic Meningioma; Adult Anaplastic Oligodendroglioma; Adult Brain Stem Glioma; Adult Choroid Plexus Tumor; Adult Craniopharyngioma; Adult Diffuse Astrocytoma; Adult Ependymoblastoma; Adult Ependymoma; Adult Giant Cell Glioblastoma; Adult Glioblastoma; Adult Gliosarcoma; Adult Grade I Meningioma; Adult Grade II Meningioma; Adult Medulloblastoma; Adult Meningeal Hemangiopericytoma; Adult Mixed Glioma; Adult Myxopapillary Ependymoma; Adult Oligodendroglioma; Adult Papillary Meningioma; Adult Pilocytic Astrocytoma; Adult Pineal Gland Astrocytoma; Adult Pineoblastoma; Adult Pineocytoma; Adult Subependymal Giant Cell Astrocytoma; Adult Subependymoma; Adult Supratentorial Primitive Neuroectodermal Tumor (PNET); Childhood Choroid Plexus Tumor; Childhood Craniopharyngioma; Childhood Ependymoblastoma; Childhood Grade I Meningioma; Childhood Grade II Meningioma; Childhood Grade III Meningioma; Childhood High-grade Cerebellar Astrocytoma; Childhood High-grade Cerebral Astrocytoma; Childhood Infratentorial Ependymoma; Childhood Low-grade Cerebellar Astrocytoma; Childhood Low-grade Cerebral Astrocytoma; Childhood Medulloepithelioma; Childhood Supratentorial Ependymoma; Meningeal Melanocytoma; Newly Diagnosed Childhood Ependymoma; Recurrent Adult Brain Tumor; Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Anaplastic Oligoastrocytoma; Recurrent Childhood Anaplastic Oligodendroglioma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Diffuse Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Fibrillary Astrocytoma; Recurrent Childhood Gemistocytic Astrocytoma; Recurrent Childhood Giant Cell Glioblastoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Gliomatosis Cerebri; Recurrent Childhood Gliosarcoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood

  10. First application of liquid-metal-jet sources for small-animal imaging: High-resolution CT and phase-contrast tumor demarcation

    SciTech Connect

    Larsson, Daniel H.; Lundstroem, Ulf; Burvall, Anna; Hertz, Hans M.

    2013-02-15

    Purpose: Small-animal studies require images with high spatial resolution and high contrast due to the small scale of the structures. X-ray imaging systems for small animals are often limited by the microfocus source. Here, the authors investigate the applicability of liquid-metal-jet x-ray sources for such high-resolution small-animal imaging, both in tomography based on absorption and in soft-tissue tumor imaging based on in-line phase contrast. Methods: The experimental arrangement consists of a liquid-metal-jet x-ray source, the small-animal object on a rotating stage, and an imaging detector. The source-to-object and object-to-detector distances are adjusted for the preferred contrast mechanism. Two different liquid-metal-jet sources are used, one circulating a Ga/In/Sn alloy and the other an In/Ga alloy for higher penetration through thick tissue. Both sources are operated at 40-50 W electron-beam power with {approx}7 {mu}m x-ray spots, providing high spatial resolution in absorption imaging and high spatial coherence for the phase-contrast imaging. Results: High-resolution absorption imaging is demonstrated on mice with CT, showing 50 {mu}m bone details in the reconstructed slices. High-resolution phase-contrast soft-tissue imaging shows clear demarcation of mm-sized tumors at much lower dose than is required in absorption. Conclusions: This is the first application of liquid-metal-jet x-ray sources for whole-body small-animal x-ray imaging. In absorption, the method allows high-resolution tomographic skeletal imaging with potential for significantly shorter exposure times due to the power scalability of liquid-metal-jet sources. In phase contrast, the authors use a simple in-line arrangement to show distinct tumor demarcation of few-mm-sized tumors. This is, to their knowledge, the first small-animal tumor visualization with a laboratory phase-contrast system.

  11. A Study of CD45RA+ Depleted Haploidentical Stem Cell Transplantation in Children With Relapsed or Refractory Solid Tumors and Lymphomas

    ClinicalTrials.gov

    2016-10-18

    Ewing Sarcoma; Gastrointestinal Tumor; Germ Cell Tumor; Hepatic Tumor; Lymphoma; Wilms Tumor; Rhabdoid Tumor; Clear Cell Carcinoma; Renal Cell Carcinoma; Melanoma; Neuroblastoma; Rhabdomyosarcoma; Non-rhabdomyosarcoma

  12. Feasibility of a Modified cone-Beam cT rotation Trajectory to improve liver Periphery Visualization during Transarterial chemoembolization

    PubMed Central

    Schernthaner, Rüdiger E.; Chapiro, Julius; Sahu, Sonia; Withagen, Paul; Duran, Rafael; Sohn, Jae Ho; Radaelli, Alessandro; van der Bom, Imramsjah Martin; Geschwind, Jean-François H.; Lin, MingDe

    2015-01-01

    Purpose To compare liver coverage and tumor detectability by using preprocedural magnetic resonance (MR) images as a reference, as well as radiation exposure of cone-beam computed tomography (CT) with different rotational trajectories. Materials and Methods Fifteen patients (nine men and six women; mean age ± standard deviation, 65 years ± 5) with primary or secondary liver cancer were retrospectively included in this institutional review board–approved study. A modified conebeam CT protocol was used in which the C-arm rotates from +55° to –185° (open arc cone-beam CT) instead of –120° to +120° (closed arc cone-beam CT). Each patient underwent two sessions of transarterial chemoembolization between February 2013 and March 2014 with closed arc and open arc cone-beam CT (during the first and second transarterial chemoembolization sessions, respectively, as part of the institutional transarterial chemoembolization protocol). For each cone-beam CT examination, liver volume and tumor detectability were assessed by using MR images as the reference. Radiation exposure was compared by means of a phantom study. For statistical analysis, paired t tests and a Wilcoxon signed rank test were performed. Results Mean liver volume imaged was 1695 cm3 ± 542 and 1857 cm3 ± 571 at closed arc and open arc cone-beam CT, respectively. The coverage of open arc cone-beam CT was significantly higher compared with closed arc cone-beam CT (97% vs 86% of the MR imaging liver volume, P = .002). In eight patients (53%), tumors were partially or completely outside the closed arc cone-beam CT field of view. All tumors were within the open arc cone-beam CT field of view. The open arc cone-beam CT radiation exposure by means of weighted CT index was slightly lower compared with that of closed arc cone-beam CT (–5.1%). Conclusion Open arc cone-beam CT allowed for a significantly improved intraprocedural depiction of peripheral hepatic tumors while achieving a slight radiation

  13. Asparagus polysaccharide and gum with hepatic artery embolization induces tumor growth and inhibits angiogenesis in an orthotopic hepatocellular carcinoma model.

    PubMed

    Weng, Ling-Ling; Xiang, Jian-Feng; Lin, Jin-Bo; Yi, Shang-Hui; Yang, Li-Tao; Li, Yi-Sheng; Zeng, Hao-Tao; Lin, Sheng-Ming; Xin, Dong-Wei; Zhao, Hai-Liang; Qiu, Shu-Qi; Chen, Tao; Zhang, Min-Guang

    2014-01-01

    Liver cancer is one of leading digestive malignancies with high morbidity and mortality. There is an urgent need for the development of novel therapies for this deadly disease. It has been proven that asparagus polysaccharide, one of the most active derivates from the traditional medicine asparagus, possesses notable antitumor properties. However, little is known about the efficacy of asparagus polysaccharide as an adjuvant for liver cancer chemotherapy. Herein, we reported that asparagus polysaccharide and its embolic agent form, asparagus gum, significantly inhibited liver tumor growth with transcatheter arterial chemoembolization (TACE) therapy in an orthotopic hepatocellular carcinoma (HCC) tumor model, while significantly inhibiting angiogenesis and promoting tumor cell apoptosis. Moreover, asparagine gelatinous possessed immunomodulatory functions and showed little toxicity to the host. These results highlight the chemotherapeutic potential of asparagus polysaccharide and warrant a future focus on development as novel chemotherapeutic agent for liver cancer TACE therapy. PMID:25605207

  14. Asparagus polysaccharide and gum with hepatic artery embolization induces tumor growth and inhibits angiogenesis in an orthotopic hepatocellular carcinoma model.

    PubMed

    Weng, Ling-Ling; Xiang, Jian-Feng; Lin, Jin-Bo; Yi, Shang-Hui; Yang, Li-Tao; Li, Yi-Sheng; Zeng, Hao-Tao; Lin, Sheng-Ming; Xin, Dong-Wei; Zhao, Hai-Liang; Qiu, Shu-Qi; Chen, Tao; Zhang, Min-Guang

    2014-01-01

    Liver cancer is one of leading digestive malignancies with high morbidity and mortality. There is an urgent need for the development of novel therapies for this deadly disease. It has been proven that asparagus polysaccharide, one of the most active derivates from the traditional medicine asparagus, possesses notable antitumor properties. However, little is known about the efficacy of asparagus polysaccharide as an adjuvant for liver cancer chemotherapy. Herein, we reported that asparagus polysaccharide and its embolic agent form, asparagus gum, significantly inhibited liver tumor growth with transcatheter arterial chemoembolization (TACE) therapy in an orthotopic hepatocellular carcinoma (HCC) tumor model, while significantly inhibiting angiogenesis and promoting tumor cell apoptosis. Moreover, asparagine gelatinous possessed immunomodulatory functions and showed little toxicity to the host. These results highlight the chemotherapeutic potential of asparagus polysaccharide and warrant a future focus on development as novel chemotherapeutic agent for liver cancer TACE therapy.

  15. Tumor Bed Delineation for Partial Breast and Breast Boost Radiotherapy Planned in the Prone Position: What Does MRI Add to X-ray CT Localization of Titanium Clips Placed in the Excision Cavity Wall?

    SciTech Connect

    Kirby, Anna M. Yarnold, John R.; Evans, Philip M.; Morgan, Veronica A.; Schmidt, Maria A.; Scurr, Erica D.; Souza, Nandita de

    2009-07-15

    Purpose: To compare tumor bed (TB) volumes delineated using magnetic resonance imaging plus computed tomography and clips (MRCT) with those delineated using CT and clips (CT/clips) alone in postlumpectomy breast cancer patients positioned prone and to determine the value of MRCT for planning partial breast irradiation (PBI). Methods and Materials: Thirty women with breast cancer each had 6 to 12 titanium clips secured in the excision cavity walls at lumpectomy. Patients underwent CT imaging in the prone position, followed by MRI (T{sub 1}-weighted [standard and fat-suppressed] and T{sub 2}-weighted sequences) in the prone position. TB volumes were delineated separately on CT and on fused MRCT datasets. Clinical target volumes (CTV) (where CTV = TB + 15 mm) and planning target volumes (PTV) (where PTV = CTV + 10 mm) were generated. Conformity indices between CT- and MRCT-defined target volumes were calculated (ratio of the volume of agreement to total delineated volume). Discordance was expressed as a geographical miss index (GMI) (where the GMI = the fraction of total delineated volume not defined by CT) and a normal tissue index (the fraction of total delineated volume designated as normal tissue on MRCT). PBI dose distributions were generated to cover CT-defined CTV (CTV{sub CT}) with {>=}95% of the reference dose. The percentage of MRCT-defined CTV (CTV{sub MRCT}) receiving {>=}95% of the reference dose was measured. Results: Mean conformity indices were 0.54 (TB), 0.84 (CTV), and 0.89 (PTV). For TB volumes, the GMI was 0.37, and the NTI was 0.09. Median percentage volume coverage of CTV{sub CT} was 97.1% (range, 95.3%-100.0%) and of CTV{sub MRCT} was 96.5% (range, 89.0%-100.0%). Conclusions: Addition of MR to CT/clip data generated TB volumes that were discordant with those based on CT/clips alone. However, clinically satisfactory coverage of CTV{sub MRCT} by CTV{sub CT}-based tangential PBI fields provides support for CT/clip-based TB delineation remaining the

  16. SU-C-BRE-05: PTV Margin Determination Based On Tumor Radiobiological Characteristics and Geometric Uncertainties Derived From Daily Cone- Beam CT Images

    SciTech Connect

    Selvaraj, J

    2014-06-15

    Purpose: To determine required PTV margins for ≤1% loss in mean population TCP using systematic (Σ) and random (σ) errors calculated from daily cone-beam CT (CBCT) images of head and neck patients. Methods: Daily CBCT images were acquired for 50 head and neck patients. The CBCT image sets acquired at each fraction were registered with planning CT to obtain positional errors for each patient for each fraction. Systematic and random errors were calculated from data collected for 50 patients as described in IPEM On Target report. CTV delineation uncertainty of 2mm is added quadratically to systematic error. Assuming a spherical target volume, the dose in each voxel of target volume is summed for each fraction in the treatment by shifting the dose grid to calculate mean population TCP inclusive of geometric uncertainties using a Monte Carlo method. These simulations were repeated for the set of Σ and σ in each axis for different PTV margins and drop in TCP for each margin are obtained. In order to study the effect of dose-response curve on PTV margins, two different σα of 0.048 Gy-1 and 0.218 Gy-1 representing steep and shallow dose-response curves are studied. Σ were 2.5, 2.5, 2.1 mm and σ were 0.3, 0.3 0.2 mm respectively in x, y and z axis respectively. Results: PTV margins based on tumor radiobiological characteristics are 4.8, 4.8 and 4 mm in x, y and z axis assuming 25 treatment fractions for σα 0.048 Gy-1 (steep) and 4.2,4.2 and 2.2 for σα of 0.218 Gy-1 (shallow). While the TCP-based margins did not differ much in x and y axis, it is considerably smaller in z axis for shallow DRC. Conclusion: TCP based margins are substantially smaller than physical dose-based margin recipes. This study also demonstrates the importance of considering tumor radiobiological characteristics while deriving margins.

  17. Tumor progression locus 2 ablation suppressed hepatocellular carcinoma development by inhibiting hepatic inflammation and steatosis in mice

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Tumor progression locus 2 (TPL2), a serine threonine kinase, functions as a critical regulator of inflammatory pathways and mediates oncogenic events. The potential role of Tpl2 in nonalcoholic fatty liver disease (NAFLD) associated hepatocellular carcinoma (HCC) development remains unkn...

  18. Three-Dimensional Ground Glass Opacity Ratio in CT Images Can Predict Tumor Invasiveness of Stage IA Lung Cancer

    PubMed Central

    Yu, Woo Sik; Hong, Sae Rom; Lee, Jin Gu; Lee, Jae Seok; Jung, Hee Suk; Kim, Dae Joon; Chung, Kyung Young

    2016-01-01

    Purpose We investigated the relationship between various parameters, including volumetric parameters, and tumor invasiveness according to the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification. Materials and Methods We retrospectively reviewed 99 patients with completely resected stage IA lung adenocarcinoma. The correlation between several parameters [one-dimensional ground glass opacity (1D GGO) ratio, two-dimensional (2D) GGO ratio, three-dimensional (3D) GGO ratio, 1D solid size, 2D solid size, and 3D solid size] and tumor invasiveness according to IASLC/ATS/ERS classification was investigated using receiver operating characteristic (ROC) analysis. Adenocarcinoma in situ and minimally invasive adenocarcinoma were referred to as noninvasive adenocarcinoma. Results The areas under the curve (AUC) to predict invasive adenocarcinoma for the 1D, 2D, and 3D GGO ratios were 0.962, 0.967, and 0.971, respectively. The optimal cut-off values for the 1D, 2D, and 3D GGO ratios were 38%, 62%, and 74%, respectively. The AUC values for 1D, 2D, and 3D solid sizes to predict invasive adenocarcinoma were 0.933, 0.944, and 0.903, respectively. The optimal cut-off values for 1D, 2D, and 3D solid sizes were 1.2 cm, 1.5 cm2, and 0.7 cm3, respectively. The difference in the ROC curves for 3D GGO ratio and 3D solid size was significant (p=0.01). Conclusion Computed tomography image-related parameters based on GGO were well correlated with and predictive of invasiveness according to IASLC/ATS/ERS classification. 3D GGO ratio was more strongly correlated with pathologic invasiveness than 3D solid size. PMID:27401643

  19. Transplacental carcinogenicity of inorganic arsenic in the drinking water: induction of hepatic, ovarian, pulmonary, and adrenal tumors in mice.

    PubMed

    Waalkes, Michael P; Ward, Jerrold M; Liu, Jie; Diwan, Bhalchandra A

    2003-01-01

    Arsenic is a known human carcinogen, but development of rodent models of inorganic arsenic carcinogenesis has been problematic. Since gestation is often a period of high sensitivity to chemical carcinogenesis, we performed a transplacental carcinogenicity study in mice using inorganic arsenic. Groups (n = 10) of pregnant C3H mice were given drinking water containing sodium arsenite (NaAsO(2)) at 0 (control), 42.5, and 85 ppm arsenite ad libitum from day 8 to 18 of gestation. These doses were well tolerated and body weights of the dams during gestation and of the offspring subsequent to birth were not reduced. Dams were allowed to give birth, and offspring were weaned at 4 weeks and then put into separate gender-based groups (n = 25) according to maternal exposure level. The offspring received no additional arsenic treatment. The study lasted 74 weeks in males and 90 weeks in females. A complete necropsy was performed on all mice and tissues were examined by light microscopy in a blind fashion. In male offspring, there was a marked increase in hepatocellular carcinoma incidence in a dose- related fashion (control, 12%; 42.5 ppm, 38%; 85 ppm, 61%) and in liver tumor multiplicity (tumors per liver; 5.6-fold over control at 85 ppm). In males, there was also a dose-related increase in adrenal tumor incidence and multiplicity. In female offspring, dose-related increases occurred in ovarian tumor incidence (control, 8%; 42.5 ppm, 26%; 85 ppm, 38%) and lung carcinoma incidence (control, 0%; 42.5 ppm, 4%; 85 ppm, 21%). Arsenic exposure also increased the incidence of proliferative lesions of the uterus and oviduct. These results demonstrate that oral inorganic arsenic exposure, as a single agent, can induce tumor formation in rodents and establishes inorganic arsenic as a complete transplacental carcinogen in mice. The development of this rodent model of inorganic arsenic carcinogenesis has important implications in defining the mechanism of action for this common

  20. Hepatitis B virus (HBV) receptors: Deficiency in tumor results in scant HBV infection and overexpression in peritumor leads to higher recurrence risk

    PubMed Central

    Ye, Fei; Fan, Qing-Min; Yu, Guo-Feng; Yu, Dan-Dan; Gao, Lu; Sun, Kai; Han, Zhi-Peng; Li, Rong; Yang, Yang; Zhao, Qiu-Dong; Wu, Meng-Chao; Wang, Hong-Yang; Wei, Li-Xin

    2015-01-01

    Hepatitis B virus (HBV) infection is a risk factor for hepatocarcinogenesis and recurrence. Here, we sought to characterize intratumoral and peritumoral expression of HBsAg and its specific receptors in HBsAg-positive hepatocellular carcinoma (HCC) patients and further examined their correlation with the recurrence-free survival (RFS). HCC tissue and adjacent normal tissue specimens were acquired from HBsAg-positive patients. The presence of HBsAg and receptors, as well as hepatic progenitor cells (HPCs) were detected by tissue microassay and immunohistochemistry. Necroinflammatory activity was evaluated by HE staining. The mean IOD of HBsAg and HBV DNA in the intratumoral tissues was markedly lower than that in the peritumoral tissues (P < 0.001). Pearson correlation analysis further showed a significant correlation between the expression of HBsAg and NTCP (r = 0.461, P < 0.001) or ASGPR (r = 0.506, P < 0.001) in peritumoral tissues. And the peritumoral HBsAg and receptors presented a positive association with necroinflammatory activity (P < 0.05). Inflammation induced by HBV infection presented a positive association with HPCs activation (P < 0.05). Additionally, due to lack of HBV receptors, HPCs was not preferentially infected with HBV, but activated HPCs had a significant correlation with HBsAg expression in peritumoral tissues, and the peritumoral HPCs activation was associated with RFS of HCC patients, therefore, the overexpression of HBsAg and receptors in peritumor were also with higher recurrence risk (P < 0.05). In conclusion, lack of HBV receptors resulted in scant HBV infection in tumor cells, and overexpression of HBsAg and receptors in peritumor was strongly associated with higher recurrence risk in HCC patients. PMID:26515593

  1. Facial Paralysis Secondary to Extensive Perineural Spread of Adenocarcinoma of the Parotid Gland Identified by PET/CT.

    PubMed

    Achong, Dwight M; Zloty, Martin

    2016-06-01

    Brain MRI in an 82-year-old man with presumed Bell's palsy revealed a clinically unsuspected right parotid gland mass but no other acute findings. Biopsy revealed poorly differentiated adenocarcinoma. Staging F-FDG PET/CT revealed an FDG-avid parotid mass, abnormal FDG uptake along the course of the facial nerve from mass to skull base, and multiple FDG-avid right level II neck lymph nodes and hepatic metastases. The PET/CT findings and prolonged clinical course suggest that diffuse perineural spread of tumor from a smoldering parotid neoplasm, and not idiopathic Bell's palsy, was responsible for the patient's facial paralysis. PMID:26825200

  2. Induction of hepatic tumors with 7,12-dimethylbenz(a)anthracene in two species of viviparous fishes (genus Poeciliopsis)

    SciTech Connect

    Schultz, M.E.; Schultz, R.J.

    1982-04-01

    Liver neoplasms were induced in two species of viviparous fishes, Poeciliopsis lucida and P. monacha, by repeated short-term exposures to an aqueous suspension of 5 ppm 7,12-dimethylbenz(a)anthracene (DMBA). Predominantly hepatocellular neoplasms developed in 47 out of 106 fish surviving the period allowed for tumor development, 6-9 months after initial exposure to DMBA. The use of short-term exposure periods of 6 hr in young fish and up to 20 hr in adults reduced stress and mortalities caused by the toxicity of DMBA at 5 ppm. A lower concentration of DMBA, 0.25 ppm, failed to induce tumors in any of the surviving 230 of 295 young fish administered repeated 20-hr exposures. This study shows for the first time that DMBA is carcinogenic to fish.

  3. Inhibitory effects of the attenuated Salmonella typhimurium containing the IL-2 gene on hepatic tumors in mice.

    PubMed

    Ha, Xiao-qin; Yin, Qiang; Zhao, Hong-bin; Hui, Ling; Wang, Mei-liang; Peng, Jun-hua; Dong, Ju-zi; Deng, Zhi-yun; Zhao, Yong; Zhang, Yuan-yuan

    2012-01-01

    To observe the inhibitory effects of an attenuated S. typhimurium strain carrying IL-2 gene (TPI) on hepatoma cell line (HepG2) and transplanted tumors in mice. TPI, TPG (an attenuated S. typhimurium strain carrying green fluorescent protein gene), and TP (an attenuated S. typhimurium strain) strains were transfected into HepG2 cells. At 48 h after transfecting, the transfection rate was 82.58 ± 1.74%. The expression level of IL-2 was (99.5 ± 12.2) ng/1 × 10(6) cells. Compared with TPG, TP, and normal mouse groups, the proportion of CD4(+) T and CD8(+) T cells in the blood from the TPI group was higher, the levels of IgM and IgG(1) were significantly increased, and the proliferation activity of splenic lymphocyte was significantly stronger. The transplanted tumor weight in the TPI group was significantly smaller than that in the other two groups. The infiltration of lymphocytes increased in the tumor from TPI group mice. TPI was effectively transfected into cancer cells, which expressed the protein of interest. Oral administration of TPI prolonged survival of mice transplanted with hepatoma cell tumours.

  4. Viral Hepatitis

    MedlinePlus

    ... Public Home » For Veterans and the Public Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... the Public Veterans and Public Home How is Hepatitis C Treated? Find the facts about the newest ...

  5. Effect of embolic microspheres in the treatment of primary hepatic carcinoma.

    PubMed

    Wang, K B; Sui, H; Li, W; Cui, L M; Bai, B

    2016-01-01

    The purpose of this study was to evaluate the clinical effect of embolic microspheres in the treatment of primary hepatic carcinoma. Fifty-eight patients who were confirmed with primary hepatic carcinoma by imaging were retrospectively analyzed. They were firstly perfused with 50 mg of oxaliplatin and 40 mg of epirubicin. Embolic microspheres were then injected into the distal end of targeted blood vessels. After this procedure, dynamic observation was carried out until tumor stain disappeared. Liver function and blood indexes were reexamined on days 5, 6, 7 and 28 after treatment, and moreover, the liver was examined with Magnetic Resonance Imaging (MRI) or computed tomography (CT). Compared to traditional lipiodol embolization, embolic microspheres did not aggregate the damage on liver function and the imaging examination suggested necrosis of some tumor tissues. Embolic microspheres proved to be effective in treating primary hepatic carcinoma. It produces no damage on liver function and can lead to significant shrinkage of hepatic carcinoma and necrosis of some tumor tissues. Embolic microspheres, which merely block distal branches of tumor-feeding artery, can avoid collateral circulation induced by permanent blocking, thus achieve a good treatment effect.

  6. Viral Hepatitis

    MedlinePlus

    ... with hepatitis? How does a pregnant woman pass hepatitis B virus to her baby? If I have hepatitis B, what does my baby need so that she ... Can I breastfeed my baby if I have hepatitis B? More information on viral hepatitis What is hepatitis? ...

  7. Primary hepatic angiosarcoma.

    PubMed

    Chaudhary, P; Bhadana, U; Singh, R A K; Ahuja, A

    2015-09-01

    Primary hepatic angiosarcoma is a rare, aggressive tumor; composed of spindle or pleomorphic cells that line, or grow into, the lumina of pre-existing vascular spaces like sinusoids and terminal hepatic venules; with only about 200 cases diagnosed annually worldwide but it is the most common primary malignant mesenchymal tumor of the liver in adults and accounts for 2% of all primary hepatic malignancies. HAS occurs in association with known chemical carcinogens, but 75% of the tumors have no known etiology. Patients present with vague symptoms like abdominal pain, weight loss, fatigue or an abdominal mass. Hepatic angiosarcoma is usually multicentric and involves both lobes, entire liver may also found to be involved. CD31 is the most reliable marker. These tumors lack specific features on imaging, so, pathological diagnosis is necessary. There are no established treatment guidelines because of low frequency and aggressive nature of tumor, chemotherapy is only palliative, liver resection is indicated for solitary mass and liver transplant is contraindicated. The aim of this article is to comprehensively review all the available literature and to present detailed information and an update on primary hepatic angiosarcoma. PMID:26008857

  8. Rare association of adrenal tumors.

    PubMed

    Tica, Irjna; Tica, V I; Mihailov, Claudia

    2007-01-01

    Adrenal incidentalomas represent a true problem both in the clinical diagnosis and in their treatment. A great variety of pathologies may be found under the umbrella of this concept: benign adenomas - functioning or not, myelolipomas, hamartomas, or granulomatous infiltrations of the adrenal. The possibility of malignancy should be considered in each case, especially in patients with a known extra-adrenal primary. In true incidentalomas, size appears to be predictive of malignancy. We present an interesting case because of the surprising association of two adrenal tumors, with a long time lapse between them, with ascites and pleurisy and because of the difficulty of treatment in a patient refusing surgery. We did not find such an association in the medical literature. Miss MR, 61 years old, was treated surgically for pheochromocytoma 28 years ago (left adrenalectomy). She was diagnosed in the past with peritoneal carcinomatosis; paraneoplastic left pleurisy, chronic hepatitis of unknown etiology. She presented at admission cashexia, pallor, signs of left pleural effusion and of ascites, hearts beats and blood pressure within normal limits. Investigations were performed including hormonal tests, ultrasound investigation, hepatic tests, and CT scan but no specific tumour markers. A right adrenal incidentaloma of 21/15 mm - in association with ascites and pleurisy - was found at CT scan. Diagnostic problems are discussed because the patient refused surgery, so no pathological examination was available.

  9. [Role of 18FDG-PET/CT in the management and gross tumor volume definition for radiotherapy of head and neck cancer; single institution experiences based on long-term follow-up].

    PubMed

    Hideghéty, Katalin; Cserháti, Adrienne; Besenyi, Zsuzsanna; Zag, Levente; Gaál, Szilvia; Együd, Zsófia; Mózes, Petra; Szántó, Erika; Csenki, Melinda; Rusz, Orsolya; Varga, Zoltán; Dobi, Ágnes; Maráz, Anikó; Pávics, László; Lengyel, Zsolt

    2015-06-01

    The purpose of our work is evaluation of the impact of 18FDG-PET/CT on the complex management of locoregionally advanced (T3-4N1-3) head and neck squamous cell cancer (LAHNSC), and on the target definition for 3D conformal (3DCRT) and intensity-modulated radiotherapy (IMRT). 18FDG-PET/CT were performed on 185 patients with LAHNSC prior to radiotherapy/chemoradiation in the treatment position between 2006 and 2011. Prior to it 91 patients received induction chemotherapy (in 20 cases of these, baseline PET/CT was also available). The independently delineated CT-based gross tumor volume (GTVct) and PET/CT based ones (GTVpet) were compared. Impact of PET/CT on the treatment strategy, on tumor response evaluation to ICT, on GTV definition furthermore on overall and disease-specific survival (OS, DSS) was analysed. PET/CT revealed 10 head and neck, 2 lung cancers for 15 patients with carcinoma of unknown primary (CUP) while 3 remained unknown. Second tumors were detected in 8 (4.4%), distant metastasis in 15 (8.2%) cases. The difference between GTVct and GTVpet was significant (p=0.001). In 16 patients (14%) the GTVpet were larger than GTVct due to multifocal manifestations in the laryngo-pharyngeal regions (4 cases) or lymph node metastases (12 cases). In the majority of the cases (82 pts, 72%) PET/CT-based conturing resulted in remarkable decrease in the volume (15-20%: 4 cases, 20-50%: 46 cases, >50%: 32 cases). On the basis of the initial and post-ICT PET/CT comparison in 15/20 patients more than 50% volume reduction and in 6/20 cases complete response were achieved. After an average of 6.4 years of follow-up the OS (median: 18.3±2.6 months) and DSS (median: 25.0±4.0 months) exhibited close correlation (p=0.0001) to the GTVpet. In cases with GTVpet <10 cm3 prior to RT, DSS did not reach the median, the mean is 82.1±6.1 months, while in cases with GTVpet 10-40 cm3 the median of the DSS was 28.8±4.9 months (HR = 3.57; 95% CI: 1.5-8.3), and in those with GTVpet >40

  10. Chemoembolization for Hepatocellular Carcinoma Supplied Exclusively by the Hepatic Falciform Artery

    SciTech Connect

    Kim, Gyoung Min; Kim, Hyo-Cheol Chung, Jin Wook; Lee, In Joon; Kim, Han Myun; Jae, Hwan Jun; Park, Jae Hyung

    2012-08-15

    Purpose: The purpose of this study was to describe imaging appearances of hepatocellular carcinoma (HCC) supplied exclusively by the hepatic falciform artery (HFA) and safety of chemoembolization via the HFA. Methods: During the past 6 years, we have performed chemoembolization for the treatment of 12 patients with HCCs supplied exclusively by the HFA. Computed tomography (CT) scans, digital subtraction angiograms, and medical records were retrospectively reviewed by consensus. Results: Tumors were located in Couinaud segments IV (n = 7) and III (n = 5) and in subcapsular areas around the falciform ligaments. Tumor size ranged from 1.0 to 1.8 cm (mean, 1.3 cm; median, 1.3 cm). HFAs originated from A4 (n = 7), A3 (n = 4), and the left hepatic artery near the umbilical point (n = 1). All tumors were supplied exclusively by the HFA. Prophylactic embolization of the distal HFA before chemoembolization was performed using gelatin sponge particles in only one patient, and selective chemoembolization via the HFA was achieved in all patients. One patient suffered from a skin rash after chemoembolization and recovered after conservative management. Individual responses of tumors supplied exclusively by the HFA were complete response (n = 8), partial response (n = 1), and stable disease (n = 2) at the first follow-up enhanced CT scan. Conclusions: The HFA can supply HCC located in subcapsular areas around the falciform ligament, and the tumors can be safely chemoembolized without significant complications.

  11. Hepatic regenerating nodules in hereditary tyrosinemia

    SciTech Connect

    Day, D.L.; Letourneau, J.G.; Allan, B.T.; Sharp, H.L.; Ascher, N.; Dehner, L.P.; Thompson, W.M.

    1987-08-01

    Hereditary tyrosinemia is an autosomal recessive, enzymatic disorder that results in micro- and macronodular cirrhosis in early childhood. Hepatocellular carcinoma occurs in approximately one-third of affected children. We evaluated the imaging studies performed in five children with this disorder. Pathologic examination of all five of the livers revealed cirrhosis and multiple regenerating nodules; hepatocellular carcinoma was present in two of the five livers. All five patients had high-attenuation or high- and low-attenuation foci within the liver. These high-attenuation foci were not apparent as focal lesions in three of four hepatic sonograms or in one of two hepatic nuclear scans. Angiography showed tumor vascularity in one patient with a focal hepatocellular carcinoma, but was indeterminate in a second patient with severe cirrhosis and multifocal hepatocellular carcinoma. Children with cirrhosis due to tyrosinemia may develop regenerating nodules that appear as high-attenuation hepatic foci on CT scans. It is difficult to differentiate regenerating nodules from multifocal hepatocellular carcinoma in these patients.

  12. Prediction of recurrence after HCC resection. Faint oily deposits on preoperative Lipiodol-CT of remnant liver tissue.

    PubMed

    Yamamoto, M; Iimuro, Y; Mogaki, M; Kachi, K; Fujii, H; Matsumoto, Y

    1994-07-01

    In trying to clarify the high recurrence rate after removal of small hepatocellular carcinoma (HCC), we assessed the postoperative evolution of minute hepatic Lipiodol deposits which had been diagnosed as artifacts on the preoperative Lipiodol-CT. Of 27 patients with solitary HCC less than 5 cm in diameter, 14 had such Lipiodol deposits in the preoperative CT and 9 of them (64%) developed recurrent tumors. On the other hand, 6 of the 13 patients without deposits (46%) suffered recurrence, but in 5 of these 6 patients the HCC was metachronous multicentric. The cumulative survival rate of the non-deposit group was better than that of the deposit group (p < 0.1). The present study suggested that, even in patients with small HCC, minute concomitant tumors invisible by conventional imaging techniques may exist at the time of surgery. Some of these lesions without sufficient tumor vasculature showing a hypervascular blush on angiography appear to retain small, vague Lipiodol deposits.

  13. Hepatic angiomyolipoma: what management?

    PubMed

    Barbier, L; Torrents, J; Hardwigsen, J

    2014-01-01

    An 80-year-old woman was referred for the surgical treatment of a 110-mm right hepatic tumor. The biopsy revealed an adenoma, and a right hepatectomy was performed. Histopathology indicated a major fat component with epitheliod cells, immunoreactivity for HMB45, Melan A, and smooth muscle actin, describing a hepatic epithelioid angiomyolipoma (AML). The AML belongs to the group of tumors with a Perivascular Epithelioid Cell differentiation. Its diagnosis is based on imaging and biopsy, and therefore might be difficult. Hepatic AML are mainly benign tumors; however, some tend to behave in a malignant manner. In case of histological proof, close clinical and radiological monitoring can be proposed if its size is less than 5 cm and no pejorative histological features are found. Nevertheless, follow-up is still required if resection is performed in search of recurrence or metastatic spread. PMID:25073214

  14. [A patient with thyroid cancer evaluated according to Response Evaluation Criteria in Solid Tumors during treatment for breast cancer recurrence in hepatic and cervical lymph nodes].

    PubMed

    Hayashi, Keiko; Enomoto, Takumo; Oshida, Sayuri; Habiro, Takeyoshi; Hatate, Kazuhiko; Sengoku, Norihiko; Watanabe, Masahiko

    2013-11-01

    We describe a case of a 69-year-old woman who underwent left breast-preserving surgery and axillary dissection for left-sided breast cancer at 60 years of age. The histopathological diagnosis was papillotubular carcinoma, luminal A (pathological T1N0M0).In the eighth year after surgery, computed tomography (CT) revealed recurrence in the liver and cervical lymph node metastasis. The patient did not respond to 3 months of treatment with letrozole (progressive disease [PD]). Six courses of chemotherapy with epirubicin and cyclophosphamide (EC) were administered. Subsequently, the attending physician was replaced while the patient was receiving paclitaxel( PTX).After 4 courses of treatment with PTX, the liver metastasis disappeared (complete response [CR]).However, the cervical lymph nodes did not shrink (PD).The cytological diagnosis was papillary thyroid cancer with associated cervical lymph node metastasis. Total thyroidectomy and D3b cervical lymph node dissection were performed. The pathological diagnosis was pEx0T1bN1Mx, pStage IVA disease. Replacement of the attending physician is a critical turning point for patients. During chemotherapy or hormone therapy for breast cancer, each organ should be evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST).In the case of our patient, thyroid cancer was diagnosed according to RECIST. Cancer specialists should bear in mind that the treatment policy may change dramatically depending on the results of RECIST assessment.

  15. F-18 FDG PET/CT and Tc-99m sulfur colloid SPECT imaging in the diagnosis and treatment of a case of dual solitary fibrous tumors of the retroperitoneum and pancreas.

    PubMed

    Azadi, Javad; Subhawong, Andrea; Durand, Daniel James

    2012-03-01

    Although FDG PET is increasingly used for the staging of many types of sarcoma, little has been written regarding the FDG PET imaging characteristics of solitary fibrous tumor. We report a patient undergoing FDG PET/CT surveillance for squamous cell carcinoma of the tongue who was incidentally found to have two soft tissue masses in the retroperitoneum and pancreatic tail. Due to their low degree of FDG avidity, they were followed conservatively for approximately one year as they gradually increased in size. Technetium-99m sulfur colloid SPECT helped confirm that the pancreatic tail mass was not a splenule, after which both lesions were surgically resected and found to be extrathoracic solitary fibrous tumors without malignant features. These findings suggest that, as with other low-grade sarcomas, benign extrathoracic solitary fibrous tumors exhibit relatively little glycolytic metabolism in vivo.

  16. Detection rate and prognostic value of circulating tumor cells and circulating tumor DNA in metastatic uveal melanoma.

    PubMed

    Bidard, François-Clément; Madic, Jordan; Mariani, Pascale; Piperno-Neumann, Sophie; Rampanou, Aurore; Servois, Vincent; Cassoux, Nathalie; Desjardins, Laurence; Milder, Maud; Vaucher, Isabelle; Pierga, Jean-Yves; Lebofsky, Ronald; Stern, Marc-Henri; Lantz, Olivier

    2014-03-01

    Circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) have been recently investigated in several cancer types, but their respective clinical significance remains to be determined. In our prospective study, we compared the detection rate and the prognostic value of these two circulating biomarkers in patients with metastatic uveal melanoma. GNAQ/GNA11 mutations were characterized in archived tumor tissue. Using a highly sensitive and mutation-specific bidirectional pyrophosphorolysis-activated polymerization (bi-PAP) technique, GNAQ c.626A>T, GNAQ c.626A>C and GNA11 c.626A>T copy numbers were quantified in plasma from 12 mL of blood. CTCs were detected at the same time in 7.5 mL of blood by the CellSearch technique. Patient characteristics and outcome were prospectively collected. CTCs (≥1) were detected in 12 of the 40 included patients (30%, range 1-20). Among the 26 patients with known detectable mutations, ctDNA was detected and quantified in 22 (84%, range 4-11,421 copies/mL). CTC count and ctDNA levels were associated with the presence of miliary hepatic metastasis (p = 0.004 and 0.03, respectively), with metastasis volume (p = 0.005 and 0.004) and with each other (p < 0.0001). CTC count and ctDNA levels were both strongly associated with progression-free survival (p = 0.003 and 0.001) and overall survival (p = 0.0009 and <0.0001). In multivariate analyses, ctDNA appeared to be a better prognostic marker than CTC. In conclusion, ctDNA and CTC are correlated and both have poor prognostic significance. CTC detection can be performed in every patient but, in patients with detectable mutations, ctDNA was more frequently detected than CTC and has possibly more prognostic value.

  17. SU-E-J-123: Assessing Segmentation Accuracy of Internal Volumes and Sub-Volumes in 4D PET/CT of Lung Tumors Using a Novel 3D Printed Phantom

    SciTech Connect

    Soultan, D; Murphy, J; James, C; Hoh, C; Moiseenko, V; Cervino, L; Gill, B

    2015-06-15

    Purpose: To assess the accuracy of internal target volume (ITV) segmentation of lung tumors for treatment planning of simultaneous integrated boost (SIB) radiotherapy as seen in 4D PET/CT images, using a novel 3D-printed phantom. Methods: The insert mimics high PET tracer uptake in the core and 50% uptake in the periphery, by using a porous design at the periphery. A lung phantom with the insert was placed on a programmable moving platform. Seven breathing waveforms of ideal and patient-specific respiratory motion patterns were fed to the platform, and 4D PET/CT scans were acquired of each of them. CT images were binned into 10 phases, and PET images were binned into 5 phases following the clinical protocol. Two scenarios were investigated for segmentation: a gate 30–70 window, and no gating. The radiation oncologist contoured the outer ITV of the porous insert with on CT images, while the internal void volume with 100% uptake was contoured on PET images for being indistinguishable from the outer volume in CT images. Segmented ITVs were compared to the expected volumes based on known target size and motion. Results: 3 ideal breathing patterns, 2 regular-breathing patient waveforms, and 2 irregular-breathing patient waveforms were used for this study. 18F-FDG was used as the PET tracer. The segmented ITVs from CT closely matched the expected motion for both no gating and gate 30–70 window, with disagreement of contoured ITV with respect to the expected volume not exceeding 13%. PET contours were seen to overestimate volumes in all the cases, up to more than 40%. Conclusion: 4DPET images of a novel 3D printed phantom designed to mimic different uptake values were obtained. 4DPET contours overestimated ITV volumes in all cases, while 4DCT contours matched expected ITV volume values. Investigation of the cause and effects of the discrepancies is undergoing.

  18. Diagnostic Value of Serum Level of Soluble Tumor Necrosis Factor Receptor IIα in Egyptian Patients With Chronic Hepatitis C Virus Infection and Hepatocellular Carcinoma

    PubMed Central

    Fouad, Shawky A; Elsaaid, Nehal H; Mohamed, Nagwa A; Abutaleb, Osama M

    2014-01-01

    Background: The prognosis of hepatocellular carcinoma (HCC) is unfavorable and needs serum markers that could detect it early to start therapy at a potentially curable phase. Objectives: The aim of this study was to determine the value of serum soluble tumor necrosis factor (TNF) receptor-IIα (sTNFR-IIα) in diagnosis of HCC in patients with chronic hepatitis C virus (HCV) infection. Patients and Methods: The study was performed on 110 subjects who were classified into five groups. Group I included 20 patients with chronic noncirrhotic HCV infection and persistently normal transaminases for ≥6 months. Group II included 20 patients with chronic noncirrhotic HCV infection and elevated transaminases. Group III included 20 patients with Chronic HCV infection and liver cirrhosis. Group IV included 20 patients with chronic HCV infection with liver cirrhosis and HCC. Group V included 30 healthy age and sex-matched controls. Medical history was taken from all participants and they underwent clinical examination and abdominal ultrasonography. in addition, the following laboratory tests were requested: liver function tests, complete blood count, HBsAg, anti-HCVAb, HCV-RNA by qualitative PCR, and serum levels of α-fetoprotein (AFP) and sTNFR-IIα. Results: The serum level of sTNFR-IIα was significantly higher in patients with HCC in comparison to the other groups. A positive correlation was found between the serum levels of sTNFR-IIα and AST and ALT in patients of group-II. Diagnosis of HCC among patients with HCV infection and cirrhosis could be ascertained when sTNFR-IIα is assessed at a cutoff value of ≥ 250 pg/mL. Conclusions: Serum sTNFR-IIα could be used as a potential serum marker in diagnosing HCC among patients with HCV infection. PMID:25386197

  19. Structure-based rational design of peptide hydroxamic acid inhibitors to target tumor necrosis factor-α converting enzyme as potential therapeutics for hepatitis.

    PubMed

    Wu, Dan; Gu, Qiuhong; Zhao, Ning; Xia, Fei; Li, Zhiwei

    2015-12-01

    The human tumor necrosis factor-α converting enzyme (TACE) has recently been raised as a new and promising therapeutic target of hepatitis and other inflammatory diseases. Here, we reported a successful application of the solved crystal structure of TACE complex with a peptide-like ligand INN for rational design of novel peptide hydroxamic acid inhibitors with high potency and selectivity to target and inhibit TACE. First, the intermolecular interactions between TACE catalytic domain and INN were characterized through an integrated bioinformatics approach, with which the key substructures of INN that dominate ligand binding were identified. Subsequently, the INN molecular structure was simplified to a chemical sketch of peptide hydroxamic acid compound, which can be regarded as a linear tripeptide capped by a N-terminal carboxybenzyl group (chemically protective group) and a C-terminal hydroxamate moiety (coordinated to the Zn(2+) at TACE active site). Based on the sketch, a virtual combinatorial library containing 180 peptide hydroxamic acids was generated, from which seven samples were identified as promising candidates by using a knowledge-based protein-peptide affinity predictor and were then tested in vitro with a standard TACE activity assay protocol. Consequently, three designed peptide hydroxamic acids, i.e. Cbz-Pro-Ile-Gln-hydroxamic acid, Cbz-Leu-Ile-Val-hydroxamic acid and Cbz-Phe-Val-Met-hydroxamic acid, exhibited moderate or high inhibitory activity against TACE, with inhibition constants Ki of 36 ± 5, 510 ± 46 and 320 ± 26 nM, respectively. We also examined the structural basis and non-bonded profile of TACE interaction with a designed peptide hydroxamic acid inhibitor, and found that the inhibitor ligand is tightly buried in the active pocket of TACE, forming a number of hydrogen bonds, hydrophobic forces and van der Waals contacts at the interaction interface, conferring both stability and specificity for TACE-inhibitor complex

  20. Tumor necrosis factor-alpha -308G/A polymorphism and risk of hepatocellular carcinoma in hepatitis C virus-infected patients

    PubMed Central

    Talaat, Roba M.; Esmail, Ahmed A.; Elwakil, Reda; Gurgis, Adel A.; Nasr, Mahmoud I.

    2012-01-01

    Tumor necrosis factor-alpha (TNF-α) is an important cytokine in generating an immune response against infection with hepatitis C virus (HCV). The functions of TNF-α may be altered by single-nucleotide polymorphisms (SNPs) in its gene structure. We hypothesized that SNPs in TNF-α may be important in determining the outcome of an HCV infection. To test this hypothesis, we investigated the role of the polymorphism -308G/A, which is located in the promoter region of the TNF-α gene, in the progression of HCV infection in Egyptian patients using a quantitative real-time polymerase chain reaction (qRT-PCR). The distribution of this polymorphism and its impact on the serum level of TNF-α was compared between 90 HCV-infected patients [45 with HCV-induced cirrhosis and 45 with HCV-related hepatocellular carcinoma (HCC)] and 45 healthy Egyptian volunteers without any history of liver disease. Our results showed that at the TNF-α -308 position, the G/G allele was most common (78.5%) in the study population, with the G/A and A/A alleles occurring less frequently (13.3% and 8.1%, respectively). Frequencies of G/G, G/A, and A/A genotypes were 87%, 7%, and 6% in patients with liver cirrhosis and were 94%, 4%, and 2% in patients with HCC, respectively. Serum levels of TNF-α were significantly higher in HCV-infected patients than in healthy controls, indicating that the TNF-α -308 polymorphism does not influence the production of TNF-α. The serum level of TNF-α was positively correlated with HCV infection. Taken together, these findings suggest that the TNF-α -308 polymorphism may not be a host genetic factor associated with the severity of HCV infection, but may be an independent risk factor for HCC. PMID:22200181

  1. Dietary fat interacts with the -514C>T polymorphism in the hepatic lipase gene promoter on plasma lipid profiles in a multiethnic Asian population: the 1998 Singapore National Health Survey.

    PubMed

    Tai, E Shyong; Corella, Dolores; Deurenberg-Yap, Mabel; Cutter, Jeffery; Chew, Suok Kai; Tan, Chee Eng; Ordovas, Jose M

    2003-11-01

    We have previously reported an interaction between -514C>T polymorphism at the hepatic lipase (HL) gene and dietary fat on high-density lipoprotein-cholesterol (HDL-C) metabolism in a representative sample of white subjects participating in the Framingham Heart Study. Replication of these findings in other populations will provide proof for the relevance and consistency of this marker as a tool for risk assessment and more personalized cardiovascular disease prevention. Therefore, we examined this gene-nutrient interaction in a representative sample of Singaporeans (1324 Chinese, 471 Malays and 375 Asian Indians) whose dietary fat intake was recorded by a validated questionnaire. When no stratification by fat intake was considered, the T allele was associated with higher plasma HDL-C concentrations (P = 0.001), higher triglyceride (TG) concentrations (P = 0.001) and higher HDL-C/TG ratios (P = 0.041). We found a highly significant interaction (P = 0.001) between polymorphism and fat intake in determining TG concentration and the HDL-C/TG ratio (P = 0.001) in the overall sample even after adjustment for potential confounders. Thus, TT subjects showed higher TG concentrations only when fat intake supplied >30% of total energy. This interaction was also found when fat intake was considered as continuous (P = 0.035). Moreover, in the upper tertile of fat intake, TT subjects had 45% more TG than CC individuals (P < 0.01). For HDL-C concentration, the gene-diet interaction was significant (P = 0.015) only in subjects of Indian origin. In conclusion, our results indicate that there are differences in the association of -514C>T polymorphism with plasma lipids according to dietary intake and ethnic background. Specifically, the TT genotype is associated with a more atherogenic lipid profile when subjects consume diets with a fat content > 30%. PMID:14608050

  2. CT -- Body

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Body Computed tomography (CT) of the body uses special x-ray ... Body? What is CT Scanning of the Body? Computed tomography, more commonly known as a CT or CAT ...

  3. Fulminant hepatic failure secondary to primary hepatic angiosarcoma.

    PubMed

    Abegunde, Ayokunle T; Aisien, Efe; Mba, Benjamin; Chennuri, Rohini; Sekosan, Marin

    2015-01-01

    Background. Hepatic angiosarcoma is a rare and aggressive tumor that often presents at an advanced stage with nonspecific symptoms. Objective. To report a case of primary hepatic angiosarcoma in an otherwise healthy man with normal liver function tests two months prior to presenting with a short period of jaundice that progressed to fulminant hepatic failure. Methods. Case report and review of literature. Conclusion. This case illustrates the rapidity of progression to death after the onset of symptoms in a patient with hepatic angiosarcoma. Research on early diagnostic strategies and newer therapies are needed to improve prognosis in this rare and poorly understood malignancy with limited treatment options.

  4. Fulminant Hepatic Failure Secondary to Primary Hepatic Angiosarcoma

    PubMed Central

    Abegunde, Ayokunle T.; Aisien, Efe; Mba, Benjamin; Chennuri, Rohini; Sekosan, Marin

    2015-01-01

    Background. Hepatic angiosarcoma is a rare and aggressive tumor that often presents at an advanced stage with nonspecific symptoms. Objective. To report a case of primary hepatic angiosarcoma in an otherwise healthy man with normal liver function tests two months prior to presenting with a short period of jaundice that progressed to fulminant hepatic failure. Methods. Case report and review of literature. Conclusion. This case illustrates the rapidity of progression to death after the onset of symptoms in a patient with hepatic angiosarcoma. Research on early diagnostic strategies and newer therapies are needed to improve prognosis in this rare and poorly understood malignancy with limited treatment options. PMID:25815217

  5. Metastatic pathway-specific transcriptome analysis identifies MFSD4 as a putative tumor suppressor and biomarker for hepatic metastasis in patients with gastric cancer

    PubMed Central

    Tanaka, Haruyoshi; Shibata, Masahiro; Iwata, Naoki; Hayashi, Masamichi; Kobayashi, Daisuke; Tanaka, Chie; Yamada, Suguru; Fujii, Tsutomu; Nakayama, Goro; Sugimoto, Hiroyuki; Koike, Masahiko; Fujiwara, Michitaka; Kodera, Yasuhiro

    2016-01-01

    Gastric cancer (GC) with hepatic metastasis remains a fatal disease. Global expression profiling was conducted using tissues from patients who had GC with synchronous hepatic metastasis, and major facilitator superfamily domain containing 4 (MFSD4) was identified as a candidate biomarker for hepatic metastasis in GC. Functional and expression analyses of this molecule in GC cell lines and clinical samples were conducted. We analyzed MFSD4 expression, DNA methylation, and copy number. RNA interference experiments evaluated the effects of MFSD4 expression on cell phenotype and apoptosis. We analyzed tissues of 200 patients with GC to assess the diagnostic performance of MFSD4 levels for predicting hepatic recurrence, metastasis, or both. Differential expression of MFSD4 mRNA by GC cell lines correlated positively with the levels of NUDT13 and OCLN mRNAs and inversely with those of BMP2. Hypermethylation of the MFSD4 promoter was detected in cells with lower levels of MFSD4 mRNA. Inhibition of MFSD4 expression significantly increased the invasiveness and motility of GC cells but did not influence cell proliferation or apoptosis. MFSD4 mRNA levels in primary GC tissues were reduced in patients with concomitant hepatic metastasis or recurrence compared with those without. Low levels of MFSD4 mRNA in primary GC tissues were an independent risk factor of hepatic recurrence and metastasis. MFSD4 expression in gastric tissues may represent a useful biomarker for identification of patients at high risk for hepatic recurrence, metastasis, or both. PMID:26872374

  6. Bcl3-dependent stabilization of CtBP1 is crucial for the inhibition of apoptosis and tumor progression in breast cancer.

    PubMed

    Choi, Hee June; Lee, Ji Min; Kim, Hyunkyung; Nam, Hye Jin; Shin, Hi-Jai R; Kim, Dongha; Ko, Enyoung; Noh, Dong-Young; Kim, Keun Il; Kim, Jung Hwa; Baek, Sung Hee

    2010-09-24

    B-cell lymphoma 3 (Bcl3) is a proto-oncogene upregulated in a wide range of cancers, including breast cancer. Although Bcl3 is known to promote cell proliferation and inhibit apoptosis, the molecular mechanisms underlying the proto-oncogenic function of Bcl3 have not been completely elucidated. To gain insight into the oncogenic role of Bcl3, we applied a proteomic approach, which led to the identification of C-terminal binding protein 1 (CtBP1) as a binding partner of Bcl3. A PXDLS/R motif embedded in Bcl3 was found to mediate the interaction between Bcl3 and CtBP1, which caused the stabilization of CtBP1 by blocking proteasome-dependent degradation. Apoptotic stimuli-induced degradation of CtBP1 was significantly abolished by the upregulation of Bcl3, leading to the sustained repression of pro-apoptotic gene expression and subsequent inhibition of apoptosis. Intriguingly, a strong positive correlation between the protein levels of Bcl3 and CtBP1 was detected in breast cancer patient samples. Our study reveals a novel combinatorial role for Bcl3 and CtBP1, providing an explanation for the acquisition of resistance to apoptosis in cancer cells, which is a major requirement for cancer development.

  7. CD4+CD25+CD127low Regulatory T Cells Play Predominant Anti-Tumor Suppressive Role in Hepatitis B Virus-Associated Hepatocellular Carcinoma

    PubMed Central

    Sharma, Shreya; Khosla, Ritu; David, Paul; Rastogi, Archana; Vyas, Ashish; Singh, Dileep; Bhardwaj, Ankit; Sahney, Amrish; Maiwall, Rakhi; Sarin, Shiv Kumar; Trehanpati, Nirupma

    2015-01-01

    Background: Hepatocellular carcinoma (HCC) is the second leading cause of cancer death worldwide and hepatitis B is one of the commonest causes. T regulatory cells (Tregs) are strong immunomodulators and are likely to play a major role in HCC development. HBV infection is reported to induce expansion of Tregs. We investigated the CD4+CD25+CD127−veFoxP3+ Tregs in HBV-related HCC as compared to non-HBV-HCC. Patients and Methods: Whole blood immunophenotyping was analyzed by multicolor flow cytometry in patients with HBV-related HCC (HBV-HCC, n = 17), non-HBV-HCC (n = 22; NASH = 16, alcohol-related = 6), and chronic hepatitis B infection (CHBV; n = 10). Tregs functionality was checked by in vitro suppression assays using CD4+ CD25+ CD127low Tregs. Levels of serum alpha-fetoprotein (AFP), expression of FoxP3, IL-10, PD1, TGF-β, and Notch in Tregs, and liver explants were analyzed by flow cytometry, immunohistochemistry, and quantitative RT-PCR. Results: CD4+CD25+hi and Foxp3 expression in CD4+CD25+hiCD127low was significantly increased (P = 0.04, P = 0.007) in HBVHCC compared to non-HBVHCC and CHBV patients. HBVHCC also showed high IL-10 and TGF-β secreting CD4 + CD25 + hiTregs. The PD1 expression in CD4 + CD25+hi was significantly decreased in the HBVHCC than non-HBVHCC. In HBVHCC, AFP levels were significantly high (median 941, range 2–727940) than non-HBVHCC (median 13.5, range 2–18,900). In HBVHCC, patients with high AFP (range; 3982–727940 ng/ml) showed positive correlation with Foxp3 expression in CD4+CD25+hi CD127low (r = 0.857, P = 0.014). Reduced PD1 expression in HBVHCC also had negative correlation with FOXP3 in CD4+CD25+hi CD127low (r = −0.78, P = 0.04). However, AFP levels in non-HBVHCC showed negative correlation with (R = −0.67, P = 0.005) with CD4+CD25+hi Tregs. Conclusion: Our results demonstrate that CD4+ CD25+hi Tregs from HBVHCC patients have decreased expression of PD1

  8. Hepatitis virus panel

    MedlinePlus

    Hepatitis A antibody test; Hepatitis B antibody test; Hepatitis C antibody test; Hepatitis D antibody test ... or past infection, or immunity to hepatitis A Hepatitis B tests: Hepatitis B surface antigen (HBsAg), you have ...

  9. Hepatitis C and HIV

    MedlinePlus

    ... Problems : Hepatitis C Subscribe Translate Text Size Print Hepatitis C What is Hepatitis? Hepatitis means inflammation of the liver. This condition ... our related pages, Hepatitis A and Hepatitis B . Hepatitis C and HIV About 25% of people living ...

  10. Hepatitis B and HIV

    MedlinePlus

    ... Problems : Hepatitis B Subscribe Translate Text Size Print Hepatitis B What is Hepatitis? Hepatitis means inflammation of the liver. This condition ... our related pages, Hepatitis A and Hepatitis C . Hepatitis B and HIV About 10% of people living ...

  11. Prognostication and response assessment in liver and pancreatic tumors: The new imaging

    PubMed Central

    De Robertis, Riccardo; Tinazzi Martini, Paolo; Demozzi, Emanuele; Puntel, Gino; Ortolani, Silvia; Cingarlini, Sara; Ruzzenente, Andrea; Guglielmi, Alfredo; Tortora, Giampaolo; Bassi, Claudio; Pederzoli, Paolo; D’Onofrio, Mirko

    2015-01-01

    Diffusion-weighted imaging (DWI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and perfusion computed tomography (CT) are technical improvements of morphologic imaging that can evaluate functional properties of hepato-bilio-pancreatic tumors during conventional MRI or CT examinations. Nevertheless, the term “functional imaging” is commonly used to describe molecular imaging techniques, as positron emission tomography (PET) CT/MRI, which still represent the most widely used methods for the evaluation of functional properties of solid neoplasms; unlike PET or single photon emission computed tomography, functional imaging techniques applied to conventional MRI/CT examinations do not require the administration of radiolabeled drugs or specific equipments. Moreover, DWI and DCE-MRI can be performed during the same session, thus providing a comprehensive “one-step” morphological and functional evaluation of hepato-bilio-pancreatic tumors. Literature data reveal that functional imaging techniques could be proposed for the evaluation of these tumors before treatment, given that they may improve staging and predict prognosis or clinical outcome. Microscopic changes within neoplastic tissues induced by treatments can be detected and quantified with functional imaging, therefore these techniques could be used also for post-treatment assessment, even at an early stage. The aim of this editorial is to describe possible applications of new functional imaging techniques apart from molecular imaging to hepatic and pancreatic tumors through a review of up-to-date literature data, with a particular emphasis on pathological correlations, prognostic stratification and post-treatment monitoring. PMID:26078555

  12. Primary hepatic benign schwannoma

    PubMed Central

    Hayashi, Michihiro; Takeshita, Atsushi; Yamamoto, Kazuhiro; Tanigawa, Nobuhiko

    2012-01-01

    Schwannoma is predominantly a benign neoplasm of the Schwann cells in the neural sheath of the peripheral nerves. Occurrence of schwannoma in parenchymatous organs, such as liver, is extremely rare. A 64-year-old man without neurofibromatosis was observed to have a space-occupying lesion of 23mm diameter in the liver during follow-up examination for a previously resected gastrointestinal stromal tumor (GIST) in the small intestine. He underwent lateral segmentectomy of the liver under a provisional diagnosis of hepatic metastatic recurrence of the GIST. Histological examination confirmed the diagnosis of a benign schwannoma, confirmed by characteristic pathological findings and positive immunoreactions with the neurogenic marker S-100 protein, but negative for c-kit, or CD34. The tumor was the smallest among the reported cases. When the primary hepatic schwannoma is small in size, preoperative clinical diagnosis is difficult. Therefore, this disease should be listed as differential diagnosis for liver tumor with clinically benign characteristics. PMID:22530081

  13. Bipolar radiofrequency ablation for liver tumors: comparison of contrast-enhanced ultrasound with contrast-enhanced MRI/CT in the posttreatment imaging evaluation

    PubMed Central

    Bo, Xiao-Wan; Xu, Hui-Xiong; Sun, Li-Ping; Zheng, Shu-Guang; Guo, Le-Hang; Lu, Feng; Wu, Jian; Xu, Xiao-Hong

    2014-01-01

    Objective: The aim of the study was to assess the role of contrast-enhanced ultrasound (CEUS) in treatment response evaluation after percutaneous bipolar radiofrequency ablation (BRFA) for liver tumors. Methods: From May 2012 to May 2014, 39 patients with 73 tumors were treated by BRFA. One month after the treatment, CEUS and CEMRI/CECT were conducted to evaluate the treatment response. The results of CEUS were compared with CEMRI/CECT. Results: Of the 73 tumors ablated, eight (11.0%) were found to have residual viable tumor tissue and 65 (89.0%) were successfully ablated based on CEMRI/CECT within 1-month after ablation. CEUS detected seven of the eight residual tumors and 63 of 65 completely ablated tumors. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS were 87.5% (7/8), 96.9% (63/65), 77.8% (7/9), 98.4% (63/64) and 95.9% (70/73), respectively. The complete ablation (CR) rates for the tumors ≤3.0 cm, 3.1-5.0 cm, and >5.0 cm were 96.6% (58/60), 63.6% (7/11), and 0% (0/2), respectively (P<0.001). CR rates were 94.7% (36/38) for primary liver tumors and 82.9% (29/35) for metastatic liver tumors (P=0.212), and were 97.4% (38/39) for the tumors with curative treatment intention and 79.4% (27/34) for those with palliative treatment intention (P=0.037). Major complication was not encountered in this series. Conclusions: BRFA is an effective technique of percutaneous ablation for liver tumors and CEUS can be used to assess its therapeutic effect accurately. PMID:25337258

  14. Hepatic abscesses

    PubMed Central

    Rajagopalan, S.; Langer, V.

    2012-01-01

    Hepatic abscesses are potentially lethal diseases if early diagnosis and treatment are not instituted. They are prevalent all over the globe and pyogenic abscesses are predominant over amoebic. With better control of intra abdominal and systemic infections by a spectrum of antibiotics, aetiology of pyogenic abscesses are secondary to interventions and diseases in the biliary tree to a large extent today. The common organisms isolated are the Gram negative group. Amoebic abscesses continue to plague some regions of the world where hygiene and sanitation are questionable. Over the years, diagnosis, treatment and prognosis have evolved remarkably. Imaging modalities like ultrasonography and CT scan have become the cornerstone of diagnosis. The absence of ionizing radiation makes MRI an attractive alternative in patients who require multiple follow up scans. Serological testing in amoebic abscesses has become more reliable. Though antibiotics have remained the principal modality of management, percutaneous drainage of abscesses have vastly improved the chances of cure and bring down the morbidity drastically in pyogenic abscesses. Amoebic abscesses respond well to medical treatment with nitroimidazoles, and minimally invasive surgical drainage is an option in cases where open surgery is indicated. PMID:24532886

  15. Enrichment of maternal diet with conjugated linoleic acids influences desaturases activity and fatty acids profile in livers and hepatic microsomes of the offspring with 7,12-dimethylbenz[a]anthracene-induced mammary tumors.

    PubMed

    Białek, Agnieszka; Stawarska, Agnieszka; Tokarz, Andrzej; Czuba, Katarzyna; Konarska, Anna; Mazurkiewicz, Magdalena

    2014-01-01

    The aim of this study was to assess the influence of diet supplementation of pregnant and breast-feeding female Sprague-Dawley rats with conjugated linoleic acids (CLA) on the Δ6- and Δ5-desaturase activity in hepatic microsomes as well as on fatty acids profile and lipids peroxidation in liver and hepatic microsomes of the progeny with chemically induced mammary tumors. Rats were divided into two groups with different diet supplementation (vegetable oil (which did not contain CLA) or CLA). Their female offspring was divided within these groups into two subgroups: (1)--fed the same diet as mothers (K1 - oil, 01 - CLA), and (2)--fed the standard fodder (K2, O2). At 50th day of life, the progeny obtained carcinogenic agent (7,12-dimethylbenz[a]anthracene). Higher supply of CLA in diet of mothers resulted in lower susceptibility to chemically induced mammary tumors in their offspring (p = 0.0322). It also influenced the fatty acids profile in livers and in hepatic microsomes, especially polyunsaturated n3 and n6 fatty acids. CLA inhibited the activity of the desaturases, which confirmed that CLA can reduce the level of arachidonic acid directly, reducing linoleic acid content in membranes, or indirectly, through the regulation of its metabolism. We were unable to confirm or deny the antioxidative properties of CLA. Our results indicate that the higher supply of CLA in mothers' diet during pregnancy and breastfeeding causes their incorporation into tissues of children, changes the efficiency of fatty acids metabolism and exerts health-promoting effect in their adult life reducing the breast cancer risk.

  16. Combination Therapy of Transcatheter Arterial Chemoembolization and Arterial Administration of Antiangiogenesis on VX2 Liver Tumor

    SciTech Connect

    Deng Gang; Zhao DenglLing; Li Guangchao; Yu Hui; Teng Gaojun

    2011-08-15

    Purpose: This study was designed to evaluate the antitumorigenic efficiency of Endostar (an antiangiogenic agent) arterially administrated combined with transcatheter arterial chemoembolization (TACE) on liver tumor, and validation of perfusion CT for quantitative measurements of the results.Experimental DesignThirty rabbits bearing VX2 liver tumors were randomly and equally distributed into three groups. One of the following treatment protocols was performed in each group: 1) group 1 was treated with TACE and simultaneously arterially administrated Endostar; 2) group 2 with TACE alone, and 3) a control group that had saline injected through hepatic artery. Routine CT scan was performed before treatment, and perfusion CT imaging was performed 2 weeks after treatment. Immunohistochemical biomarkers of microvascular density (MVD) and the expression of vascular endothelial growth factor (VEGF) were measured for assessments of angiogenesis. Results: We observed a statistically significant reduction from the control in the volume, growth rate, and size of the tumor 2 weeks after treatment with both TACE plus Endostar and with TACE alone (P < 0.01). Although there was no statistically significant difference in tumor size between the group with TACE plus Endostar and the group with TACE alone (P > 0.05), MVD and VEGF were significantly less expressed in the TACE plus Endostar group than both groups with TACE alone and the control group (P < 0.01). Blood flow (BF), blood volume (BV), and permeability-surface area products (PS) in the group with TACE plus Endostar on perfusion CT were significantly higher than other two groups (P < 0.05), which were positively correlated with the MVD and VEGF values (P < 0.05). Conclusions: TACE with arterial administration of Endostar simultaneously significantly inhibited the angiogenesis biomarkers associated with TACE in a rabbit model bearing VX2 liver tumor, which indicates that the combined treatment protocol may have potential

  17. Combined 18F-FDG and 11C-Methionine PET/CT scans in a case of metastatic hepatocellular carcinoma

    PubMed Central

    D’souza, Maria M.; Sharma, Rajnish; Jaimini, Abhinav; Saw, Sanjiv Kumar; Singh, Dinesh; Mondal, Anupam

    2014-01-01

    A 37-year-old male who underwent a central hepatectomy of the liver for hepatocellular carcinoma (HCC) was referred for an 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) study to rule out tumor recurrence or metastases. The scan showed a recurrent hepatic mass at the operative site, along with low-grade uptake in bilateral pulmonary metastases, mediastinal and hilar lymph nodes, and few skeletal sites. A non-FDG avid intracranial extradural mass was visualized in the right frontal lobe. The 11C-methionine PET/CT scan performed subsequently revealed a larger area of involvement at the primary site, along with widespread metastases to the lungs, mediastinal, hilar, and abdominal lymph nodes, and multiple skeletal sites. Further, dural metastasis with high tracer uptake was noted in the frontal region. To the best of our knowledge, this is the first case documented in the literature, wherein 11C-methionine PET/CT played a significant role in delineating the widespread dissemination, including the extremely rare dural involvement in a case of HCC. This report highlights the potential value of 11C-methionine PET/CT in assessing the hepatic and extrahepatic tumor burden in cases of HCC, especially in clinically unexpected locations. PMID:25210286

  18. The fibromatoses: CT-pathologic correlation.

    PubMed

    Francis, I R; Dorovini-Zis, K; Glazer, G M; Lloyd, R V; Amendola, M A; Martel, W

    1986-11-01

    Although CT has been used in the evaluation of benign fibroblastic tumors (fibromatoses), data are lacking on radiologic-histopathologic correlation. In an attempt to explain the variable CT appearance of these lesions, a retrospective analysis was carried out of CT findings and histopathologic features in nine patients with fibromatoses. In three of four patients who had precontrast CT scans, the tumors were hyperdense relative to muscle, whereas in one patient the lesion was hypodense. The postenhancement appearance was variable. The pathologic specimens were analyzed and graded for collagen content, cellular content, tumor necrosis, and tumor vascularity. No consistent relationship could be established between the CT appearance of these lesions and their histologic appearance.

  19. Hepatitis C: Treatment

    MedlinePlus

    ... Public Home » Hepatitis C » Hepatitis C Treatment Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... Enter ZIP code here Enter ZIP code here Hepatitis C Treatment for Veterans and the Public Treatment ...

  20. Hepatitis C and Incarceration

    MedlinePlus

    HEPATITIS C & INCARCERATION What is hepatitis? “Hepatitis” means inflammation or swelling of the liver. The liver is an important ... viral hepatitis: Hepatitis A, Hepatitis B, and Hepatitis C. They are all different from each other and ...

  1. Hepatitis A

    MedlinePlus

    ... an inflammation of the liver. One type, hepatitis A, is caused by the hepatitis A virus (HAV). The disease spreads through contact with ... washed in untreated water Putting into your mouth a finger or object that came into contact with ...

  2. Autoimmune hepatitis

    MedlinePlus

    Lupoid hepatitis; Chronic acute liver disease ... This form of hepatitis is an autoimmune disease . The body's immune system cannot tell the difference between healthy body tissue and harmful, outside ...

  3. Hepatitis D

    MedlinePlus

    ... if the hepatitis B virus is also present. Transmission Hepatitis D can be found in the blood, ... other body fluids of people who are infected. Transmission happens when infected body fluid enters another person’s ...

  4. Hepatitis C

    MedlinePlus

    ... 2014 Select a Language: Fact Sheet 507 Hepatitis C WHAT IS HEPATITIS C? HOW IS IT DIAGNOSED? ... treatment may be less likely to work. Hep C treatment is less effective for coinfected people. Cure ...

  5. Dynamic contrast-enhanced CT of head and neck tumors: perfusion measurements using a distributed-parameter tracer kinetic model. Initial results and comparison with deconvolution-based analysis

    NASA Astrophysics Data System (ADS)

    Bisdas, Sotirios; Konstantinou, George N.; Sherng Lee, Puor; Thng, Choon Hua; Wagenblast, Jens; Baghi, Mehran; San Koh, Tong

    2007-10-01

    The objective of this work was to evaluate the feasibility of a two-compartment distributed-parameter (DP) tracer kinetic model to generate functional images of several physiologic parameters from dynamic contrast-enhanced CT data obtained of patients with extracranial head and neck tumors and to compare the DP functional images to those obtained by deconvolution-based DCE-CT data analysis. We performed post-processing of DCE-CT studies, obtained from 15 patients with benign and malignant head and neck cancer. We introduced a DP model of the impulse residue function for a capillary-tissue exchange unit, which accounts for the processes of convective transport and capillary-tissue exchange. The calculated parametric maps represented blood flow (F), intravascular blood volume (v1), extravascular extracellular blood volume (v2), vascular transit time (t1), permeability-surface area product (PS), transfer ratios k12 and k21, and the fraction of extracted tracer (E). Based on the same regions of interest (ROI) analysis, we calculated the tumor blood flow (BF), blood volume (BV) and mean transit time (MTT) by using a modified deconvolution-based analysis taking into account the extravasation of the contrast agent for PS imaging. We compared the corresponding values by using Bland-Altman plot analysis. We outlined 73 ROIs including tumor sites, lymph nodes and normal tissue. The Bland-Altman plot analysis revealed that the two methods showed an accepted degree of agreement for blood flow, and, thus, can be used interchangeably for measuring this parameter. Slightly worse agreement was observed between v1 in the DP model and BV but even here the two tracer kinetic analyses can be used interchangeably. Under consideration of whether both techniques may be used interchangeably was the case of t1 and MTT, as well as for measurements of the PS values. The application of the proposed DP model is feasible in the clinical routine and it can be used interchangeably for measuring

  6. Adrenal cortex dysfunction: CT findings

    SciTech Connect

    Huebener, K.H.; Treugut, H.

    1984-01-01

    The computed tomographic appearance of the adrenal gland was studied in 302 patients with possible endocrinologic disease and 107 patients undergoing CT for nonendocrinologic reasons. Measurements of adrenal size were also made in 100 adults with no known adrenal pathology. CT proved to be a sensitive diagnostic tool in combination with clinical studies. When blood hormone levels are increased, CT can differentiate among homogeneous organic hyperplasia, nodular hyperplasia, benign adenoma, and malignant cortical adenoma. When blood hormone levels are decreased, CT can demonstrate hypoplasia or metastatic tumorous destruction. Calcifications can be demonstrated earlier than on plain radiographs. When hormone elimination is increased, the morphologic substrate can be identified; tumorous changes can be localized and infiltration of surrounding organs recognized.

  7. Hepatitis A

    MedlinePlus

    ... Organizations ​​ (PDF, 341 KB)​​​​​ Alternate Language URL Español Hepatitis A Page Content On this page: What is ... Nutrition Points to Remember Clinical Trials What is hepatitis A? Hepatitis * A is a virus , or infection, ...

  8. Autoimmune Hepatitis

    MedlinePlus

    ... Organizations ​​ (PDF, 341 KB)​​​​​ Alternate Language URL Autoimmune Hepatitis Page Content On this page: What is autoimmune ... Points to Remember Clinical Trials What is autoimmune hepatitis? Autoimmune hepatitis is a chronic—or long lasting— ...

  9. Hepatitis C

    MedlinePlus

    ... an inflammation of the liver. One type, hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with ... childbirth. Most people who are infected with hepatitis C don't have any symptoms for years. If ...

  10. Segmentation of liver region with tumorous tissues

    NASA Astrophysics Data System (ADS)

    Zhang, Xuejun; Lee, Gobert; Tajima, Tetsuji; Kitagawa, Teruhiko; Kanematsu, Masayuki; Zhou, Xiangrong; Hara, Takeshi; Fujita, Hiroshi; Yokoyama, Ryujiro; Kondo, Hiroshi; Hoshi, Hiroaki; Nawano, Shigeru; Shinozaki, Kenji

    2007-03-01

    Segmentation of an abnormal liver region based on CT or MR images is a crucial step in surgical planning. However, precisely carrying out this step remains a challenge due to either connectivities of the liver to other organs or the shape, internal texture, and homogeneity of liver that maybe extensively affected in case of liver diseases. Here, we propose a non-density based method for extracting the liver region containing tumor tissues by edge detection processing. False extracted regions are eliminated by a shape analysis method and thresholding processing. If the multi-phased images are available then the overall outcome of segmentation can be improved by subtracting two phase images, and the connectivities can be further eliminated by referring to the intensity on another phase image. Within an edge liver map, tumor candidates are identified by their different gray values relative to the liver. After elimination of the small and nonspherical over-extracted regions, the final liver region integrates the tumor region with the liver tissue. In our experiment, 40 cases of MDCT images were used and the result showed that our fully automatic method for the segmentation of liver region is effective and robust despite the presence of hepatic tumors within the liver.

  11. Simultaneous SPECT imaging of multi-targets to assist in identifying hepatic lesions

    PubMed Central

    Guo, Zhide; Gao, Mengna; Zhang, Deliang; Li, Yesen; Song, Manli; Zhuang, Rongqiang; Su, Xinhui; Chen, Guibing; Liu, Ting; Liu, Pingguo; Wu, Hua; Du, Jin; Zhang, Xianzhong

    2016-01-01

    Molecular imaging technique is an attractive tool to detect liver disease at early stage. This study aims to develop a simultaneous dual-isotope single photon emission computed tomography (SPECT)/CT imaging method to assist diagnosis of hepatic tumor and liver fibrosis. Animal models of liver fibrosis and orthotopic human hepatocellular carcinoma (HCC) were established. The tracers of 131I-NGA and 99mTc-3P-RGD2 were selected to target asialoglycoprotein receptor (ASGPR) on the hepatocytes and integrin αvβ3 receptor in tumor or fibrotic liver, respectively. SPECT imaging and biodistribution study were carried out to verify the feasibility and superiority. As expected, 99mTc-3P-RGD2 had the ability to evaluate liver fibrosis and detect tumor lesions. 131I-NGA showed that it was effective in assessing the anatomy and function of the liver. In synchronized dual-isotope SPECT/CT imaging, clear fusion images can be got within 30 minutes for diagnosing liver fibrosis and liver cancer. This new developed imaging approach enables the acquisition of different physiological information for diagnosing liver fibrosis, liver cancer and evaluating residual functional liver volume simultaneously. So synchronized dual-isotope SPECT/CT imaging with 99mTc-3P-RGD2 and 131I-NGA is an effective approach to detect liver disease, especially liver fibrosis and liver cancer. PMID:27377130

  12. Validation of nonrigid registration in pretreatment and follow-up PET/CT scans for quantification of tumor residue in lung cancer patients.

    PubMed

    Spijkerman, Jolanda; Fontanarosa, Davide; Das, Marco; Van Elmpt, Wouter

    2014-01-01

    Nonrigid registrations of pre- and postradiotherapy (RT) PET/CT scans of NSCLC patients were performed with different algorithms and validated tracking internal landmarks. Dice overlap ratios (DR) of high FDG-uptake areas in registered PET/CT scans were then calculated to study patterns of relapse. For 22 patients, pre- and post-RT PET/CT scans were registered first rigidly and then nonrigidly. For three patients, two types (based on Demons or Morphons) of nonrigid registration algorithms each with four different parameter settings were applied and assessed using landmark validation. The two best performing methods were tested on all patients, who were then classified into three groups: large (Group 1), minor (Group2) or insufficient improvement (Group 3) of registration accuracy. For Group 1 and 2, DRs between high FDG-uptake areas in pre- and post-RT PET scans were determined. Distances between corresponding landmarks on deformed pre-RT and post-RT scans decreased for all registration methods. Differences between Demons and Morphons methods were smaller than 1 mm. For Group 1, landmark distance decreased from 9.5 ± 2.1 mm to 3.8 ± 1.2 mm (mean ± 1 SD, p < 0.001), and for Group 3 from 13.6 ± 3.2 mm to 8.0 ± 2.2 mm (p = 0.025). No significant change was observed for Group 2 where distances decreased from 5.6± 1.3 mm to 4.5 ± 1.1 mm (p = 0.093). DRs of high FDG-uptake areas improved significantly after nonrigid registration for most patients in Group 1. Landmark validation of nonrigid registration methods for follow-up CT imaging in NSCLC is necessary. Nonrigid registration significantly improves matching between pre- and post-RT CT scans for a subset of patients, although not in all patients. Hence, the quality of the registration needs to be assessed for each patient individually. Successful nonrigid registration increased the overlap between pre- and post-RT high FDG-uptake regions. PMID:25207414

  13. Comparison of IGRT Registration Strategies for Optimal Coverage of Primary Lung Tumors and Involved Nodes Based on Multiple Four-Dimensional CT Scans Obtained Throughout the Radiotherapy Course

    SciTech Connect

    Mohammed, Nasiruddin; Kestin, Larry; Grills, Inga; Shah, Chirag; Glide-Hurst, Carri; Yan, Di; Ionascu, Dan

    2012-03-15

    Purpose: To investigate the impact of primary tumor and involved lymph node (LN) geometry (centroid, shape, volume) on internal target volume (ITV) throughout treatment for locally advanced non-small cell lung cancer using weekly four-dimensional computed tomography (4DCT). Methods and Materials: Eleven patients with advanced non-small cell lung cancer were treated using image-guided radiotherapy with acquisition of weekly 10-Phase 4DCTs (n = 51). Initial ITV was based on planning 4DCT. Master-ITV incorporated target geometry across the entire treatment (all 4DCTs). Geographic miss was defined as the % Master-ITV positioned outside of the initial planning ITV after registration is complete. Registration strategies considered were bony (B), primary tumor soft tissue alone (T), and registration based on primary tumor and involved LNs (T{sub L}N). Results: The % geographic miss for the primary tumor, mediastinal, and hilar lymph nodes based on each registration strategy were (1) B: 30%, 30%, 30%; (2) T: 21%, 40%, 36%; and (3) T{sub L}N: 26%, 26%, 27%. Mean geographic expansions to encompass 100% of the primary tumor and involved LNs were 1.2 {+-} 0.7 cm and 0.8 {+-} 0.3 cm, respectively, for B and T{sub L}N. Primary and involved LN expansions were 0.7 {+-} 0.5 cm and 1.1 {+-} 0.5 cm for T. Conclusion: T is best for solitary targets. When treatments include primary tumor and LNs, B and T{sub L}N provide more comprehensive geographic coverage. We have identified high % geographic miss when considering multiple registration strategies. The dosimetric implications are the subject of future study.

  14. Radiofrequency Ablation Assisted by Real-Time Virtual Sonography and CT for Hepatocellular Carcinoma Undetectable by Conventional Sonography

    SciTech Connect

    Nakai, Motoki Sato, Morio; Sahara, Shinya; Takasaka, Isao; Kawai, Nobuyuki; Minamiguchi, Hiroki; Tanihata, Hirohiko; Kimura, Masashi; Takeuchi, Nozomu

    2009-01-15

    Real-time virtual sonography (RVS) is a diagnostic imaging support system, which provides the same cross-sectional multiplanar reconstruction images as ultrasound images on the same monitor screen in real time. The purpose of this study was to evaluate radiofrequency ablation (RFA) assisted by RVS and CT for hepatocellular carcinoma (HCC) undetectable with conventional sonography. Subjects were 20 patients with 20 HCC nodules not detected by conventional sonography but detectable by CT or MRI. All patients had hepatitis C-induced liver cirrhosis; there were 13 males and 7 females aged 55-81 years (mean, 69.3 years). RFA was performed in the CT room, and the tumor was punctured with the assistance of RVS. CT was performed immediately after puncture, and ablation was performed after confirming that the needle had been inserted into the tumor precisely. The mean number of punctures and success rates of the first puncture were evaluated. Treatment effects were evaluated with dynamic CT every 3 months after RFA. RFA was technically feasible and local tumor control was achieved in all patients. The mean number of punctures was 1.1, and the success rate of the first puncture was 90.0%. This method enabled safe ablation without complications. The mean follow-up period was 13.5 month (range, 9-18 months). No local recurrence was observed at the follow-up points. In conclusion, RFA assisted by RVS and CT is a safe and efficacious method of treatment for HCC undetectable by conventional sonography.

  15. Hepatic hemangioma -review-.

    PubMed

    Bajenaru, N; Balaban, V; Săvulescu, F; Campeanu, I; Patrascu, T

    2015-01-01

    Hepatic hemangiomas are benign tumors of the liver consisting of clusters of blood-filled cavities, lined by endothelial cells, fed by the hepatic artery. The vast majority of HH are asymptomatic, most often being discovered incidentally during imaging investigations for various unrelated pathologies. Typical hemangiomas, the so-called capillary hemangiomas, range from a few mm to 3 cm, do not increase in size over time and therefore are unlikely to generate future symptomatology. Small (mm-3 cm) and medium (3 cm-10 cm) hemangiomas are well-defined lesions, requiring no active treatment beside regular follow-ups. However, the so-called giant liver hemangiomas, of up to 10 cm (most commonly) and even 20+ cm in size (according to occasional reports) can, and usually will develop symptoms and complications that require prompt surgical intervention or other kind of therapy. HH belong to the class of hepatic "incidentalomas", so-called because they are diagnosed incidentally, on imaging studies performed as routine examinations or for other reasons than the evaluation of a possible liver mass. Less than half of HH present with overt clinical symptoms, consisting, most often, of upper abdominal pain (this is usually the case for large lesions, which cause the distension of Glisson's capsule). Hepatic hemangiomas require a careful diagnosis to differentiate from other focal hepatic lesions, co-occurring diagnoses are also possible.

  16. LNA aptamer based multi-modal, Fe3O4-saturated lactoferrin (Fe3O4-bLf) nanocarriers for triple positive (EpCAM, CD133, CD44) colon tumor targeting and NIR, MRI and CT imaging.

    PubMed

    Roy, Kislay; Kanwar, Rupinder K; Kanwar, Jagat R

    2015-12-01

    , survivin splice variant (survivin 2B) and other anti-apoptotic proteins Bad, Bcl-2 and XIAP. Apart from the promising anti-cancer efficacy and the exceptional tumor targeting ability observed by multimodal imaging using near-infrared (NIR) imaging, magnetic resonance imaging (MRI) and computerized tomographic (CT) techniques, these NCs also maintained the immunomodulatory benefits of bLf as they were able to increase the RBC, hemoglobin, iron calcium and zinc levels in mice. PMID:26318819

  17. (18)F-FDG PET/CT for Monitoring the Response of Breast Cancer to miR-143-Based Therapeutics by Targeting Tumor Glycolysis.

    PubMed

    Miao, Ying; Zhang, Ling-Fei; Guo, Rui; Liang, Sheng; Zhang, Min; Shi, Shuo; Shang-Guan, Cheng-Fang; Liu, Mo-Fang; Li, Biao

    2016-01-01

    Increased glucose utilization is a hallmark of cancer, and tumor metabolism is emerging as anticancer target for therapeutic intervention. Triple-negative breast cancers TNBC are highly glycolytic and show poor clinical outcomes. We previously identified hexokinase 2, the major glycolytic enzyme, as a target gene of miR-143 in TNBC. Here, we developed a therapeutic formulation using cholesterol-modified miR-143 agomir encapsulated in a neutral lipid-based delivery agent that blocked tumor growth and glucose metabolism in TNBC tumor-bearing mice when administered systemically. The antioncogenic effects were accompanied by a reduction in the direct target hexokinase 2 and [(18)F]-fluorodeoxyglucose ((18)F-FDG) uptake based on positron emission tomography/computed tomography. Treatment with miR-143 formulation has minimal toxic effects and mice tolerated it well. Thus, we demonstrated that miR-143 is a robust inhibitor of the Warburg effect and an effective therapeutic target for TNBC. In addition, (18)F-FDG positron emission tomography/computed tomography can be used to specifically monitor the response of TNBC to miR-143-based therapeutics by targeting tumor glycolysis. PMID:27574783

  18. 18F-FDG PET/CT for Monitoring the Response of Breast Cancer to miR-143-Based Therapeutics by Targeting Tumor Glycolysis

    PubMed Central

    Miao, Ying; Zhang, Ling-fei; Guo, Rui; Liang, Sheng; Zhang, Min; Shi, Shuo; Shang-Guan, Cheng-fang; Liu, Mo-fang; Li, Biao

    2016-01-01

    Increased glucose utilization is a hallmark of cancer, and tumor metabolism is emerging as anticancer target for therapeutic intervention. Triple-negative breast cancers TNBC are highly glycolytic and show poor clinical outcomes. We previously identified hexokinase 2, the major glycolytic enzyme, as a target gene of miR-143 in TNBC. Here, we developed a therapeutic formulation using cholesterol-modified miR-143 agomir encapsulated in a neutral lipid-based delivery agent that blocked tumor growth and glucose metabolism in TNBC tumor-bearing mice when administered systemically. The antioncogenic effects were accompanied by a reduction in the direct target hexokinase 2 and [18F]-fluorodeoxyglucose (18F-FDG) uptake based on positron emission tomography/computed tomography. Treatment with miR-143 formulation has minimal toxic effects and mice tolerated it well. Thus, we demonstrated that miR-143 is a robust inhibitor of the Warburg effect and an effective therapeutic target for TNBC. In addition, 18F-FDG positron emission tomography/computed tomography can be used to specifically monitor the response of TNBC to miR-143-based therapeutics by targeting tumor glycolysis. PMID:27574783

  19. First Left Hepatic Trisectionectomy Including Segment One with New Associated Liver Partition and Portal Vein Ligation with Staged Hepatectomy (ALPPS) Modification: How To Do It?

    PubMed Central

    Obed, Aiman; Jarrad, Anwar; Bashir, Abdalla

    2016-01-01

    Patient: Female, 36 Final Diagnosis: Synchronic CRLM Symptoms: Abdominal pain • abnormal finding in abdominal-pelvic CT scan Medication: — Clinical Procedure: Extended left hepatectomy with left hemicolectomy Specialty: Surgery Objective: Unusual clinical course Background: Associated Liver Partition and Portal vein ligation with Staged hepatectomy (ALPPS) leads to rapid hepatic hypertrophy and decreases incidence of post-hepatectomy liver failure in patients with a marginal future liver remnant. Various procedural ALPPS modifications were previously described. Here, we present the first case of a new ALPPS modification, carrying out a left hepatic trisectionectomy with segment 1. Case Report: We present the case of a 36-year-old woman with locally advanced sigmoid adeno-carcinoma and extensive left liver metastases extending to segment V and VIII, who received state-of-the-art systemic conversion chemotherapy. Preoperative CT volumetric scan demonstrated a FLR/TLV (Future Liver Remnant/Total Liver Volume) of 22%. A left hepatic trisectionectomy procedure was conducted using our new ALPPS modification. Sufficient hepatic hypertrophy of FLR was reached with a volume increase of 100%. The period between the 2 stages was 7 days. The patient underwent left trisectionectomy and left colectomy with tumor-free margins. All dissected lymph nodes were tumor-negative. The surgical intra- and postoperative course was uneventful. Medically, the patient acquired an Acinetobacter infection, with severe sepsis and acute renal injury. After 3 dialysis sessions, the renal function recovered completely. Afterwards, the patient recovered slowly, and reintroduction ambulation and oral feeding was prolonged. Later on, the patient received Xeloda 1500 mg twice daily as adjuvant chemotherapy. Conclusions: The new ALPPS modification leads to a sufficient hypertrophy of FRL within 1 week, allowing left hepatic trisectionectomy with tumor-free FRL. Despite the challenging complications

  20. Hepatitis Vaccines

    PubMed Central

    Ogholikhan, Sina; Schwarz, Kathleen B.

    2016-01-01

    Viral hepatitis is a serious health problem all over the world. However, the reduction of the morbidity and mortality due to vaccinations against hepatitis A and hepatitis B has been a major component in the overall reduction in vaccine preventable diseases. We will discuss the epidemiology, vaccine development, and post-vaccination effects of the hepatitis A and B virus. In addition, we discuss attempts to provide hepatitis D vaccine for the 350 million individuals infected with hepatitis B globally. Given the lack of a hepatitis C vaccine, the many challenges facing the production of a hepatitis C vaccine will be shown, along with current and former vaccination trials. As there is no current FDA-approved hepatitis E vaccine, we will present vaccination data that is available in the rest of the world. Finally, we will discuss the existing challenges and questions facing future endeavors for each of the hepatitis viruses, with efforts continuing to focus on dramatically reducing the morbidity and mortality associated with these serious infections of the liver. PMID:26978406

  1. [Autoimmune hepatitis].

    PubMed

    Ostojić, Rajko

    2003-01-01

    Autoimmune hepatitis is an unresolving, hepatocellular inflammation of unknown cause that is characterized by the presence of periportal hepatitis on histologic examination, tissue autoantibodies in serum, and hypergammaglobulinemia. By international consensus, the designation autoimmune hepatitis has replaced alternative terms for the condition. Three types of autoimmune hepatitis have been proposed based on immunoserologic findings. Type 1 autoimmune hepatitis is characterized by the presence of antinuclear antibodies (ANA) or smooth muscle antibodies (SMA) (or both) in serum. Seventy percent of patients with type 1 of autoimmune hepatitis are women. This type is the most common form and accounts for at least 80% of cases. Type 2 is characterized by the presence of antibodies to liver-kidney microsome type 1 (anti-LKM1) in serum. Patients with this type of autoimmune hepatitis are predominantly children. Type 3 autoimmune hepatitis is characterized by the presence of antibodies to soluble liver antigen (anti-SLA) in serum. There are no individual features that are pathognomonic of autoimmune hepatitis, and its diagnosis requires the confident exclusion of other conditions. The large majority of patients show satisfactory response to corticosteroid (usually prednisone or prednisolone) therapy. For the past 30 years it has been customary to add azathioprine as a "steroid sparing" agent to allow lower doses of steroids to be used and remission, once achieved, can be sustained in many patients with azathioprine alone after steroid withdrawal. Patients with autoimmune hepatitis who have decompensated during or after corticosteroid therapy are candidates for liver transplantation.

  2. Viral hepatitis*

    PubMed Central

    Deinhardt, F.; Gust, I. D.

    1982-01-01

    Three forms of viral hepatitis can be recognized: hepatitis A, hepatitis B, and hepatitis non-A, non-B. Hepatitis A is caused by a picornavirus, is transmitted by the faceal—oral route, does not become chronic, and no chronic virus carriers exist. The virus can be grown in cell cultures, and killed as well as live attenuated virus vaccines are under development. Hepatitis B is caused by an enveloped virus containing a circular, double-stranded form of DNA. The disease is transmitted parenterally through inoculation of blood or blood products containing virus or through close personal contact with a virus-positive person. Hepatitis B becomes chronic in a certain number of cases and can lead to cirrhosis and primary liver cell carcinoma. The blood and certain body secretions of individuals with a persistent or chronic infection may remain infectious for many years. The hepatitis B virus cannot be grown in cell cultures but the entire genome has been sequenced and cloned in bacterial and eukaryotic cells. An inactivated virus vaccine has been prepared from hepatitis B surface antigen present in the plasma of hepatitis B virus carriers and further vaccines are under development. The agents of hepatitis non-A, non-B have not been identified. It is possible to distinguish between a predominantly parenterally transmitted and an orally transmitted form of hepatitis non-A, non-B. The latter is reported to be caused by a picornavirus that does not, however, have any antigenic relationship with hepatitis A virus. PMID:6817933

  3. MR and CT appearance of cardiac hemangioma

    SciTech Connect

    Kemp, J.L.; Kessler, R.M.; Raizada, V.; Williamson, M.R.

    1996-05-01

    We present a case of cardiac hemangioma in a symptomatic patient. MR and CT each have specific characteristics that should make one consider including or excluding this in the differential diagnosis of a cardiac tumor. 7 refs., 3 figs.

  4. Autoimmune hepatitis.

    PubMed

    Roberts, E A

    1995-01-01

    Autoimmune hepatitis can present as either acute or chronic disease in children. Clinical and laboratory features, including association with extrahepatic autoimmune syndromes and prompt response to immunosuppressive treatment, circulating autoantibodies and hypergammaglobulinemia, suggest an immune etiology. However, the disease mechanism remains uncertain. Different types of autoimmune hepatitis are defined on the basis of which autoantibodies are present: anti-smooth muscle (type 1), anti-liver/kidney microsomal (type 2), or anti-soluble liver antigen (type 3). Diseases which may be clinically similar to autoimmune hepatitis must be excluded before the diagnosis of autoimmune hepatitis is established: Wilson's disease, primary sclerosing cholangitis, chronic hepatitis B or C, and drug-induced liver disease are among the most important entities. Corticosteroids alone or with azathioprine constitute the usual treatment for autoimmune hepatitis. Although some children achieve a complete remission, or even recovery, and can stop immunosuppressive treatment, others required low-dose prednisone treatment indefinitely.

  5. Hepatitis B Vaccine

    MedlinePlus

    ... as a combination product containing Hepatitis A Vaccine, Hepatitis B Vaccine) ... What is hepatitis B?Hepatitis B is a serious infection that affects the liver. It is caused by the hepatitis B virus. ...

  6. Hepatitis C: Clinical Trials

    MedlinePlus

    ... and Public Home » Hepatitis C » Treatment Decisions Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... can I find out about participating in a hepatitis C clinical trial? Many trials are being conducted ...

  7. Hepatitis B

    MedlinePlus

    ... A Hepatitis B HPV (Human Papillomavirus) Influenza (Flu) Measles Meningococcal Disease Mumps Pertussis (Whooping Cough) Pneumococcal Disease Rubella (German Measles) Shingles (Herpes Zoster) Tetanus (Lockjaw) Professional Resources Adult ...

  8. Hepatic epithelioid hemangioendothelioma metastasized to the peritoneum, omentum and mesentery: a case report.

    PubMed

    Gurung, Sanita; Fu, Hua; Zhang, Wei Wen; Gu, Yong Hong

    2015-01-01

    Epithelioid hemangioendothelioma (EHAE) is a malignant vascular tumor derived from endothelial cell often misdiagnosed as Hepatic carcinoma on the basis of radiological features. Till now etiology of this rare curiosity is unknown but it is related with use of oral contraceptives pills (OCP), liver trauma, exposure to vinyl chloride and hepatitis. We herein report on a case which failed to be diagnosed by cytopathology, computed tomography (CT) and magnetic resonance imaging (MRI). Patient was a 46 yr old man presented with abdominal distension for a month. Initial liver function test (LFT) was increased whereas renal function test (RFT) and alpha-fetoprotein (AFP) were normal. His abdominal ultrasound revealed multiple hypoechoic nodules and multiple liver calcifications. Subsequently laparoscopic omental biopsy and Ultrasound guided liver biopsy was done showing the neoplastic cells scattered in fibrous stroma. The immunohistochemistry for endothelial tumor cells stained positive for Vimentin (+++), CD10 (+++), CD34 (++), CD31 (+), Factor VIII antigen (focal) (+) and low proliferative activity for ki-67. Our case is very interesting in which patient admitted with nonspecific symptoms of abdominal pain and diagnosed to be a Malignant Hepatic EHAE metastasized to the peritoneum, omentum and mesentery. The patient was on thalidomide 50 mg/day and increased to 100 mg/day. 5-Flurouracil (FU) intraperitoneal chemotherapy and other symptomatic and supportive treatment was given to the patient. Our case highlights on the importance of immunohistopathological diagnosis, compare the radiological findings of this disease and discuss the treatment strategy with review of available literature. PMID:26191313

  9. Preoperative staging of colorectal cancer: CT vs. integrated FDG PET/CT.

    PubMed

    Shin, Sang Soo; Jeong, Yong Yeon; Min, Jung Jun; Kim, Hyeong Rok; Chung, Tae Woong; Kang, Heoung Keun

    2008-01-01

    Accurate preoperative staging is essential in determining the optimal therapeutic planning for individual patients. The computed tomography (CT) in the preoperative staging of colorectal cancer, even if controversial, may be useful for planning surgery and/or neoadjuvant therapy, particularly when local tumor extension into adjacent organs or distant metastases are detected. There have been significant changes in the CT technology with the advent of multi-detector row CT (MDCT) scanner. Advances in CT technology have raised interest in the potential role of CT for detection and staging of colorectal cancer. In recent studies, MDCT with MPR images has shown promising accuracy in the evaluation of local extent and nodal involvement of colorectal cancer. Combined PET/CT images have significant advantages over either alone because it provides both functional and anatomical data. Therefore, it is natural to expect that PET/CT would improve the accuracy of preoperative staging of colorectal cancer. The most significant additional information provided by PET/CT relates to the accurate detection of distant metastases. For the evaluation of patients with colorectal cancer, CT has relative advantages over PET/CT in regard to the depth of tumor invasion through the wall, extramural extension, and regional lymph node metastases. PET/CT should be performed on selected patients with suggestive but inconclusive metastatic lesions with CT. In addition, PET/CT with dedicated CT protocols, such as contrast-enhanced PET/CT and PET/CT colonography, may replace the diagnostic CT for the preoperative staging of colorectal cancer.

  10. PET/CT in radiation oncology

    SciTech Connect

    Pan, Tinsu; Mawlawi, Osama

    2008-11-15

    PET/CT is an effective tool for the diagnosis, staging and restaging of cancer patients. It combines the complementary information of functional PET images and anatomical CT images in one imaging session. Conventional stand-alone PET has been replaced by PET/CT for improved patient comfort, patient throughput, and most importantly the proven clinical outcome of PET/CT over that of PET and that of separate PET and CT. There are over two thousand PET/CT scanners installed worldwide since 2001. Oncology is the main application for PET/CT. Fluorine-18 deoxyglucose is the choice of radiopharmaceutical in PET for imaging the glucose uptake in tissues, correlated with an increased rate of glycolysis in many tumor cells. New molecular targeted agents are being developed to improve the accuracy of targeting different disease states and assessing therapeutic response. Over 50% of cancer patients receive radiation therapy (RT) in the course of their disease treatment. Clinical data have demonstrated that the information provided by PET/CT often changes patient management of the patient and/or modifies the RT plan from conventional CT simulation. The application of PET/CT in RT is growing and will become increasingly important. Continuing improvement of PET/CT instrumentation will also make it easier for radiation oncologists to integrate PET/CT in RT. The purpose of this article is to provide a review of the current PET/CT technology, to project the future development of PET and CT for PET/CT, and to discuss some issues in adopting PET/CT in RT and potential improvements in PET/CT simulation of the thorax in radiation therapy.

  11. Interleukin-1 and tumor necrosis factor-α trigger restriction of hepatitis B virus infection via a cytidine deaminase activation-induced cytidine deaminase (AID).

    PubMed

    Watashi, Koichi; Liang, Guoxin; Iwamoto, Masashi; Marusawa, Hiroyuki; Uchida, Nanako; Daito, Takuji; Kitamura, Kouichi; Muramatsu, Masamichi; Ohashi, Hirofumi; Kiyohara, Tomoko; Suzuki, Ryosuke; Li, Jisu; Tong, Shuping; Tanaka, Yasuhito; Murata, Kazumoto; Aizaki, Hideki; Wakita, Takaji

    2013-11-01

    Virus infection is restricted by intracellular immune responses in host cells, and this is typically modulated by stimulation of cytokines. The cytokines and host factors that determine the host cell restriction against hepatitis B virus (HBV) infection are not well understood. We screened 36 cytokines and chemokines to determine which were able to reduce the susceptibility of HepaRG cells to HBV infection. Here, we found that pretreatment with IL-1β and TNFα remarkably reduced the host cell susceptibility to HBV infection. This effect was mediated by activation of the NF-κB signaling pathway. A cytidine deaminase, activation-induced cytidine deaminase (AID), was up-regulated by both IL-1β and TNFα in a variety of hepatocyte cell lines and primary human hepatocytes. Another deaminase APOBEC3G was not induced by these proinflammatory cytokines. Knockdown of AID expression impaired the anti-HBV effect of IL-1β, and overexpression of AID antagonized HBV infection, suggesting that AID was one of the responsible factors for the anti-HBV activity of IL-1/TNFα. Although AID induced hypermutation of HBV DNA, this activity was dispensable for the anti-HBV activity. The antiviral effect of IL-1/TNFα was also observed on different HBV genotypes but not on hepatitis C virus. These results demonstrate that proinflammatory cytokines IL-1/TNFα trigger a novel antiviral mechanism involving AID to regulate host cell permissiveness to HBV infection.

  12. Interleukin-1 and Tumor Necrosis Factor-α Trigger Restriction of Hepatitis B Virus Infection via a Cytidine Deaminase Activation-induced Cytidine Deaminase (AID)*

    PubMed Central

    Watashi, Koichi; Liang, Guoxin; Iwamoto, Masashi; Marusawa, Hiroyuki; Uchida, Nanako; Daito, Takuji; Kitamura, Kouichi; Muramatsu, Masamichi; Ohashi, Hirofumi; Kiyohara, Tomoko; Suzuki, Ryosuke; Li, Jisu; Tong, Shuping; Tanaka, Yasuhito; Murata, Kazumoto; Aizaki, Hideki; Wakita, Takaji

    2013-01-01

    Virus infection is restricted by intracellular immune responses in host cells, and this is typically modulated by stimulation of cytokines. The cytokines and host factors that determine the host cell restriction against hepatitis B virus (HBV) infection are not well understood. We screened 36 cytokines and chemokines to determine which were able to reduce the susceptibility of HepaRG cells to HBV infection. Here, we found that pretreatment with IL-1β and TNFα remarkably reduced the host cell susceptibility to HBV infection. This effect was mediated by activation of the NF-κB signaling pathway. A cytidine deaminase, activation-induced cytidine deaminase (AID), was up-regulated by both IL-1β and TNFα in a variety of hepatocyte cell lines and primary human hepatocytes. Another deaminase APOBEC3G was not induced by these proinflammatory cytokines. Knockdown of AID expression impaired the anti-HBV effect of IL-1β, and overexpression of AID antagonized HBV infection, suggesting that AID was one of the responsible factors for the anti-HBV activity of IL-1/TNFα. Although AID induced hypermutation of HBV DNA, this activity was dispensable for the anti-HBV activity. The antiviral effect of IL-1/TNFα was also observed on different HBV genotypes but not on hepatitis C virus. These results demonstrate that proinflammatory cytokines IL-1/TNFα trigger a novel antiviral mechanism involving AID to regulate host cell permissiveness to HBV infection. PMID:24025329

  13. Genetic polymorphisms in tumor necrosis factor (TNF)-alpha and TNF-beta in a population-based study of systemic lupus erythematosus: associations and interaction with the interleukin-1alpha-889 C/T polymorphism.

    PubMed

    Parks, Christine G; Pandey, Janardan P; Dooley, Mary Anne; Treadwell, Edward L; St Clair, E W; Gilkeson, Gary S; Feghali-Bostwick, Carol A; Feghali-Botswick, Carol L; Cooper, Glinda S

    2004-06-01

    Tumor necrosis factor (TNF) is involved in the pathogenesis of systemic lupus erythematosus (SLE), but the role of TNF polymorphisms in SLE susceptibility remains unclear. Previous studies in different populations report an inconsistent association of the TNF-alpha -308A allele with SLE, sometimes depending on the presence of HLA-DR3. We examined the association of polymorphisms in TNF-alpha (-308G/A, -238G/A) and TNFbeta (+252A/G) in a population-based study of SLE in the southeastern United States and considered TNF-SLE associations with respect to HLA-DR3 and DR2 and the interleukin (IL)-1alpha -889C/T polymorphism, previously linked to SLE in this population. Genotypes were analyzed for 230 recently diagnosed SLE patients who met American College of Rheumatology classification criteria and 276 age- and sex-matched controls, randomly selected from driver's license registries. Carriage of the TNF-alpha -308A allele was significantly associated with SLE in Caucasians (OR = 2.3; 95% CI 1.4, 3.9), but not African Americans. Analyses stratified by IL-1alpha -889 genotypes (C/C vs C/T or T/T) revealed independent associations of SLE with TNF-alpha -308A or HLA-DR2 and DR3. This reflected a significant interaction of TNF and IL-1 genotypes in Caucasians, and yielded a strong association (OR = 8.0, p < 0.00001) for the combined "HLA-DR3, TNF-alpha -308A, IL-1alpha -889C/C" genotype. These findings provide evidence of cytokine gene epistasis in SLE susceptibility.

  14. First-In-Human Study Demonstrating Tumor-Angiogenesis by PET/CT Imaging with 68Ga-NODAGA-THERANOST, a High-Affinity Peptidomimetic for αvβ3 Integrin Receptor Targeting

    PubMed Central

    Baum, Richard P.; Kulkarni, Harshad R.; Müller, Dirk; Danthi, Narasimhan; Kim, Young-Seung; Brechbiel, Martin W.

    2015-01-01

    Abstract 68Ga-NODAGA-THERANOST™ is an αvβ3 integrin antagonist and the first radiolabeled peptidomimetic to reach clinical development for targeting integrin receptors. In this first-in-human study, the feasibility of integrin receptor peptidomimetic positron emission tomography/computed tomography (PET/CT) imaging was confirmed in patients with non-small-cell lung cancer and breast cancer. Methods: Patients underwent PET/CT imaging with 68Ga NODAGA-THERANOST. PET images were analyzed qualitatively and quantitatively and compared to 2-deoxy-2-(18F) fluoro-d-glucose (18F-FDG) findings. Images were obtained 60 minutes postinjection of 300–500 MBq of 68Ga-NODAGA-THERANOST. Results: 68Ga-NODAGA-THERANOST revealed high tumor-to-background ratios (SUVmax=4.8) and uptake at neoangiogenesis sites. Reconstructed fused images distinguished cancers with high malignancy potential and enabled enhanced bone metastasis detection. 18F-FDG-positive lung and lymph node metastases did not show uptake, indicating the absence of neovascularization. Conclusions: 68Ga-NODAGA-THERANOST was found to be safe and effective, exhibiting in this study rapid blood clearance, stability, rapid renal excretion, favorable biodistribution and PK/PD, low irradiation burden (μSv/MBq/μg), and convenient radiolabeling. This radioligand might enable theranostics, that is, a combination of diagnostics followed by the appropriate therapeutics, namely antiangiogenic therapy, image-guided presurgical assessment, treatment response evaluation, prediction of pathologic response, neoadjuvant-peptidomimetic-radiochemotherapy, and personalized medicine strategies. Further clinical trials evaluating 68Ga-NODAGA-THERANOST are warranted. PMID:25945808

  15. [Autoimmune hepatitis].

    PubMed

    Marcais, O; Larrey, D

    1994-01-01

    Acute and chronic autoimmune hepatitis are uncommon inflammatory liver diseases, mainly occurring in young women, in association with hypergammaglobulinemia and serum autoantibodies. Different types have been described: type 1 characterized by anti-smooth muscle and anti-nuclear antibodies; type 2 characterized by anti-LKM1 antibodies; type 3 characterized by anti-SLA antibodies. Other types, still not clearly defined, may exist. Autoimmune hepatitis are associated with HLA A1 B8 DR3 and HLA DR4. Without any treatment, the disease leads to cirrhosis and, uncommonly, to fulminant hepatitis. Large doses of corticosteroids usually allow to control the disease. Relapse of hepatitis is frequent after corticosteroid withdrawal. Concomitant administration of immunosuppressive agents such as azathioprine allows to reduce corticosteroid dosage and contributes to maintain the remission of the disease. Liver transplantation may be indicated in cases of severe cirrhosis or fulminant hepatitis.

  16. Multiplanar CT of the spine

    SciTech Connect

    Rothman, S.L.G.; Glenn, W.V. Jr.

    1986-01-01

    This is an illustrated text on computed tomography (CT) of the lumbar spine with an emphasis on the role and value of multiplanar imaging for helping determine diagnoses. The book has adequate discussion of scanning techniques for the different regions, interpretations of various abnormalities, degenerative disk disease, and different diagnoses. There is a 50-page chapter on detailed sectional anatomy of the spine and useful chapters on the postoperative spine and the planning and performing of spinal surgery with CT multiplanar reconstruction. There are comprehensive chapters on spinal tumors and trauma. The final two chapters of the book are devoted to CT image processing using digital networks and CT applications of medical computer graphics.

  17. Surveillance of HCC Patients after Liver RFA: Role of MRI with Hepatospecific Contrast versus Three-Phase CT Scan-Experience of High Volume Oncologic Institute.

    PubMed

    Granata, Vincenza; Petrillo, Mario; Fusco, Roberta; Setola, Sergio Venanzio; de Lutio di Castelguidone, Elisabetta; Catalano, Orlando; Piccirillo, Mauro; Albino, Vittorio; Izzo, Francesco; Petrillo, Antonella

    2013-01-01

    Purpose. To compare the diagnostic accuracy of hepatospecific contrast-enhanced MRI versus triple-phase CT scan after radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients. Methods. Thirty-four consecutive HCC patients (42 hepatic nodules) were treated with percutaneous RFA and underwent MR and CT scans. All patients were enrolled in a research protocol that included CT with iodized contrast medium injection and MR with hepatospecific contrast medium injection. All patients were restaged within four weeks and at 3 months from ablation. The images were reviewed by four different radiologists to evaluate tumor necrosis, residual or recurrence disease, and evidence of new foci. Results. Thirty-two nodules were necrotic after treatment; 10 showed residual disease. Six new HCCs were identified. At first month followup CT has identified 34 necrotic lesions and 8 residual diseases; no new foci were recognized. At MRI instead, 32 complete necrotic lesions were identified, 10 lesions showed residual disease, and 2 new HCCs were found. At three months, CT demonstrated 33 completely necrotic lesions, 9 residual diseases, and 2 new HCCs. MR showed 31 complete necrotic lesions, 11 cases of residual disease, and 6 new HCCs. Conclusions. Hepatospecific contrast-enhanced MRI is more effective than multiphase CT in assessment of HCC treated with RFA. PMID:24324487

  18. HEPATIC VISCERAL LARVA MIGRANS DUE TO TOXOCARA CANIS IN A 72-YEAR-OLD MAN.

    PubMed

    Ko, Ki Dong; Lee, Jae Joon; Kim, Kyoung Kon; Suh, Heuy Sun; Hwang, In Cheol; Choi, Seung Joon

    2015-03-01

    Hepatic toxocariasis is visceral larva migrans caused by Toxocara. We report a case of hepatic toxocariasis detected incidentally during a health checkup. The patient had elevated levels of eosinophils, total IgE, and anti-Toxocara IgG antibodies. On contrast-enhanced computed tomography (CT) imaging he had a single, 2.16 cm, oval, ill-defined, low-attenuation hepatic nodule which was best appreciated during the portal venous phase of the scan. Clinicians should consider hepatic toxocariasis as a possible diagnosis in any individual who presents with eosinophilia of unknown etiology and an ill-defined hepatic lesion on CT imaging. PMID:26513919

  19. Contrast-Enhanced Abdominal Angiographic CT for Intra-abdominal Tumor Embolization: A New Tool for Vessel and Soft Tissue Visualization

    SciTech Connect

    Meyer, Bernhard Christian Frericks, Bernd Benedikt; Albrecht, Thomas; Wolf, Karl-Juergen; Wacker, Frank Klaus

    2007-07-15

    C-Arm cone-beam computed tomography (CACT), is a relatively new technique that uses data acquired with a flat-panel detector C-arm angiography system during an interventional procedure to reconstruct CT-like images. The purpose of this Technical Note is to present the technique, feasibility, and added value of CACT in five patients who underwent abdominal transarterial chemoembolization procedures. Target organs for the chemoembolizations were kidney, liver, and pancreas and a liposarcoma infiltrating the duodenum. The time for patient positioning, C-arm and system preparation, CACT raw data acquisition, and data reconstruction for a single CACT study ranged from 6 to 12 min. The volume data set produced by the workstation was interactively reformatted using maximum intensity projections and multiplanar reconstructions. As part of an angiography system CACT provided essential information on vascular anatomy, therapy endpoints, and immediate follow-up during and immediately after the abdominal interventions without patient transfer. The quality of CACT images was sufficient to influence the course of treatment. This technology has the potential to expedite any interventional procedure that requires three-dimensional information and navigation.

  20. Uncommon scintigraphic findings of multiple hepatic hemangiomas

    SciTech Connect

    el-Desouki, M.; Joharjy, I.A.; al-Muzrakchi, A.M.; Bashi, S.A. )

    1991-03-01

    Tc-99m labeled red blood cell scintigraphy is a valuable, noninvasive technique for differentiating hepatic hemangioma from other lesions by demonstrating a 'perfusion blood pool mismatch.' The characteristic finding on dynamic CT scan of peripheral and subsequent central enhancement is not usually seen on Tc-99m RBC angiography, probably due to rapid mixing and dilution of the radionuclide and low resolution of the gamma camera. A case of multiple hepatic hemangioma is presented in which Tc-99m RBC dynamic angiography demonstrated peripheral enhancement with subsequent central filling. In addition, delayed static images showed more hepatic lesions.

  1. Clinicopathological features of primary hepatic diffuse large B-cell lymphoma: a report of seven cases and a literature review

    PubMed Central

    Zheng, Jinfeng; Hou, Yiliang; Zhou, Ruting; Zhong, Dingrong

    2015-01-01

    We studied the imaging and histopathological features of primary hepatic diffuse large B-cell lymphoma in order to explore the clinicopathological features, diagnosis, differential diagnoses, and treatment. Immunolabelling was performed in seven cases of primary hepatic diffuse large B-cell lymphoma using histological and immunohistochemical techniques. The clinical manifestations; imaging, histopathological, and immunohistochemical features; treatment; and prognosis of primary hepatic diffuse large B-cell lymphoma were observed and analyzed in light of the relevant literature. The average age of the seven patients was 63.4 years. Moreover, bulge of the upper right abdomen and progressive athrepsia and anemia were observed in all seven patients. Computed tomography (CT) revealed the presence of multiple solid hypodense lesions. Further, CT also revealed an enhanced irregular focus. Histopathological analysis revealed the following characteristics: heavy infiltration composed mainly of medium-sized round cells with a lightly stained cytoplasm, prominent nucleoli and vesicular nuclei, nuclear fission and visible sky star phenomena. The tumor cells showed diffuse expression of CD19, CD20, and CD79a, with the percentage of Ki67-positive cells being 75%-80%. All these findings indicated that primary hepatic diffuse large B-cell lymphoma is rare and generally has a poor prognosis. Biopsy and immunohistochemical staining are helpful in its diagnosis. Further, the differential diagnoses include secondary liver diffuse large B-cell lymphoma, low/undifferentiated cancer of the liver, hepatoblastoma, leukemia of the liver, and other tumors. Early surgery and chemotherapy can have a good curative effect. PMID:26722490

  2. Solitary Fibrous Tumor of the Liver: A Rare Tumor in a Rarer Location

    PubMed Central

    Dey, Biswajit; Gochhait, Debasis; Kaushal, Gourav; Barwad, Adarsh; Pottakkat, Biju

    2016-01-01

    Solitary fibrous tumor is an uncommon mesenchymal neoplasm. Liver is a rare location of this tumor. We report a case of hepatic solitary fibrous tumor in a 56-year-old female, who presented with right upper abdominal pain. An extended right hepatectomy was performed. Histopathological and immunohistochemical examination revealed solitary fibrous tumor of the liver. PMID:27746883

  3. Improvement of the cine-CT based 4D-CT imaging

    SciTech Connect

    Pan Tinsu; Sun Xiaojun; Luo Dershan

    2007-11-15

    An improved 4D-CT utility has been developed on the GE LightSpeed multislice CT (MSCT) and Discovery PET/CT scanners, which have the cine CT scan capability. Two new features have been added in this 4D-CT over the commercial Advantage 4D-CT from GE. One feature was a new tool for disabling parts of the respiratory signal with irregular respiration and improving the accuracy of phase determination for the respiratory signal from the Varian real-time positioning and monitoring (RPM) system before sorting of the cine CT images into the 4D-CT images. The second feature was to allow generation of the maximum-intensity-projection (MIP), average (AVG) and minimum-intensity-projection (mip) CT images from the cine CT images without a respiratory signal. The implementation enables the assessment of tumor motion in treatment planning with the MIP, AVG, and mip CT images on the GE MSCT and PET/CT scanners without the RPM and the Advantage 4D-CT with a GE Advantage windows workstation. Several clinical examples are included to illustrate this new application.

  4. Optimised radiological diagnosis of hepatic fungal infection during the treatment of leukemia.

    PubMed

    Petrausch, Ulf; Frauenfelder, Thomas; Mueller, Nicolas J; Arn, Kornelius; Stussi, Georg; Schanz, Urs

    2012-09-01

    Hepatic fungal infection is a frequent complication in patients receiving intensive chemotherapy for acute leukaemia. Hepatic lesions may be detected using computerised tomographic (CT) scans, but there is no standardised CT protocol for the diagnosis and follow-up of hepatic fungal infection. We therefore retrospectively analysed the number and the volume of hepatic fungal lesions in 24 CT of 20 consecutive patients treated for acute leukaemia during late-arterial and porto-venous phase. The mean number of lesions per patient was 31 (range: 3-105) in the late-arterial and 26 (3-81) in the porto-venous CT (P = 0.026). The mean total volume of all lesions was 6.45 ml in the late-arterial and 4.07 ml in the porto-venous CT representing a 1.6fold difference between the two CT scans (P = 0.008). The total volume of the lesions negatively correlated to the absolute contrast difference between liver parenchyma and liver vein (Pearson correlation, r = -0.62; P = 0.002). In conclusion, the late-arterial CT provides a superior distinction of hepatic lesions due to a delayed perfusion of the outer rim of the fungal lesions resulting in an extended visibility. The late-arterial CT is superior to the porto-venous CT for initial diagnosis and follow-up of hepatic fungal infection.

  5. Imaging and PET-PET/CT imaging.

    PubMed

    Von Schulthess, Gustav K; Hany, Thomas F

    2008-03-01

    PET-CT has grown because the lack of anatomic landmarks in PET makes "hardware-fusion" to anatomic cross-sectional data extremely useful. Addition of CT to PET improves specificity, but also sensitivity, and adding PET to CT adds sensitivity and specificity in tumor imaging. The synergistic advantage of adding CT is that the attenuation correction needed for PET data can also be derived from the CT data. This makes PET-CT 25-30% faster than PET alone, leading to higher patient throughput and a more comfortable examination for patients typically lasting 20 minutes or less. FDG-PET-CT appears to provide relevant information in the staging and therapy monitoring of many tumors, such as lung carcinoma, colorectal cancer, lymphoma, gynaecological cancers, melanoma and many others, with the notable exception of prostatic cancer. For this cancer, choline derivatives may possibly become useful radiopharmaceuticals. The published literature on the applications of FDG-PET-CT in oncology is still limited but several well-designed studies have demonstrated the benefits of PET-CT.

  6. 18F FDOPA PET/CT or PET/MRI in Measuring Tumors in Patients With Newly Diagnosed or Recurrent Gliomas

    ClinicalTrials.gov

    2016-06-22

    Adult Anaplastic Ependymoma; Adult Anaplastic Oligodendroglioma; Adult Brain Stem Glioma; Adult Diffuse Astrocytoma; Adult Giant Cell Glioblastoma; Adult Glioblastoma; Adult Gliosarcoma; Adult Mixed Glioma; Adult Oligodendroglioma; Adult Pilocytic Astrocytoma; Adult Pineal Gland Astrocytoma; Adult Subependymal Giant Cell Astrocytoma; Childhood High-grade Cerebellar Astrocytoma; Childhood High-grade Cerebral Astrocytoma; Childhood Low-grade Cerebellar Astrocytoma; Childhood Low-grade Cerebral Astrocytoma; Recurrent Adult Brain Tumor; Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Anaplastic Oligoastrocytoma; Recurrent Childhood Anaplastic Oligodendroglioma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Diffuse Astrocytoma; Recurrent Childhood Fibrillary Astrocytoma; Recurrent Childhood Gemistocytic Astrocytoma; Recurrent Childhood Giant Cell Glioblastoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Gliomatosis Cerebri; Recurrent Childhood Gliosarcoma; Recurrent Childhood Oligoastrocytoma; Recurrent Childhood Oligodendroglioma; Recurrent Childhood Pilomyxoid Astrocytoma; Recurrent Childhood Protoplasmic Astrocytoma; Recurrent Childhood Subependymal Giant Cell Astrocytoma; Recurrent Childhood Visual Pathway and Hypothalamic Glioma; Recurrent Childhood Visual Pathway Glioma; Untreated Childhood Anaplastic Astrocytoma; Untreated Childhood Anaplastic Oligoastrocytoma; Untreated Childhood Anaplastic Oligodendroglioma; Untreated Childhood Brain Stem Glioma; Untreated Childhood Cerebellar Astrocytoma; Untreated Childhood Cerebral Astrocytoma; Untreated Childhood Diffuse Astrocytoma; Untreated Childhood Fibrillary Astrocytoma; Untreated Childhood Gemistocytic Astrocytoma; Untreated Childhood Giant Cell Glioblastoma; Untreated Childhood Glioblastoma; Untreated Childhood Gliomatosis Cerebri; Untreated Childhood Gliosarcoma; Untreated Childhood

  7. CT and PET-CT of a dog with multiple pulmonary adenocarcinoma.

    PubMed

    Kim, Jisun; Kwon, Seong Young; Cena, Rohani; Park, Seungjo; Oh, Juyeon; Oui, Heejin; Cho, Kyoung-Oh; Min, Jung-Joon; Choi, Jihye

    2014-04-01

    A 10-year-old, intact female Yorkshire terrier had multiple pulmonary nodules on thoracic radiography and ultrasonography with no lesions elsewhere. Computed tomography (CT) and positron emission tomography and computed tomography (PET-CT) using 18F-fluorodeoxyglucose (FDG) were performed to identify metastasis and undetected primary tumors. On CT examination, pulmonary nodules had a hypoattenuating center with thin peripheral enhancement, suggesting ischemic or necrotizing lesion. In PET-CT at 47 min after intravenous injection of 11.1 MBq/kg of FDG, the maximum standardized uptake value of each pulmonary nodule was about from 3.8 to 6.4. There were no abnormal lesions except for four pulmonary nodules on the CT and PET-CT. Primary lung tumor was tentatively diagnosed, and palliative therapy using 2 mg/kg tramadol and 2.2 mg/kg carprofen twice per day was applied. After the dog's euthanasia due to deteriorated clinical signs and poor prognosis, undifferentiated pulmonary adenocarcinoma was diagnosed through histopathologic and immunochemistry examination. To the best of the authors' knowledge, this is the first study of CT and PET-CT features of canine pulmonary adenocarcinoma. In this case, multiple pulmonary adenocarcinoma could be determined on the basis of FDG PET-CT through screening the obvious distant metastasis and/or lymph node invasions and excluding unknown primary tumors.

  8. Hepatitis B

    MedlinePlus

    ... U.S. Preventive Services Task Force recommendation statement. Ann Intern Med . 2014;161(1):58-66. PMID 24863637 ... Development Conference Statement: Management of hepatitis B. Ann Intern Med . 2009;150:104-10. PMID: 19124811 www. ...

  9. Hepatitis B

    MedlinePlus

    ... and Change Plan Wallet card for patients to record their alcohol use over a 4-week period as a way to monitor and reduce their drinking behavior. Glossary Definitions of terms commonly used with viral hepatitis and ...

  10. Hepatitis B

    MedlinePlus

    ... All babies should get the vaccine, but older children and adults can get it too. If you travel to countries where Hepatitis B is common, you should get the vaccine. NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  11. Hepatic Sarcoidosis.

    PubMed

    Tadros, Micheal; Forouhar, Faripour; Wu, George Y

    2013-12-01

    Sarcoidosis is a multisystem disease characterized by the presence of non-caseating granulomas in affected organs. Pulmonary involvement is the most common site of disease activity. However, hepatic involvement is also common in sarcoidosis, occurring in up to 70% of patients. Most patients with liver involvement are asymptomatic. Therefore, the majority of cases are discovered incidentally, frequently by the finding of elevated liver enzymes. Pain in the right upper quadrant of the abdomen, fatigue, pruritus, and jaundice may be associated with liver involvement. Portal hypertension and cirrhosis are complications linked to long-standing hepatic sarcoidosis. Liver biopsy is usually required to confirm the diagnosis. It is important to differentiate hepatic sarcoidosis from other autoimmune and granulomatous liver diseases. Not all cases of hepatic sarcoidosis require treatment. For symptomatic patients, the first line treatment includes corticosteroids or ursodeoxycholic acid. Various immunosuppressant agents can be used as second line agents. Rarely, severe cases require liver transplantation.

  12. Autoimmune hepatitis.

    PubMed

    Heneghan, Michael A; Yeoman, Andrew D; Verma, Sumita; Smith, Alastair D; Longhi, Maria Serena

    2013-10-26

    Autoimmune hepatitis is a disease of the hepatic parenchyma that can present in acute or chronic forms. In common with many autoimmune diseases, autoimmune hepatitis is associated with non-organ-specific antibodies in the context of hepatic autoimmunity. This dichotomy has made definition of a unifying hypothesis in the pathophysiology of the disease difficult, although data from the past 8 years have drawn attention to the role of regulatory T cells. Several triggers have been identified, and the disease arises in genetically susceptible individuals. Clinical and biochemical remission is achievable in up to 85% of cases. For the remaining patients, alternative immunosuppression strategies are an option. Liver transplantation provides an excellent outcome for patients with acute liver failure or complications of end-stage liver disease, including hepatocellular carcinoma. Variant or overlapping syndromes are worthy of consideration when unexpected disease features arise.

  13. Anatomical evaluation of hepatic vascular system in healthy beagles using X-ray contrast computed tomography.

    PubMed

    Oishi, Yasuhisa; Tani, Kenji; Nakazawa, Hiroshi; Itamoto, Kazuhito; Haraguchi, Tomoya; Taura, Yasuho

    2015-08-01

    Liver contrast X-ray computed tomography (CT) has been used for evaluation of hepatic vessels for liver transplantation, liver lobectomy, interventional radiology and diagnosis of hepatocellular carcinoma in humans. However, there remains scant available anatomical information on normal hepatic vessels in the veterinary field. In this study, visualization of hepatic vessels was evaluated in 32 normal beagle dogs by X-ray contrast CT using triple phase images. The following hepatic vessels were clearly visualized: arterial, portal and hepatic veins. With regards to the running patterns of the portal vein and hepatic vein, there were no significant differences between the dogs. However, the hepatic artery exhibited some differences in each dog. In particular, the hepatic artery of the quadrate lobe and the right lateral lobe had many running patterns. The results of the present study could be useful for veterinary diagnosis, surgery and interventional radiology. PMID:25843113

  14. Caffeic acid phenethyl ester preferentially sensitizes CT26 colorectal adenocarcinoma to ionizing radiation without affecting bone marrow radioresponse

    SciTech Connect

    Chen, Y.-J.; Liao, H.-F.; Tsai, T.-H.; Wang, S.-Y.; Shiao, M.-S. . E-mail: msshiao@vghtpe.gov.tw

    2005-11-15

    Purpose: Caffeic acid phenethyl ester (CAPE), a component of propolis, was reported capable of depleting glutathione (GSH). We subsequently examined the radiosensitizing effect of CAPE and its toxicity. Methods and Materials: The effects of CAPE on GSH level, GSH metabolism enzyme activities, NF-{kappa}B activity, and radiosensitivity in mouse CT26 colorectal adenocarcinoma cells were determined. BALB/c mouse with CT26 cells implantation was used as a syngeneic in vivo model for evaluation of treatment and toxicity end points. Results: CAPE entered CT26 cells rapidly and depleted intracellular GSH in CT26 cells, but not in bone marrow cells. Pretreatment with nontoxic doses of CAPE significantly enhanced cell killing by ionizing radiation (IR) with sensitizer enhancement ratios up to 2.2. Pretreatment of CT26 cells with N-acetyl-L-cysteine reversed the GSH depletion activity and partially blocked the radiosensitizing effect of CAPE. CAPE treatment in CT26 cells increased glutathione peroxidase, decreased glutathione reductase, and did not affect glutathione S-transferase or {gamma}-glutamyl transpeptidase activity. Radiation activated NF-{kappa}B was reversed by CAPE pretreatment. In vivo study revealed that pretreatment with CAPE before IR resulted in greater inhibition of tumor growth and prolongation of survival in comparison with IR alone. Pretreatment with CAPE neither affected body weights nor produced hepatic, renal, or hematopoietic toxicity. Conclusions: CAPE sensitizes CT26 colorectal adenocarcinoma to IR, which may be via depleting GSH and inhibiting NF-{kappa}B activity, without toxicity to bone marrow, liver, and kidney.

  15. Tumor Sensitive Matching Flow: A Variational Method to Detecting and Segmenting Perihepatic and Perisplenic Ovarian Cancer Metastases on Contrast-Enhanced Abdominal CT

    PubMed Central

    Liu, Jianfei; Wang, Shijun; Linguraru, Marius George; Yao, Jianhua; Summers, Ronald M.

    2015-01-01

    Accurate automated segmentation and detection of ovarian cancer metastases may improve the diagnosis and prognosis of women with ovarian cancer. In this paper, we focus on an important subset of ovarian cancer metastases that spread to the surface of the liver and spleen. Automated ovarian cancer metastasis detection and segmentation are very challenging problems to solve. These metastases have a wide variety of shapes and intensity values similar to that of the liver, spleen and adjacent soft tissues. To address these challenges, this paper presents a variational approach, called tumor sensitive matching flow (TSMF), to detect and segment perihepatic and perisplenic ovarian cancer metastases. TSMF is an image motion field that only highlights metastasis-caused deformation on the surface of liver and spleen while dampening all other image motion between the patient image and the atlas image. It provides several benefits: 1) juxtaposing the roles of image matching and metastasis classification within a variational framework; 2) only requiring a small set of features from a few patient images to train a metastasis-likelihood function for classification; and 3) dynamically creating shape priors for geodesic active contour (GAC) to prevent inaccurate metastasis segmentation. We compared the TSMF to an organ surface partition (OSP) baseline approach. At a false positive rate of 2 per patient, the sensitivities of TSMF and OSP were 87% and 17% (p < 0.001), respectively. In a comparison of the segmentations conducted using TSMF-constrained GAC and conventional GAC, the volume overlap rates were 73±9% and 46±26% (p < 0.001) and average surface distances were 2.4±1.2mm and 7.0±6.0mm (p < 0.001), respectively. These encouraging results demonstrate that TSMF could accurately detect and segment ovarian cancer metastases. PMID:24835180

  16. Optimizing safety of selective internal radiation therapy (SIRT) of hepatic tumors with 90Y resin microspheres: a systematic approach to preparation and radiometric procedures.

    PubMed

    Schleipman, A Robert; Gallagher, Patrick W; Gerbaudo, Victor H

    2009-02-01

    Arterial administration of 90Y microspheres is used for salvage therapy in patients with primary or metastasized tumors within the liver. The clinical use of high-yield beta emitters presents unique calibration, dosage measurement, and exposure monitoring tasks. This report illustrates the following issues: determination of container and volume-specific correction factors in a standard dose calibrator for various receipt and dispensing vial geometries using a U.S. National Institute of Standards and Technology-traceable 90Y standard solution; documentation of delivery and localization of the radionuclide; statistically-verified ion chamber measurements of residual (non infused) radioactivity; and measurement of occupational radiation exposures.

  17. Gastric interposition following transhiatal esophagectomy: CT evaluation

    SciTech Connect

    Gross, B.H.; Agha, F.P.; Glazer, G.M.; Orringer, M.B.

    1985-04-01

    Transhiatal esophagectomy without thoracotomy (THE) but with gastric interposition results in less morbidity and mortality than standard transpleural esophagectomy with thoracotomy. Barium examination has been the primary radiographic study following THE for detecting postoperative complications. The authors reviewed computed tomography (CT) scans of 21 patients who had undergone THE and correlated CT appearance with clinical status and with findings of the barium studies. Local mediastinal recurrent neoplasm was detected by CT in seven patients; barium study within 2 weeks of the CT scan failed to detect tumor recurrence in three of these patients. CT is the modality of choice for detecting locally recurrent neoplasm and distant metastases following THE and may also be helpful in patients with postoperative mediastinal abscess. Normal mediastinal CT anatomy after esophagectomy is reviewed in order to warn against pitfalls in scan interpretation.

  18. Hepatitis C FAQs

    MedlinePlus

    ... of Viral Hepatitis Contact Us Quick Links to Hepatitis ... A | B | C | D | E Viral Hepatitis Home ... Outbreaks State and Local Partners & Grantees Resource Center Hepatitis C FAQs for the Public Recommend on Facebook ...

  19. Hepatitis B FAQs

    MedlinePlus

    ... of Viral Hepatitis Contact Us Quick Links to Hepatitis ... A | B | C | D | E Viral Hepatitis Home ... Outbreaks State and Local Partners & Grantees Resource Center Hepatitis B FAQs for the Public Recommend on Facebook ...

  20. Hepatitis A Test

    MedlinePlus

    ... be limited. Home Visit Global Sites Search Help? Hepatitis A Testing Share this page: Was this page ... HAV-Ab total; Anti-HAV Formal name: Viral Hepatitis A Antibody Related tests: Hepatitis B Testing ; Hepatitis ...

  1. Delta agent (Hepatitis D)

    MedlinePlus

    Hepatitis D virus ... Hepatitis D virus (HDV) is found only in people who carry the hepatitis B virus. HDV may make liver ... B virus but who never had symptoms. Hepatitis D infects about 15 million people worldwide. It occurs ...

  2. Feature