Language：English   Publisher：Minimally Invasive Therapy and Allied Technologies  

Introduction: The purpose is to clarify the safety and clinical contribution of computed tomography (CT)-guided percutaneous needle-biopsy for patients with cervical spine lesion. Material and methods: Between June 2015 and August 2022, CT-guided percutaneous needle biopsies were performed for 15 cervical spine lesions of 15 patients (8 male, 7 female; 2–81 years old). The technical success, clinical contribution, and safety were evaluated. Technical success was defined as the completion of the biopsy procedure. Clinical contribution was defined as any contribution to the therapeutic strategy. Safety was assessed by the Common Terminology Criteria for Adverse Events, version 5.0. Results: The technical success rate was 100%. In all 15 patients, nontarget organs (e.g., major vessels, spinal cord) could be avoided. The post-biopsy histological diagnoses were myeloma (n = 2), metastatic adenocarcinoma (n = 2), chordoma (n = 2), Langerhans cell histiocytosis (n = 3), and one case each of malignant lymphoma, schwannoma, pyogenic spondylitis, non-pyogenic spondylitis, degenerative change, and non-pathological fracture. All of these diagnoses contributed to the therapeutic strategy decisions. One case of grade 2 pain was observed, but no complications with grade 3 or more were observed during or after the biopsies. Conclusion: CT-guided percutaneous needle biopsies for cervical spine lesions were safe and clinically beneficial.

DOI： 10.1080/13645706.2024.2311720

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Language：English   Publisher：Abdominal Radiology  

Purpose: To elucidate how precisely microvascular invasion (MVI) in hepatocellular carcinoma (HCC) can be predicted using multiparametric assessment of gadoxetic acid-enhanced MRI. Methods: In this retrospective single-center study, patients who underwent liver resection or transplantation of HCC were evaluated. Data obtained in patients who underwent liver resection were used as the training set. Nine kinds of MR findings for predicting MVI were compared between HCCs with and without MVI by univariate analysis, followed by multiple logistic regression analysis. Using significant findings, a predictive formula for diagnosing MVI was obtained. The diagnostic performance of the formula was investigated in patients who underwent liver resection (validation set 1) and in patients who underwent liver transplantation (validation set 2) using a receiver operating characteristic curve analysis. The area under the curves (AUCs) of these three groups were compared. Results: A total of 345 patients with 356 HCCs were selected for analysis. Tumor diameter (D) (P = 0.021), tumor washout (TW) (P < 0.01), and peritumoral hypointensity in the hepatobiliary phase (PHH) (P < 0.01) were significantly associated with MVI after multivariate analysis. The AUCs for predicting MVI of the predictive formula were as follows: training set, 0.88 (95% confidence interval (CI) 0.82,0.93); validation set 1, 0.81 (95% CI 0.73,0.87); validation set 2, 0.67 (95% CI 0.51,0.80). The AUCs were not significantly different among three groups (training set vs validation set 1; P = 0.15, training set vs validation set 2; P = 0.09, validation set 1 vs validation set 2; P = 0.29, respectively). Conclusion: Our multiparametric assessment of gadoxetic acid-enhanced MRI performed quite precisely and with good reproducibility for predicting MVI. Graphical abstract: (Figure presented.)

DOI： 10.1007/s00261-023-04179-3

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.4274/dir.2023.232381.

Language：English   Publisher：Diagnostic and Interventional Radiology  

PURPOSE This retrospective study evaluates the impact of preoperative lipiodol marking on the outcomes of computed tomography (CT)-guided cryoablation for histologically diagnosed sporadic renal cell carcinoma (RCC). METHODS This study analyzed the data of 173 patients who underwent CT-guided cryoablation for histologi-cally proven sporadic RCC at a single institution between April 2014 and December 2020. The local control rate (LCR), recurrence-free survival rate (RFSR), overall survival rate (OSR), changes in renal function, and complications in patients with (n = 85) and without (n = 88) preoperative lipiodol marking were compared. RESULTS The 5-year LCR and 5-year RFSR were significantly higher in patients with lipiodol marking (97.51% and 93.84%, respectively) than in those without (72.38% and 68.10%, respectively) (P value <0.01, log-rank test). There were no significant differences between the two groups regarding the 5-year OSR (97.50% vs. 86.82%) or the deterioration in chronic kidney disease stage (12.70% vs. 16.43%). Grade ≥3 complications occurred in patients with lipiodol marking (n = 2, retroperitoneal hemato-ma and cerebral infarction in 1 patient each) and without (n = 5; urinary fistula in 2, colonic perfo-ration in 2, urinary infection in 1). CONCLUSION Lipiodol marking before CT-guided cryoablation for sporadic RCC is a feasible approach to improv-ing local control and RFS while mitigating the decline in renal function. Additionally, it may help reduce complications.

DOI： 10.4274/dir.2023.232381

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Language：Japanese   Publisher：(株)メディカルアイ  

腎門部に生じた腎細胞癌は、標準治療である外科的切除では部分切除術が困難であることが多く、腎摘出術となると腎機能低下は避けられない。今回我々は、対側腎摘出後で片腎の腎門部に生じた腎細胞癌に対してCTガイド下経皮的凍結療法を施行し、良好な局所制御と腎機能温存が得られた症例を経験したので報告する。(著者抄録)

Language：English   Publisher：Diagnostic and Interventional Radiology  

PURPOSE To retrospectively determine the diagnostic accuracy of a percutaneous core biopsy performed before cryoablation for small-sized renal cell carcinoma. METHODS In this study, 216 patients underwent a percutaneous core biopsy for 242 renal lesions suspected to be renal cell carcinoma on image findings before cryoablation at Kyushu University Hospital. We calculated the success rate of the histological diagnosis and investigated factors that may have contributed to the diagnostic success. Complications caused by the biopsy procedure were also evaluated. RESULTS The histological diagnosis was successful in 203 lesions (82.8%). The success rate of the histologi-cal diagnosis was 65.4% (34/52 cases) for tumors with a diameter of ≤15 mm and 88.9% (169/190 cases) for those >15 mm. Therefore, tumor diameter was a factor contributing to the histological diagnosis success rate in both univariate and multivariable analyses (P < 0.001). For lesions with a tumor diameter ≤15 mm, the histological diagnosis success rates increased from 50.0% to 76.2% in the presence of pre-lipiodol marking and to 85.7% when the biopsy procedure was performed separately from cryoablation; the latter was statistically significant (P = 0.039). Major complications that may have been caused by the biopsy procedure were grade 3 bleeding and tract seeding (one case each). CONCLUSION Percutaneous core biopsy in cryoablation for small-sized renal cell carcinoma had a high diagnostic rate and was safely performed. For lesions with a tumor diameter ≤15 mm, a separate biopsy procedure and pre-lipiodol marking may improve the diagnostic accuracy.

DOI： 10.4274/dir.2022.221152

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jhbp.1345.

Language：English   Publisher：Journal of Hepato-Biliary-Pancreatic Sciences  

Purpose: To evaluate the prognostic impact of dynamic gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) in patients with hepatocellular carcinoma (HCC). Methods: We retrospectively reviewed the data of 206 patients with HCC who underwent preoperative Gd-EOB-DTPA-enhanced MRI and hepatectomy and quantitatively evaluated the signal intensity ratio of the tumor to the surrounding liver tissue in the portal phase (SIRPP). We verified the survival rates and assessed the prognostic factors associated with overall survival (OS) and recurrence-free survival (RFS) using SIRPP. Results: Multivariate analysis revealed that the independent predictive factors for poorly-differentiated HCC were α-fetoprotein > 20 ng/mL (hazard ratio [HR]: 3.1909, 95% confidence interval [CI]: 1.3464–7.5622, p =.0084) and SIRPP ≤ 0.85 (HR: 3.7155, 95% CI: 1.521–9.076, p =.004). The 5-year OS and RFS rates in the high and low SIRPP groups were 83.2 and 52.1%, respectively (p <.0001) and 49.7 and 18.5%, respectively (p =.0003). Multivariate analysis revealed that SIRPP ≤ 0.68 was an independent prognostic factor related to OS (HR: 4.4537, 95% CI: 1.6581–11.9626, p =.003). Conclusion: The SIRPP of preoperative Gd-EOB-DTPA-enhanced MRI might predict the histological differentiation and prognosis of HCC.

DOI： 10.1002/jhbp.1345

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Language：English   Publisher：John Wiley & Sons Australia, Ltd  

肝細胞癌(HCC)患者におけるダイナミックGd-EOB-DTPA造影MRI所見と予後との関連を検討した。Gd-EOB-DTPA造影MRIの施行後に肝切除を受けたHCC患者206例を対象に後ろ向きレビューを行い、門脈相における肝組織周囲に対する腫瘍の信号強度比(SIRPP)を算出し、全生存率(OS)、無再発生存率(RFS)との関連を評価した。58例(28.2%)に未分化成分が検出され、多変量解析では未分化型HCCの独立予測因子としてAFP 20ng/mL超およびSIRPP 0.85以下が抽出された。患者生存を評価したROC解析ではSIRPPのカットオフ値は0.68と算出され、この値をもとにSIRPP高値群166例とSIRPP低値群40例に分類すると、高値群にはF3またはF4の組織学的肝硬変が多く、SIRPP低値群にはBCLCステージBまたはC、腹腔鏡下肝切除の施行、未分化型HCC、被膜形成、顕微的被膜浸潤・脈管浸潤・胆管浸潤を多く認めた。また、AFP、AFP-L3、DCP、手術時間、術中出血量、腫瘍サイズはSIRPP低値群の方が有意に高値を示しており、5年OSはSIRPP高値群が83.2%、低値群が52.1%、5年RFSはSIRPP高値群が49.7%、低値群が18.5%と有意差が認められた。多変量解析ではOSの独立予測因子としてDCP 100mAU/mL以上、SIRPP 0.68以下、RFSの独立予測因子として腫瘍数2個以上が示された。ダイナミックGd-EOB-DTPA造影MRIによりHCCの組織学的分化度と予後を予測できうると思われた。

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1111/hepr.13902.

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

日本の単一施設の肝細胞癌(HCC)患者64例の腫瘍データ80件を後ろ向きに評価し、術中インドシアニングリーン(ICG)蛍光画像(FI)パターン、術前Gd-EOB-DTPA造影MRI所見、術前MRI拡散強調画像(DWI)、組織学的分化の臨床的関連性を評価した。ICG FIでrim陽性であった患者では、rim陰性患者に比べて低分化HCC率とGd-EOB-DTPA造影MRI肝胆道相(HBP)の低信号率が有意に高く、Gd-EOB-DTPA造影MRI門脈相の周囲肝組織に対する腫瘍のシグナル強度比(SIRPP)とMRI DWI見かけの拡散係数(ADC)が有意に低値であった。ICG FIで癌性に分類された患者は、非癌性患者に比べて中分化HCC率、Gd-EOB-DTPA造影MRI HBPの高信号率とSIRPP、MRI DWI ADCが有意に高値であった。多変量解析において、SIRPP低値、ADC低値、HBPの低信号率はrim陽性HCCの有意な予測因子であり、SIRPP高値、ADC高値、HBPの高信号率は癌性HCCの有意な予測因子であった。

Language：English   Publisher：Hepatology Research  

Aim: We aimed to evaluate the association between the intraoperative indocyanine green (ICG) fluorescence imaging (FI) pattern, preoperative magnetic resonance imaging (MRI) findings using gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA), preoperative diffusion-weighted imaging (DWI) of MRI, and histological differentiation of hepatocellular carcinoma (HCC). Methods: We retrospectively reviewed the data for 80 tumors of 64 patients. Intraoperative ICG FI patterns were classified into cancerous or rim-positive type. We evaluated the signal intensity ratio of the tumor and the surrounding liver tissue in the portal phase (SIRPP) and intensity in the hepatobiliary phase (HBP) of Gd-EOB-DTPA-enhanced MRI, the apparent diffusion coefficient (ADC) in the DWI of MRI, and clinicopathologic factors. Results: In the rim-positive group, the rate of poorly differentiated HCC and hypointensity type in HBP were significantly higher, and SIRPP and ADC were significantly lower than the rim-negative group. In the cancerous group, the rate of well or moderately differentiated HCC and hyperintensity type in HBP, SIRPP, and ADC were significantly higher than the noncancerous group. Multivariate analysis identified low SIRPP, low ADC, and hypointensity type in HBP as the significant predictive factors for rim-positive HCC and high SIRPP, high ADC, and hyperintensity type in HBP as the significant predictive factors for cancerous HCC. The positive rate of programmed cell death 1-ligand 1 and vessels that encapsulate tumor clusters status of the rim-positive HCC and HCC with low SIRPP were significantly higher than the control group. Conclusions: The intraoperative ICG FI pattern of HCC closely correlated with histological differentiation, preoperative SIRPP and intensity type in the Gd-EOB-DTPA MRI, and preoperative ADC in the DWI of MRI.

DOI： 10.1111/hepr.13902

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Publisher：金原出版  

DOI： 10.18888/rp.0000002332

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.ejrad.2023.110756.

Language：English   Publisher：European Journal of Radiology  

Purpose: To clarify the relationship between extracellular volume (ECV) measured by dual-energy CT (DECT) and efficacy of preoperative neoadjuvant chemotherapy (NAC) in patients with pancreatic ductal adenocarcinoma (PDAC), as compared with single-energy CT (SECT). Methods: We enrolled 67 patients with PDAC who underwent dynamic contrast-enhanced CT with a dual-energy CT system prior to NAC. Attenuation values were measured on unenhanced and the equilibrium-phase 120-kVp equivalent CT images for PDAC and the aorta. ΔHU-tumor, ΔHU-tumor/ΔHU-aorta, and SECT-ECV were calculated. Iodine densities of the tumor and aorta were measured in the equilibrium phase, and DECT-ECV of the tumor was calculated. Response to NAC was evaluated and the correlation between imaging parameters and response to NAC was statistically assessed. Results: Tumor DECT-ECVs were significantly lower in the response group (n = 7) than in the non-response group (n = 60), with most significant difference (p = 0.0104). DECT-ECV showed highest diagnostic value with an Az value of 0.798. When using the optimal cut off value of DECT-ECV (<26.0 %), sensitivity, specificity, accuracy, positive predictive value, and negative value for predicting response group were 71.4 %, 85.0 %, 83.6 %, 35.7 % and 96.2 %, respectively. Conclusion: PDAC with lower DECT-ECV can potentially show better response to NAC. DECT-ECV might be a useful biomarker for predicting response to NAC in patients with PDAC.

DOI： 10.1016/j.ejrad.2023.110756

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Language：Japanese   Publisher：金原出版(株)  

症例は50歳代男性で、腎細胞癌(淡明細胞癌)、骨転移の診断で化学療法施行中であったが、経過中のCTで胆嚢底部に増強される微小なポリープ状病変が出現し、経時的に増大した。病変は腹部MRI T2強調像で軽度高信号、T1強調像(in phase)で等信号を呈したが、out of phaseで信号低下はなく、拡散強調像では高信号で軽度の拡散制限を認めた。造影MRIでは動脈優位相で増強され、遅延相はwash outされた。胆嚢癌疑いで腹腔鏡下胆嚢摘出術を行い、腫瘤性病変(20mm大)の病理所見よりgrade 2の腎細胞癌(淡明細胞癌)の転移と診断された。後方視的にMRI所見を再検討した。その結果、chemical shift imagingで脂肪は認めないが、dynamic studyで早期濃染とwash outを呈しており、画像上は腎細胞癌の胆嚢転移を疑う所見であった。

Publisher：金原出版  

DOI： 10.18888/op.0000003205

CiNii Research

Language：English   Publisher：Medicine (United States)  

Acute liver failure (ALF) is a disorder defined by coagulopathy and encephalopathy with a poor prognosis. No effective therapies have been established except for liver transplantation. We previously reported a subgroup of patients with acute liver injury who developed microcirculatory disturbance. We also established and reported transcatheter arterial steroid injection therapy (TASIT) as a new treatment of ALF. Here, we analyze the effectiveness of TASIT in a larger cohort and evaluate the impact on ALF patients with or without microcirculatory disturbance. We conducted a single-center retrospective study to evaluate the effectiveness of TASIT in patients with ALF admitted at Kyushu University Hospital between January 2005 and March 2018. TASIT is performed by injecting methylprednisolone via the proper hepatic artery for 3 days. One hundred ninety-4 patients with ALF were enrolled and analyzed in this study. Of the 87 patients given TASIT, 71 (81.6%) recovered without any complications and 16 (18.4%) died or underwent liver transplantation. Of the 107 patients not administered TASIT, 77 (72.0%) recovered and 30 (28.0%) progressed to irreversible liver failure. In the high-lactate dehydrogenase subgroup, 52 (86.7%) of the 60 patients with TASIT recovered, and the survival rate was significantly higher than that in patients who did not receive TASIT. Multivariate regression analysis revealed that the TASIT procedure was one of the significant prognostic factors in the high-lactate dehydrogenase subgroup and was significantly associated with prothrombin activity percentage improvement. TASIT is an effective treatment for patients with ALF, especially in those with microcirculatory disturbance.

DOI： 10.1097/MD.0000000000033090

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1097/MD.0000000000033090.

Language：Japanese   Publisher：金原出版(株)  

32歳女性。既往として右乳房血管肉腫に対する部分切除が行われた。今回、上腹部痛を主訴に当院へ救急搬送となった。入院後、約6時間経過で血圧低下と貧血進行を認めたため、造影CTを行ったところ、転移性肝血管肉腫の破裂による腹腔内出血と診断された。TAEのみでは止血困難であることから、本症例は術前にIVRによる栄養血管を塞栓後、術中、中心静脈圧のコントロールと体外循環を視野に入れた静脈路確保が行われた。安全に左肝切除術を施行することができたことで、術後は合併症なく退院し、目下は全身化学療法が行われている。

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.4274/dir.2022.221152.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.ejrad.2022.110461.

Language：English   Publisher：European Journal of Radiology  

Purpose: To investigate whether the iodine density of liver parenchyma in the equilibrium phase and extracellular volume fraction (ECV) measured by deep learning-based spectral computed tomography (CT) can enable noninvasive liver fibrosis staging. Method: We retrospectively analyzed 63 patients who underwent dynamic CT using deep learning-based spectral CT before a hepatectomy or liver transplantation. The iodine densities of the liver parenchyma (I-liver) and abdominal aorta (I-aorta) were independently measured by two radiologists using iodine density images at the equilibrium phase. The iodine-density ratio (I-ratio: I-liver/I-aorta) and CT-ECV were calculated. Spearman's rank correlation analysis was used to evaluate the relationship between the I-ratio or CT-ECV and liver fibrosis stage, and receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performances of the I-ratio and CT-ECV. Results: The I-ratio and CT-ECV showed significant positive correlations with liver fibrosis stage (ρ = 0.648, p < 0.0001 and ρ = 0.723, p < 0.0001, respectively). The areas under the ROC curve for the CT-ECV were 0.882 (F0 vs ≥ F1), 0.873 (≤F1 vs ≥ F2), 0.848 (≤F2 vs ≥ F3), and 0.891 (≤F3 vs F4). Conclusions: Deep learning-based spectral CT may be useful for noninvasive assessments of liver fibrosis.

DOI： 10.1016/j.ejrad.2022.110461

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Language：English   Publisher：(公社)宮崎県医師会  

動脈-腸管瘻は消化管出血の原因としてはまれであるが,初発症状が致死性の大量出血の場合もある緊急性の高い疾患である。症例は44歳,9妊7産,子宮頸癌IB3期(扁平上皮癌)に対して広汎子宮全摘出術,両側付属器摘出術,術後補助療法として同時化学放射線療法を施行した。治療終了6ヵ月後に骨盤内再発を認め,全身化学療法を施行したが奏効しなかった。MSI検査の結果,MSI-highであったためペムブロリズマブ療法を開始した。腫瘍の著明な縮小を認め,4コース後の治療効果判定はPRであった。ペムブロリズマブ療法4コース目day7,当科入院中に突然,多量の下血,意識レベルの低下を認めた。緊急造影CTの結果,左内腸骨動脈からS状結腸への造影剤の漏出を認め,左内腸骨動脈-S状結腸瘻と診断した。直ちに左内腸骨動脈塞栓術を施行し止血した。発症から止血まで3時間の間に赤血球32単位,新鮮凍結血漿28単位,血小板10単位の輸血を要した。(著者抄録)

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.21873/anticanres.15883.

Language：English   Publisher：Anticancer Research  

Background/Aim: We investigated whether the malignant switch of intraductal papillary mucinous neoplasm (IPMN) of the pancreas can be predicted by using the T1ρ, T2, and apparent diffusion coefficient (ADC) values of cyst fluid. Patients and Methods: We retrospectively analyzed the magnetic resonance (MR) images of 60 patients (26 males, 34 females, mean age 61 years) with branch-duct type and mixed-type IPMNs. The IPMNs were diagnosed clinically in 39 patients and histologically in 21 patients. The malignant potential was classified by MR imaging based on the international consensus guidelines for the management of IPMN established in 2017. Morphologically, 42 patients had "worrisome features" and three had "high-risk stigmata." Histologically, 14 lesions were diagnosed as low-grade dysplasia and seven as intermediate-grade dysplasia. The T1ρ, T2, and ADC values of cyst fluid in each patient's largest cyst were measured on the same slice, avoiding solid components. Spearman's rank correlation test was used to determine the correlation between the morphological malignancy and the T1ρ, T2, and ADC values. These values were also compared between the low-grade and intermediate-grade groups by Mann-Whitney U-test. Results: There was a significant rank-correlation between the morphological classification and T2 value (p=0.04). The T2 value of the intermediate-grade group was significantly higher than that of the low-grade group (p=0.03). No significant correlations were morphologically or histologically obtained regarding T1ρ and ADC. Conclusion: The T2 value of cyst fluid together with other MR-signs may be useful for predicting the malignant switch in IPMN of the pancreas.

DOI： 10.21873/anticanres.15883

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.2463/mrms.mp.2020-0151.

Language：English   Publisher：(一社)日本磁気共鳴医学会  

ガドキセト酸ナトリウム造影MRI(Gd-EOB-MRI)による肝細胞造影相(HBP)に、time-reversed gradient-echoシーケンスを用いたT2-enhanced spin-echoイメージング(T2FFEイメージング)を行い、肝血管腫と転移性腫瘍の鑑別能を比較した。2013年12月～2014年12月までの期間内に、著者らの所属する医療施設で肝腫瘍疑いのためGd-EOB-MRI検査が施行された患者のうち、選定基準を満たした患者61例(男性36例、女性25例、年齢32～83歳)に伴う肝血管腫37病巣と転移性腫瘍96病巣について後向きに評価した。その結果、3D fat-suppressed T2-weighted imaging(3D FS-T2WI)とT2FFEイメージング併用時のROC曲線下面積(AUC)は、3D FS-T2WIとDWIおよび見かけの拡散係数(ADC)併用時のAUCとの有意差はみられなかったが、病変の大きさに関係なくダイナミックGd-EOB-MRIのAUCに比べ有意に大きかった。以上より、Gd-EOB-MRIのHBPにおける3D FS-T2WIとT2FFEイメージングの併用により、3D FS-T2WIとDWIおよびADC併用と同等の正確度が得られ、肝血管腫と転移性腫瘍の鑑別に有用であることが確認された。

Language：English   Publisher：Japan Medical Association / The Japanese Associaiton of Medical Sciences  

<p><b>Introduction:</b> This study aimed to validate whether preoperative sarcopenia can predict long-term outcomes in patients with hepatocellular carcinoma (HCC) and identify the associations between sarcopenia and polyunsaturated fatty acids (PUFAs).</p><p><b>Methods:</b> This large, retrospective study included 353 patients who underwent hepatic resection for HCC and preoperative computed tomography scans. Skeletal muscle mass was measured at the third lumbar vertebrae. The cutoff value for sarcopenia followed the Japan Society of Hepatology's assessment criteria for sarcopenia.</p><p><b>Results:</b> Ninety-three patients (26.3%) with preoperative sarcopenia were enrolled. These patients had a significantly lower body mass index (p < 0.0001) and serum albumin level (p = 0.0070) as well as a higher rate of advanced-stage cancer (p = 0.0062) than those without sarcopenia. Patients with sarcopenia had significantly shorter overall survival than the other patients before (p = 0.0001) and after (p = 0.0415) propensity score matching. The sarcopenia group was significantly associated with low levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which were categorized based on omega-3 PUFAs, compared with those in the non-sarcopenia group (p = 0.0030 and p = 0.0135).</p><p><b>Conclusions:</b> We demonstrated an association between sarcopenia and the long-term prognosis in patients with HCC. Low EPA and DHA levels were associated with preoperative sarcopenia. Further prospective studies are needed to investigate whether nutritional support using omega-3 PUFAs can prevent and manage skeletal muscle mass depletion.</p>

DOI： 10.31662/jmaj.2022-0037

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CiNii Research

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.31662/jmaj.2022-0037.

Language：English   Publisher：(公社)日本医師会  

肝細胞癌患者において肝切除前のサルコペニアから術後の長期転帰を予測できるか検討し、サルコペニアと多価不飽和脂肪酸[エイコサペンタエン酸(EPA)およびドコサヘキサエン酸(DHA)]との関連を評価した。術前のCT画像から第3腰椎の骨格筋量を評価した。サルコペニアのカットオフ値は、日本肝臓学会のサルコペニア判定基準に従った。術前の血液検査でEPAとDHAを測定した。患者353例を解析対象とした。術前にサルコペニアを認めた患者(S群)は93例(中央値74歳、うち男性56例)。認めなかった患者(非S群)は260例(中央値70歳、男性191例)であった。S群は非S群よりBMI(p<0.0001)と血清アルブミン値(p=0.0070)が有意に低く、進行癌の割合が高かった(p=0.0062)。S群の全生存期間は非S群より有意に短かった(傾向スコアマッチング前p=0.0001、マッチング後p=0.0415)。S群は非S群よりEPAおよびDHAの低さと有意に関連した(p=0.0030およびp=0.0135)。以上から、肝細胞癌患者においてサルコペニアと長期予後は関連し、サルコペニアとEPAおよびDHAの低さも関連した。

Language：English   Publisher：Fukuoka Medical Association  

Purpose : The specific objectives of our study were to examine whether the visibility of hepatocellular carcinoma (HCC) lesions on early phase abdominal contrast-enhanced computed tomography (CT) images can be improved by optimal pseudo-colorization with a rainbow color map. / Methods : The chromaticity of grayscale and rainbow color maps displayed on a medical liquid-crystal display was measured using a colorimeter. The differences in the chromaticity, bE00, between the HCC lesion and liver parenchyma in 22 cases were evaluated. The rainbow color map was revised by changing only the window level (WL) to match the HCC lesion with a peak of bE00. Visual evaluation of the 22 cases was performed using Scheffeʼs paired comparison by ten observers. The average psychological measurement (a) was calculated using the grayscale, rainbow color map, and revised rainbow color map to examine the effectiveness of the proposed method. / Results : In all cases, the a measure was highest in the order of revised rainbow, grayscale, and rainbow. These results indicate that the visibility of HCC lesions in early phase abdominal contrastenhanced CT images could be improved by modifying the pseudo-color map with optimal colorization based on bE00. / Conclusions : The visibility of HCC lesions in early phase abdominal contrast-enhanced CT images was improved by shifting only the WL setting so that the HCC contrast would match the pixel range with higher bE00 on the rainbow color map. This method can be applied to various cases and color maps, and the visibility of the target lesion can be easily improved.

DOI： 10.15017/4795999

CiNii Research

Language：English   Publisher：福岡医学会  

【目的】本研究は、腹部造影コンピュータ断層撮影(CT)動脈相における肝細胞癌(HCC)病変の視認性が、rainbowカラーマップを使用した適切な疑似カラー画像化によって改善することを目的とした。【方法】医用画像表示用液晶ディスプレイに表示されるgrayscaleおよびrainbowカラーマップの色度を、色彩輝度計を使用して測定した。2017年4月から2019年12月までに腹部造影CT動脈相を撮影された22症例のHCC病変を対象とした。22症例において、HCC病変と肝実質の間の色度の違い(ΔE00)を評価した。適切なカラー画像化として、ウィンドウレベル(WL)のみを変更して、HCC病変のコントラストがRainbowカラーマップのΔE00の最も高いピクセル範囲に一致するようにRainbowカラーマップを修正した(revised rainbow)。10名の観察者によりScheffeの一対比較法を用いて22症例のHCC病変の視認性を評価した。提案した手法の有用性を調査するため、grayscale、rainbow、revised rainbowそれぞれにおいて、平均嗜好度(α)を求めた。【結果】すべての症例において(α)は、revised rainbow、grayscale、rainbowの順に高かった。これらの結果は、提案手法であるΔE00に基づいた適切な疑似カラー画像化によって、腹部造影CT動脈相におけるHCC病変の視認性を改善できることを示している。【結論】腹部造影CT動脈相におけるHCC病変の視認性は、HCC病変のコントラストがrainbowカラーマップ上のより高いΔE00のピクセル範囲と一致するようにWL設定のみをシフトすることによって改善された。本提案手法は、さまざまな症例やカラーマップに適用でき、標的病変の視認性を簡単に向上させることができる。(著者抄録)

Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

症例は40歳代男性。アルコール性肝硬変、陳旧性脳出血、糖尿病で加療中にCTで左腎細胞癌を指摘された。病変の大部分が腎実質に埋没しており、部分切除は困難と判断された。凍結療法目的で著者らの施設に紹介受診となった。造影CTで左腎上極腹側に1.8cm大の造影効果を伴う結節を認め、凍結針計3本を穿刺(1本は腎門部経由)して10分凍結、5分自然解凍、10分凍結を施行した。治療後3年の造影CTで凍結療法部に接して7mm大の造影効果を伴う結節が出現し、局所再発と考えた。また、凍結療法部から離れた左腎上極腎門部に10mm大の動脈瘤を疑う所見を認めた。再発腎細胞癌のリピオドールマーキングと仮性動脈瘤の塞栓を行い、翌日に再発腎細胞癌に対する凍結療法を行った。その後2年が経過したが、再発を認めていない。

DOI： 10.1200/JCO.2022.40.6_suppl.TPS397

Web of Science

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Magnetic Resonance Imaging  

Purpose: To investigate the utility of T1ρ and T2 relaxations for assessing the severity of liver fibrosis (F stage) and necro-inflammation (A stage) in patients with chronic liver disease (CLD). Materials and methods: We calculated T1ρ and T2 relaxations of the liver parenchyma in 82 patients who underwent liver surgery. F and A stages of enrolled patients were assessed by referring to surgically resected specimens. The relationships between T1ρ or T2 relaxation and F or A stage were assessed using one-way analysis of variance followed by Tukey's multiple comparison test, Spearman's rank correlation test and a receiver operating characteristic analysis. Results: The T1ρ and T2 values of the liver parenchyma were significantly increased as the F and A stages progressed. The T1ρ and T2 values showed significant differences between F0 and F4, between F1 and F4, and between F2 and F4. In addition, T1ρ values showed a significant difference between F0 and F3 as well. The highest diagnostic ability for fibrosis was obtained when differentiating ≥F3 from ≤F2 using T1ρ: the sensitivity was 82.8%, the specificity 79.2% and the area under the curve (AUC) 0.87. The sensitivity and AUC of T1ρ relaxation (46.9% and 0.67) were significantly higher than those of T2 relaxation (29.7% and 0.60) for differentiating ≥A1 from A0. Conclusion: T1ρ and T2 relaxations have potential as a biochemical marker for assessing the severity of liver fibrosis and necro-inflammation. T1ρ relaxation may be slightly superior to T2 relaxation in terms of diagnostic ability for liver fibrosis and necro-inflammation.

DOI： 10.1016/j.mri.2022.01.002

Web of Science

Scopus

PubMed

Language：English   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: To evaluate the utility of T2-enhanced spin-echo imaging using the time-reversed gradient echo sequence (T2FFE imaging) in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI (Gd-EOB-MRI) for differentiating hemangiomas from metastatic tumors.</p><p>Methods: A total of 61 patients with 133 liver lesions, including 37 hemangiomas and 96 metastatic tumors, were scanned by Gd-EOB-MRI. Four data sets were independently analyzed by two readers: (1) 3D fat-suppressed T2-weighted imaging (FS-T2WI) alone; (2) the combination of 3D FS-T2WI and T2FFE imaging in the HBP of Gd-EOB-MRI; (3) the combination of 3D FS-T2WI, diffusion-weighted imaging (DWI) with the b-value of 1000 s/mm² and the apparent diffusion coefficient (ADC); and (4) a dynamic study of Gd-EOB-MRI. After classifying the lesion sizes as ≤ 10 mm or > 10 mm, we conducted a receiver-operating characteristic analysis to compare diagnostic accuracies among the four data sets for differentiating hemangiomas from metastatic tumors.</p><p>Results: The areas under the curves (AUCs) of the four data sets of two readers were: (1) ≤ 10 mm (0.85 and 0.91) and > 10 mm (0.88 and 0.97), (2) ≤ 10 mm (0.94 and 0.94) and > 10 mm (0.96 and 0.95), (3) ≤ 10 mm (0.90 and 0.87) and > 10 mm (0.89 and 0.95), and (4) ≤ 10 mm (0.62 and 0.67) and > 10 mm (0.76 and 0.71), respectively. Data sets (2) and (3) showed no significant differences in AUCs, but both showed significantly higher AUCs compared to that of (4) regardless of the lesion size (<i>P</i> < 0.05).</p><p>Conclusion: The combination of 3D FS-T2WI and T2FFE imaging in the HBP of Gd-EOB-MRI achieved an accuracy equivalent to that of the combination of 3D FS-T2WI, DWI, and ADC and might be helpful in differentiating hemangiomas from metastatic tumors.</p>

DOI： 10.2463/mrms.mp.2020-0151

Web of Science

Scopus

PubMed

CiNii Research

Language：Japanese   Publisher：The Japanese Society of Interventional Radiology  

The clinical diagnosis of soft tissue tumors, especially malignant sarcomas, is highly dependent on histopathological diagnosis by biopsy. However, the rarity of sarcomas makes it difficult to accumulate knowledge and improve techniques, and inappropriate biopsies are frequently performed. Inappropriate biopsy techniques can make surgery difficult and worsen the patient's prognosis, and so biopsies should be performed by experienced operators in appropriate facilities. The important thing to note during biopsy is that the tumor capsule is disrupted at biopsy, and the access route is invariably “contaminated” with tumor. Therefore, the technique and route of biopsy must consider that the access route must be removed along with the tumor during wide resection after biopsy. In addition, the target should be carefully defined to avoid necrosis and hemorrhage and to biopsy the components with high viability. Accordingly, it is important to examine the surrounding anatomy and internal structure of the tumor in detail preoperatively using appropriate imaging modalities in order to perform an effective and safe biopsy.

DOI： 10.11407/ivr.36.119

CiNii Research

Language：Japanese   Publisher：The Japanese Society of Interventional Radiology  

We treated a patient with a pseudoaneurysm detected 3 years after cryoablation for renal cell carcinoma (RCC). The pseudoaneurysm was located in the hilar region of the kidney, which was the puncture route of the cryo-needle but outside the area of the cryoablation. The puncture through the renal hilum was thought to be one of the factors that led to the development of the pseudoaneurysm. Since the angiographic findings revealed the pseudoaneurysm to be accompanied by an arteriovenous fistula, we speculate that the arteriovenous fistula was first induced by the renal hilar puncture and that the pseudoaneurysm was formed by prolonged arterial pressure stimulation. The development of arteriovenous fistulae and pseudoaneurysms should be considered in cases in which cryoablation for RCC is performed by a puncture through the renal hilum.

DOI： 10.11407/ivr.36.147

CiNii Research

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.21873/invivo.12656.

Language：Japanese   Publishing type：Research paper (scientific journal)  

目的：小径腎癌は一般的に予後良好であるが、高悪性度の一部は転移し予後不良となり、予後不良群を抽出するリスク層別化因子の同定が望まれている。本研究では、ゲノムプロファイリングとperfusion CT (pCT)やMRIの所見との関係性を評価し、有効なバイオマーカーとして利用できるイメージング因子の同定を試みた。
方法：2018/4～2019/3の間にpCT、MRIを施行した淡明細胞癌18例に対して生検組織からRNA　sequenceを施行し発現量を求めた。本研究では腎癌におけるゲノムプロファィリングを元とした予後因子に細胞周期（CCP）スコアとclear cell type A/ clear cell type B (ccA/ccB) サブタイプを採用した。CCPスコアは腎癌における転移の独立予後因子、ccA/ccBサブタイプではccAに分類された症例はccBに対して予後が良好なことが判明している。
腫瘍の画像評価では、腫瘍径と脂肪・偽被膜の有無を評価し、また腫瘍の画像パラメータ（Ktrans・Kep・VE・VP・ADC）を測定した。これらのパラメータと腫瘍径腫瘍のザイズ、RNA発現との関連性を評価した。
結果：腫瘍径はKepと正の相関、VE, VP, ADC, 血管新生のRNA発現と負の相関を示した。CCPスコアはKep. KtransKtrans, Kepと負の相関を示した。ccAに分類された腫瘍ではMRIで偽被膜が観察しやすい傾向があった。
結論：腫瘍径は腫瘍の低灌流と関連があったが、ゲノムプロファイリングをもとにした予後因子との関連は見られなかった。KtransやKepといったパラメータや偽被膜といった腫瘍の特徴は遺伝子ベースのリスク層別化を可能にするかもしれない。

DOI： 10.1371/journal.pone.0256471

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.5334/jbsr.2444.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/acm2.13318.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.transproceed.2021.02.024.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.ejrad.2021.109575.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00270-020-02709-w

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.2463/mrms.tn.2019-0183.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.mri.2020.08.018.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1111/hepr.13477.

Language：English   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1148/rg.2020190037.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.ejrad.2019.108656.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00261-019-02189-8.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00270-019-02238-1.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1111/1754-9485.12925

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

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DOI： 10.1093/nar/gki214

Language：English  

DOI： 10.1093/nar/gkh642

Language：English  

DOI： 10.1093/nar/gkh214

Language：English  

DOI： 10.1074/jbc.C300316200

Language：Japanese  

Event date： 2022.5

Language：English  

Country：United States  

Event date： 2021.5

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2020.8

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2019.9

Language：English  

Country：Spain  

Event date： 2019.5 - 2019.6

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2019.2 - 2018.3

Language：English  

Venue：Varna   Country：Austria  

Event date： 2018.5 - 2018.6

Language：English  

Country：Japan  

Event date： 2017.2

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2016.5

Language：English   Presentation type：Oral presentation (general)  

Venue：Miyazaki   Country：Japan  

Event date： 2015.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡   Country：Japan  

Event date： 2014.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：奈良   Country：Japan  

Event date： 2014.3

Language：English   Presentation type：Symposium, workshop panel (public)  

Venue：Viena   Country：Austria  

Event date： 2013.12

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡   Country：Japan  

Event date： 2013.5

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：軽井沢   Country：Japan  

Event date： 2013.4

Venue：横浜   Country：Japan  

Event date： 2013.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜   Country：Japan  

Event date： 2012.12

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2012.11

Language：English  

Country：United States  

Event date： 2012.9

Language：English   Presentation type：Oral presentation (general)  

Venue：Nagasaki   Country：Japan  

Event date： 2012.5 - 2012.6

Country：Japan  

Event date： 2011.11 - 2011.12

Venue：Chicago   Country：United States  

Event date： 2011.8

Venue：大阪   Country：Japan  

Event date： 2011.5

Venue：金沢   Country：Japan  

Event date： 2010.6

Venue：軽井沢   Country：Japan  

Event date： 2008.12 - 2008.11

Venue：Chucago   Country：United States  

Event date： 2008.5

Venue：Karuizawa   Country：Japan  

Event date： 2008.4

Venue：横浜   Country：Japan  

Event date： 2007.6 - 2011.6

Venue：熊本   Country：Japan  

Event date： 2007.6

Venue：宮崎   Country：Japan  

Event date： 2006.9

Venue：筑波   Country：Japan  

Event date： 2006.5 - 2006.7

Venue：東京   Country：Japan  

Language：Japanese  

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Language：Japanese  

Language：Japanese  

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Language：Japanese  

Language：English  

Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Type：Competition, symposium, etc. 

Type：Competition, symposium, etc. 

Type：Competition, symposium, etc.