Small Hepatocellular Carcinoma

Twenty-two patients with 37 small (3 cm or less) nodular lesions of hepatocellular carcinoma (HCC) were examined with ultrasonography (US), CT, MR imaging, digital subtraction angiography (DSA), and CT following intraarterial injection of Lipiodol (Lipiodol-CT). All patients subsequently underwent surgery, and the gold standard was provided by intraoperative US. The detection rate was 70% for US, 65% for CT, 62% for MR imaging, 73% for DSA, and 86% for Lipiodol-CT. A significant difference (p<0.05) was observed between the detection rate of Lipiodol-CT and the detection rates of all the other imaging modalities. The difference was even more manifest (p<0.02) when only lesions smaller than or equal to 1 cm were considered. It is concluded that Lipiodol-CT is the single most sensitive examination to detect small nodules of HCC. It should therefore be considered a mandatory step in the preoperative evaluation of patients with HCC considered to be surgical candidates after noninvasive imaging studies.

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Digital versus screen film mammography: Impact on positive predictive values following transition.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.12 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 12-12

Author(s):

Elizabeth Roy ◽

David Motiuk ◽

Paul Burrowes ◽

Bobbie Docktor

Keyword(s):

Detection Rate ◽

Precancerous Lesions ◽

Premalignant Lesions ◽

Breast Lesions ◽

Benign Lesions ◽

Detection Rates ◽

Predictive Values ◽

Significant Difference ◽

History Of ◽

The Difference

12 Background: The Calgary Health Region changed from screen film mammography (SFM) to digital mammography (DM) in 2005. This retrospective study was designed to determine the effect of this conversion on positive predictive values (PPV) for cancerous and precancerous breast lesions. Methods: In the Calgary region, biopsies for mammographic calcifications are only done at Foothills Medical Centre (FMC) by a small group of mammographers employing homogeneous techniques. From FMC’s database, we reviewed core biopsy data for mammographic calcifications in the years 2002-2004 (SFM years) and 2008-2010 (DM years). Mammographic masses were excluded. We determined PPVs for each set of years for detection of cancerous lesions (PPV3for calcifications). We further calculated the PPVs of SFM and DM for detection of high-risk lesions, including ADH, ALH, LCIS, and papilloma collectively (precancerous lesions). The detection rates of benign lesions (excluding precancerous lesions) after biopsy were also determined. Statistical analysis was performed using two-tail z-tests. Results: 3,778 biopsies in 3,544 patients were reviewed. The difference in overall detection rate of cancer after biopsy for mammographic calcification between SFM (PPV3 = 24.7%) and DM (PPV3 = 23.8%) was not statistically significant (p = .53). On further analysis, the PPV for precancerous lesions increased (p < .0001) in DM (11.6%) versus SFM (7.8%). No significant difference (p = .065) was found in detection of benign lesions. Conclusions: In comparing DM to SFM, we found no significant change in PPV3 with respect to calcifications. However, with DM, there was a statistically significant increase in detection of lesions considered at risk for future malignancy. Given that the natural history of these premalignant lesions is incompletely understood, the significance of this finding is in question. This potential trend could be further strengthened by determining PPV1for cancerous and precancerous lesions with respect to calcifications. [Table: see text]

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MRI-directed biopsy for primary detection of prostate cancer in a population of 223 men: MRI In-Bore vs MRI-transrectal ultrasound fusion-targeted techniques

British Journal of Radiology ◽

10.1259/bjr.20210528 ◽

2021 ◽

Author(s):

Maurizio Del Monte ◽

Stefano Cipollari ◽

Francesco Del Giudice ◽

Martina Pecoraro ◽

Marco Bicchetti ◽

...

Keyword(s):

Prostate Cancer ◽

Detection Rate ◽

Transrectal Ultrasound ◽

Focal Therapy ◽

Malignant Cells ◽

Median Percentage ◽

Detection Rates ◽

Biopsy Core ◽

Significant Difference ◽

Chi Squared

Objectives: To compare the detection rates of overall prostate cancer (PCa) and clinically significant PCa (csPCa) and the median percentage of cancer per biopsy core between MRI-guided In-bore and MRI-TRUS fusion-targeted biopsy (TBx). Methods: In this retrospective study, 223 patients who underwent prostate multiparametric MRI (mpMRI) and subsequent MR-directed biopsy were included. For PCa and csPCa detection rate (DR), contingency tables were tested via the Pearson’s chi-squared to explore the variance of the outcome distribution. The percentage of cancer per biopsy core was tested with a two-tailed Mann-Withney test. Results: One hundred and seventeen and 106 patients underwent MRI-TRUS fusion or MRI In-bore TBx, respectively. 402 MRI biopsy targets were identified, of which 206 (51.2%) were biopsied with the MRI-TRUS TBx and 196 (48.8%) with the MRI In-bore TBx technique. Per-patient PCa and csPCa detection rates were 140/223 (62.8%) and 97/223 (43.5%), respectively. PCa-DR was 73/117 (62.4%) and 67/106 (63.2%) for MRI-TRUS and MRI In-Bore TBx (p = 0.9), while csPCa detection rate reached 50/117 (42.7%) and 47/106 (44.3%), respectively (p = 0.81). The median per-patient percentage of malignant tissue within biopsy cores was 50% (IQR: 27–65%) for PCa and 60% (IQR: 35–68%) for csPCa, with a statistically significant difference between the techniques. Conclusion No statistically significant difference in the detection rate of MRI In-bore and MRI-TRUS fusion TBx was found. MRI In-bore TBx showed higher per-core percentage of malignant cells. Advances in knowledge MRI In-bore biopsy might impact risk stratification and patient management considering the higher per-core percentage of malignant cells, especially for patients eligible for active surveillance or focal therapy.

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Detection of SFTS Virus RNA and Total Antibodies in Wild Animals, Jiangsu, China, 2014-2019

10.21203/rs.3.rs-520795/v1 ◽

2021 ◽

Author(s):

Shuyi Liang ◽

Zhifeng Li ◽

Nan Zhang ◽

Xiaochen Wang ◽

Jianli Hu

Keyword(s):

Detection Rate ◽

Jiangsu Province ◽

Enzyme Linked Immunosorbent Assay ◽

Wild Animals ◽

Detection Rates ◽

Qrt Pcr ◽

Virus Rna ◽

Significant Difference ◽

Severe Fever ◽

Antibodies Detection

Abstract Background Severe fever with thrombocytopenia syndrome (SFTS) is a novel infectious disease caused by severe fever with thrombocytopenia syndrome virus (SFTSV). Currently, SFTS is endemic to some areas in China, and wild animals are considered to play important roles in the circulation of SFTSV in the environment. Wild animals monitoring for SFTSV has been fulfilled since 2014 in Jiangsu Province. We studied the results of the detection to provide basic data for better diagnosis of wild animals. Methods This research was conducted in Jiangsu Province from 2014 to 2019. Sera of wild animals (Rodents, pheasants and hedgehogs) were collected to detect SFTSV both RNA and total antibodies by qRT-PCR and enzyme-linked immunosorbent assay. Statistical analysis was performed by using SPSS 25.0 (Chicago, IL, USA).Results A total of 95.8% (1298/1355) of the specimens had the same SFTSV RNA and total antibodies detection results. However, there was a significant difference between the detection rates of SFTSV RNA and total antibodies, and the detection consistency was very poor. The detection rate of SFTSV total antibodies was highest in hedgehogs(19.54%).Conclusions SFTSV total antibodies testing was preferred method during wild animals surveillance. Also, hedgehog could be a competent reservoir for SFTSV.

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Dosimetry and Comparison between Different CT Protocols (Low Dose, Ultralow Dose, and Conventional CT) for Lung Nodules’ Detection in a Phantom

Radiology Research and Practice ◽

10.1155/2021/6667779 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Cleverson Alex Leitão ◽

Gabriel Lucca de Oliveira Salvador ◽

Priscilla Tazoniero ◽

Danny Warszawiak ◽

Cristian Saievicz ◽

...

Keyword(s):

Detection Rate ◽

Low Dose ◽

Lung Nodule ◽

Lung Nodules ◽

Ultralow Dose ◽

Thermoluminescent Dosimeters ◽

Significant Difference ◽

Nodule Detection ◽

The Difference ◽

Conventional Ct

Background. The effects of dose reduction in lung nodule detection need better understanding. Purpose. To compare the detection rate of simulated lung nodules in a chest phantom using different computed tomography protocols, low dose (LD), ultralow dose (ULD), and conventional (CCT), and to quantify their respective amount of radiation. Materials and Methods. A chest phantom containing 93 simulated lung nodules was scanned using five different protocols: ULD (80 kVp/30 mA), LD A (120 kVp/20 mA), LD B (100 kVp/30 mA), LD C (120 kVp/30 mA), and CCT (120 kVp/automatic mA). Four chest radiologists analyzed a selected image from each protocol and registered in diagrams the nodules they detected. Kruskal–Wallis and McNemar’s tests were performed to determine the difference in nodule detection. Equivalent doses were estimated by placing thermoluminescent dosimeters on the surface and inside the phantom. Results. There was no significant difference in lung nodules’ detection when comparing ULD and LD protocols ( p = 0.208 to p = 1.000 ), but there was a significant difference when comparing each one of those against CCT ( p < 0.001 ). The detection rate of nodules with CT attenuation values lower than −600 HU was also different when comparing all protocols against CCT ( p < 0.001 to p = 0.007 ). There was at least moderate agreement between observers in all protocols (κ-value >0.41). Equivalent dose values ranged from 0.5 to 9 mSv. Conclusion. There is no significant difference in simulated lung nodules’ detection when comparing ULD and LD protocols, but both differ from CCT, especially when considering lower-attenuating nodules.

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Balloon-Occluded Trans-Arterial Chemoembolization Technique with Alternate Infusion of Cisplatin and Gelatin Slurry for Small Hepatocellular Carcinoma Nodules Adjacent to the Glisson Sheath

BioMed Research International ◽

10.1155/2019/8350926 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Toshiyuki Irie ◽

Nobuyuki Takahashi ◽

Toshiro Kamoshida

Keyword(s):

Hepatocellular Carcinoma ◽

Contrast Medium ◽

Drug Carrier ◽

Objective Response ◽

Small Hepatocellular Carcinoma ◽

Small Tumor ◽

Study Results ◽

Significant Difference ◽

Tace Group ◽

Arterial Chemoembolization

Objective. It is difficult to control small hepatocellular carcinoma (HCC) nodules adjacent to the Glisson sheath (GS) by trans-arterial chemoembolization (TACE) probably due to multiple small tumor feeders directly branching from the trunk artery. The purpose of this study was to conduct a retrospective evaluation of a new TACE technique called the repeated alternate infusion of cisplatin solution and gelatin slurry distal to balloon occlusion (RAIB-TACE), for the treatment of small HCC nodules adjacent to GS. Materials and Methods. Small nodules less than 4 cm attached to proximal portion of the subsegmental to lobar level portal branch were retrospectively selected. Between January 2011 and April 2014, 29 nodules in 29 patients were treated by super-selective lipiodol TACE/balloon-occluded TACE (B-TACE) (Lip-TACE group). Since April 2014, treatment protocols for small nodules adjacent to GS were changed, and 14 nodules in 12 patients were treated by RAIB-TACE (RAIB-TACE group). In RAIB-TACE group, alternate infusion of cisplatin solution and sparse gelatin slurry (mixture of 80 mg of gelatin fragments and 20 mL of contrast medium) were repeated until arterial flow was ceased. In Lip-TACE group, lipiodol was used as drug carrier and dense gelatin slurry (mixture of 80 mg of gelatin fragments and 2 mL of contrast medium) as embolization material. Dynamic CT/MRI was obtained 1-3 months after TACE, and response of each nodule was evaluated basing on modified RECIST criteria. Results. In RAIB-TACE group, all 14 nodules (100%) were diagnosed as CR or PR. In Lip-TACE group, 18 of 29 (62.1%) were diagnosed as CR or PR. There was a statistically significant difference in objective response ratio between the groups (p=0.008, Fisher’s test). Biloma (n=1) and benign stricture of the right hepatic duct (n=1) were seen in RAIB-TACE group. The biloma shrunk without treatment and the patient had no symptom, but the patient with biliary stricture repeated cholangitis and was treated by administration of antibiotics. Conclusion. The study results show that RAIB-TACE is more effective than lipiodol TACE/B-TACE for small hepatocellular carcinoma adjacent to GS. We speculate that one of the reasons to explain why Lip-TACE is inferior to RAIB-TACE is that viscous lipiodol or dense gelatin slurry could not flow into small tumor feeders effectively.

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Impact of diffusion-weighted MR imaging on the characterization of small hepatocellular carcinoma in the cirrhotic liver

Magnetic Resonance Imaging ◽

10.1016/j.mri.2012.01.002 ◽

2012 ◽

Vol 30 (5) ◽

pp. 656-665 ◽

Cited By ~ 41

Author(s):

François Le Moigne ◽

Marion Durieux ◽

Brigitte Bancel ◽

Nawele Boublay ◽

Loïc Boussel ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Mr Imaging ◽

Cirrhotic Liver ◽

Small Hepatocellular Carcinoma ◽

Diffusion Weighted

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A multicenter nonrandomized controlled trial to evaluate the efficacy of surgery versus radiofrequency ablation for small hepatocellular carcinoma (SURF cohort trial).

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.4581 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 4581-4581

Author(s):

Ryosuke Tateishi ◽

Kiyoshi Hasegawa ◽

Yoshikuni Kawaguchi ◽

Tadatoshi Takayama ◽

Namiki Izumi ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Early Stage ◽

Controlled Trial ◽

Patient Characteristics ◽

Small Hepatocellular Carcinoma ◽

Multicenter Randomized Controlled Trial ◽

Early Hcc ◽

The Difference

4581 Background: In parallel with a multicenter randomized controlled trial that reported an equal recurrence-free survival (RFS) of early-stage hepatocellular carcinoma (HCC) patients who underwent either surgery (SUR) or radiofrequency ablation (RFA), we also enrolled HCC patients who fulfilled the enrollment criteria but did not give consent to participate in the RCT. Methods: All patients gave informed consent to participate in this study. Inclusion criteria were as follows: primary HCC with less than or equal to 3 tumors, each measuring 3 cm or smaller; without vascular invasion or extrahepatic metastasis; Child-Pugh score of 7 or less; and ages between 20 and 79 years. The feasibility for both treatments was confirmed by a joint chart review by surgeons and hepatologists. The primary endpoint was RFS and overall survival. A pre-specified interim analysis was performed to compare RFS. Results: Between April 2009 and August 2015, 740 patients (371 in SUR, 369 in RFA) were enrolled from 49 participating hospitals in Japan. The SUR group had significantly fewer patients with chronic hepatitis C (56.6% vs. 69.4%), higher median value of platelet count (145 vs. 120 × 109/L), and more patients with > 2 cm tumors (49.9% vs. 27.9%); most patients had a single tumor (91.1% vs. 88.3%). During the median follow-up period of 5 years, tumor recurrence was observed in 192 of SUR and 218 of RFA with 3-year RFS being 66.0% and 61.7%, respectively ( P = 0.091). In subgroup analysis, RFS was significantly better in SUR in patients with ≤ 2 cm tumors (62.9% vs. 51.7% in 3 years; hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.56-0.93; P = 0.014), whereas the difference was not significant in those with > 2 cm tumors (52.7% vs. 46.4%; HR 0.85, 95% CI 0.63-1.18; P = 0.34). The adjusted HR for RFS using inversed probability of treatment weighting was 0.89 (95% CI, 0.72-1.10; P = 0.287). Conclusions: The imbalance in patient characteristics reflected a real-world practice. Factors related to background liver disease rather than tumor characteristics might have a larger impact on the recurrence in early HCC. Clinical trial information: C000001796 .

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3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

Prostate Cancer ◽

10.1155/2013/783243 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

Alexandre Peltier ◽

Fouad Aoun ◽

Fouad El-Khoury ◽

Eric Hawaux ◽

Ksenija Limani ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Detection ◽

Prostate Biopsy ◽

Detection Rate ◽

Transrectal Ultrasound ◽

Daily Practice ◽

Cancer Detection Rate ◽

Prior History ◽

Detection Rates ◽

Significant Difference

Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice.Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol.Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05). There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection.Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

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Three-dimensional constructive interference in steady-state magnetic resonance imaging in syringomyelia: advantages over conventional imaging

Journal of Neurosurgery Spine ◽

10.3171/spi/2008/8/5/429 ◽

2008 ◽

Vol 8 (5) ◽

pp. 429-435 ◽

Cited By ~ 23

Author(s):

Florian Roser ◽

Florian H. Ebner ◽

Søren Danz ◽

Felix Riether ◽

Rainer Ritz ◽

...

Keyword(s):

Spinal Cord ◽

Steady State ◽

Magnetic Resonance ◽

Mr Imaging ◽

Preoperative Evaluation ◽

Motion Artifacts ◽

Csf Flow ◽

Constructive Interference ◽

Detection Rates ◽

Mr Sequences

Object Neuroradiology has become indispensable in detecting the pathophysiology in syringomyelia. Constructive interference in steady-state (CISS) magnetic resonance (MR) imaging can provide superior contrast at the sub-arachnoid tissue borders. As this region is critical in preoperative evaluation, the authors hypothesized that CISS imaging would provide superior assessment of syrinx pathology and surgical planning. Methods Based on records collected from a database of 130 patients with syringomyelia treated at the authors' institution, 59 patients were prospectively evaluated with complete neuroradiological examinations. In addition to routine acquisitions with FLAIR, T1- and T2-weighted, and contrast-enhanced MR imaging series, the authors obtained sagittal cardiac-gated sequences to visualize cerebrospinal fluid (CSF) pulsations and axial 3D CISS MR sequences to detect focal arachnoid webs. Statistical qualitative and quantitative evaluations of spinal cord/CSF contrast, spinal cord/CSF delineation, motion artifacts, and artifacts induced by pulsatile CSF flow were performed. Results The 3D CISS MR sequences demonstrated a contrast-to-noise ratio significantly better than any other routine imaging sequence (p < 0.001). Moreover, 3D CISS imaging can detect more subarachnoid webs and cavitations in the syrinx than T2-weighted MR imaging with less flow-void artifact. The limitation of 3D CISS imaging is a susceptibility to motion artifacts that can cause reduced spatial resolution. Lengthy acquisition times for axial segments can be reduced with multiplanar reconstruction of 3D CISS–generated sagittal images. Conclusions Constructive interference in steady-state imaging is the MR sequence of choice in the preoperative evaluation of syringomyelia, allowing significantly higher detection rates of focal subarachnoid webs, whereas standard T2-weighted MR imaging shows turbulent CSF flow voids. Constructive interference in steady-state MR imaging enables the neurosurgeon to accurately identify cases requiring decompression for obstructed CSF. Motion artifacts can be eliminated with technical variations.

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