Prediction of Embolization Area after Conventional Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma Using SYNAPSE VINCENT

Purpose: Transcatheter arterial chemoembolization (TACE) is one of the most effective therapeutic options for hepatocellular carcinoma (HCC) and it is important to protect residual liver function after treatment as well as the effect. To reduce the liver function deterioration, we evaluated the automatic software to predict the embolization area of TACE in 3 dimensions. Materials and Methods: Automatic prediction software of embolization area was used in chemoembolization of 7 HCCs. Embolization area of chemoembolization was evaluated within 1 week CT findings after TACE and compared simulated area using automatic prediction software. Results: The maximal diameter of these tumors is in the range 12-42 mm (24.6 ± 9.5 mm). The average time for detecting tumor-feeding branches was 242 s. The total time to detect tumor-feeding branches and simulate the embolization area was 384 s. All cases could detect all tumor-feeding branches of HCC, and the expected embolization area of simulation with automatic prediction software was almost the same as the actual areas, as shown by CT after TACE. Conclusion: This new technology has possibilities to reduce the amount of contrast medium used, protect kidney function, decrease radiation exposure, and improve the therapeutic effect of TACE.

Η αξιολόγηση της κάθαρσης του πράσινου της ινδοκυανίνης (ICG) προεγχειρητικά ως μέθοδος ελέγχου της ηπατικής λειτουργίας μετά ηπατεκτομή

Purpose: Liver failure is a major cause of early mortality followinghepatectomy. The future-remnant liver function is an important factor whenassessing the risk for postoperative liver impairment. Several techniques havebeen established for this evaluation, including the ICG test. Aim of the study isto evaluate the ICG clearance in patients scheduled for liver resectionregarding perioperative and postoperative risk factors.Methods: Thirty-one patients, scheduled for liver resection, underwent theICG test. Peri-operative and postoperative variables were recorded andanalyzed using non-parametric tests.Results: Procedures extended from wedge excisions to extendedhepatectomies. Major complications included 1 case of a non-ST elevationmyocardial infarct, 1 case of inferior vena cava thrombosis, 2 cases of liverinsufficiency and 1 case of renal failure. Two patients died due to myocardialinfarction and postoperative liver failure respectively. PDR was foundpositively correlated with total blood loss, transfusion and operation duration.Conclusions: The role of residual liver function and particularly the hepaticreserve assessment on liver surgery may be of most benefit in the routinestratification of risk, enabling surgical procedures to be performed with safety.In this study, the ICG clearance markers were found significantly correlated with perioperative risk factors in histologically „normal‟ liver parenchyma.Interpretation of ICG clearance results may appraise in these patients aninadequate hepatic reserve in the remaining parenchyma postoperatively.Thus, in addition to CT volumetry, functional assessment of the hepaticreserve with ICG may persuade the preoperative planning and preventpostoperative liver failure.

Quantitative rat liver function test by galactose single point method

Summary The purpose of this study was to investigate the galactose single point (GSP) method, a residual liver function test recently recommended by the US Food and Drug Administration, which can be a useful tool for rat liver function measurement. Rats were treated either with carbon tetrachloride (CCl4) alone (1 mL/kg, intraperitoneally [i.p.]) for one day or with isoniazid (INH) alone (150 mg/kg, i.p.) or (in order to ameliorate the effects of INH) with a combination of INH and bis- p-nitrophenyl phosphate (BNPP) (25 mg/kg, i.p.) for 21 days. Hepatotoxicity was assayed by plasma aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities and scores of histological activity index-necroinflammation (HAI-NI) of the respective liver specimens. The GSP method in rats was defined by the galactose blood level after 60 min. Significant differences in GSP values were observed between controls and the CCl4-treated rats. After 21 days of treatment, no significant changes in AST and ALT values were observed among the control, INH and INH-BNPP groups. There were significant differences in average GSP values for controls ( P < 0.001) and INH-BNPP ( P < 0.001) compared with INH alone. Highly significant correlations ( P < 0.001) were obtained between GSP and scores of HAI-NI for all the groups. GSP was concluded to be a more sensitive biomarker of INH-induced hepatotoxicity than AST or ALT in the rats. The GSP method has been proved to be a simple and useful tool for the quantitative determination of liver function in rats, which can possibly be extended to other animals.