A5084454250- Hepatocellular Carcinoma Treatment and Prognosis
- Liver Disease Diagnosis and Treatment
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Pancreatic and Hepatic Oncology Research
- MRI in cancer diagnosis
- Medical Imaging and Pathology Studies
- Radiomics and Machine Learning in Medical Imaging
- Gallbladder and Bile Duct Disorders
- Pancreatitis Pathology and Treatment
- Colorectal Cancer Treatments and Studies
- Endoplasmic Reticulum Stress and Disease
- Cancer Diagnosis and Treatment
- Pediatric Hepatobiliary Diseases and Treatments
- Lung Cancer Treatments and Mutations
- Advanced MRI Techniques and Applications
- Medical Imaging Techniques and Applications
- Immune Cell Function and Interaction
- Liver physiology and pathology
- Genetic factors in colorectal cancer
- Caveolin-1 and cellular processes
- Cytokine Signaling Pathways and Interactions
- Tracheal and airway disorders
- Ultrasound and Hyperthermia Applications
- Diagnosis and treatment of tuberculosis
- Colorectal and Anal Carcinomas
Kyoto Katsura Hospital
2015-2024
Kyoto University
2010-2015
Osaka Red Cross Hospital
2007-2012
Abstract Background Although atezolizumab plus bevacizumab (Atezo/Bev) therapy has been used as the preferred first-line treatment for advanced hepatocellular carcinoma (HCC), up to 26% of patients do not achieve disease control, suggesting alternative treatments might be more beneficial such patients. We investigated key predictors refractoriness Atezo/Bev therapy, particularly in setting. Methods retrospectively analyzed 302 with HCC who received between October 2020 and September 2022...
<b><i>Background/Aims:</i></b> Direct-acting antiviral agents (DAAs) have increased the sustained viral response rate with minimal adverse effects and short treatment duration. In addition, recent data suggest possibility that hepatitis C virus (HCV) clearance results in rapid improvement metabolic pathways. The aim of present study was to evaluate whether DAA without ribavirin lowers hemoglobin A1c (HbA1c) at 12 weeks after therapy completion....
Corona enhancement is the visualized drainage area from a hypervascular tumor observed on single-level dynamic computed tomography during hepatic arteriography (CTHA) and thought to be high-risk for micrometastases. However, because it cannot with ordinary ultrasonography (US), we aimed visualize corona US by means of arterial injection contrast material measure its thickness. Forty-one hepatocellular carcinoma (HCC) cases were prospectively investigated. (USHA) was executed selective...
Chronic inflammation triggers the aberrant expression of a DNA mutator enzyme, activation-induced cytidine deaminase (AID), and contributes to tumorigenesis through accumulation genetic aberrations. To gain further insight into inflammation-mediated genotoxic events required for carcinogenesis, we examined role chronic in emergence aberrations liver with constitutive AID expression. Treatment thioacetamide (TAA) at low-dose concentrations caused minimal hepatic both wild-type (WT) transgenic...
【目的】RFA後の治療効果判定として結節周囲に得られた凝固域の程度に応じて症例を分類し，それぞれの局所再発率を求めその意義を検討する．【方法】RVS誘導下RFAを施行した77症例99結節を対象とした．結節周囲に得られた凝固域の程度に応じて根治度（Radicality grade, R grade）を4段階（R0, R1, R2, R3）に定義した．根治度ごとの累積局所再発率を求めるとともに，局所再発に寄与する因子を解析した．また，再発症例において，再発部位における治療後腫瘍との距離を検討した．【結果】根治度別の累積局所再発率は，2年で，R3：3.7%, R2：13.6%, R1：52.6%, R0：66.7%であった．多変量解析では根治度のみが局所再発に寄与する独立した有意な因子として検出された．局所再発した25例のうち20例は，治療結節外側の凝固域が5 mm未満の部位に再発を認めた．【結論】RFAの良好な治療効果判定基準として，全周に5 mm以上の凝固域を獲得することが望まれる．
A 79-year-old man was admitted to our hospital because of increased hepatobiliary enzyme levels. Dynamic computed tomography and magnetic resonance imaging showed a liver tumor measuring 60 mm containing fat foci at the cranial aspect tumor. We diagnosed patient with hypovascular hepatocellular carcinoma (HCC) deposition, performed caudate lobe resection. Pathology examination revealed two intermingled components: moderately differentiated HCC deposition neuroendocrine (NEC). Primary...
A 70-year-old man was diagnosed with multiple lung metastases from hepatocellular carcinoma, and lenvatinib initiated. Three months later, the response progressive disease. Sorafenib therapy as a second-line drug started. had shrunk. After sorafenib failure, patient received regorafenib treatment for six until failure. rechallenge fourth-line The rechallenge, which continued two months, induced partial response. after failure may be good option, but further prospective studies are needed.
肝癌に対するラジオ波熱凝固療法（RFA）は小型肝癌に対する標準治療として普及している．本邦でのRFAはモノポーラ機器が用いられてきたが，2012年9月に「バイポーラRFAシステムCelonPOWER」が保険適用となった．2008～9年に大阪赤十字病院を含む国内4施設で当機器の臨床試験が行われ，そのうち当院における全27症例を検討し報告する．1回のRFAで十分な凝固域が得られた割合は全33結節中28結節（84.8%）であり，追加治療を行った4結節は全て2回目のRFAで十分な凝固域が得られた．十分な凝固域を得た31結節のうち経過観察中に（平均観察期間14.3カ月）局所再発を認めたものは2結節（6.5%）であった．術後に治療を要する合併症を来したものは1例（3.7%）であった．バイポーラ電極針を用いたRFAは有用と考えられるが，より適切なプロトコル設定やモノポーラ機器との使い分けが課題である．
症例は21歳男性．腎炎の経過観察中に，USにて低エコー，単純CTにて高吸収を呈し，dynamic CTおよびMRIにて早期相で造影される多発結節を認めた．レボビスト造影USのpost vascular imageやSPIO MRIでは，Kuppfer細胞の存在を示唆され，USガイド下針生検では，FNH様過形成結節と診断されたが，single level dynamic CTHAにてリング様濃染を結節様高吸収域内部に認めた．周辺肝が脂肪肝を呈したため，結節血流流出部がspared areaとなり，リング様濃染部に相当する領域を含めて画像上結節様に観察されていたと考えられた．過形成結節においても，肝細胞癌に特徴的とされるリング様濃染を呈することがあると考えられ報告した．
A 67-year-old male with chronic pancreatitis presented upper abdominal pain and melena. Abdominal dynamic computed tomography revealed a splenic artery aneurysm in the main pancreatic duct. Esophagogastroduodenoscopy showed active bleeding from Vater's papilla. The patient was diagnosed hemosuccus pancreaticus (HP) due to rupture of treated interventional radiology (IVR). patient's poor lung function did not allow for radical operation follow-up examination recommended. HP relapsed 7 months...
We report a case of resected hepatocellular carcinomas (HCCs) after drug-eluting bead transarterial chemoembolization (DEB-TACE). A 67-year-old man with alcoholic liver disease was diagnosed HCCs. Serological markers for hepatitis B and C viruses were negative. Among tumor markers, alpha-fetoprotein 2.7ng/mL, protein induced by vitamin K absence II 868mAU/mL. Two HCCs detected using dynamic computed tomography: one 9cm in diameter S8 the other 2cm S4. performed DEB-TACE HepaSphere(®)...
Correspondence and reprint request: Ryuichi Kita, M.D., Ph.D. Department of Gastroenterology Hepatology, Osaka Red Cross Hospital. 5-53 Fudegasaki-cho, Tennoji-ku, 543-8555. Telephone: +81-6-6774-5111. Fax: +81-6-6774-5131. E-mail: r-kita@osaka-med.jrc.or.jp Manuscript received:November 24, 2011. accepted: December 14,2011. July-August, Vol. 11 No.4, 2012: 572-573 LETTER TO EDITOR
肝細胞癌に対するラジオ波熱凝固療法では，十分なablative marginを得て凝固することが重要であり，その評価は通常CTで行われる．今回，当院でRFAを行った連続70結節に造影CTとソナゾイド®造影超音波を用いてablative marginに関する4段階の治療効果判定（R判定）を行い，結果を比較した．R判定の完全一致率は50%，重み付きκ係数は0.49であったが，再治療要不要判定の一致率は73%と高く，概ねCTと同等の評価が可能であった．また，造影超音波では16結節（26.2%）で凝固域内に腫瘍影が同定できた．この群では，造影CTで腫瘍にリピオドール®集積を認めた群とのR判定の完全一致率は70%，重み付きκ係数は0.75と高値であり，リピオドール®動注の下での造影CTと同程度のablative marginの評価が可能であった．以上より，ソナゾイド®造影超音波は，良好な画像が得られた場合，再治療要不要の判定に，凝固域内に腫瘍影が同定できた例でのablative marginの治療効果判定に有用であると言えた．
Corona enhancements on single level dynamic CTHA (sCTHA) images are thought to be characteristic of hypervascular metastatic liver tumors and HCCs. Herein we present two cases (an FNH a nodule-in-nodule type HCC) in which sCTHA showed corona enhancements. In the literature, venous sinusoidal drainage pathways have been confirmed histopathologically FNH. We presume that flow occurs mainly through hepatic pathway via is faint may visible only when amount becomes large followed by an increase...
A 92-year-old woman was hospitalized with upper abdominal pain. She had a history of acute biliary pancreatitis and chronic heart failure undergone gastrectomy Roux-en-Y reconstruction. admitted recurrent an exacerbation failure. Biliary drainage could not successfully be achieved endoscopically or percutaneous transhepatic EUS-guided because the reconstruction non-dilation bile duct. We accomplished in one session puncture common duct ultrasound guidance rendezvous technique. report this...
Stereotactic body radiation therapy using respiratory tracking system is a new treatment strategy for hepatocellular carcinoma. Before the system, implantation of fiducial gold marker required, but way and an appropriate position are unclear. Here, we report method placement. First, identified best area that showed same motion as tumor by 4D-CT. Next, detected inserted virtual on image CTAP 3D-workstation. Third, recognized Volume Navigation® placed successfully. This would be useful easy to...