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Hisahiko Sekihara - One of the best experts on this subject based on the ideXlab platform.

  • Hepatocellular carcinoma: Therapeutic experience with Percutaneous Ethanol Injection under real-time contrast-enhanced color Doppler sonography with the contrast agent Levovist
    Journal of Ultrasound in Medicine, 2002
    Co-Authors: Kazuhito Shirato, Kazushi Numata, Hisahiko Sekihara, Manabu Morimoto, Naohiko Tomita, Atsushi Kokawa, Kazuya Sugimori, Toshifumi Saito, Katsuaki Tanaka
    Abstract:

    OBJECTIVE To describe our experience with Percutaneous Ethanol Injection under real-time contrast-enhanced color Doppler sonography with Levovist (SH U 508A; Nihon Schering, Osaka, Japan) for hepatocellular carcinoma after transcatheter arterial infusion. METHODS Twenty patients (17 men and 3 women; mean age, 58.4 years) with 23 hepatocellular carcinoma nodules (mean +/- SD, 2.7 +/- 1.5 cm) underwent Percutaneous Ethanol Injection under real-time contrast-enhanced color Doppler sonography 1 week after transcatheter arterial infusion. Therapeutic effects were assessed by contrast-enhanced computed tomography and posttreatment fine-needle biopsy. This study was performed on a prospective basis. RESULTS After the transcatheter arterial infusion, contrast-enhanced color Doppler sonography showed intense intratumoral color signals in all 23 hepatocellular carcinomas. After the Percutaneous Ethanol Injection, contrast-enhanced color Doppler sonography, fine-needle biopsy, and contrast-enhanced computed tomography showed no color signals, no viable tumor tissues, and no enhancement in any of the 23 hepatocellular carcinomas. Three to 5 (mean, 3.3) Percutaneous Ethanol Injection sessions with a 5.2- to 15.6-mL (mean, 12.8-mL) total volume of Ethanol per tumor were required for complete disappearance of color signals on contrast-enhanced color Doppler sonography. CONCLUSIONS Percutaneous Ethanol Injection under real-time contrast-enhanced color Doppler sonography has considerable efficacy in treating hepatocellular carcinoma.

  • Combination therapy of Percutaneous mitoxantrone Injection, Percutaneous Ethanol Injection, and transcatheter arterial embolization for intrahepatic hepatocellular carcinoma and adrenal metastasis.
    Hepato-gastroenterology, 2001
    Co-Authors: Takayoshi Kiba, Kazushi Numata, Satoru Saito, Takehiko Kitamura, Katsumi Morita, Hisahiko Sekihara
    Abstract:

    We treated a 63-year-old man who had recurrent large hepatocellular carcinomas (> 5 cm in diameter) and left adrenal metastasis with the combination approach of Percutaneous intratumoral chemotherapy with mitoxantrone, Percutaneous Ethanol Injection, and transcatheter arterial embolization. He received repeated transcatheter arterial embolization and Percutaneous Ethanol Injection combination therapy for intrahepatic hepatocellular carcinomas, which controlled his disease for 6 months from the first treatment. After that, left adrenal metastasis was detected by biopsy specimen. Therefore, we repeated more transcatheter arterial embolization and Percutaneous Ethanol Injection to the liver and left adrenal gland, but this combination therapy could not control the hepatocellular carcinomas in these organs. With the patient's consent, he was treated with the combination approach of Percutaneous intratumoral chemotherapy with mitoxantrone, Percutaneous Ethanol Injection, and transcatheter arterial embolization for hepatocellular carcinomas of the liver and left adrenal gland. After this combination therapy, we followed-up the viable lesions by color Doppler ultrasonography and computed tomography examination. However, we could not detect these viable lesions of hepatocellular carcinomas in his body until one month before he died. When the degree of hepatic failure worsened due to the natural course of cirrhosis, this combination therapy was stopped 7 months before he died. He died of pulmonary tumor emboli from metastasis of inferior vena cava 24 months after the combination therapy started. However, on autopsy there was almost no remaining hepatocellular carcinoma found in the main lesions of liver and left adrenal gland. We suggest that a combination approach of Percutaneous intratumoral chemotherapy with mitoxantrone, Percutaneous Ethanol Injection, and transcatheter arterial embolization may be indicated in elderly cases of intrahepatic large hepatocellular carcinoma and adrenal metastasis, which are not under control only by transcatheter arterial embolization and Percutaneous Ethanol Injection.

  • Medullary thyroid carcinoma with multiple hepatic metastases: treatment with transcatheter arterial embolization and Percutaneous Ethanol Injection.
    Internal Medicine, 1999
    Co-Authors: Tetsuo Isozaki, Takayoshi Kiba, Kazushi Numata, Satoru Saito, Takeshi Shimamura, Takehiko Kitamura, Katsumi Morita, Katsuaki Tanaka, Hisahiko Sekihara
    Abstract:

    A 54-year-old man with medullary thyroid carcinoma in the thyroid gland was unable to undergo total thyroidectomy because the tumor had invaded the mediastinum. Radiation therapy and chemotherapy were given. Seven years later, intractable diarrhea and abdominal pain appeared, and computed tomography demonstrated hypervascular tumors in the thyroid gland and in the liver. The tumors were successfully treated with Percutaneous Ethanol Injection to a lesion in the thyroid gland and transcatheter arterial embolization followed by Percutaneous Ethanol Injection to tumors in the liver. Transcatheter arterial embolization and Percutaneous Ethanol Injection may be valuable in treating medullary thyroid carcinoma.

Choong Gon Choi - One of the best experts on this subject based on the ideXlab platform.

  • efficacy of sonographically guided Percutaneous Ethanol Injection for treatment of thyroid cysts versus solid thyroid nodules
    American Journal of Roentgenology, 2003
    Co-Authors: Jin Hyoung Kim, Ho Kyu Lee, Jung Hyun Lee, Ii Min Ahn, Choong Gon Choi
    Abstract:

    OBJECTIVE. Sonographically guided Percutaneous Ethanol Injection has been recently proposed as a treatment for nonfunctioning benign thyroid nodules such as cysts or solid nodules. The objective of this study was to compare the efficacy of Ethanol Injection in thyroid cysts and solid nodules. SUBJECTS AND METHODS. We studied 20 patients with simple or complex thyroid cysts and 22 patients with solid thyroid nodules. All lesions were confirmed by fine-needle aspiration biopsy to be benign. The mean volume of the instilled absolute Ethanol (99.9%) was 62.2% of the whole tumor volume for solid nodules and 63.4% of the cystic volume for cysts. Follow-up sonography was performed 1‐6 months (mean, 4.4 months for cysts and 4.6 months for solid nodules) after the procedure. RESULTS. The mean volume reduction rate for cysts (65%) was greater than that for solid nodules (38.3%) ( p < 0.01, Student’s t test). The volume of the instilled Ethanol correlated significantly with the volume reduction rate of cysts but not with that of solid nodules ( p < 0.01, Student’s t test). CONCLUSION. Sonographically guided Percutaneous Ethanol Injection is more effective for thyroid cysts than for solid thyroid nodules.

Andrea Frasoldati - One of the best experts on this subject based on the ideXlab platform.

Hajime Nawata - One of the best experts on this subject based on the ideXlab platform.

  • The use of Percutaneous Ethanol Injection therapy for recurrence of hepatocellular carcinoma.
    Hepato-gastroenterology, 1995
    Co-Authors: K Kotoh, Sakai H, Morotomi I, Hajime Nawata
    Abstract:

    Forty patients with hepatocellular carcinoma were treated with Percutaneous Ethanol Injection therapy. All patients had fewer than three tumors of less than 30 mm in diameter. Additionally, all recurrences with fewer than 3 tumors of less than 30 mm in diameter was repeated for 33 recurrences and discontinued in 17 cases. Duration between treatments became significantly shorter with successive treatments. There was no significant difference in the duration between treatments in patients classified by tumor size (less than 20 mm vs. 20 mm or more), whereas there was a significantly lower recurrence rate in patients with solitary tumors as compared with those with multiple HCC. Laboratory data before successive PEI- treatments were also compared, and showed that hepatic functional reserve did not decrease with repeat Percutaneous Ethanol Injection. The cumulative survival rate in all 40 patients after the first treatment was significantly higher than in the 17 patients for whom treatment was discontinued.

  • the effect of Percutaneous Ethanol Injection therapy on small solitary hepatocellular carcinoma is comparable to that of hepatectomy
    The American Journal of Gastroenterology, 1994
    Co-Authors: K Kotoh, Hironori Sakai, Shigeru Sakamoto, S Nakayama, M Satoh, I Morotomi, Hajime Nawata
    Abstract:

    OBJECTIVES Forty patients with solitary hepatocellular carcinoma (HCC) smaller than 20 mm in diameter were admitted to our hospitals from March 1986 to December 1989. Of that 40 patients, 17 were treated with hepatectomy, 12 with Percutaneous Ethanol Injection therapy, and 11 with the combination of Percutaneous Ethanol Injection therapy and transcatheter arterial embolization. METHOD Following up the patients after their first treatment for 2 months to 6 yr, as of April 30, 1993, we evaluated the effects of hepatectomy, Percutaneous Ethanol Injection therapy, and the combination of Percutaneous Ethanol Injection therapy and transcatheter arterial embolization. RESULTS Of the 23 patients who did not undergo surgery, eight died from recurrence of HCC and one died from ruptured varices. Of the 14 surviving patients, 10 experienced recurrences during the follow-up period. Of the 17 patients who underwent surgery, one died in hospital and four died from recurrence of carcinoma. Of the remaining 12 patients, nine experienced recurrences. The cumulative survival and recurrence rates were similar in operated and nonoperated patients. There was no significant difference in these rates in patients treated with versus without transcatheter arterial embolization. CONCLUSION Our results showed that the efficacy of hepatectomy and the efficacy Percutaneous Ethanol Injection therapy for small solitary HCC were similar. However, Percutaneous Ethanol Injection therapy was safer and less expensive than hepatectomy.

Jin Hyoung Kim - One of the best experts on this subject based on the ideXlab platform.

  • efficacy of sonographically guided Percutaneous Ethanol Injection for treatment of thyroid cysts versus solid thyroid nodules
    American Journal of Roentgenology, 2003
    Co-Authors: Jin Hyoung Kim, Ho Kyu Lee, Jung Hyun Lee, Ii Min Ahn, Choong Gon Choi
    Abstract:

    OBJECTIVE. Sonographically guided Percutaneous Ethanol Injection has been recently proposed as a treatment for nonfunctioning benign thyroid nodules such as cysts or solid nodules. The objective of this study was to compare the efficacy of Ethanol Injection in thyroid cysts and solid nodules. SUBJECTS AND METHODS. We studied 20 patients with simple or complex thyroid cysts and 22 patients with solid thyroid nodules. All lesions were confirmed by fine-needle aspiration biopsy to be benign. The mean volume of the instilled absolute Ethanol (99.9%) was 62.2% of the whole tumor volume for solid nodules and 63.4% of the cystic volume for cysts. Follow-up sonography was performed 1‐6 months (mean, 4.4 months for cysts and 4.6 months for solid nodules) after the procedure. RESULTS. The mean volume reduction rate for cysts (65%) was greater than that for solid nodules (38.3%) ( p < 0.01, Student’s t test). The volume of the instilled Ethanol correlated significantly with the volume reduction rate of cysts but not with that of solid nodules ( p < 0.01, Student’s t test). CONCLUSION. Sonographically guided Percutaneous Ethanol Injection is more effective for thyroid cysts than for solid thyroid nodules.