The Experts below are selected from a list of 390 Experts worldwide ranked by ideXlab platform
Katsuaki Tanaka - One of the best experts on this subject based on the ideXlab platform.
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Comparison Between Low Mechanical Index and High Mechanical Index Contrast Modes of Contrast-Enhanced Ultrasonography: Evaluation of Perfusion Defects of Hypervascular Hepatocellular Carcinomas During the Post-Vascular Phase.
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2019Co-Authors: Zaya Duisyenbi, Kazushi Numata, Akito Nozaki, Masaaki Kondo, Katsuaki Tanaka, Hiromi Nihonmatsu, Hiroyuki Fukuda, Makoto Chuma, Shin MaedaAbstract:OBJECTIVES We evaluated the detection rates for perfusion defects in hypervascular hepatocellular carcinomas comparing the low mechanical index (MI) and high MI contrast modes during the post-vascular phase (PVP) of contrast-enhanced ultrasonography. METHODS Seventy-eight patients with 84 hypervascular hepatocellular carcinomas (mean diameter, 23.4 ± 11.2 mm) were selected for this retrospective study. All the patients underwent whole-liver scanning using conventional ultrasonography before injection of a Perflubutane-based contrast agent (Sonazoid), and all the detected nodules were classified as either hypoechoic or hyperechoic nodules. Next, hypoechoic and hyperechoic nodules were evaluated using contrast-enhanced ultrasonography, and the presence of a perfusion defect was assessed for each nodule using both the low MI (0.2-0.3) and the high MI (0.7-1.2) contrast modes during the PVP (10 minutes after injection). The data were analyzed using the McNemar test. RESULTS Forty-four nodules were classified as hypoechoic nodules, and the remaining 40 nodules were classified as hyperechoic nodules using conventional ultrasonography. The detection rate for perfusion defects determined using the high MI contrast mode was higher than that determined using the low MI contrast mode in hyperechoic nodules during the PVP (low MI, 58% [23 of 40]; high MI, 90% [36 of 40]; P
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Use of fusion imaging combining contrast-enhanced ultrasonography with a Perflubutane-based contrast agent and contrast-enhanced computed tomography for the evaluation of percutaneous radiofrequency ablation of hypervascular hepatocellular carcinoma.
European journal of radiology, 2011Co-Authors: Kazushi Numata, Manabu Morimoto, Akito Nozaki, Masaaki Kondo, Hiroyuki Fukuda, Shin Maeda, Shigeo Takebayashi, Masahiro Okada, Takashi Oshima, Katsuaki TanakaAbstract:Abstract Objective We evaluated the efficacy of fusion imaging, which fuses contrast-enhanced ultrasonography images with arterial-phase, contrast-enhanced CT images as a reference on a single screen in real time, for the evaluation of the effectiveness of radiofrequency ablation for treatment of hypervascular hepatocellular carcinoma. Materials and methods Eighty hepatocellular carcinoma lesions with a maximum diameter of between 1 and 3 cm that were scheduled for treatment with radiofrequency ablation were enrolled in this prospective study. After bolus injection of Perflubutane-based contrast agent, fusion imaging combining contrast-enhanced ultrasonography images and arterial-phase, contrast-enhanced CT images was performed one day after radiofrequency ablation. We used two functions, which were subsets of the fusion imaging, to confirm the location of the hepatocellular carcinoma lesions in the ablated areas and to evaluate the presence or absence of an adequate safety margin. Contrast-enhanced CT was performed one month after the ablation. Two blinded observers reviewed the images obtained using both modalities to evaluate the effect of ablation. Results When the one-month contrast-enhanced CT images were used as the reference standard, the sensitivity, specificity, and accuracy of the one-day fusion imaging for the diagnosis of adequate ablation were 97%, 83%, and 96%, respectively; the kappa value for the agreement between the findings obtained using the two modalities was 0.75. Conclusion Fusion imaging combining contrast-enhanced ultrasonography images and arterial-phase, contrast-enhanced CT images as a reference appears to be a useful method for the early evaluation of the efficacy of radiofrequency ablation for the treatment of hypervascular hepatocellular carcinoma.
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Differentiation of focal liver lesions using three-dimensional ultrasonography: Retrospective and prospective studies
World journal of gastroenterology, 2010Co-Authors: Wen Luo, Kazushi Numata, Manabu Morimoto, Akito Nozaki, Michio Ueda, Masaaki Kondo, Satoshi Morita, Katsuaki TanakaAbstract:AIM: To differentiate focal liver lesions based on enhancement patterns using three-dimensional ultrasonography (3D US) with Perflubutane-based contrast agent.
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Differentiation of focal liver lesions using three-dimensional ultrasonography: Retrospective and prospective studies
2010Co-Authors: Wen Luo, Kazushi Numata, Manabu Morimoto, Akito Nozaki, Michio Ueda, Masaaki Kondo, Satoshi Morita, Katsuaki TanakaAbstract:AIM: To differentiate focal liver lesions based on en-hancement patterns using three-dimensional ultraso-nography (3D US) with Perflubutane-based contrast agent. METHODS: Two hundred and eighty two patients with focal liver lesions, including 168 hepatocellular carci-nomas (HCCs), 63 metastases, 40 hemangiomas and 11 focal nodular hyperplasias (FNHs), were examined by 3D US with Perflubutane-based contrast agent. Tomographic ultrasound images and sonographic an-giograms were reconstructed. Among 282 lesions, enhancement patterns of 163 lesions between Januar
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Evaluation of the therapeutic efficacy of high-intensity focused ultrasound ablation of hepatocellular carcinoma by three-dimensional sonography with a Perflubutane-based contrast agent.
European journal of radiology, 2009Co-Authors: Kazushi Numata, Manabu Morimoto, Akito Nozaki, Hiroyuki Fukuda, Masao Ohto, Ryu Itou, Masaaki Kondou, Eii Karasawa, Katsuaki TanakaAbstract:Abstract Objective We performed contrast-enhanced three-dimensional sonography (CE 3D US) with a Perflubutane-based contrast agent to immediately evaluate the completeness of ablation of small hepatocellular carcinoma (HCC) lesions by extracorporeal high-intensity focused ultrasound (HIFU). Subjects and methods Twenty-one HCC lesions were treated by a single ultrasound-guided HIFU ablation session, and CE 3D US was performed before, immediately after, and 1 week, and 1 month after HIFU, and contrast-enhanced CT (CE CT) or contrast-enhanced MRI (CE MRI) was performed before HIFU, 1 week and 1 month after HIFU, and during the follow-up period. Results Immediately and 1 month after HIFU, 17 lesions were evaluated as adequately ablated by CE 3D US, and the other 4 lesions as residual tumors. One month after HIFU, 18 were evaluated as adequately ablated by CE CT or CE MRI, and the other 3 as residual tumors. The evaluation by CE 3D US immediately after HIFU and by CE CT or CE MRI 1 month after HIFU was concordant with 20 lesions. The kappa value for agreement between the findings of CE 3D US and other modalities by two blinded observers was 0.83. When the 1-month CE CT or CE MRI findings were used as the reference standard, the sensitivity, specificity, and accuracy of CE 3D US immediately after HIFU for the diagnosis of the adequate ablation were 100%, 75%, and 95%, respectively. Conclusion CE 3D US appears to be a useful method for immediate evaluation of therapeutic efficacy of HIFU ablation of HCC lesions.
Osamu Yokosuka - One of the best experts on this subject based on the ideXlab platform.
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Non-Invasive Diagnosis of Portal Hypertensive Gastropathy: Quantitative Analysis of Microbubble-Induced Stomach Wall Enhancement
Ultrasound in medicine & biology, 2016Co-Authors: Soichiro Kiyono, Hitoshi Maruyama, Taro Shimada, Osamu Yokosuka, Kazufumi Kobayashi, Takayuki Kondo, Tadashi Sekimoto, Tadashi YamaguchiAbstract:The aim of the study described here was to elucidate the efficacy of contrast-enhanced ultrasound (CEUS) prospectively as a tool in the diagnosis of portal hypertensive gastropathy (PHG). The peak enhancement time at the upper stomach wall (PT) and intensity ratio at the upper stomach/the spleen (IR) between pre- and peak enhancement were evaluated by CEUS with Perflubutane microbubble agent in 56 patients, 42 with cirrhosis (16 with PHG) and 14 controls. The IR was higher in patients with PHG (1.21 ± 0.11) than in those without (0.91 ± 0.15, p
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HEPATIC FILLING RATE OF A MICROBUBBLE AGENT: A NOVEL PREDICTOR OF LONG-TERM OUTCOMES IN PATIENTS WITH CIRRHOSIS
Ultrasound in medicine & biology, 2014Co-Authors: Tadashi Sekimoto, Hiroyuki Ishibashi, Hitoshi Maruyama, Masanori Takahashi, Taro Shimada, Osamu Yokosuka, Soichiro Kiyono, Takayuki Kondo, Tadashi YamaguchiAbstract:Abstract The aim of the study described here was to evaluate the significance of the hepatic filling rate of a Perflubutane microbubble agent in predicting long-term outcomes and prognoses in 32 patients with cirrhosis (37–76 y, 20 females, Child–Pugh A16, B16). The time from delivery of the contrast agent to the hepatic artery to maximum enhancement of the liver parenchyma on the sonogram was defined as the hepatic filling rate (mean = 18.6 s). Hepatic filling rate did not correlate significantly with the Child–Pugh score or the model for end-stage liver disease score. However, the survival rate was lower (93.3% at 1 y, 60.2% at 3 y) and the rate of occurrence of hepatocellular carcinoma (HCC) was higher (13.3% at 1 y, 33.3% at 3 y) in the group with the slow filling rate (≥18 s) than in the group with the rapid filling rate (
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Natural history of postvascular-phase iso-enhanced lesions on the sonogram in chronic liver diseases.
Journal of gastroenterology and hepatology, 2013Co-Authors: Takayuki Kondo, Hitoshi Maruyama, Masanori Takahashi, Taro Shimada, Osamu Yokosuka, Tadashi Sekimoto, Fumihiko Kanai, Tetsuhiro Chiba, Tadashi YamaguchiAbstract:Background and Aim This study examined the natural history of postvascular-phase iso-enhanced lesions (PIELs) on contrast-enhanced sonograms to determine the potential risk and predictive factors for developing hepatocellular carcinoma (HCC) in chronic liver diseases. Methods This prospective study included 87 PIELs on contrast-enhanced sonograms (postvascular-phase: 10 min post-injection of Perflubutane microbubbles) in 72 patients with chronic liver diseases (45 males and 27 females; age 65.0 ± 10.8y; PIEL diameter 12.5 ± 4.2 mm). The PIELs were followed up by ultrasound/contrast-enhanced ultrasound, computed tomography, or magnetic resonance imaging at 3 to 6 months intervals. Results Twenty patients developed HCCs during the study period (median, 22.0 months). The cumulative risk of HCC occurrence was 7.9% at 1 year and 36.0% at 3 years. The presence of coexistent HCC (hazard ratio [HR], 4.975; 95% confidence interval [CI], 1.729–14.316; P = 0.003) and alpha-fetoprotein > 20 ng/mL (HR, 4.104; 95% CI, 1.621–10.392; P = 0.003) were significant factors for the risk of HCC occurrence. Fourteen of these lesions were diagnosed as HCCs that developed from iso-enhanced lesions. Cumulative HCC occurrence rates from PIEL > 14 mm was 23.5% at 1 year and 46.3% at 3 years. Cox regression analysis showed that PIEL > 14 mm (HR, 6.780; 95% CI, 2.060–22.32; P = 0.002) and alpha-fetoprotein > 20 ng/mL (HR, 4.892; 95% CI, 1.559–15.350; P = 0.007) were statistically significant factors for HCC occurrence. Conclusions Patients with coexistent HCC, alpha-fetoprotein > 20 ng/mL, or PIEL > 14 mm should be carefully monitored because of the high potential for HCC occurrence.
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Pretreatment microbubble-induced enhancement in hepatocellular carcinoma predicts intrahepatic distant recurrence after radiofrequency ablation.
AJR. American journal of roentgenology, 2013Co-Authors: Hitoshi Maruyama, Masanori Takahashi, Taro Shimada, Hidehiro Kamesaki, Tadashi Sekimoto, Fumihiko Kanai, Osamu YokosukaAbstract:OBJECTIVE. The purpose of this study is to examine whether pretreatment findings in hepatocellular carcinoma (HCC) using contrast-enhanced ultrasound can predict local or distant recurrence after radiofrequency ablation (RFA). SUBJECTS AND METHODS. Subjects of the prospective study were 54 patients with HCC lesions treated by RFA. Intensity differences between lesion and liver parenchyma at early arterial (4 seconds) and peak enhancement times and washout at late phase were provided on contrast-enhanced sonograms with Perflubutane microbubble agent. The pretreatment findings were examined with respect to intrahepatic local and distant recurrence. RESULTS. Univariate analysis showed that intensity differences at the early arterial time (hazard ratio [HR], 2.2; 95% CI, 1.0–4.6; p = 0.042) and lesion frequency (HR, 2.3; 95% CI, 1.0–5.0; p = 0.044) were risk factors for distant recurrence. Multivariate analysis showed that intensity differences at the early arterial time (HR, 2.7; 95% CI, 1.2–5.8; p = 0.014) ...
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Characterization of hepatic lesions (≤ 30 mm) with liver-specific contrast agents: a comparison between ultrasound and magnetic resonance imaging.
European journal of radiology, 2012Co-Authors: Masanori Takahashi, Hitoshi Maruyama, Taro Shimada, Tadashi Sekimoto, Fumihiko Kanai, Hidehiro Kamezaki, Osamu YokosukaAbstract:Abstract Purpose Imaging-based differentiation of hepatic lesions (≤30 mm) between well-differentiated hepatocellular carcinomas (w-HCC) and regenerative nodules (RN) presents difficulties. The aim was to compare the diagnostic abilities to differentiate w-HCC from RN using contrast-enhanced ultrasound and magnetic resonance imaging (MRI) both with liver-specific contrast agents. Materials and methods This prospective study included 67 pathologically proven hepatic lesions (17.5 ± 5.4 mm, 54 w-HCCs, 13 RNs) in 56 patients with chronic hepatitis/cirrhosis (male 40, female 16; 29–79y). Hepatic-arterial/liver-specific phase enhancements were assessed quantitatively by ultrasound with Perflubutane microbubble agent and MRI with gadolinium-ethoxybenzyl-diethylenetriamine with respect to the histological findings. Results Sensitivity, specificity and accuracy of hepatic-arterial phase hyper-enhancement for w-HCC were 59.3%, 100% and 67.2% by ultrasound and 46.3%, 100% and 56.7% by MRI without significant difference. Meanwhile, those of liver-specific-phase hypo-enhancement for w-HCC were 44.4%, 100% and 55.2% by ultrasound and 87.0% (p Conclusions Hypervascularity is a significant feature which distinguishes w-HCC from RN, and ultrasound exerts a beneficial impact better than MRI for such characterization. However, both imaging have comparable abilities in the characterization of non-hypervascular lesions, compensating mutually for the poor sensitivity of ultrasound and the poor specificity of MRI in the liver-specific phase.
Kazushi Numata - One of the best experts on this subject based on the ideXlab platform.
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Use of intra-procedural fusion imaging combining contrast-enhanced ultrasound using a Perflubutane-based contrast agent and auto sweep three-dimensional ultrasound for guiding radiofrequency ablation and evaluating its efficacy in patients with hepat
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology North American Hyperthermia Group, 2020Co-Authors: Katsuyuki Sanga, Kazushi Numata, Hiromi Nihonmatsu, Katsuaki Ogushi, Hiroyuki Fukuda, Makoto Chuma, Hiroshi Hashimoto, Norihiro Koizumi, Shin MaedaAbstract:Purpose: This study evaluated the usefulness of intraprocedural contrast-enhanced ultrasound (CEUS)/ultrasound (US) fusion imaging using a Perflubutane-based contrast agent combined with preprocedu...
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Differential diagnosis of gallbladder polypoid lesions using contrast-enhanced ultrasound
Abdominal Radiology, 2019Co-Authors: Haruo Miwa, Kazushi Numata, Katsuyuki Sanga, Kazuya Sugimori, Akane Hirotani, Shun Tezuka, Yoshihiro Goda, Kuniyasu Irie, Tomohiro Ishii, Takashi KanekoAbstract:Purpose The purpose of the study is to evaluate the utility of contrast-enhanced ultrasound (CEUS) for the differential diagnosis of gallbladder polypoid lesions (GPLs). Methods Thirty-six patients with GPLs (17 with gallbladder cancer, 19 with benign polyps) who underwent CEUS were enrolled in the study. The mean age of patients was 65.7 ± 12.6 years. Perflubutane-based contrast agent and high-mechanical index mode, which can eliminate the background B-mode and provide precise visualization of tumor vessels, were used for CEUS, and two blinded readers evaluated the images, retrospectively. Results Patient age and size of malignant GPLs (72.4 ± 9.4 years and 23.4 ± 7.5 mm) were significantly greater than those for benign lesions (59.6 ± 12.3 years and 12.4 ± 2.9 mm) ( P
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Comparison Between Low Mechanical Index and High Mechanical Index Contrast Modes of Contrast-Enhanced Ultrasonography: Evaluation of Perfusion Defects of Hypervascular Hepatocellular Carcinomas During the Post-Vascular Phase.
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2019Co-Authors: Zaya Duisyenbi, Kazushi Numata, Akito Nozaki, Masaaki Kondo, Katsuaki Tanaka, Hiromi Nihonmatsu, Hiroyuki Fukuda, Makoto Chuma, Shin MaedaAbstract:OBJECTIVES We evaluated the detection rates for perfusion defects in hypervascular hepatocellular carcinomas comparing the low mechanical index (MI) and high MI contrast modes during the post-vascular phase (PVP) of contrast-enhanced ultrasonography. METHODS Seventy-eight patients with 84 hypervascular hepatocellular carcinomas (mean diameter, 23.4 ± 11.2 mm) were selected for this retrospective study. All the patients underwent whole-liver scanning using conventional ultrasonography before injection of a Perflubutane-based contrast agent (Sonazoid), and all the detected nodules were classified as either hypoechoic or hyperechoic nodules. Next, hypoechoic and hyperechoic nodules were evaluated using contrast-enhanced ultrasonography, and the presence of a perfusion defect was assessed for each nodule using both the low MI (0.2-0.3) and the high MI (0.7-1.2) contrast modes during the PVP (10 minutes after injection). The data were analyzed using the McNemar test. RESULTS Forty-four nodules were classified as hypoechoic nodules, and the remaining 40 nodules were classified as hyperechoic nodules using conventional ultrasonography. The detection rate for perfusion defects determined using the high MI contrast mode was higher than that determined using the low MI contrast mode in hyperechoic nodules during the PVP (low MI, 58% [23 of 40]; high MI, 90% [36 of 40]; P
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Differential diagnosis of gallbladder polypoid lesions using contrast-enhanced ultrasound
Abdominal radiology (New York), 2018Co-Authors: Haruo Miwa, Kazushi Numata, Katsuyuki Sanga, Kazuya Sugimori, Akane Hirotani, Shun Tezuka, Yoshihiro Goda, Kuniyasu Irie, Tomohiro Ishii, Takashi KanekoAbstract:The purpose of the study is to evaluate the utility of contrast-enhanced ultrasound (CEUS) for the differential diagnosis of gallbladder polypoid lesions (GPLs). Thirty-six patients with GPLs (17 with gallbladder cancer, 19 with benign polyps) who underwent CEUS were enrolled in the study. The mean age of patients was 65.7 ± 12.6 years. Perflubutane-based contrast agent and high-mechanical index mode, which can eliminate the background B-mode and provide precise visualization of tumor vessels, were used for CEUS, and two blinded readers evaluated the images, retrospectively. Patient age and size of malignant GPLs (72.4 ± 9.4 years and 23.4 ± 7.5 mm) were significantly greater than those for benign lesions (59.6 ± 12.3 years and 12.4 ± 2.9 mm) (P
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Use of vessel patterns on contrast-enhanced ultrasonography using a Perflubutane-based contrast agent for the differential diagnosis of regenerative nodules from early hepatocellular carcinoma or high-grade dysplastic nodules in patients with chronic
Abdominal imaging, 2015Co-Authors: Kazushi Numata, Manabu Morimoto, Akito Nozaki, Masaaki Kondo, Hiromi Nihonmatsu, Hiroyuki Fukuda, Makoto Chuma, Masahiro Okada, Takashi Oshima, Takamichi MurakamiAbstract:We evaluated the use of tumor vessel patterns observed during arterial-phase contrast-enhanced ultrasonography (US) to differentiate regenerative nodules (RN) from early hepatocellular carcinoma (HCC) or high-grade dysplastic nodules (HGDN) in patients with chronic liver disease. Pathologically confirmed lesions (83 early HCC, 6 HGDN, and 13 RN with mean maximal diameters of 15.4, 15.3, and 16.2 mm, respectively) were enrolled in this retrospective study. We performed contrast-enhanced US using a Perflubutane-based contrast agent. We then classified the tumor vessels observed during the arterial phase of contrast-enhanced US into two patterns: peripheral vessels (centripetal pattern) and central vessels (centrifugal pattern). Eighty-one (97.6%) of the 83 early HCC exhibited various enhancement patterns (hypovascular, 44.6%; isovascular, 25.3%; and hypervascular, 27.7%) and a peripheral vessel pattern, while the remaining 2 lesions (2.4%) exhibited hypovascular enhancement and a central vessel pattern. All 6 HGDN lesions were hypovascular with a peripheral vessel pattern. Twelve (92.3%) of the 13 RN were hypovascular with a central vessel pattern, and the remaining one (7.7%) was hypervascular with a central vessel pattern. When lesions exhibiting a central vessel pattern during arterial-phase contrast-enhanced US were diagnosed as RN, the sensitivity, specificity, and accuracy of these diagnoses were 100%, 97.8%, and 98.0%, respectively. The tumor vessel patterns observed during arterial-phase contrast-enhanced US may be useful for differentiating RN from early HCC or HGDN in patients with chronic liver disease.
Hitoshi Maruyama - One of the best experts on this subject based on the ideXlab platform.
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Non-Invasive Diagnosis of Portal Hypertensive Gastropathy: Quantitative Analysis of Microbubble-Induced Stomach Wall Enhancement
Ultrasound in medicine & biology, 2016Co-Authors: Soichiro Kiyono, Hitoshi Maruyama, Taro Shimada, Osamu Yokosuka, Kazufumi Kobayashi, Takayuki Kondo, Tadashi Sekimoto, Tadashi YamaguchiAbstract:The aim of the study described here was to elucidate the efficacy of contrast-enhanced ultrasound (CEUS) prospectively as a tool in the diagnosis of portal hypertensive gastropathy (PHG). The peak enhancement time at the upper stomach wall (PT) and intensity ratio at the upper stomach/the spleen (IR) between pre- and peak enhancement were evaluated by CEUS with Perflubutane microbubble agent in 56 patients, 42 with cirrhosis (16 with PHG) and 14 controls. The IR was higher in patients with PHG (1.21 ± 0.11) than in those without (0.91 ± 0.15, p
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Intensity-Based Assessment of Microbubble-Enhanced Ultrasonography: Phase-Related Diagnostic Ability for Cellular Differentiation of Hepatocellular Carcinoma.
Ultrasound in medicine & biology, 2015Co-Authors: Takayuki Kondo, Hitoshi Maruyama, Masanori Takahashi, Taro Shimada, Soichiro Kiyono, Tadashi Sekimoto, Sadahisa Ogasawara, Eiichiro Suzuki, Yoshihiko Ooka, Akinobu TawadaAbstract:This prospective study aimed to elucidate the effect of phase-related quantitative parameters of contrast-enhanced ultrasound (CEUS) with Perflubutane microbubble agent to assess the cellular differentiation of hepatocellular carcinoma (HCC). Intensity was analyzed in 94 lesions (19.4 ± 4.9 mm, 86 patients), 47 well-differentiated HCCs (wHCCs) and 47 moderately-differentiated HCCs (mHCCs): I(e) (early phase) = I(te) (tumor) - I(le) (liver), I(p) (post-vascular phase) = I(tp) (tumor) - I(lp) (liver), I(ep) = I(e) - I(p). The area under the receiver operating characteristic curve with the best cutoff value (I(e), 13.2, I(p), -4.5, I(ep), 21.3) for discriminating between wHCC and mHCC was 0.6922 for Ie, 0.7680 for Ip and 0.7925 for Iep, which indicated a significantly greater ability to differentiate between wHCC and mHCC compared with visual/qualitative assessment (early phase, 0.6170, p = 0.04; post-vascular phase, 0.6702, p = 0.01; both phases, 0.7021, p = 0.04). In conclusion, I(ep) was found to have the highest diagnostic ability, suggesting it is a promising parameter for the cellular differentiation of HCCs with CEUS.
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HEPATIC FILLING RATE OF A MICROBUBBLE AGENT: A NOVEL PREDICTOR OF LONG-TERM OUTCOMES IN PATIENTS WITH CIRRHOSIS
Ultrasound in medicine & biology, 2014Co-Authors: Tadashi Sekimoto, Hiroyuki Ishibashi, Hitoshi Maruyama, Masanori Takahashi, Taro Shimada, Osamu Yokosuka, Soichiro Kiyono, Takayuki Kondo, Tadashi YamaguchiAbstract:Abstract The aim of the study described here was to evaluate the significance of the hepatic filling rate of a Perflubutane microbubble agent in predicting long-term outcomes and prognoses in 32 patients with cirrhosis (37–76 y, 20 females, Child–Pugh A16, B16). The time from delivery of the contrast agent to the hepatic artery to maximum enhancement of the liver parenchyma on the sonogram was defined as the hepatic filling rate (mean = 18.6 s). Hepatic filling rate did not correlate significantly with the Child–Pugh score or the model for end-stage liver disease score. However, the survival rate was lower (93.3% at 1 y, 60.2% at 3 y) and the rate of occurrence of hepatocellular carcinoma (HCC) was higher (13.3% at 1 y, 33.3% at 3 y) in the group with the slow filling rate (≥18 s) than in the group with the rapid filling rate (
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Natural history of postvascular-phase iso-enhanced lesions on the sonogram in chronic liver diseases.
Journal of gastroenterology and hepatology, 2013Co-Authors: Takayuki Kondo, Hitoshi Maruyama, Masanori Takahashi, Taro Shimada, Osamu Yokosuka, Tadashi Sekimoto, Fumihiko Kanai, Tetsuhiro Chiba, Tadashi YamaguchiAbstract:Background and Aim This study examined the natural history of postvascular-phase iso-enhanced lesions (PIELs) on contrast-enhanced sonograms to determine the potential risk and predictive factors for developing hepatocellular carcinoma (HCC) in chronic liver diseases. Methods This prospective study included 87 PIELs on contrast-enhanced sonograms (postvascular-phase: 10 min post-injection of Perflubutane microbubbles) in 72 patients with chronic liver diseases (45 males and 27 females; age 65.0 ± 10.8y; PIEL diameter 12.5 ± 4.2 mm). The PIELs were followed up by ultrasound/contrast-enhanced ultrasound, computed tomography, or magnetic resonance imaging at 3 to 6 months intervals. Results Twenty patients developed HCCs during the study period (median, 22.0 months). The cumulative risk of HCC occurrence was 7.9% at 1 year and 36.0% at 3 years. The presence of coexistent HCC (hazard ratio [HR], 4.975; 95% confidence interval [CI], 1.729–14.316; P = 0.003) and alpha-fetoprotein > 20 ng/mL (HR, 4.104; 95% CI, 1.621–10.392; P = 0.003) were significant factors for the risk of HCC occurrence. Fourteen of these lesions were diagnosed as HCCs that developed from iso-enhanced lesions. Cumulative HCC occurrence rates from PIEL > 14 mm was 23.5% at 1 year and 46.3% at 3 years. Cox regression analysis showed that PIEL > 14 mm (HR, 6.780; 95% CI, 2.060–22.32; P = 0.002) and alpha-fetoprotein > 20 ng/mL (HR, 4.892; 95% CI, 1.559–15.350; P = 0.007) were statistically significant factors for HCC occurrence. Conclusions Patients with coexistent HCC, alpha-fetoprotein > 20 ng/mL, or PIEL > 14 mm should be carefully monitored because of the high potential for HCC occurrence.
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Pretreatment microbubble-induced enhancement in hepatocellular carcinoma predicts intrahepatic distant recurrence after radiofrequency ablation.
AJR. American journal of roentgenology, 2013Co-Authors: Hitoshi Maruyama, Masanori Takahashi, Taro Shimada, Hidehiro Kamesaki, Tadashi Sekimoto, Fumihiko Kanai, Osamu YokosukaAbstract:OBJECTIVE. The purpose of this study is to examine whether pretreatment findings in hepatocellular carcinoma (HCC) using contrast-enhanced ultrasound can predict local or distant recurrence after radiofrequency ablation (RFA). SUBJECTS AND METHODS. Subjects of the prospective study were 54 patients with HCC lesions treated by RFA. Intensity differences between lesion and liver parenchyma at early arterial (4 seconds) and peak enhancement times and washout at late phase were provided on contrast-enhanced sonograms with Perflubutane microbubble agent. The pretreatment findings were examined with respect to intrahepatic local and distant recurrence. RESULTS. Univariate analysis showed that intensity differences at the early arterial time (hazard ratio [HR], 2.2; 95% CI, 1.0–4.6; p = 0.042) and lesion frequency (HR, 2.3; 95% CI, 1.0–5.0; p = 0.044) were risk factors for distant recurrence. Multivariate analysis showed that intensity differences at the early arterial time (HR, 2.7; 95% CI, 1.2–5.8; p = 0.014) ...
Kenichi Takahashi - One of the best experts on this subject based on the ideXlab platform.
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Utility of Contrast-enhanced Ultrasonography with Perflubutane for Determining Histologic Grade in Hepatocellular Carcinoma
Ultrasound in medicine & biology, 2015Co-Authors: Toshifumi Tada, Takashi Kumada, Hidenori Toyoda, Takanori Ito, Yasuhiro Sone, Yuji Kaneoka, Atsuyuki Maeda, Seiji Okuda, Katsuhiko Otobe, Kenichi TakahashiAbstract:The purpose of this study was to clarify the diagnostic value of contrast-enhanced ultrasonography (CEUS) with Perflubutane in determining the histologic grade in hepatocellular carcinoma (HCC). A total of 147 surgically resected HCCs were dichotomized as well differentiated HCC (wd-HCC) and moderately- or poorly-differentiated HCC (mp-HCC). CEUS findings were evaluated during the arterial phase (vascularity, level and shape of enhancement), portal phase (presence or absence of washout) and post-vascular phase (echo intensity and shape). Receiver operating characteristic (ROC) curve analysis for the diagnosis of mp-HCC yielded area under the ROC curve (Az) values for arterial phase vascularity and portal phase washout of 0.910 and 0.807, respectively. The Az value for the combination of vascularity and washout for the diagnosis of mp-HCC was 0.956 (95% confidence interval, 0.910-0.979), corresponding to high diagnostic value. In conclusion, CEUS can provide high-quality imaging assessment for determining the histologic grade of HCCs.
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Utility of contrast-enhanced ultrasound with Perflubutane for diagnosing the macroscopic type of small nodular hepatocellular carcinomas
European Radiology, 2014Co-Authors: Toshifumi Tada, Takashi Kumada, Hidenori Toyoda, Takanori Ito, Yasuhiro Sone, Yuji Kaneoka, Atsuyuki Maeda, Seiji Okuda, Katsuhiko Otobe, Kenichi TakahashiAbstract:Objective To clarify the diagnostic value of contrast-enhanced ultrasound (CEUS) with Perflubutane in the macroscopic classification of small nodular hepatocellular carcinomas (HCCs). Methods A total of 99 surgically resected nodular HCCs with a maximum diameter of 3 cm or less were analysed. HCCs were macroscopically categorized as simple nodular (SN) and non-SN. CEUS findings were evaluated during the arterial phase (vascularity, level and shape of enhancement), portal phase (presence or absence of washout) and post-vascular phase (echo intensity and shape). Results Sixty-eight HCCs were categorized as SN and the remaining 31 were categorized as non-SN. For diagnosis of non-SN HCC, the areas under the receiver operating characteristic curve ( A _z) value for the shape of enhancement in the late arterial phase and the shape of the post-vascular image were 0.824 (95 % confidence interval [CI] 0.721–0.895) and 0.878 (95 % CI 0.788–0.933), respectively. The A _z value for the combination of the shape of enhancement in the late arterial phase and the shape of the post-vascular image for the diagnosis of non-SN HCC was 0.907 (95 % CI 0.815–0.956), corresponding to a high diagnostic value. Conclusion CEUS can provide high-quality imaging assessment for determining the macroscopic classification of small nodular HCCs. Key points • Non-SN is one of the poor prognostic factors in patients with HCC • Assessment of macroscopic type provides valuable information for the management of HCC • CEUS can provide high-quality imaging assessment for macroscopic classification of HCC • For non-SN HCC diagnosed using CEUS, hepatectomy is preferred as curative treatment
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Utility of contrast-enhanced ultrasound with Perflubutane for diagnosing the macroscopic type of small nodular hepatocellular carcinomas
European radiology, 2014Co-Authors: Toshifumi Tada, Takashi Kumada, Hidenori Toyoda, Takanori Ito, Yasuhiro Sone, Yuji Kaneoka, Atsuyuki Maeda, Seiji Okuda, Katsuhiko Otobe, Kenichi TakahashiAbstract:Objective To clarify the diagnostic value of contrast-enhanced ultrasound (CEUS) with Perflubutane in the macroscopic classification of small nodular hepatocellular carcinomas (HCCs).