Early enhancement in the arterial phase might be a useful indicator of lower malignant potential and better survival in ICC patients.

Purpose: Arterial enhancement of intrahepatic cholangiocarcinoma (ICC) has been noted. To precisely identify the characteristics of tumor enhancement patterns, we examined the relationship between CT attenuation in the tumor and clinicopathological parameters or prognosis.Methods: Subjects were 42 ICC patients who had undergone hepatectomy. Microvessel density (MVD) determined by CD34 staining was compared with imaging. Attenuation was calculated in images from multi-detector CT of tumor and non-tumorous regions. Enhancement patterns were divided into two groups: arterial enhancement with higher attenuation (>16 HU; Hyper group, n=12); and arterial enhancement with lower attenuation (Hypo group, n=30).Results: Univariate analysis identified high tumor marker level, increased size, less-differentiation, incomplete resection, increased bleeding and lower MVD as significantly associated with poor survival (p<0.05). Increased attenuation throughout the whole ICC correlated significantly with radiological findings and MVD. Concomitant hepatitis, well-differentiation, and smaller tumor were more significantly frequent in the Hyper group than in the Hypo group (p<0.05). Postoperative early recurrence was significantly less frequent in the Hyper group, and overall survival was significantly better in the Hyper group (p<0.05). Conclusions:Increased CT attenuation correlated with ICC tumor vascularity. Increased tumor enhancement in the arterial phase was associated with chronic hepatitis, lower malignancy and better survival.Key words: intrahepatic cholangiocarcinoma-tumor enhancement-multidetector computed tomography-prognosis-hepatectomy Nanashima et al., Page 3 Intrahepatic cholangiocarcinoma (ICC) is a well-characterized liver cancer for which various prognostic risk factors have been clarified [1][2][3]. ICC is composed of cells that mostly resemble those of the peripheral bile ducts, but recent reports have suggested that ICC may not always display uniform characteristics [4][5][6][7][8]. ICC can be classified into subgroups according to macroscopic findings, with clinical and pathological characteristics and prognosis differing significantly among subgroups [9,10].While diagnosis of the ICC subtype would be useful for predicting prognosis and determining the need for adjuvant treatments with hepatic resection, clearly distinguishing subgroups is often difficult, particularly in advanced tumors. Although a variety of prognostic parameters have been identified in recent research, the definitive factors associated with poor prognosis have not been well clarified [11,12]. Recent histological and molecular studies have revealed that tumor vascularity of ICC is closely associated with malignant behavior and patient prognosis [13,14]. Higher tumor vascularity might be related to the presence of chronic viral hepatitis, which is also related to carcinogenesis for hepatocellular carcinoma (HCC) [15]. We have previously examined histological parameters in ICC and clarified that higher tumor vascularity as dete...

Non-invasive ARFI imaging elastography is useful in evaluating impaired liver function or in the differential diagnosis of liver malignancies, highly hepatic fibrosis and in predicting posthepatectomy morbidity.

The new G-PDT treatment showed a high prevalence of apoptosis and inhibition of tumor growth in treatment of BDC cells.

ObjectivesThe aim of the study was to clarify the clinical significance of single-photon emission computed tomography/computed tomography (SPECT/CT) imaging in terms of technetium-99m galactosyl human serum albumin ( 99m Tc-GSA) scintigraphy. To this end, we examined the relationship using data from surgical records of 67 patients with hepatocellular carcinoma who underwent hepatectomy. Materials and methodsLiver functional parameters or functional volume was estimated by 99m Tc-GSA scintigraphy and computed tomography volumetry was used to estimate morphological volume. ResultsLiver uptake ratio at 15 min (LHL15) was correlated with the indocyanine green retention rate at 15 min (ICGR15; R=−0.608, P<0.01); however, five patients (7.5%) had values outside this correlation.In these patients, LHL15 reflected clinical status and patient outcomes more. Although morphological and functional volumes were well correlated (P<0.01), functional volume was decreased in the diseased liver with portal vein tumor thrombus or portal vein embolization. By applying ConclusionUnder the ICGR15 test as the standard for preoperative hepatic function, auxiliary application of LHL15 and functional volumetry provides useful information on hepatocellular carcinoma patients undergoing hepatectomy.