Publications (11)13.64 Total impact
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Article: Hepatocellular carcinoma treated with radio frequency ablation: an early evaluation with magnetic resonance imaging.
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ABSTRACT: To determine the usefulness of nonenhanced T1-weighted spoiled gradient-recalled acquisition in the steady-state (SPGR) MRI in the early assessment of the efficacy of radio frequency (RF) therapy for hepatocellular carcinoma (HCC). A total of 23 patients with 28 HCC nodules treated with percutaneous RF ablation underwent nonenhanced MRI within two days after the RF procedure and contrast-enhanced computed tomography (CT) one week after. MR assessment of ablation efficacy according to the concentric zonal pattern on T1-weighted SPGR imaging was compared with the one-week CT and presence of local recurrence by means of follow-up study for 12 months or more. In 18 of 28 ablated nodules, SPGR images revealed a central hyperintense zone covering the entire tumor, CT showed a nonenhanced area covering the entire tumor, and no local recurrence was demonstrated in the follow-up studies. In nine of 28 nodules, the central hyperintense zone did not cover the entire tumor; and local recurrence was demonstrated in three nodules. In the remaining one nodule, no signal change was seen in the treated area on SPGR images and CT showed the presence of residual viable tumor. Nonenhanced T1-weighted MRI was considered useful for early assessment of the efficacy of RF therapy for HCC.Journal of Magnetic Resonance Imaging 04/2008; 27(3):546-51. · 2.70 Impact Factor -
Article: Hepatocellular carcinoma treated with radio frequency ablation: An early evaluation with magnetic resonance imaging
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ABSTRACT: PurposeTo determine the usefulness of nonenhanced T1-weighted spoiled gradient-recalled acquisition in the steady-state (SPGR) MRI in the early assessment of the efficacy of radio frequency (RF) therapy for hepatocellular carcinoma (HCC).Materials and MethodsA total of 23 patients with 28 HCC nodules treated with percutaneous RF ablation underwent nonenhanced MRI within two days after the RF procedure and contrast-enhanced computed tomography (CT) one week after. MR assessment of ablation efficacy according to the concentric zonal pattern on T1-weighted SPGR imaging was compared with the one-week CT and presence of local recurrence by means of follow-up study for 12 months or more.ResultsIn 18 of 28 ablated nodules, SPGR images revealed a central hyperintense zone covering the entire tumor, CT showed a nonenhanced area covering the entire tumor, and no local recurrence was demonstrated in the follow-up studies. In nine of 28 nodules, the central hyperintense zone did not cover the entire tumor; and local recurrence was demonstrated in three nodules. In the remaining one nodule, no signal change was seen in the treated area on SPGR images and CT showed the presence of residual viable tumor.Conclusion Nonenhanced T1-weighted MRI was considered useful for early assessment of the efficacy of RF therapy for HCC. J. Magn. Reson. Imaging 2007. © 2007 Wiley-Liss, Inc.Journal of Magnetic Resonance Imaging 02/2008; 27(3):546 - 551. · 2.70 Impact Factor -
Article: [Analysis of the 25-patient who underwent a removal of W-spiral catheter after cessation of hepatic arterial infusion chemotherapy].
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ABSTRACT: The authors analyzed the 25-patient who underwent a removal of W-spiral (WS) catheter after cessation of hepatic arterial infusion (HAI) chemotherapy. The catheter was easily removed in all cases, which resulted in improved patients' quality of life as well as preserved patency of hepatic arteries. However, arterial bleeding was occurred postoperatively in one case, which needed a surgical treatment. Although HAI using WS catheter and subsequent removal of the catheter is a reasonable strategy, a careful management of some complications should be considered.Gan to kagaku ryoho. Cancer & chemotherapy 12/2007; 34(12):1961-3. -
Article: [Prophylactic hepatic arterial infusion chemotherapy after curative surgery of colorectal liver metastases--the viewpoint from patients' quality of life].
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ABSTRACT: In order to establish a reasonable prophylactic hepatic arterial infusion (HAI) chemotherapy following curative resection of colorectal liver metastases, the authors performed a randomized control study comparing two regimen. A weekly 5 hour-administration of 5-FU (1500 mg) which was repeated for 8 weeks showed a comparable effect to a continuous infusion group with an identical total dosage of 5-FU. Furthermore, adverse events were observed in only several patients of each group with low grade severity, suggesting that this simple regimen with a weekly HAI is promising. We also analyzed the clinical course of patients receiving HAI using a W spiral catheter which has a shape memory alloy in its tip. The catheter was implanted angiographycally without coil fixation to the vascular wall, which allowed us to remove the catheter after cessation of the scheduled chemotherapy. In all of the patients, the catheters were easily removed without any complications. A 3D-CT angiograph revealed that the hepatic arteries were well patent in all of the patients with a 3.3 Fr type catheter. HAI chemotherapy is basically an invasive treatment. In consideration of its efficacies as well as limitations, a reasonable approach is needed from the viewpoint of patients' quality of life.Gan to kagaku ryoho. Cancer & chemotherapy 12/2006; 33(12):1756-8. -
Article: [Hepatic arterial infusion chemotherapy using W-spiral (WS) catheter].
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ABSTRACT: The authors investigated the usefulness of W-Spiral (WS) catheters for hepatic arterial infusion (HAI) chemotherapy especially from the viewpoint of a removable catheter after cessation of chemotherapy. A WS catheter was successfully inserted into the hepatic artery without a coil fixation in 40 out of 47 patients with hepatic malignant disease. A stable position of the catheter tip was maintained throughout the period in all cases. In 20 patients, the catheter was easily and uneventfully removed after chemotherapy, which resulted in improved patients' quality of life. An electron microscope examination revealed that there was no fibrin network formation on the surface of the catheter. Stenosis of the hepatic artery was confirmed in 7 out of 12 patients with 5 Fr catheter by 3DCT angiography, whereas patency of the artery was well preserved in 7 of 8 cases with 3.3 Fr catheter. This catheter has a special shape-memory alloy in its tip, which allows a preferable fixation without coils and removal of the catheter if desired. HAI using this catheter and subsequent removal of it is a reasonable strategy especially for patients who need limited courses of chemotherapy.Gan to kagaku ryoho. Cancer & chemotherapy 11/2005; 32(11):1715-7. -
Article: Adjuvant hepatic arterial infusion after curative resection of colorectal liver metastases using removable intra-arterial catheters with shape-memory alloy.
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ABSTRACT: Although there are some reports that adjuvant hepatic arterial infusion (HAI) chemotherapy reduces the hepatic recurrence following curative resection of colorectal liver metastases, problems of indwelling catheters after chemotherapy cessation remains unsolved. The usefulness of adjuvant HAI was investigated using a removable port-catheter system. Spiral catheterstrade mark were attempted to be placed in 17 patients who underwent curative hepatectomy. The catheter contains a special shape-memory alloy at its tip, which allows stable fixation to the vascular wall without coiling so the catheter can be removed if necessary. 5-fluorouracil (5-FU) in total dose of 12 g was intra-arterially administered. W spiral catheterstrade mark were successfully placed in the hepatic artery by percutaneous approach in 82% of the patients. All patients underwent scheduled chemotherapy without serious adverse events. Reservoir-catheter system was removed easily and uneventfully after discontinuation of the chemotherapy. 3D-CT angiography revealed that the hepatic artery was well preserved with short-term chemotherapy. Postoperative hepatic recurrence was observed only in 18% of the patients with the median follow-up time of 19.9 months. Prophylactic 5-FU HAI using W spiral cathetertrade mark and subsequent catheter extirpation is a promising strategy following curative resection of colorectal liver metastases.Journal of Surgical Oncology 01/2005; 88(4):248-55. · 2.10 Impact Factor -
Article: [Application of metallic stents for both inferior vena cava and biliary obstruction by lymph node involvement in a patient with recurrent hepatocellular carcinoma].
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ABSTRACT: The authors experienced a case with obstruction of the inferior vena cava (IVC) and the common bile duct due to a recurrent hepatocellular carcinoma. In order to improve severe edema of the lower extremities and obstructive jaundice, IVC metallic stent as well as biliary stent were applied. A Luminexx stent of 8 cm in length was placed in the bile duct via subcutaneous route after biliary drainage. A spiral zigzag stent of 8 cm in length was also inserted into the IVC through the femoral vein following balloon dilatation of the obstructed portion. Subsequently, jaundice and edema were dramatically improved in a short period of time, which resulted in patient discharge from the hospital. Although the patient died of the cancer in 2 months, the quality of life was well maintained until death.Gan to kagaku ryoho. Cancer & chemotherapy 11/2004; 31(11):1943-5. -
Article: MR appearances of radiofrequency thermal ablation region: histopathologic correlation with dog liver models and an autopsy case.
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ABSTRACT: The purpose of this study was to evaluate the utility of magnetic resonance (MR) imaging for indicating the extent of true tissue necrosis of the liver after radiofrequency (RF) ablation in comparison with histopathologic findings in dog models and an autopsy case. RF ablation of the liver parenchyma was performed on three dogs under general anesthesia. MR appearances of the RF-ablated regions on T1-weighted fast-low angle shot (FLASH; repetition time/echo time [TR/TE]/flip angle: 120/3.8/70),T2-weighted turbo spin echo (3000/80/echo train = 25) and contrast-enhanced T1-weighted images were compared with histopathologic findings. An autopsy case with hepatocellular carcinoma was also enrolled in this study. All ablated regions showed three zones on T1-weighted FLASH images: a central zone with low intensity, a broad hyperintense middle zone, and a surrounding hypointense band. The central and middle zones corresponded to the degrees of coagulation necrosis observed during histopathologic examination, whereas no viable cells were seen in these zones during the microscopic examination using nicotinamide adenine dinucleotide diaphorase stain. The surrounding hypointense band corresponded to sinusoidal congestion in the acute phase and to fibrotic change in the subacute phase. MR imaging using the FLASH sequence can accurately determine the extent of the necrotic area after RF ablation.Academic Radiology 10/2004; 11(10):1180-9. · 1.69 Impact Factor -
Article: [Prophylactic hepatic arterial infusion chemotherapy after resection of colorectal liver metastases using removable W-spiral catheter].
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ABSTRACT: The authors investigated the usefulness of W-Spiral Catheters for adjuvant hepatic arterial infusion (HAI) chemotherapy following curative resection of colorectal liver metastases. The catheter has a special shape-memory alloy in its tip, which allows preferable fixation without coils and removal of the catheter if desired. A W-spiral catheter was successfully placed in 13 out of 16 patients who had undergone curative hepatectomy. In the remaining 3 cases in which the hepatic artery was smaller in diameter, a catheter was placed using the conventional GDA coiling method. Removal of the W-Spiral Catheter was attempted in 10 of the 13 patients with a Spiral Catheter after termination of HAI chemotherapy. In all cases, the catheters were easily and uneventfully removed, and 3D-CT angiography revealed that the hepatic artery was well preserved in most cases. These findings suggest that a new approach to prophylactic HAI chemotherapy with W-Spiral Catheters and subsequent removal of the catheters is reasonable and desirable.Gan to kagaku ryoho. Cancer & chemotherapy 11/2003; 30(11):1766-8. -
Article: Successful treatment of common bile duct stricture after laparoscopic cholecystectomy by percutaneous transhepatic balloon dilatation.
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ABSTRACT: A biliary stricture is one of the most serious complications of laparoscopic cholecystectomy and usually requires a laparotomy. A 50-year-old man was diagnosed with common bile duct stricture after laparoscopic cholecystectomy. Percutaneous transhepatic balloon dilatation was an effective and less invasive treatment for common bile duct stricture following laparoscopic cholecystectomy.Surgical laparoscopy, endoscopy & percutaneous techniques 09/2003; 13(4):271-5. · 1.23 Impact Factor -
Article: Therapeutic effectiveness of segmental arterioportal chemoembolization via hepatic artery for localized hepatocellular carcinoma
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ABSTRACT: Segmental arterioportal chemoembolization via hepatic artery with overflow to the segmental portal vein was performed in 41 patients with hepatocellular carcinoma. Emulsion of doxorubicin (mean 37 mg) and two-to-three volume of iodized oil (mean 11 ml) was infused from a segmental artery of the liver until the segmental portal branches around the tumor were visualized fluoroscopically. By the iodized oil accumulation, the tumors were divided into five types: single nodular (SN); single nodular with proliferation (SN-P); multinodular fused (MN-F); multinodular (MN); and massive. Massive and MN types showed high incidence of local recurrence. However, SN-P and MN-F types showed a good tumor response and no local recurrence. In 32 unresected cases the overall response rate was 53%, the 1-year actuarial survival was 90% and 3-year survival was 43%. Six of nine operative specimens revealed complete necrosis of the tumor microscopically and three showed 90–95% necrosis. Thick fibrous capsules were found in all nine resected cases around the necrosis both of the tumor and of the non-cancerous parenchyma. This therapy was regarded as having a great capacity to kill the infiltrative portion of localized tumor and the thick capsule may be a peculiarity of this therapy which played a major role in guarding against regrowth of the tumor.European Radiology 09/1992; 2(5):413-420. · 3.22 Impact Factor
Top co-authors
Top Journals
Institutions
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2008
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Damascus University
- Department of Radiology
Damascus, Damascus City, Syria
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2004
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Osaka City University
- Department of Radiology
Ōsaka-shi, Osaka-fu, Japan
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2003
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Nippon Telegraph and Telephone
Tokyo, Tokyo-to, Japan
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