• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3595-3604
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• 2015

Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.

• The Korean Journal of Nuclear Medicine
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• v.39 no.3
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• pp.200-208
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• 2005

Purpose: Tc-99m labeled diethylenetriaminepentaacctic acid (DTPA)-coupled galactosylated human serum albumin (GSA) is a currently used imaging agent for asialoglycoprotein receptor (ASGPR) of the liver, but, it has several shortcomings. Recently a new ASGPR imaging agent, $^{99m}Tc$-lactosylated human serum albumin (LSA), with simple labeling procedure, high labeling efficiency, high stability was developed. In order to assess the feasibility of the $^{99m}Tc$-LSA as a ASGPR imaging radiopharmaceuticals, we performed biodistribution study of the tracer in liver injured mice model and the results were compared with histolgic data. Materals and Methods: To induce hepatic damage in ICR mice, diethylnitrosamine (DEN) ($60mg/kg/week{\times}5time$, low dose or $180mg/kg/week{\times}2times$, high dose) and thioacetamide (TAA) ($50mg/kg{\times}1time$) were administrated intraperitoneally. Degree of liver damage was evaluated by tissue hematoxilin-eosin stain, and expression of asialoglycoprotein receptor (ASGPR) was assessed by immunohistochemistry using ASGPR antibody. $^{99m}Tc$-LSA was intravenously administrated via tail vein in DEN or TAA treated mice, and biodistribution study of the tracer was also performed. Results: DEN treated mice showed ballooning of hepatocyte and inflammatory cell infiltration in low dose group and severe hapatocyte necrosis in high dose group, and low dose group showed higher ASGPR staining than control mice in immunohistochemical staining. TAA treated mice showed severe hepatic necrosis. $^{99m}Tc$-LSA Biodistribution study showed that mice with hepatic necrosis induced by high dose DEN or TAA revealed higher blood activity and lower liver activity than control mice, due to slow clearance of the tracer by the liver. The degree of liver uptake was inversely correlated with the degree of histologic liver damage. But low dose DEN treated mice with mild hepatic injury showed normal blood clearance and hepatic activity, partly due to overexpression of ASGPR in mice with mild degree hepatic injury. Conclusion: Liver uptake of $^{99m}Tc$-LSA was inversely correlated with degree of histologic hepatic injury in DEN and TAA treated mice. These results support that $^{99m}Tc$-LSA can be used to evaluate the liver status in liver disease patients.

• Asian-Australasian Journal of Animal Sciences
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• v.29 no.2
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• pp.219-229
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• 2016

Fatty liver is a common metabolic disorder of dairy cows during the transition period. Historically, the diagnosis of fatty liver has involved liver biopsy, biochemical or histological examination of liver specimens, and ultrasonographic imaging of the liver. However, more convenient and noninvasive methods would be beneficial for the diagnosis of fatty liver in dairy cows. The plasma metabolic profiles of dairy cows with fatty liver and normal (control) cows were investigated to identify new biomarkers using $^1H$ nuclear magnetic resonance. Compared with the control group, the primary differences in the fatty liver group included increases in ${\beta}$-hydroxybutyric acid, acetone, glycine, valine, trimethylamine-N-oxide, citrulline, and isobutyrate, and decreases in alanine, asparagine, glucose, ${\gamma}$-aminobutyric acid glycerol, and creatinine. This analysis revealed a global profile of endogenous metabolites, which may present potential biomarkers for the diagnosis of fatty liver in dairy cows.

• Korean Journal of Digital Imaging in Medicine
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• v.14 no.1
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• pp.21-29
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• 2012

The purpose of this study is to evaluate the mutual relations by measuring SNR from T2 weighted image and ADC values on the basis of the stiffness values from liver tissues. This study was conducted that total 37 people(23 of males and 11 of females) were taken the liver MRI examination and average age was $54.5{\pm}12.7$ years old. The equipment was MAGNETOM Skyra 3.0T (SIEMENS, Erlangen, Germany) and 32 channel body-array coil. The examination were conducted with HASTE T2 weighted image by axial plane, Spin-echo EPI (echo planner image) DWI (b-value = 800) and Magnetic resonance elastography. The ROIs (region of interest: 200-300 $mm^2$) were established on the basis of the first axial stiffness image corresponded 95% confidence interval from axial stiffness image and then were measured values. After drawing the grid lines, signals were measured SNR from T2 weighted image and ADC values on the same locations that were analysed other 3 planes respectively. The results were showed correlation (0.057) that were increased to SNR from T2 weighted image by increasing stiffness value that no significant difference statistically p = 0.003. Other results were showed correlations (-0.301) that were decreased to ADC values by increasing stiffness values that no significant difference statistically p = 0.088. In the 3.0T equipment, the results may be error in much the same fashion as the 1.5T from ADC values by evaluation of fibrosis stage. However, Magnetic resonance elastography would be useful method that is used to diagnose exactly liver fibrosis stages in the 3.0T.

• Korean Journal of Digital Imaging in Medicine
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• v.14 no.2
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• pp.57-61
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• 2012

To compare the accuracy of breath-hold magnetic resonance imaging sequences to establish the most effective superparamagnetic iron oxide-enhanced sequence for detection of hepatic metastases. A total of 100 patients(50men and 50women, mean age: 60years) with liver disease(including malignant and benign liver lesions) were investigated at 3.0T machine (GE, General Electric Medical System, Excite HD) with 8Ch body coil. Pulse sequence for MR imaging decided to the FS-T2-FSE-RT(TR/TE/Thick./Freq./Phase=12857ms/100ms/7mm/512/384), MGRE(TR/TE/Thick./Freq./Phase=100ms/9.7ms/7mm/384/288), in-out of phase echo(TR/$TE_1$, $TE_2$/Thick./Freq./Phase=140ms/2.4, 5.8ms/7mm/352/300), Images obtained before the injection of SPIO. Six sequences were optimized for lesion detection: FS-T2-FSE-RT, multigradient recalled echo data image(MGRE), T2-weighted MGRE with an 9.7msec echo time. Images were reviewed independently by five blinded observers. The accuracy of each sequence was measured by using picture archiving communication system analysis. All results were correlated with findings at multidectator computed tomography examination. Differences between the mean results of the six observers were measured by using paired student t-test analysis. Postcontrast T2-weighted MGRE sequences were the most accurate and were significantly superior to postcontrast FS-T2-FSE-RT, T2-weighted MGRE, in-out of phase MR sequences(p < .05). For all lesions that were malignant or smaller than 1 cm, respectively, contrast to noise ratio of pre and postcontrast sequences were -1and -0.3 for T2-weighted FSE, 0.53 and 4.5 in-out of phase, 7, 7.08, 5.08, 3.32, 1.7, 1.16, 0.79, 0.68 for GRE with 2.9, 7.5, 12.1, 16.6, 21.2, 25.8, 30.4, 35.0 TE values. Breath-hold various TE precontrast sequences offer improvement in sensitivity compared with fixed multigradient recalled echo sequences alone.

• Journal of Intelligence and Information Systems
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• v.11 no.1
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• pp.17-33
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• 2005

This paper presents the proposed a classifier of liver cirrhotic step using MR(magnetic resonance) imaging and hierarchical neural network. The data sets for classification of each stage, which were normal, 1type, 2type and 3type, were analysis in the number of data was 231. We extracted liver region and nodule region from T1-weight MR liver image. Then objective interpretation classifier of liver cirrhotic steps. Liver cirrhosis classifier implemented using hierarchical neural network which gray-level analysis and texture feature descriptors to distinguish normal liver and 3 types of liver cirrhosis. Then proposed Neural network classifier learned through error back-propagation algorithm. A classifying result shows that recognition rate of normal is $100\%$, 1type is $82.8\%$, 2type is $87.1\%$, 3type is $84.2\%$. The recognition ratio very high, when compared between the result of obtained quantified data to that of doctors decision data and neural network classifier value. If enough data is offered and other parameter is considered this paper according to we expected that neural network as well as human experts and could be useful as clinical decision support tool for liver cirrhosis patients.

• Investigative Magnetic Resonance Imaging
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• v.5 no.1
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• pp.43-48
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• 2001

Purpose : To evaluate changes in rabbit liver parenchyma on MR images following percutaneous Holmium-166 injection, and to correlate those changes with histologic findings. Materials and methods. Holmium-166 (10-25 mCi) was percutaneously injected into the liver of rabbit (n=12) under sonographic guidance. MR images were obtained between one to two weeks (acute phasea) after the injection in four rabbits, and between two to four weeks (subacute phase) after the injection in four rabbits. Tissue specimens of these eight rabbits were obtained immediately after MR imaging. Tissue specimens were obtained without MR imaging in four rabbits (between one to two weeks in one rabbit and between three to four weeks in three rabbits). Results : Tissue specimens showed central liquefactive necrosis and peripheral coagulative necrosis containing deposition of small particles and hemorrhage. The peripheral margin of the lesions showed formation of the granulation tissue with fibrosis, which tended to be more prominent in subacute phase. The area of the necrosis tended to correlate with the dose of the radioactive Holmium-166. On MR images, the central portion of the necrosis showed hyperintensity on 72-weighted image, hypointensity on the precontrast T1-weighted images, and no enhancement on the dynamic MR images. The peripheral portion of the necrosis showed hypointensity on T2-weighted images, iso or mild hypointensity on the T1-weighted images, and mild peripheral enhancement on the delayed dynamic MR images. The peripheral margin of the lesion showed hypointensity on both T1- and T1-weighted images with increased enhancement on the delayed phase images of the dynamic MR images. Conclusion : After percutaneous Holmium-166 injection into rabbit liver parenchyma, the central portion showed liquefactive necrosis, the peripheral portion showed coagulative necrosis with granulation, fibrosis, hemorrhage and depostition of small granules. MR imaging may be helpful in evaluation of the histological change of the liver after percutaneous Holmium-166 treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.2
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• pp.147-151
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• 2016

Neonatal hemochromatosis (NH) is a severe neonatal liver injury that is confirmed by extra-hepatic iron accumulation. Although a recent study described treating NH with exchange transfusions and intravenous immunoglobulin, liver transplantation should be considered for patients with severe liver failure that does not respond to other medical treatment. Herein, we report the case of a two-month-old female infant who presented with persistent ascites and hyperbilirubinemia. Her laboratory findings demonstrated severe coagulopathy, high indirect and direct bilirubin levels, and high ferritin levels. Abdominal magnetic resonance imaging presented low signal intensity in the liver on T2-weighted images, suggesting iron deposition. The infant was diagnosed with NH as a result of the clinical findings and after congenital infection and metabolic diseases were excluded. The infant was successfully treated with a living-donor liver transplantation. Living related liver transplantation should be considered as a treatment option for NH in infants.

• Investigative Magnetic Resonance Imaging
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• v.20 no.4
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• pp.231-240
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• 2016

Purpose: To determine whether liver stiffness (LS) measured by magnetic resonance elastography (MRE) can predict the outcome of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients. Materials and Methods: A total of 107 patients with Child-Pugh class A liver function who were treated with RFA for single HCC and who had undergone a gradient-echo MRE within 6 months before RFA were included. We evaluated the relationship between the LS values and the ablation volume, local tumor progression (LTP), and intrahepatic distant recurrence (IDR). We also constructed receiver operating characteristic (ROC) curves to examine the role of LS in predicting liver function deterioration, which was defined as an increase of Child-Pugh score by one point or more at 1 year after RFA. Results: There was no significant correlation between LS and ablation volume, and neither time to LTP nor IDR was associated with LS. Among the 66 patients who did not have recurrence 1 year after RFA, 5 patients (7.6%) developed liver function deterioration. A high LS value was significantly associated with development of liver function deterioration after RFA and the area under the ROC curve was 0.764 (95% CI 0.598-0.929, P = 0.003). Conclusion: LS measured by MRE could not predict ablation volume and tumor recurrence. However, high LS values were significantly associated with development of liver function deterioration.

• 대한핵의학회:학술대회논문집
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• 2005.11a
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• pp.341.2-341.2
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• 2005