RSNA2014 「おすすめ演題」について
祖父江慶太郎先生(神戸大学 ※デューク大学留学中)にお答えいただきました。
【MRI】
CODE： GIS325
Peritumoral Hyperintensity on Hepatobiliary Phase of Gd-EOB-DTPA Enhanced MRI in Hepatocellular Carcinomas: Correlation with Peritumoral Hyperplasia Showing Glutamine Synthetase Overexpression
Norihide Yoneda et al.
DATE: Sunday
TIME: 12:30-1:00
LOCATION:
PURPOSE: Peritumoral hyperintensity (PH) is occasionally seen in hepatocellular carcinoma (HCC) on the hepatobiliary phase (HB phase) of Gd-EOB-DTPA enhanced MRI (EOB-MRI). However, the mechanism of PH is still unknown. A recent study showed peritumoral hyperplasia (PTH) associated with over-expression of glutamine synthetase (GS) in HCC or metastatic carcinoma. The aim of this study was to analyze the correlation between PH on the HB phase of EOB-MRI and GS expression indicating PTH.
【コメント】
EOB造影MRI肝細胞相におけるHCC周囲の高信号域についての発表。病理学的考察がなされています。
CODE: GIS333
Susceptibility-weighted Imaging of Multistep Hepatocarcinogenesis in Cirrhotic Livers: Correlation with Histopathology
Ruo Kun Li et al.
DATE: Sunday
TIME: 1:00-1:30
LOCATION:
PURPOSE: To investigative imaging characteristics of multistep hepatocarcinogenesis in cirrhotic livers on susceptibility-weighted imaging (SWI) and correlate with histopathologic results.
【コメント】
SWIを用いてDysplastic noduleとHCCとの鑑別が可能かを検討しています。
CODE： SSC05-01
Early Therapeutic Response Evaluation after FOLFOX and FOLFIRI Treatment in Patients with Liver Metastasis from Colorectal Cancer Using IVIM DWI and DCE-MRI
Jung Hoon Kim MD et al.
DATE: Monday
TIME: 10:30-10:40
LOCATION: E451A
PURPOSE: The purpose of this study is early therapeutic response evaluation after cytotoxic chemotherapy using FOLFOX and FOLFIRI in patients with liver metastasis from colorectal cancer using IVIM DWI and DCE-MRI.
【コメント】
大腸癌肝転移に対する化学療法の効果予測に、Dynamic contrast-enhanced MRIよりもIVIM（IntraVoxel Incoherent Motion）DWIが有用であるという報告です。
CODE: GIS338
Imaging Outcomes of Liver Imaging Reporting and Data System (LI-RADS) 2, 3 and 4 Categories on CT and MR Examination
Masahiro Tanabe MD et al.
DATE: Monday
TIME: 12:15-12:45
LOCATION:
PURPOSE: The Liver Imaging Reporting and Data System (LI-RADS) released by the ACR is a comprehensive system for standardized interpretation and reporting of CT and MR examinations performed in patients at risk for hepatocellular carcinoma (HCC). The purpose of this study was to assess imaging outcomes of LR-2 (probably benign), LR-3 (intermediate probability for HCC) and LR-4 (probable HCC) observations. Specifically, we sought to determine the proportion of LR-2, LR-3, and LR-4 observations that, during clinical imaging follow-up and in the absence of treatment progress regress or remain stable in category code.
【コメント】
American College of Radiologyから提唱されているHCC画像診断アルゴリズム（LI-RADS）における、HCCと断定できない肝病変に対する自然経過についての報告です。
CODE: VSGI21-09
Performance of LI-RADS Criteria for Diagnosis of Pathologically Proven Hepatocellular Carcinoma Using Gd-EOB-DTPA, and Comparisons with the Japan Society of Hepatology 2010 Criteria
Stephanie Channual MD et al.
DATE: Monday
TIME: 10:45-10:55
LOCATION: E350
PURPOSE: Only recently has LI-RADS (LR) expanded to apply to hepatobiliary (HB) contrast agents, with lesion appearance on the HB phase considered to be an ancillary feature that favors the diagnosis of hepatocellular carcinoma (HCC). In contrast, the Japan Society of Hepatology (JSH) includes lesion appearance on the HB phase as a major criteria that favors the diagnosis of HCC. The purpose of our study was to determine the performance of LI-RADS v2014 and Japan Society of Hepatology (JSH) 2010 criteria for the non- invasive diagnosis of HCC.
【コメント】
先に述べたLI-RADSにおけるEOB-MRIの位置づけと日本の肝癌診療ガイドラインとの比較について報告しています。
CODE: GIS351
MRI Based Liver Iron Content Determination Using Signal Intensity Ratio Analysis: RF Spoiled vs. Not RF Spoiled Gradient Echo
Arthur P Wunderlich PhD et al.
DATE: Monday
TIME: 12:45-1:15
LOCATION:
PURPOSE: Annihilation of remaining magnetization by radio frequency (RF) spoiling alters image contrast compared to solely gradient spoiling. We studied influence of RF-spoiling (RFS) on liver iron content (LIC) results of gradient echo (GRE) MRI utilizing signal intensity ratio (SIR), i.e. ratio of liver to muscle signal.
【コメント】
肝臓の鉄沈着の評価を、従来のspoiled-GRE法とnon-spoiled GRE法とで比較した報告です。
CODE: SSE09-01
Accuracy of Liver Fat Quantification by CT, MRI and US: A Prospective Comparison with Magnetic Resonance Spectroscopy (MRS)
Harald Kramer MD et al.
DATE: Monday
TIME: 3:00-3:10
LOCATION: E451A
PURPOSE: The hallmark feature of non-alcoholic fatty liver disease (NAFLD) is the accumulation of triglycerides within hepatocytes (steatosis), which can lead to inflammation, fibrosis, and cirrhosis. Magnetic resonance spectroscopy (MRS) is widely considered to be the reference standard for accurate non-invasive quantification of fat content in the liver. The purpose of this study was to evaluate the accuracy of quantitative confounder-corrected chemical shift-encoded MRI, dual-energy computed tomography (CT) and ultrasound (US) to quantify hepatic steatosis in comparison to MRS.
【コメント】
NAFLの定量評価について、MRI-based PDFF、material decomposition Dual-energy CT、shear wave velocity-USの3者をGold standardであるMRSと比較した報告です。
CODE: GIS353
The Relationships between Signal Changes with Time in the Hepatobiliary Phase of Gd-EOB-DTPA Enhanced MR Imaging and the Degree of Histopathologic Grades in Hepatocellular Carcinomas
Atsushi Higaki MD et al.
DATE: Tuesday
TIME: 12:15-12:45
LOCATION:
PURPOSE: The purpose of this study was to evaluate the relationships between signal intensity in the three hepatobiliary phases (10, 15, 20 minutes) of Gd-EOB-DTPA enhanced MR imaging and the degree of histopathologic grades in hepatocellular carcinoma (HCC).
【コメント】
肝細胞相におけるEOB造影剤取り込みの変化と組織Gradeとの関連性について報告されています。
CODE: GIS354
Computer-aided Assessment of Hepatic Contour Abnormalities as an Imaging Biomarker for the Prediction of Hepatocellular Carcinoma Development in Patients with Chronic Hepatitis C
Satoshi Goshima MD, PhD et al.
DATE: Tuesday
TIME: 12:15-12:45
LOCATION:
PURPOSE: To evaluate whether hepatic fibrosis index (HFI) quantified on the basis of hepatic contour abnormality is a risk factor for the development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C.
【コメント】
肝表の形態をCADによって解析し、線維化を評価することでHCC発症の予測因子となり得ることを報告しています。
CODE: SSM08-01
DWI Can Predict Early Therapy Response in Patients with Hepatocellular Carcinoma after Selective Internal Radiation Therapy (SIRT)
Juliane Schelhorn MD et al.
DATE: Wednesday
TIME: 3:00 – 3:10
LOCATION: E353A
PURPOSE: Selective internal radiation therapy (SIRT) with Yttrium-90 (Y90) microspheres is a promising therapy option in patients with advanced hepatocellular carcinoma (HCC). Early detection of therapy response is warranted to ensure adequate ongoing treatment, but size measurements and contrast enhancement are often not conclusive. We aimed to evaluate diffusion weighted imaging (DWI) for early prediction of tumor response in patients with HCC following SIRT.
【コメント】
Radioembolizationの治療効果予測にDWIが有用であるとの報告です。
CODE: SSQ06-03
Use of Liver MRI Following Standard Staging Abdomiopelvic CT to Evaluate Newly-diagnosed Colorectal Cancer Patients
Kichang Han MD et al.
DATE: Thursday
TIME: 10:50 – 11:00
LOCATION: E350
PURPOSE: No clear guidelines yet exist regarding how to use liver MRI in evaluating patients with newly-diagnosed colorectal cancer. This study was to investigate the clinical impact of liver MRI in staging evaluation of newly-diagnosed colorectal cancer patients, primarily focusing on those who demonstrate diminutive indeterminate hypoattenuating (‘too-small-to-characterize’ [TSTC]) focal hepatic lesions or metastasis-negative hepatic findings on standard staging CT.
【コメント】
新規大腸癌患者に対して全例にMRIを施行することの妥当性についての大規模研究です。
