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Hong Kong, Hong Kong

Chim C.S.,University of Hong Kong | Ma E.S.K.,Hong Kong Sanatorium Hospital
Oncology Letters | Year: 2013

The current case report presents the prolonged survival of >20 years in a myeloma patient with secondary plasma cell leukemia and myelomatous pleural effusion. FISH on marrow plasma cells showed hyperdiploidy and concomitant t(14;16) and karyotypes predicting superior and short survival. The possibility of primary hyperdiploidy with t(14;16) as a secondary event has been discussed. Source


Chen S.-Z.,Interventional Imaging | Yuan J.,Hong Kong Sanatorium Hospital | Deng M.,Interventional Imaging | Wei J.,Philips | And 3 more authors.
European Radiology | Year: 2016

Purpose: To evaluate Chemical Exchange Saturation Transfer (CEST) MRI for liver imaging at 3.0-T. Materials and methods: Images were acquired at offsets (n = 41, increment = 0.25 ppm) from −5 to 5 ppm using a TSE sequence with a continuous rectangular saturation pulse. Amide proton transfer-weighted (APTw) and GlycoCEST signals were quantified as the asymmetric magnetization transfer ratio (MTRasym) at 3.5 ppm and the total MTRasym integrated from 0.5 to 1.5 ppm, respectively, from the corrected Z-spectrum. Reproducibility was assessed for rats and humans. Eight rats were devoid of chow for 24 hours and scanned before and after fasting. Eleven rats were scanned before and after one-time CCl4 intoxication. Results: For reproducibility, rat liver APTw and GlycoCEST measurements had 95 % limits of agreement of −1.49 % to 1.28 % and −0.317 % to 0.345 %. Human liver APTw and GlycoCEST measurements had 95 % limits of agreement of −0.842 % to 0.899 % and −0.344 % to 0.164 %. After 24 hours, fasting rat liver APTw and GlycoCEST signals decreased from 2.38 ± 0.86 % to 0.67 ± 1.12 % and from 0.34 ± 0.26 % to −0.18 ± 0.37 % respectively (p < 0.05). After CCl4 intoxication rat liver APTw and GlycoCEST signals decreased from 2.46 ± 0.48 % to 1.10 ± 0.77 %, and from 0.34 ± 0.23 % to −0.16 ± 0.51 % respectively (p < 0.05). Conclusion: CEST liver imaging at 3.0-T showed high sensitivity for fasting as well as CCl4 intoxication. Key Points: • CEST MRI of in-vivo liver was demonstrated at clinical 3 T field strength. • After 24-hour fasting, rat liver APTw and GlycoCEST signals decreased significantly. • After CCl4 intoxication both rat liver APTw and GlycoCEST signals decreased significantly. • Good scan–rescan reproducibility of liver CEST MRI was shown in healthy volunteers. © 2015, European Society of Radiology. Source


Deng M.,Interventional Imaging | Chen S.-Z.,Interventional Imaging | Yuan J.,Hong Kong Sanatorium Hospital | Chan Q.,Philips | And 3 more authors.
Molecular Imaging and Biology | Year: 2016

Purpose: This study seeks to explore whether chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) can detect liver composition changes between after-meal and over-night-fast statuses. Procedures: Fifteen healthy volunteers were scanned on a 3.0-T human MRI scanner in the evening 1.5–2 h after dinner and in the morning after over-night (12-h) fasting. Among them, seven volunteers were scanned twice to assess the scan–rescan reproducibility. Images were acquired at offsets (n = 41, increment = 0.25 ppm) from −5 to 5 ppm using a turbo spin echo (TSE) sequence with a continuous rectangular saturation pulse. Amide proton transfer-weighted (APTw) and GlycoCEST signals were quantified with the asymmetric magnetization transfer ratio (MTRasym) at 3.5 ppm and the total MTRasym integrated from 0.5 to 1.5 ppm from the corrected Z-spectrum, respectively. To explore scan time reduction, CEST images were reconstructed using 31 offsets (with 20 % time reduction) and 21 offsets (with 40 % time reduction), respectively. Results: For reproducibility, GlycoCEST measurements in 41 offsets showed the smallest scan-rescan mean measurements variability, indicated by the lowest mean difference of −0.049 % (95 % limits of agreement, −0.209 to 0.111 %); for APTw, the smallest mean difference was found to be 0.112 % (95 % limits of agreement, −0.698 to 0.921 %) in 41 offsets. Compared with after-meal, both GlycoCEST measurement and APTw measurement under different offset number decreased after 12-h fasting. However, as the offsets number decreased (41 offsets vs. 31 offsets vs. 21 offsets), GlycoCEST map and APTw map became more heterogeneous and noisier. Conclusion: Our results show that CEST liver imaging at 3.0 T has high sensitivity for fasting. © 2015, World Molecular Imaging Society. Source


Yau T.,University of Hong Kong | Cheng P.N.,Bio Cancer Treatment International Ltd | Chan P.,Ruttonjee Hospital | Chen L.,Bio Cancer Treatment International Ltd | And 5 more authors.
Investigational New Drugs | Year: 2015

This study was designed to evaluate the efficacy, safety profile, pharmacokinetics, pharmacodynamics and quality of life of pegylated recombinant human arginase 1 (Peg-rhAgr1) in patients with advanced hepatocellular carcinoma (HCC). Patients were given weekly doses of Peg-rhAgr1 (1600 U/kg). Tumour response was assessed every 8 weeks using RECIST 1.1 and modified RECIST criteria. A total of 20 patients were recruited, of whom 15 were deemed evaluable for treatment efficacy. Eighteen patients (90 %) were hepatitis B carriers. Median age was 61.5 (range 30-75). Overall disease control rate was 13 %, with 2 of the 15 patients achieving stable disease for >8 weeks. The median progression-free survival (PFS) was 1.7 (95 % CI: 1.67-1.73) months, with median overall survival (OS) of all 20 enrolled patients being 5.2 (95 % CI: 3.3-12.0) months. PFS was significantly prolonged in patients with adequate arginine depletion (ADD) >2 months versus those who had ≤2 months of ADD (6.4 versus 1.7 months; p∈=∈0.01). The majority of adverse events (AEs) were grade 1/2 non-hematological toxicities. Transient liver dysfunctions (25 %) were the most commonly reported serious AEs and likely due to disease progression. Pharmacokinetic and pharmacodynamic data showed that Peg-rhAgr1 induced rapid and sustained arginine depletion. The overall quality of life of the enrolled patients was well preserved. Peg-rhAgr1 is well tolerated with a good toxicity profile in patients with advanced HCC. A weekly dose of 1600 U/kg is sufficient to induce ADD. Significantly longer PFS times were recorded for patients who had ADD for >2 months. © 2015 Springer Science+Business Media New York. Source


Chan H.H.L.,Hong Kong Sanatorium Hospital | Lo G.,Hong Kong Sanatorium Hospital
Hong Kong Medical Journal | Year: 2016

Introduction: Screening mammogram can decrease the mortality of breast cancer. Studies show that women avoid mammogram because of fear of pain, diagnosis, and radiation. This study aimed to evaluate the effectiveness of a radiolucent pad (MammoPad; Hologic Inc, Bedford [MA], US) during screening mammogram to reduce pain in Chinese patients and the possibility of glandular dose reduction. Methods: This case series was conducted in a private hospital in Hong Kong. Between November 2011 and January 2012, a total of 100 Chinese patients were recruited to our study. Left mammogram was performed without MammoPad and served as a control. Right mammogram was performed with the radiolucent MammoPad. All patients were then requested to complete a simple questionnaire. The degree of pain and discomfort was rated on a 0-10 numeric analogue scale. Significant reduction in discomfort was defined as a decrease of 10% or more. Results: Of the 100 patients enrolled in this study, 66.3% of women reported at least a 10% reduction in the level of discomfort with the use of MammoPad. No statistical differences between age, breast size, and the level of discomfort were found. Conclusion: The use of MammoPad significantly reduced the level of discomfort experienced during mammography. Radiation dose was also reduced. © 2016, Hong Kong Academy of Medicine Press. All rights reserved. Source

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