Time filter

Source Type

Komatsu, Japan

Iwazawa J.,Nissay Hospital | Ohue S.,Komatsu Hospital | Hashimoto N.,Nissay Hospital | Mitani T.,Nissay Hospital
Cancer Management and Research | Year: 2012

Purpose: We aimed to compare the local control rates between miriplatin and epirubicin in lipiodol-based transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Patients and methods: Patients who underwent targeted TACE using miriplatin (47 patients, 66 lesions) or epirubicin (64 patients, 79 lesions) as the sole therapy were enrolled. The local control rates were compared using the Kaplan-Meier estimator with the log-rank test. The patient and tumor parameters were subjected to univariate and multivariate analyses using the Cox proportional hazards model. Results: The overall local recurrence rates were 39.3% and 31.6% for the miriplatin and epirubicin groups, respectively. The local control rate was significantly higher in the epirubicin group than in the miriplatin group (P< 0.001). The local control rates at 6 months and 1 year were 70.7% and 44.8% for the miriplatin group and 83.4% and 69.2% for the epirubicin group, respectively. Multivariate analysis showed that the serum α-fetoprotein level ≥ 20 ng/mL (hazard ratio 2.96; P, 0.001), miriplatin usage (hazard ratio 2.53; P = 0.002), and Child-Pugh class B (hazard ratio 1.89; P = 0.042) affected local progression. Conclusion: Lipiodol-based targeted TACE using miriplatin had inferior local control rates as compared to epirubicin in patients with HCC. © 2012 Iwazawa et al, publisher and licensee Dove Medical Press Ltd.

Iwazawa J.,Nissay Hospital | Mitani T.,Nissay Hospital | Sassa S.,Nissay Hospital | Ohue S.,Komatsu Hospital
Diagnostic and Interventional Radiology | Year: 2011

PURPOSE: To assess the feasibility of using magnetic resonance imaging for prostate cancer detection without using a contrast material. MATERIALS AND METHODS: T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCEI) were performed using a phased-array coil at 1.5 T. These examinations were performed in 178 patients with elevated serum prostate-specific antigen levels (>4.0 ng/mL) before systematic needle biopsy. Two radiologists independently evaluated images from DWI, DCEI, and a combination of the two techniques by referring to a T2WI image and by using a predefined confidence scale for cancer detection. The right and left halves of the peripheral zone and the central gland were separately rated. The diagnostic performance (Az) of each technique was assessed by analyzing their associated area under the receiver operating characteristic curves. The results of a biopsy served as a reference standard. RESULTS: Prostate cancer was detected in 72 (40.4%) of the 178 patients. For the entire prostate, the diagnostic performances of DWI (A z = 0.848) (P < 0.001) and the combined technique (Az = 0.845) (P < 0.001) were significantly more accurate than that of DCEI (A z = 0.746). DWI (74.8%) (P < 0.001) and the combined technique (72.9%) (P < 0.001) were significantly more sensitive than DCEI (52.8%). The numbers of cancer lesions that were interpreted using only DWI or DCEI were 83 (26.1%) and 13 (4.1%) of the 318 study lesions, respectively. CONCLUSION: DWI and the combined technique are more accurate and sensitive than DCEI in the detection of prostate cancer; however, DWI and DCEI play complementary roles in the accurate detection of prostate cancer. © Turkish Society of Radiology 2011.

Iwazawa J.,Nissay Hospital | Ohue S.,Komatsu Hospital | Kitayama T.,Otemae Hospital | Sassa S.,Nissay Hospital | Mitani T.,Nissay Hospital
American Journal of Roentgenology | Year: 2011

OBJECTIVE. The purpose of our study was to assess the feasibility of using C-arm CT to detect incomplete accumulation of iodized oil in hepatocellular carcinoma immediately after transarterial chemoembolization (TACE). MATERIALS AND METHODS. This retrospective study included 80 hepatocellular carcinoma lesions in 55 patients (41 men and 14 women; mean age, 69.2 years; mean tumor size, 18.1 mm [range, 5-55 mm]) who underwent TACE with a flat-detector C-arm angiographic system. C-arm CT images were acquired at the end of each session, and unenhanced MDCT images were obtained 7 days later. Two independent observers scored both sets of images, using a predefined detection scale for incomplete iodized oil accumulation. The accuracy for predicting residual lesions was compared using the area under the receiver-operating characteristic curve (Az). Contrast-enhanced CT findings obtained 1 month after TACE served as reference standards. RESULTS. Viable lesions were observed in 18 of the 80 study lesions by contrast-enhanced CT. The accuracy of the C-arm CT (Az = 0.816) was not significantly different (p = 0.449) from that of the MDCT (Az = 0.841). Sensitivity, specificity, and positive and negative predictive values for C-arm CT (80.5%, 74.2%, 47.5%, and 92.9%, respectively) and MDCT (86.1%, 75.0%, 50.0%, and 94.9%, respectively) did not differ significantly. CONCLUSION. C-arm CT is nearly equivalent to MDCT for detecting incomplete iodized oil accumulation after TACE, suggesting that the immediate assessment of iodized oil accumulation with C-arm CT without the need to perform follow-up unenhanced MDCT is likely feasible. © American Roentgen Ray Society.

Iwazawa J.,Nissay Hospital | Ohue S.,Komatsu Hospital | Hashimoto N.,Nissay Hospital | Mitani T.,Nissay Hospital
Clinical Radiology | Year: 2014

AIM: To compare the accuracy of computer software analysis using three different target-definition protocols to detect tumour feeder vessels for transarterial chemoembolization of hepatocellular carcinoma. MATERIALS AND METHODS: C-arm computed tomography (CT) data were analysed for 81 tumours from 57 patients who had undergone chemoembolization using software-assisted detection of tumour feeders. Small, medium, and large-sized targets were manually defined for each tumour. The tumour feeder was verified when the target tumour was enhanced on selective C-arm CT of the investigated vessel during chemoembolization. The sensitivity, specificity, and accuracy of the three protocols were evaluated and compared. RESULTS: One hundred and eight feeder vessels supplying 81 lesions were detected. The sensitivity of the small, medium, and large target protocols was 79.8%, 91.7%, and 96.3%, respectively; specificity was 95%, 88%, and 50%, respectively; and accuracy was 87.5%, 89.9%, and 74%, respectively. The sensitivity was significantly higher for the medium (p = 0.003) and large (p < 0.001) target protocols than for the small target protocol. The specificity and accuracy were higher for the small (p < 0.001 and p < 0.001, respectively) and medium (p < 0.001 and p < 0.001, respectively) target protocols than for the large target protocol. CONCLUSION: The overall accuracy of software-assisted automated feeder analysis in transarterial chemoembolization for hepatocellular carcinoma is affected by the target definition size. A large target definition increases sensitivity and decreases specificity in detecting tumour feeders. A target size equivalent to the tumour size most accurately predicts tumour feeders. © 2013 The Royal College of Radiologists.

Hashimoto N.,Nissay Hospital | Iwazawa J.,Nissay Hospital | Ohue S.,Komatsu Hospital | Mitani T.,Nissay Hospital
OncoTargets and Therapy | Year: 2013

Objective: We aimed to evaluate local tumor control after transarterial chemoembolization (TACE) for hepatocellular carcinoma using miriplatin and low-dose epirubicin combination therapy. Methods: We retrospectively analyzed the records of patients who underwent TACE using miriplatin plus low-dose epirubicin (30 patients, 61 nodules, August 2011-March 2012) and control patients who underwent TACE using miriplatin alone (36 patients, 70 nodules, June 2010-July 2011). The local control rate was compared between the two groups using the Kaplan-Meier estimator and the log-rank test. Factors affecting local tumor recurrence were analyzed using multivariate logistic regression analysis. Treatment-related toxicity was evaluated using the Common Terminology Criteria for Adverse Events. Results: The local control rates at 6 months and 1 year were 87% and 65% for the miriplatin plus low-dose epirubicin group, and 61% and 43% for the miriplatin group, respectively. Local tumor control rates were significantly better in the miriplatin plus low-dose epirubicin group than in the miriplatin group (P = 0.038). Multivariate analysis showed that the addition of epirubicin was an independent factor associated with better local tumor control (hazard ratio 0.2, P = 0.001). Overall incidence rates for adverse events were not significantly different between the two groups. Conclusion: Additional usage of low-dose epirubicin for TACE using miriplatin improved local tumor control of hepatocellular carcinoma with adverse effects comparable to those observed with TACE using miriplatin alone. © 2013 Hashimoto et al.

Discover hidden collaborations