• Journal of Radiation Protection and Research
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• v.31 no.4
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• pp.187-195
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• 2006

The purpose of this study was to investigate the optimal beam arrangements for hepatic tumors, according to the location of the hepatic tumor and its relationship to organs at risk (OARs). The virtual gross tumor volumes were divided into four groups according to the Couinaud's classification. Several plans were made for each virtual target, and these plans were compared for the normal tissue complication probabilities (NTCP). For group I, NTCP improved as the number of the beam ports increased. However, plans with more than 5 ports had little advantage. For group II, plans with the beam directions from the anterior side showed better results. Group III contained many OARs near the target, which placed restrictions on the beam-directions. Multi-directional plans yielded a higher dose to the OARs than a simple two-port plan using right anterior oblique and posterior beam (RAO/PA). For group IV, a simple RAO/PA port plan was adequate for protection of remaining liver. NTCP can significantly vary between radiotherapy plans when the location of the tumor and its neighboring OARs are taken into consideration. The results in this study of optimal beam arrangements could be a useful set of guidelines for radiotherapy of hepatic tumors.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.3
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• pp.188-193
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• 2019

Transarterial chemoembolization (TACE) is a commonly used and rapidly evolving non-invasive treatment for hepatocellular carcinoma (HCC). It is important that understanding individual anatomical variants and planning for tumor-feeding artery access to acquire adequate treatment effectiveness. In this study, we will report acquired arteriovenous malformation which interferes with TACE for HCC. A 72-year-old man with persistent abdominal pain for 2 days visited our hospital. The patient was chronic hepatitis B carrier and had a history of HCC treated with conventional TACE 10 years ago. Hypervascular nodular HCC in the liver segment 8 and aberrant right hepatic artery from the superior mesenteric artery were detected on computed tomography (CT). When first TACE was performed, the tumor-feeding artery originating from the left hepatic artery was found and embolized. There was no tumor-feeding artery from the right hepatic artery but arteriovenous malformation was found. After a month, follow up CT showed necrotic lesion and residual HCC and we performed secondary TACE. On secondary TACE, we selected the right hepatic artery and passed through arteriovenous malformation. Superselective-angiogram showed remnant tumoral staining and remnant tumor was embolized using drug-eluting bead and Adriamycin. Final angiogram showed no remnant tumoral staining and the patient was discharged without complication. We found the rare case of arteriovenous malformation adjacent to HCC, and we performed superselective TACE beyond arteriovenous malformation to treat HCC.

• Preventive Nutrition and Food Science
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• v.8 no.3
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• pp.239-244
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• 2003

Recently, we reported (J Korean Soc Food Sci Nutr, 31(3): 516-520, 2002) that Semisulcospira libertina (Marsh Snail) pretreatment has a hepatoprotective effect on $CCl_4$-induced liver damage in rats. The purpose of this study was to investigate the possible mechanisms of hepatoprotection by S. libertina (SL) on liver injury induced by acetaminophen (AA). Male ICR mice were pretreated with dehydrated powder of SL once daily for three consecutive days, given a single toxic dose of AA (450 mg/kg) and liver function determined 24 h later. Liver damage was assessed by quantifying serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and sorbitol dehydrogenase (SDH) activities, and by measuring hepatic lipid peroxidation. To confirm possible mechanism(s), the content of hepatic glutathione (GSH) and gene expression of tumor necrosis factor a (TNF $\alpha$) mRNA by reverse transcription-polymerase chain reaction (RTPCR) were also measured. Pretreatment with SL dramatically lowered AA-elevated ALT, AST and SDH activities. SL pretreatment decreased AA-produced lipid peroxidation by 11% and restored the AA-depleted hepatic GSH by 27%. Furthermore, SL markedly suppressed the expression of TNF $\alpha$ mRNA induced by AA. Our findings revealed that the possible hepatoprotective mechanisms of SL could be attributed, at least in part, to the glutathione-mediated detoxification as well as the regulation of TNF $\alpha$ mRNA expression.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1665-1669
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• 2015

Background: The optimal surgical strategy for the treatment of synchronous resectable gastric cancer liver metastases remains controversial. The aims of this study were to analyze the outcome and overall survival of patients presenting with gastric cancer and liver metastases treated by simultaneous resection. Materials and Methods: Between January 1990 and June 2009, 35 patients diagnosed with synchronous hepatic metastases from gastric carcinoma received simultaneous resection of both primary gastric cancer and synchronous hepatic metastases. The clinicopathologic features and the surgical results of the 35 patients were retrospectively analyzed. Results: The 5-year overall survival rate after surgery was 14.3%. Five patients survived for more than 5 years after surgery. No mortality has occurred within 30 days after resection, although two patients (5.7%) developed complications during the peri-operative course. Univariate analysis revealed that patients with the presence of lymphovascular invasion of the primary tumor, bilateral liver metastasis and multiple liver metastases suffered poor survival. Lymphovascular invasion by the primary lesion and multiple liver metastases were significant prognostic factors that influenced survival in the multivariate analysis (p=0.02, p=0.001, respectively). Conclusions: The presence of lymphovascular invasion of the primary tumor and multiple liver metastases are significant prognostic determinants of survival. Gastric cancer patients without lymphovascular invasion and with a solitary synchronous liver metastasis may be good candidates for hepatic resection. Simultaneous resection of both primary gastric cancer and synchronous hepatic metastases may effectively prolong survival in strictly selected patients.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.350-356
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• 1994

Purpose : Hepatic arterial perfusion scintigraphy with Tc-99m-macroggregated albumin (HAPS) study was carried out in 16 patients with hepatocellular carcinoma(HCC) and in six patients without liver tumor to evaluate HAPS findings of hepatocellular carcinoma and usefullness of HAPS. Materials and Methods : HAPS with planar and SPECT study were performed in 22 patients after conventional hepatic or celiac arteriography. For HAPS study, 4-5 mCi of MAA mixed with 2ml of saline was injected into proper hepatic artery or its distal branches at the rate of approximately 1ml/sec. We analysed 21 HCCs over 2cm in diameter(average diameter; 6.4cm) and 17 of 21 HCCs were over 4cm in diameter(Table 1). CT, sonography and angiography were performed within two week in all 16 patients and liver scan was performed in 12 patients. Results : Three different pattern of tumor perfusion were observed in 16 patients with HCC (Table 2). 1) diffuse increased perfusion in 16 of 21(76%)(Fig. 1) 2) increased peripheral perfusion in 4 of 21(19%) (Fig. 2) 3) diffuse decreased perfusion in 1 of 21 (5%) Arteriovenous shunt indicated by lung uptake of MAA were observed in 9 of 16(56%)(Fig. 4). In contrast, angiography demonstrates arteriovenous shunt in 2 of 16(13%). There was no accumulation of radioactivity on RBC-blood pool scan in all six patients with HCC examined (Fig. 1). Conclusion : HAPS is useful study in evaluation of perfusion pattern or vascularity of HCC and in detection of arteriovenous shunt.

• The Korean Journal of Nuclear Medicine
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• v.20 no.2
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• pp.61-71
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• 1986

An iodized oil such as Ethiodol or Lipiodol was selectively retained in the tumor vessels of the large hepatomas as well as in the small daughter hepatomas for long periods following the intra-arterial hepatic injection of such contrast material. The specific aim of the study is to deliver a high internal radiation dose to hepatocellular carcinoma (HCC) in an attempt to control the disease. We were able to replace a small fraction of the stable iodine (I-127) of the 37% iodine in Lipiodol by the $I^{-131}$ with 100% exchange efficiency. $I^{-131}$ labeled Lipiodol was injected through the super-selected tumor feeding artery under superselection or into the proper hepatic arterial level of patients who have malignant hepatomas confirmed by aspiration cytology serum AFP and various imaging modalities. Clinical traial was performed on 43 cases during recent 6 months and follow-up observation was carried out. No severe complications or other adverse reactions were encountered until nowdays. $I^{-131}-Lipiodol$ was stable in vivo and no significant activity was noted in the thyroid, stomach, blood and urine after the injection. Only small fraction of radioisotope activity was noticed in the both side of lungs. Tumor to normal liver radio was very high. Therefore, $I^{-131}-Lipiodol$ (or P-32-Lipiodol) will be effective delivering high internal radiation dose to the tumor while delivering small radiation doses to normal tissues. Labeling, tumor dose calculation and preliminary findings will be presented.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.145-147
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• 1994

Colloid uptake in various hepatic conditions such as focal nodular hyperplasia, regenerating nodules in the cirrhotic liver, hamartoma, hemangioma and rarely hepatoma has been documented. Extrahepatic tumors may show colloid uptake and they include splenic hemangioma, malignant fibrous histiocytoma, breast carcinoma and Kaposi's sarcoma. The mechanism of colloid uptake in those lesions is associated with phagocytic activity in or around the tumors. We report a pancreas islet cell tumor that showed colloid uptake on $^{99m}Tc$-phytate liver scan without histologic evidence of phagocytosis by tumor cells or infiltration of phagocytes in the tumor Microscopically the tumor was highly vascular and showed diffuse hemorrhage throughtout the tumor. We postulated that extravasation of the colloid into the tumor insterstitium caused nonspecific colloid uptake in this tumor. It is expected that hemorrhagic tumor may show nonspecific colloid uptake without phagocytosis in or about the lesion.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.155-158
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• 2010

Purpose: $^{99m}Tc$-macroaggregated albumin (MAA) hepatic arterial perfusion scintigraphy was known for useful method to evaluate patients receiving intraarterial chemotherapy for liver cancer. This study evaluate about usefulness of normal liver on hepatocellular carcinoma (HCC) from HCC patients. This study is to see the usefullness of Hepatic Arterial Perfusion Scintigraphy (HAPS) by measuring mass size, shape, lung shunting and tumor to normal ratio (T/N ratio) in relative blood stream of HCC patients compared with HCC on normal liver. Materials and Methods: From June 2009 to September 2009, HAPS studies were performed on 7 patients (men 6, women 1, mean 64) who were diagnosed HCC. HAPS was performed after proper hepatic artery $^{99m}Tc$-MAA of 5 mCi (185 MBq) injection by catheter. We performed anterior, posterior, both lateral view, SPECT of chest and abdomen. Then we set up ROI and calculated lung shunting, T/N ratio for each count, count/pixel (mean value). Results: Tumor and liver size analyzed by ROI of anterior, posterior view are 2.0-10.8 cm (mean 3.75 cm), 8.8-18.5 cm (mean 14.6 cm). T/N ratio analyzed by total tumor and total normal mean value are 2.41-5.76 (mean 3.8). lung shunting analyzed by total liver count is 3.14-13.92% (mean 6.77%). Conclusion: HAPS with $^{99m}Tc$-MAA can evaluate mass size, location, quantitative analysis through T/N ratio. also HAPS can evaluate detection of arteriovenous shunt through lung uptake before radioisotope therapy. Therefore HAPS with $^{99m}Tc$-MAA can be useful method in aspect of evaluation and treatment of HCC.

• Development and Reproduction
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• v.27 no.4
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• pp.167-174
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• 2023

Development of hepatocellular carcinoma (HCC) is driven by a multistep and long-term process. Because current therapeutic strategies are limited for HCC patients, there are increasing demands for understanding of immunotherapy, which has made technological and conceptual innovations in the treatment of cancer. Here, I discuss HCC immunotherapy in the view of interaction between liver resident cells and immune cells.

• Korean Journal of Veterinary Research
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• v.49 no.3
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• pp.249-252
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• 2009

A 6-year-old, neutered male, Schnauzer was presented with a one year history of weight loss and exercise intolerance. Physical examination revealed abdominal distention and ecchymosis on the abdominal skin. CBC and serum chemistry profiles revealed anemia and increased serum liver enzymes. Ultrasonography revealed a large liver mass which was characterized by multiple hypoechoic lesions. Postmortem examination revealed primary hepatic hemangiosarcoma. The tumor had extended to the mesentery and diaphragm, but distant metastasis was not found. This case report describes primary hepatic hemangiosarcoma which is very rare in a dog.