Comparison of hepatic MDCT, MRI, and DSA to explant pathology for the detection and treatment planning of hepatocellular carcinoma

BACKGROUND/AIMS: The diagnosis and treatment plan for hepatocellular carcinoma (HCC) can be made from radiologic imaging. However, lesion detection may vary depending on the imaging modality. This study aims to evaluate the sensitivities of hepatic multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA) in the detection of HCC and the consequent management impact on potential liver transplant patients. METHODS: One hundred and sixteen HCC lesions were analyzed in 41 patients who received an orthotopic liver transplant (OLT). All of the patients underwent pretransplantation hepatic DSA, MDCT, and/or MRI. The imaging results were independently reviewed retrospectively in a blinded fashion by two interventional and two abdominal radiologists. The liver explant pathology was used as the gold standard for assessing each imaging modality. RESULTS: The sensitivity for overall HCC detection was higher for cross-sectional imaging using MRI (51.5%, 95% confidence interval [CI]=36.2-58.4%) and MDCT (49.8%, 95% CI=43.7-55.9%) than for DSA (41.7%, 95% CI=36.2-47.3%) (P=0.05). The difference in false-positive rate was not statistically significant between MRI (22%), MDCT (29%), and DSA (29%) (P=0.67). The sensitivity was significantly higher for detecting right lobe lesions than left lobe lesions for all modalities (MRI: 56.1% vs. 43.1%, MDCT: 55.0% vs. 42.0%, and DSA: 46.9% vs. 33.9%; all P<0.01). The sensitivities of the three imaging modalities were also higher for lesions ≥2 cm vs. <2 cm (MRI: 73.4% vs. 32.7%, MDCT: 66.9% vs. 33.8%, and DSA: 62.2% vs. 24.1%; all P<0.01). The interobserver correlation was rated as very good to excellent. CONCLUSIONS: The sensitivity for detecting HCC is higher for MRI and MDCT than for DSA, and so cross-sectional imaging modalities should be used to evaluate OLT candidacy.

Modulation of radiation and cadmium induced biochemical changes in mouse kidney by Emblica officinalis Linn

Protective effect of Emblica against radiation and cadmium induced biochemical changes in mouse kidney has been studied. Adult male mice were divided into seven groups: I [shamirradiated], II [cadmium chloride], III [irradiated with 2 Gy gamma rays], IV [radiation and cadmium chloride], V [Cadmium chloride and Emblica], VI [radiation and Emblica], VII [radiation, cadmium chloride and Emblica]. The animals were autopsied after 1-28 days of treatment. The kidney was taken out and different biochemical parameters such as total proteins, glycogen, cholesterol, acid phosphatase activity, alkaline phosphatase activity, DNA and RNA were estimated. The value of glycogen, RNA, acid phosphatase and alkaline phosphatase activity increased up to day-14 in non drug treated groups and day-7 in the Emblica treated groups and thereafter decreased up to the last autopsy interval. The value of cholesterol and DNA decreased up to day-14 in non drug treated groups and day 7 in the drug treated groups then increased in all the groups. In groups III, IV, VI and VII the value of total proteins increased during early intervals and decreased thereafter, but the animals of groups II and V, which were given only cadmium chloride with or without Emblica, showed an opposite trend. The biochemical parameters showed highly significant values [p<0.001] as compared to normal ones. Results indicated that combined treatment of radiation and cadmium chloride exerts synergistic effect. The drug treated animals showed less severe biochemical changes and an early and fast recovery, which may be due to protection provided by Emblica

Type 2 diabetes mellitus among children and adolescents in Al-Ain: a case series

To characterize the features of type 2 diabetes mellitus among children and adolescents in Al-Ain, the records of every child with diabetes attending a teaching hospital in the city from January 1990 to December 2001 were retrospectively examined. Of 96 young people newly diagnosed with diabetes mellitus, 11 were identified as type 2. The clinical characteristics were: pubertal onset, female preponderance, obesity, strong family history of type 2 diabetes mellitus, high plasma glucose at presentation, adequate beta cell reserve and serum pancreatic islet cell antibody negativity. This case series adds to the evidence that type 2 diabetes mellitus is emerging among children in our region