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1.
Hepatol Res ; 45(9): 976-985, 2015 Sep.
Article in English | MEDLINE | ID: mdl-25336196

ABSTRACT

AIM: Early evaluation of the response to sorafenib for patients with hepatocellular carcinoma (HCC) remains unclear. This prospective study investigated the early evaluation of the efficacy of sorafenib in patients with advanced HCC using duplex Doppler ultrasonography (DDU). METHODS: Thirty-seven Child-Pugh class-A advanced HCC patients treated with sorafenib 400 mg b.i.d. were enrolled. Changes in portal venous area (PVA) and portal venous flow velocity (PVV) revealed by DDU before and after 2 weeks of sorafenib treatment were evaluated. The relation between the congestion index (PVA/PVV), which reflects the pathophysiological hemodynamics of the portal venous system and the tumor response, according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST), was also assessed. RESULTS: The median progression-free survival and overall survival of all the patients was 2.8 months (95% confidence interval [CI], 2.6-3.2) and 12.8 months (95% CI, 8.7-17.0), respectively. Overall, three patients (8%) had a partial response (PR), 15 (41%) stable disease (SD) and 17 (46%) progressive disease, according to the mRECIST, and two patients (6%) could not be evaluated because of worsened conditions. The decrease in the congestion index was significantly larger in the disease control group (PR/SD) after the sorafenib treatment (P = 0.035); furthermore, the congestion index was the only significant independent predictor of disease control (P = 0.033; hazard ratio, 8.456; 95% CI, 1.182-60.484). CONCLUSION: A decrease in the congestion index revealed by DDU provides an early evaluation of response in patients taking sorafenib for advanced HCC.

2.
J Med Ultrason (2001) ; 40(4): 417-24, 2013 Oct.
Article in English | MEDLINE | ID: mdl-27277455

ABSTRACT

PURPOSE: We prospectively evaluated the validity of total and viable residual splenic volume after partial splenic embolization (PSE) with three-dimensional (3D) ultrasound (US) measurement. METHODS: Twenty patients with splenomegaly were included. All splenic volumes were measured with transabdominal US using virtual organ computer-aided analysis (VOCAL). The viable residual splenic volume after PSE was estimated by using contrast-enhanced (CE) US with VOCAL. The agreement of the measurements from VOCAL and computed tomography (CT) was confirmed using interclass correlation coefficients (ICCs) and Bland-Altman plots. RESULTS: Mean volume was 503 ± 250 ml for total spleen and 209 ± 108 ml for viable residual volume. Regarding total volume, there was a high correlation and agreement (ICCs = 0.90) between 3D US and CT volumetry. Regarding viable residual volume, although there was a moderate correlation between 3D CEUS and CT volumetry, mean ICCs of 0.617 indicated poor agreement. With Bland-Altman plots, a narrow 95 % limit of agreement was observed among patients with a total volume under 1000 ml. CONCLUSION: The total splenic volume could be accurately estimated with 3D US. However, estimation of viable residual splenic volume should be limited in cases with total splenic volume under 1000 ml.

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