Angiographic Diagnosis of Malignant Disease of the Liver

Nebesar, Robert A.; Pollard, James J.; Stone, Donald L.

doi:10.1148/86.2.284

Cited by 52 publications

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“…Hepatography by thorium dioxide infusions and tomography fail to reveal measurable lesions in approximately 20% of cases and the technical problems associated with tomography make accu-rate measurement difficult.3 Hepatic artery angiography can reveal lesions as small as one cm but this technique is difficult, time consuming and has failed to reveal lesions as large as 9 cm. 6 Umbilical vein hepatography appears to be a useful method for rapidly evaluating the therapeutic effectiveness of anticancer drugs in patients with liver metastases. This is of great value, since an objective response to treatment can be observed early in the course of chemotherapy prior to a time when toxicity would be expected.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of anticancer drugs by umbilical vein hepatography

Kessler

Ramos-Yordan

1967

Cancer

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Utilizing the technique of umbilical vein catheterization, serial hepatograms were obtained in 12 patients with proven liver metastases to demonstrate the size, location and extent of space occupying hepatic lesions and to measure their response to chemotherapy. Mass lesions were visualized in all the patients studied and lesions as small as 0.5 cm in diameter could be measured accurately. A reduction in size of the hepatic metatases occurred in 5 patients. The change in tumor size was variable among lesions in any given patient with the greatest reduction usually observed with the smaller lesions. The method is accurate and reproducible, exceeds the accuracy of currently available methods for demonstrating hepatic tumors and appears to be a useful method for an objective evaluation of the therapeutic effectiveness of anticancer drugs in patients with liver metastases.

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Section: Discussionmentioning

confidence: 99%

Evaluation of anticancer drugs by umbilical vein hepatography

Kessler

Ramos-Yordan

1967

Cancer

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“…T h e injection rates for conventional study were approximately double those used for infusion angiography. Specifically, these were: conventional No. 6 INFUSION HEPATIC ANGIOGRAPHY Rb'sch et al…”

Section: Materials a K D Methodsmentioning

confidence: 96%

Infusion hepatic angiography in diagnosis of liver metastases

Rösch

Freeny

Antonovic

et al. 1976

Cancer

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Infusion hepatic angiography was used, together with conventional angiogra-phy, for diagnosis in 68 patients with liver metastases. The combination of both techniques led to a diagnostic accuracy of 97%. Metastases were missed in only two patients, both of whom had underlying liver or biliary disease. In a comparison of the two techniques, the infusion study was found diagnostically essential in five patients (7%) and afforded improved diagnosis in 49 others (72%). In 10 patients (15%), it gave. equivalent information; and in four patients (6%) less information than the conventional technique. Infusion hepatic angiog-raphy is a useful complementary technique in anatomic liver diagnosis, especially in its ability to improve upon the diagnostic accuracy of the capillary phase of hepatic angiography. Canccr 38:2278-2286, 1976. NFUSION HEPATIC ANGIOGRAPHY WAS INTRO-I duced by Wise and Siber" and modified by Kaude et al.4 and Wirtanen." In contrast to conventional hepatic angiography, which involves a 3 to 5-second injection of contrast medium , the infusion study uses a protracted (10 to 15-second) injection, a lower injection rate, and larger total dose of contrast medium. Reportedly , infusion hepatic angiography gives less detail in the arterial phase of the hepatogram,3 but provides more diagnostic information durinig the parenchymal phase of the hepatogram, increasing its density and improving the visualization of focal hepatic lesions. 3,4911 O f 22 patients with liver metastases, Kaude et al. found the infusion technique diagnostically superior to conventional hepatic angiography in 14 patients and equivalent in eight patients. However, it has also been reported that the increased hepatic density achieved by infusion angiography can occasionally obscure hypervascular metastatic nodules. We have used both the conventional and infusion hepatic angiography in 68 patients with liver metastases. This report presents our experience and compares the diagnostic effectiveness of the two techniques. Of 68 patients, 36 were female and 32 male, aged from 20 to 81 years (mean 58 years). T h e diagnosis of liver metastases was established by surgery, biopsy or both. Sites and types of primary tumors are listed in Table 1. Studies were done by the transfemoral route in 65 patients and the transaxillary route in three. Preformed polyethylene (ID 1.2 mm, 011 2.2 mm) or Torcon (Cook, Inc.) (ID 1.09 mm, O D 2.3 mm) catheters were used. Selective ce-liac angiography was done first and in case of an accessory liver supply from the superior mesen-teric artery, it was followed by superior mesen-teric angiography. For catheterizing the hepatic artery, occasionally a selective single-curve cath-eter, but mostly a superselective double-curve catheter, was used.' It was placed in the common hepatic artery in 37 patients, the proper hepatic artery in 26 patients, and a major accessory hepatic artery-a branch of the superior mesenteric-in five patients. In all patients, conventional and infusion hepatic angiographic studies were done wit...

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“…No twen d ig fu r die Detekt ion vo n Flul3signalen in Tumoren, d. h. die Bestim mung der Gewebeperfusio n, ist ein e hoh e Farbdopplersensitivitiit, die sta rk abhiingig ist von der geriitespezifischen Signalverarbeitung und den physikal ische n Gewebevo ra ussetzungen, Urn eine Gewebeperfusio nsanalyse d urc hzufilhren, rnussen moglichst niedrige Aul3geschwindigkeiten mit hoh er Se nsitivitat in seh r klein en G efafle n da rste llba r sein. Dies ist fiir oberflac hliche O rga ne mit Scha llko pfen einer hohen Ne n nfreq uen z d urchfuhrba r, im ab domine llen Bereich, wo Eindri ngtiefe n von 15 un d mehr cm not wen dig sind, Aus angiogra phische n Untersuch unge n zur Du rchblu tun g von Leb erme tastasen sind untersch iedliche Vasku lariatio nstype n bekannt (5,6,17). Maligne T umoren sind in der Regel vo rn po rta lveno sen Gefii llsystem a usge schlossen und werden arteriell versorgt (2).…”

Section: Diskussionunclassified

“…Maligne T umoren sind in der Regel vo rn po rta lveno sen Gefii llsystem a usge schlossen und werden arteriell versorgt (2). Nebesar ( 17) fand in eine r angiographischen Un te rsuchung Metastase n von Adenokarzinomen des Pankreas und der Gallenbla se, von Lungentumoren u nd Osophagu skarzinom en iiberwiegend schlecht vaskul ari siert , wiihrend Ab sied elungen von anderen Ad enokarzinomen, von K arzinoidtum oren und Hypem ephro men, vermehrt durchblutet erschienen. Die Turn orgefafse erreiche n jedoch nicht die Durchmesser, wie sie von prirnaren Lebertumoren bekannt sind.…”

Section: Diskussionunclassified

“…Led iglich d as cho langioze llulare Leberka rzin om war fa rbdo p plerso nographisch hyp ovaskul ari siert. Diese r Befund wurde a ng iog ra p hisch be stati gt und deckt sic h mit Mitt eilungen a us d er Literatu r ( 17). Hep at ozellul are Ka rzin om e weisen a ngiogra phisch ub erwiegend das Bild d es hyp ervaskul arisierten Tumors auf, wenngleich vereinzelt auch Faile avaskul arer Fo rme n beschrieben wurde n (8, 19, 2 1, 28) .…”

Section: Diskussionunclassified

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Farbcodierte Dopplersonographie (FD-Sonographie) primärer und sekundärer Lebertumoren

Börner

T²,

Herzog³

et al. 2008

Ultraschall in Med

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50 Patients with 78 focal liver lesions were examined via colour-coded Doppler system to study the vascularity of metastatic lesions and primary benign and malignant liver tumours. According to the amount of detectable colour Doppler signals, tumour vascularity was graded into 4 types. Metastases (n = 40) and cavernous haemangiomas (n = 12) seemed to be avascular with no evidence of increased vascularity (Type I/II). Conversely primary liver cancer (PLCA) (n = 7) and focal nodular hyperplasia (FNH) (n = 16) mainly produced arterial Doppler signals within the tumour (Type III/IV). AV shunts and partial portal vein thrombosis could be demonstrated in PLCA. Doppler colour flow imaging for detection of tumour vascularity may thus add to the specificity of ultrasonic tumour diagnosis.

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Angiographic Diagnosis of Malignant Disease of the Liver

Cited by 52 publications

References 0 publications

Evaluation of anticancer drugs by umbilical vein hepatography

Evaluation of anticancer drugs by umbilical vein hepatography

Infusion hepatic angiography in diagnosis of liver metastases

Farbcodierte Dopplersonographie (FD-Sonographie) primärer und sekundärer Lebertumoren

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