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CT, MR and angiographic findings of 6 patients with 9 skull metastases from hepatocellular carcinoma (HCC) were reviewed. In 3 of 6 patients, local pain or neurologic deficit was the initial main manifestation of the disease, although all had been treated for chronic liver disease. In the remaining 3 patients, skull metastases were detected following treatment of HCC. The metastatic lesions appeared as expansile osteolytic masses on CT and as hypervascular masses on angiography. All lesions were demonstrated on MR imaging. Compared with the brain parenchyma, the lesions were iso- or hypointense on T1-weighted and T2-weighted MR images. The lesions were moderately to markedly enhanced by Gd-DTPA. Flow voids were shown in the tumors in 5 lesions. HCC should be included in the differential diagnosis of an osteolytic hypervascular lesion of the skull, especially in Oriental patients. The relatively hypointense tumor on T2-weighted MR images associated with flow void, different from primary skull tumors or directly invasive tumors, may support the diagnosis of HCC metastasis.

Lipiodol accumulation patterns were correlated with local recurrences after subsegmental or conventional arterial chemoembolization therapy using iodized oil (Lipiodol-TAE). Thirty-six patients with solitary small hepatocellular carcinomas (HCCs) less than 3 cm in diameter were included in this retrospective study. Superselective subsegmental catheterization was performed in 14 patients (subsegmental Lipiodol-TAE). In the remaining 22 cases, embolization was performed from the proximal portion of the hepatic artery (conventional Lipiodol-TAE). Patterns of Lipiodol accumulations within the tumors were classified in 2 groups: complete and incomplete accumulation. Complete accumulation was observed in 71% of subsegmental Lipiodol-TAE and in 32% of conventional Lipiodol-TAE. The rate of local recurrences within 12 months was significantly higher (p < 0.01) in incomplete accumulation (100%) than in complete accumulation (13%). We suggest that when small HCCs are to be treated with TAE, subsegmental Lipiodol-TAE should be performed because of its superior capability for achieving complete Lipiodol accumulation.

The effect of transcatheter arterial chemo-embolization therapy (TACE) for hepatoma was evaluated with dynamic MR imaging with Gd-DTPA in 37 patients (44 tumors). TACE was performed using Lipiodol/cis-platinum and gelatin sponge (or microspheres) as an embolic material. All patients were examined with dynamic CT and MR imaging before and after treatment. On conventional spin echo images, changes of signal intensity after treatment varied regardless of presence of Lipiodol. Dynamic MR imaging revealed changes of tumor vascularity before and after treatment. On histologic correlation, areas of persistent tumor enhancement on dynamic MR imaging corresponded to areas of viable tumor cells while areas of nonenhancement corresponded to areas of necrosis. Dynamic MR imaging was superior in contrast resolution and was not influenced by the presence of Lipiodol compared with dynamic CT, and therefore residual viable tumors were better defined by dynamic MR imaging.

Purpose:Percutaneous microwave coagulation therapy (PMCT) is an interventional alternative for inoperable malignant liver tumors. in this paper, we report the results of our 3-year experience of PMCT in order to establish suitable indications for this treatmentMaterial and Methods:We studied a total of 27 inoperable liver tumors in 24 patients. Histology of the tumors showed 20 hepatocellular carcinomas (HCCs) (13 well differentiated, 4 moderately differentiated, and 3 poorly differentiated) and 7 metastases. These tumors were treated by PMCT and were followed for 4–40 months (average 18 months). Under US guidance, the tumors were coagulated by microwaves emitted from an electrode. the changes of tumor size after PMCT were evaluated by CT. When the tumors disappeared or were reduced in size after treatment, PMCT was regarded as effective. Complications from PMCT were also evaluated. the patient survival rate was obtained by means of the Kaplan-Meier methodResults:in tumors of 30 mm or less, treatment response was obtained in 70 of cases, while 55 of tumors larger than 30 mm responded. the tumor became smaller or disappeared in 85 of the well differentiated HCCs, and in 25 of the moderately differentiated HCCs, but none of the poorly differentiated HCCsresponded. in metastatic tumors, PMCT was effective in 57 of cases, Slight pain (24), fever (20) and subcutaneous hematoma (8) were experienced immediately after PMCT. in 2 poorly differentiated HCCs, needle tract seeding was observed. No case of liver dysfunction was seen after PMCT. the overall survival rate was 83.1 at 1 year and 68.7 at 2 yearsConclusion:Good therapeutic results were achieved with PMCT in lesions of 30 mm or less, and in well differentiated HCCs

Lipiodol accumulation patterns were correlated with local recurrences after subsegmental or conventional arterial chemoembolization therapy using iodized oil (Lipiodol-TAE). Thirty-six patients with solitary small hepatocellular carcinomas (HCCs) less than 3 cm in diameter were included in this retrospective study. Superselective subsegmental catheterization was performed in 14 patients (subsegmental Lipiodol-TAE). In the remaining 22 cases, embolization was performed from the proximal portion of the hepatic artery (conventional Lipiodol-TAE). Patterns of Lipiodol accumulations within the tumors were classified in 2 groups: complete and incomplete accumulation. Complete accumulation was observed in 71 of subsegmental Lipiodol-TAE and in 32 of conventional Lipiodol-TAE. The rate of local recurrences within 12 months was significantly higher (p < 0.01) in incomplete accumulation (100) than in complete accumulation (13). We suggest that when small HCCs are to be treated with TAE, subsegmental Lipiodol-TAE should be performed because of its superior capability for achieving complete Lipiodol accumulation.

Percutaneous microwave coagulation therapy (PMCT) is a new therapeutic technique for the treatment of solid neoplasms. In this report, we present our 5 years' experience with PMCT for the treatment of 69 hepatocellular carcinomas (HCCs) in 60 patients. Under ultrasonic guidance, we inserted a 2.1 mm guiding needle percutaneously toward the lesion and a needle electrode was precisely positioned within the lesion. Microwaves, with a frequency of 2450 MHz, were produced for 60 s, with 60 W emission. The overall success rate was 72%, the mean disease-free period was 24.2 months. The procedures were safe and tolerable for all patients. Slight pain and heat sensation were encountered in most patients. We consider PMCT an effective and safe treatment for HCCs.

The effects of ionizing radiation and ultrasound upon the induction of chromosomal-type aberrations and sister chromatid exchanges were investigated. No statistically significant increase in the frequencies of dicentric and ring chromosomes or sister chromatid exchanges was discovered after ultrasound exposure alone at the diagnostic level. Nor could elevated frequencies of these phenomena be found following exposure to ultrasound before or after ionizing radiation, compared with those resulting from an equivalent dose of ionizing radiation alone. However, simultaneous exposure to ultrasound and ionizing radiation seemed to induce a slight enhancement of sister chromatid exchanges, although no significant change was noted in the yields of dicentric and ring chromosomes.

The effect of transcatheter arterial chemo-embolization therapy (TACE) for hepatoma was evaluated with dynamic MR imaging with Gd-DTPA in 37 patients (44 tumors). TACE was performed using Lipiodolcis-platinum and gelatin sponge (or microspheres) as an embolic material. All patients were examined with dynamic CT and MR imaging before and after treatment. on conventional spin echo images, changes of signal intensity after treatment varied regardless of presence of Lipiodol. Dynamic MR imaging revealed changes of tumor vascularity before and after treatment. on histologic correlation, areas of persistent tumor enhancement on dynamic MR imaging corresponded to areas of viable tumor cells while areas of nonenhancement corresponded to areas of necrosis. Dynamic MR imaging was superior in contrast resolution and was not influenced by the presence of Lipiodol compared with dynamic CT, and therefore residual viable tumors were better defined by dynamic MR imaging.

CT, MR and angiographic findings of 6 patients with 9 skull metastases from hepatocellular carcinoma (HCC) were reviewed. In 3 of 6 patients, local pain or neurologic deficit was the initial main manifestation of the disease, although all had been treated for chronic liver disease. In the remaining 3 patients, skull metastases were detected following treatment of HCC. The metastatic lesions appeared as expansile osteolytic masses on CT and as hypervascular masses on angiography. All lesions were demonstrated on MR imaging. Compared with the brain parenchyma, the lesions were iso- or hypointense on T1-weighted and T2-weighted MR images. The lesions were moderately to markedly enhanced by Gd-DTPA. Flow voids were shown in the tumors in 5 lesions. HCC should be included in the differential diagnosis of an osteolytic hypervascular lesion of the skull, especially in Oriental patients. The relatively hypointense tumor on T2-weighted MR images associated with flow void, different from primary skull tumors or directly invasive tumors, may support the diagnosis of HCC metastasis.

Abstract.: Purpose: To analyze the influence of liver dysfunction and parenchymal pathology on the accumulation of superparamagnetic iron oxide (SPIO). Methods: We evaluated MR images of 13 patients having small hepatic neoplasms before and after administration of SPIO (10 μmol/kg). Biopsy and laboratory data confirmed the presence of severe cirrhosis in two patients, mild cirrhosis in four, chronic hepatitis in five, and normal livers in two. Degrees of liver dysfunction or liver parenchymal pathology were correlated with reductions in signal intensity of the liver and spleen after administration of SPIO. Signal intensity reduction was evaluated using a 1.5 Tesla MR unit. Results: Response to SPIO of the liver and spleen did not correlate with liver parenchymal pathology, although reductions in signal intensity of the liver were somewhat small in severely cirrhotic livers. There were slight correlations between signal intensity alterations of the liver and laboratory data such as the indocyanine green retention rate (correlation coefficient 0.47), albumin (0.36), total bilirubin (0.36), and serum glutamic oxaloacetic transaminase (GOT) (0.46). Signal intensity reduction of spleen did not correlate with liver function tests except for serum GOT. In patients with cirrhosis, heterogeneous structures were detected in the nontumorous portions of the liver. However, these did not prevent the diagnosis of small hepatomas. Conclusion: The uptake of SPIO showed some correlation with liver function but not with chronic liver parenchymal pathology. SPIO provided sufficient contrast between tumor and surrounding liver parenchyma among patients with chronic liver disease.

The red tide alga,Chattonella antiqua, was found to show a strong chemiluminescence, using luminol as the reagent, when exposed to ultraviolet irradiation. This luminescence was completely inhibited by ascorbate or catalase, suggesting that hydrogen peroxide was generated by the plankton. Red tide cells exposed to fish gill mucus from young yellowtail resulted in the release of a large number of mucocysts and a weak luminosity, and showed a strong reduction of cytochromecin the medium. Therefore, the discharge of mucocysts from the red tide, induced by the presence of gill mucus, may be accompanied by the release of active oxygen species. The active oxygen may be involved in depolymerization of mucus glycoproteins from the gill lamellae.

The generation of reactive free radicals byChattonella antiqua(‘Red Tide’), which may be a causative factor in fish death, has been demonstrated by electron spin resonance spectroscopy and a microelectrode technique. Electrochemical detection indicates that superoxide anions are produced as a primary product, and undergo further reactions during diffusion in glycocalyx to produce hydrogen, hydroxy-, and carbon-centered radicals which are detected by ESR as secondary products. It is proposed that these reactive radicals are responsible for the destruction of the mucous membranes of fish on exposure to ‘Red Tide’.