Novel T1 Analysis Method to Address Reduced Measurement Accuracy Due to Irregular Heart Rate Variability in Myocardial T1 Mapping Using Polarity-corrected Inversion Time Preparation.

Purpose: Polarity-corrected inversion time preparation (PCTIP), a myocardial T1 mapping technique, is expected to reduce measurement underestimation in the modified Look-Locker inversion recover method. However, measurement precision is reduced, especially for heart rate variability. We devised an analysis using a recurrence formula to overcome this problem and showed that it improved the measurement accuracy, especially at high heart rates.

Effects of Lenvatinib on Skeletal Muscle Volume and Cardiac Function in Patients with Hepatocellular Carcinoma.

Introduction: Previously, we reported that the tyrosine kinase inhibitor (TKI) sorafenib decreases serum levels of carnitine and reduces skeletal muscle volume. Moreover, others reported that TKIs might lead to cardiomyopathy or heart failure. Therefore, this study aimed to evaluate the effects of lenvatinib (LEN) on skeletal muscle volume and cardiac function in patients with hepatocellular carcinoma (HCC).

Lenvatinib Might Induce Activation of Host Immunity in Patients with Hepatocellular Carcinoma.

Introduction: Atezolizumab, an immune checkpoint inhibitor, plus bevacizumab, a monoclonal antibody that binds to vascular endothelial growth factor (VEGF), is an approved first-line systemic treatment for unresectable hepatocellular carcinoma (HCC). Immune checkpoint inhibitors are more effective in patients with HCC when administered with anti-VEGF drugs; however, these drugs affect host immunity. Lenvatinib is an anti-VEGF agent used to treat HCC; therefore, this study evaluated the effect of treatment of HCC with lenvatinib on host immunity in patients with chronic liver disease (CLD).

Using Dictionary Matching to Improve the Accuracy of MOLLI Myocardial T1 Analysis and Measurements of Heart Rate Variability.

We analyzed modified Look-Locker inversion recovery (MOLLI) T1 measurements by applying a dictionary matching strategy and aimed to acquire T1 measurements more accurately than those acquired by the conventional three-parameter matching analysis. We particularly clarified the robustness of this method for measuring heart rate (HR) variability. A phantom experiment using a 3T MRI system was performed for various HRs.

Usefulness of partial splenic embolization for left-sided portal hypertension in a patient with a pancreatic neuroendocrine neoplasm: a case report and review of the literature.

Left-side portal hypertension (LSPH) is caused by isolated obstruction of the splenic vein and is associated with esophagogastric varices that extend from the lower esophagus to the greater curvature of the gastric body. Here, we report on a 74-year-old man with a pancreatic neuroendocrine neoplasm (NEN) in the pancreatic tail with multiple liver metastases. We decided that partial splenic embolization (PSE) was the best course of treatment to prevent rupture of the gastric varices, which were classified as markedly enlarged, nodular, or tumor-shaped and showed erosion of the mucosa.

Adaptation of lenvatinib treatment in patients with hepatocellular carcinoma and portal vein tumor thrombosis.

Purpose: The aim of this study was to clarify the adaptation of lenvatinib treatment in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT).

Method: Fifty-three patients with HCC were treated with lenvatinib. Before and after treatment blood sampling, patients were examined by computed tomography and ultrasonography.

Usefulness of virtual touch tissue quantification for predicting the presence of esophageal varices in patients with liver cirrhosis.

Background And Aim: Measuring the hepatic venous pressure gradient (HVPG) is an established technique to detect increased portal pressure and predict the presence of esophageal varices (EVs); however, the risk of the test is greater than the information it provides. This study aimed to clarify the usefulness of virtual touch tissue quantification (VTQ), which assesses liver stiffness, in predicting the presence of EVs in patients with liver cirrhosis by comparing it with HVPG.

Methods: Two hundred seventeen patients with liver cirrhosis underwent VTQ, HVPG measurement, and upper endoscopy.

Successful treatment of advanced pancreatic leiomyosarcoma treated with gemcitabine plus -paclitaxel: a case report and literature review.

Pancreatic leiomyosarcoma (PLMS) is an extremely rare tumor that accounts for 0.1% of pancreatic malignancies, and its chemotherapy has yet to be established. Generally, soft-tissue sarcoma chemotherapy is standard treatment with doxorubicin (DXR) alone.

Sorafenib Might Induce Sarcopenia in Patients With Hepatocellular Carcinoma by Inhibiting Carnitine Absorption.

Background/aim: Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of cancers. Sorafenib, an oral multi-target TKI, improves the median overall survival time in patients with hepatocellular carcinoma (HCC). It also inhibits the absorption of carnitine by down-regulating the human organic cationic transporter OCTN2 located largely in the small intestinal mucosa and skeletal muscle.

An increase in the deoxygenated hemoglobin concentration induced by a working memory task during the refractory period in the hemodynamic response in the human cerebral cortex.

In activated brain regions, the deoxygenated hemoglobin (deoxy-Hb) concentration decreases despite an increase in oxygen consumption. This is attributed to the fact that the cerebral blood flow (CBF) induced by neuronal activation exceeds the accompanying increase in the cerebral metabolic rate of oxygen (CMRO). The discrepancy between large CBF and disproportionately small CMRO responses provides the basis for detecting the hemodynamic correlates of neuronal activities by functional magnetic resonance imaging (fMRI).

Functional Correlation between Subcellular Localizations of Japanese Encephalitis Virus Capsid Protein and Virus Production.

The flavivirus capsid protein is considered to be essential for the formation of nucleocapsid complexes with viral genomic RNA at the viral replication organelle that appears on the endoplasmic reticulum (ER), as well as for incorporation into virus particles. However, this protein is also detected at the lipid droplet (LD) and nucleolus, and physiological roles of these off-site localizations are still unclear. In this study, we made a series of alanine substitution mutants of Japanese encephalitis virus (JEV) capsid protein that cover all polar and hydrophobic amino acid residues to identify the molecular surfaces required for virus particle formation and for localization at the LD and nucleolus.

Flash Imaging Used in the Post-vascular Phase of Contrast-Enhanced Ultrasonography is Useful for Assessing the Progression in Patients with Hepatitis C Virus-Related Liver Disease.

Sonazoid is a commonly used contrast agent for characterizing liver tumors in ultrasonography (US). We performed flash imaging in the post-vascular phase of contrast-enhanced US (CEUS) to investigate associations between collapse of Sonazoid microbubbles (MB) and progression of liver disease. This study enrolled 409 patients (205 men, 204 women) with hepatitis C virus-related liver disease (CLD) between 2007 and 2017 (mean age 60 ± 14 y; range 20-90 y).

Influence of Sorafenib on Host Immunity in Patients with Liver Cirrhosis With Advanced Hepatocellular Carcinoma Stratified by Etiology.

Aim: We previously reported that sorafenib induces Th1 [interferon-γ (IFNγ)-positive interleukin 4 (IL4)-negative] dominance which prevents tumor cells from escaping the host immune system in patients with liver cirrhosis (LC) and advanced hepatocellular carcinoma (aHCC). However, in that study we did not assess the influence of sorafenib on host immunity according to the etiology of LC. Therefore, this study was retrospectively performed to evaluate the impact of sorafenib therapy for aHCC on host immunity in patients stratified according to the etiology of LC: Patients and Methods: A total of 116 adult Japanese patients with LC and aHCC received sorafenib therapy at our hospital.

[Coronary Computed Tomography Angiography for Patients with Atrial Fibrillation: Feasibility of Prospective Electrocardiography-gated Diastolic Acquisition with a Manual Exposure-termination Technique].

Coronary computed tomography angiography (CCTA) was performed in 283 patients with atrial fibrillation (Af) using a prospective electocardiogeaphic gated scanning with a manual exposure-termination technique. When preparatory 5-beat scanning contained at least one RR interval longer than 800 ms, 5-beat diastolic scanning (R+800 ms protocol) was selected. When no RR interval longer than 800 ms was observed, 2-beat scanning starting at end-systolic phase (R+210 ms to R protocol) was chosen.

[Pacemaker-induced Metallic Artifacts in Coronary Computed Tomography Angiography: Clinical Feasibility of Single Energy Metal Artifact Reduction Technique].

Background: Coronary computed tomography angiography (CCTA) in patients with pacemaker suffers from metallic lead-induced artifacts, which often interfere with accurate assessment of coronary luminal stenosis. The purpose of this study was to assess a frequency of the lead-induced artifacts and artifact-suppression effect by the single energy metal artifact reduction (SEMAR) technique.

Methods: Forty-one patients with a dual-chamber pacemaker were evaluated using a 320 multi-detector row CT (MDCT).

Single injection protocol for coronary and lower extremity CT angiographies in patients suspected for peripheral arterial disease.

To evaluate the feasibility of a single injection protocol for coronary CT angiography (CTA) and lower extremity CTA in patients suspected for peripheral arterial disease (PAD).This prospective observational study included a total of 103 patients who showed an ankle brachial index ≤0.9 and underwent the single injection protocol for coronary and lower extremity CTA.

[The Minimum Values of (RR-PQ) for High Quality Coronary CT Angiogram in Half, Automatic Patient's Motion Correction (APMC) and Full Reconstruction Using 320-ADCT (0.275 s/r)].

Background: A clear coronary CT angiography (CCTA) can be obtained when temporal resolution (TR) is shorter than slow filling (SF) duration. The SF duration was calculated by the following equation: SF=-443+0.742 (RR-PQ).

Coronary Whole-heart MR Angiography: Feasibility of Breath-hold Chasing with Diaphragmatic Navigation.

We propose a simple but novel data acquisition technique for whole-heart coronary magnetic resonance angiography (CMRA). In this technique, the breath-hold chasing MRA, data are collected during breath-hold intervals, with the navigation window manually adjusted to the diaphragmatic level. Compared with the conventional free breathing MRA, this method provided 33% reduction of acquisition time and improved visibility of right coronary artery in 18 normal subjects without any additional software or hardware requirements.

Coronary artery calcium score and CT angiography in asymptomatic elderly patients with high pretest probability for coronary artery disease.

Purpose: To evaluate the role of coronary artery calcium scoring (CACS) and/or coronary CT angiography (CCTA) in asymptomatic elderly patients with high pretest probability for coronary artery disease (CAD).

Materials And Methods: Forty-eight consecutive asymptomatic elderly (>65 years) subjects who had a high pretest probability and underwent CACS/CCTA were included. Each CCTA was evaluated for adequacy for assessment of coronary stenosis.

Assessment of coronary in-stent restenosis: value of subtraction coronary computed tomography angiography.

In conventional coronary computed tomography angiography (CCTA), metal artifacts are frequently observed where stents are located, making it difficult to evaluate in-stent restenosis. This study was conducted to investigate whether subtraction CCTA can improve diagnostic accuracy in the evaluation of in-stent restenosis. Subtraction CCTA was performed using 320-row CT in 398 patients with previously placed stents who were able to hold their breath for 25 s and in whom mid-diastolic prospective one-beat scanning was possible.

Incremental predictive value for obstructive coronary artery disease by combination of Duke Clinical Score and Agatston score.

Aims: Recent study suggests that algorithms such as the Duke Clinical score (DCS) may overestimate the pretest probability. The Agatston score representing the grade of coronary artery calcification can be simply calculated from low-radiation exposure ECG-gated plain CT. In this study, we investigated whether or not more superior diagnostic performance for obstructive coronary artery disease (CAD) can be obtained by combining DCS with the Agatston score.

Subtraction coronary computed tomography in patients with severe calcification.

To investigate the clinical usefulness of subtraction coronary computed tomographic angiography (CCTA) in patients with severe calcification. A 320-row area detector CT system was used in this study. The subjects were 78 patients (47 men and 31 women, 739 years of age) with an Agatston score of >300 who were able to undergo prospective one-beat scanning during a single breath-hold.

[Clinical usefulness of low tube current scanning with full reconstruction and automatic patient motion correction (APMC) reconstruction in a prospective ECG-gated coronary CT angiography using 320-row area detector CT].

Purpose: The purpose of this study is to validate the clinical usefulness of Advanced Patient Motion Correction (APMC) reconstruction when motion artifacts were observed in a prospective ECG-gated coronary CT angiography (CCTA), which was acquired by low tube current scanning with full reconstruction using 320-row area detector CT (0.275 s/rot.).