Publications by authors named "Kazushi Numata"

Post-transplant lymphoproliferative disease (PTLD) is a rare but life-threatening disease that occurs after organ transplantation. Histopathology is the gold standard for the diagnosis of PTLD. Because of its rarity and atypical symptoms, many patients are misdiagnosed with liver abscess, liver cancer, or missed diagnosis long before pathological diagnosis is obtained, thus delaying treatment.

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Purpose: This retrospective study aimed to investigate the role of an additional high mechanical index (MI) setting scan during the post-vascular phase (PVP) in detecting deep-seated hepatocellular carcinoma (HCC) lesions.

Methods: A total of 805 confirmed HCCs, which underwent Sonazoid-based contrast-enhanced ultrasound (CEUS) between January 2014 and October 2021, were included. Low MI scan was initially employed for lesion detection during the PVP, followed by high MI scan.

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Background: Recent advances in cancer genome analysis and the practice of precision medicine have made it possible to identify fractions with rare genetic alterations. Among biliary tract cancers, EGFR-amplified cancers are known to be rare fractions across organs and have a poor prognosis. The use of anti-EGFR antibody for EGFR-amplified cancers has been promising; however, the evidence is not yet clear.

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Because of recent advances in energy device technology, ablation has become popular worldwide. It is less invasive and provides faster postoperative recovery compared to surgery, and therefore, it has come to be applied to a wide range of organs, such as liver, lung, kidney, thyroid, and bone/soft tissue tumors. In order to properly guide the needle to the target area, imaging support is necessary, and ultrasound, which has the advantages of high resolution and real-time capability, is the most frequently used modality.

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Objective: This study aimed to establish a clinical prediction model for vessels encapsulating tumor clusters (VETC) based on preoperative ultrasonography (US) and contrast-enhanced computed tomography (CECT) imaging in patients with hepatocellular carcinoma (HCC).

Methods: Data were retrospectively collected from 215 patients who underwent hepatectomy for solitary HCC lesions. They were divided into training and validation cohorts at a ratio of 6:4.

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Article Synopsis
  • The study aimed to evaluate the effectiveness of Sonazoid contrast-enhanced ultrasound (S-CEUS) and Gadolinium-Ethoxybenzyl-Diethylenetriamine Penta-Acetic Acid magnetic-resonance imaging (EOB-MRI) for diagnosing microvascular invasion (MVI) in hepatocellular carcinoma (HCC) before surgery.
  • Using data from 111 HCC cases, researchers analyzed various imaging indicators and clinical data to create a nomogram that predicts MVI risk, identifying key factors like tumor margins and capsule integrity.
  • The resulting MVI Nomogram showed high diagnostic accuracy, potentially enhancing preoperative assessments of MVI and improving treatment outcomes for HCC patients
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  • Intestinal Behçet disease causes severe ulcers in the intestines and can lead to significant health issues; this study investigates the effectiveness of intestinal ultrasound as a monitoring tool compared to endoscopic findings and tissue samples.* -
  • The study analyzed ultrasound parameters like bowel wall thickness and vascularity in relation to the severity of ulcers discovered through endoscopy and pathological examinations, finding significant correlations between increased measurements and active ulcer stages.* -
  • Results suggest that intestinal ultrasound is a reliable method for assessing ulcer activity in Behçet disease, with specific metrics like a bowel wall thickness over 5.5 mm being indicative of active lesions.*
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  • The study aimed to find important biomarkers for predicting how patients with unresectable hepatocellular carcinoma (u-HCC) respond to a combination treatment of atezolizumab and bevacizumab (ATZ + BV).
  • Researchers evaluated circulating tumor DNA (ctDNA) and levels of various immune-related cytokines in blood samples from 158 u-HCC patients to identify potential indicators of treatment outcomes.
  • Key findings showed that while ctDNA mutations weren't correlated with treatment response, high levels of CXCL9 and low levels of LAG-3 were significant predictors of better progression-free survival and overall survival in patients undergoing ATZ + BV therapy.
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Aim: This study aims to evaluate the efficacy and safety of lenvatinib radiofrequency ablation (RFA) sequential therapy for certain hepatocellular carcinoma (HCC) patients.

Methods: One hundred and nineteen patients with unresectable HCC in the intermediate stage with Child-Pugh A were retrospectively recruited in a multicenter setting. Those in the lenvatinib RFA sequential therapy group received lenvatinib initially, followed by RFA and the retreatment with lenvatinib.

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To establish clinical prediction models of vessels encapsulating tumor clusters (VETC) pattern using preoperative contrast-enhanced ultrasound (CEUS) and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging (EOB-MRI) in patients with hepatocellular carcinoma (HCC). A total of 111 resected HCC lesions from 101 patients were included. Preoperative imaging features of CEUS and EOB-MRI, postoperative recurrence, and survival information were collected from medical records.

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Introduction: Hepatic arterial infusion chemotherapy (HAIC) with cisplatin and lenvatinib exhibits strong antitumor effects against advanced hepatocellular carcinoma (HCC). Higher antitumor activity is expected for the combination treatment. The aim of this trial was to evaluate the efficacy and safety of lenvatinib in combination with HAIC using cisplatin in patients with advanced HCC.

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Background: Although the combination of atezolizumab and bevacizumab (ATZ + BEV) is a standard treatment for advanced hepatocellular carcinoma (HCC), strategies for addressing treatment failure and prognostic factors of post-progression survival (PPS) remain unestablished.

Methods: We conducted a multicentre retrospective study to evaluate PPS following ATZ + BEV treatment in patients with advanced HCC. We classified the patients into three groups: BCLC stage B and BCLC stage C without or with new extrahepatic lesions (BCLCp-C1 and BCLCp-C2, respectively) at the time of progression.

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The proto-oncogene MYCN expression marked a cancer stem-like cell population in hepatocellular carcinoma (HCC) and served as a therapeutic target of acyclic retinoid (ACR), an orally administered vitamin A derivative that has demonstrated promising efficacy and safety in reducing HCC recurrence. This study investigated the role of MYCN as a predictive biomarker for therapeutic response to ACR and prognosis of HCC. MYCN gene expression in HCC was analyzed in the Cancer Genome Atlas and a Taiwanese cohort (N = 118).

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Background: Enhanced imaging techniques have the overwhelming advantages of being noninvasive and sensitive enough to evaluate the microcirculation of lesions, thus making them accurate in the diagnosis of hepatic lesions. Unfortunately, there is very little research on and knowledge of the imaging features of a rare cancerous condition: hepatic angiosarcoma (HA).

Case Summary: In this study, we retrospectively collected the data of six patients who underwent both contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT), and subsequently obtained a definitive histopathologic diagnosis of HA.

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Miwa and colleagues report on their experience with a newly developed peroral cholangioscope that is effective for the removal of difficult stones in the common bile duct and the cystic duct. The scope offers a large working channel and a high mobility bending section, increasing the efficacy of electrohydraulic lithotripsy.

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Background: No adjuvant treatment has been established for patients who remain at high risk for hepatocellular carcinoma recurrence after curative-intent resection or ablation. We aimed to assess the efficacy of adjuvant atezolizumab plus bevacizumab versus active surveillance in patients with high-risk hepatocellular carcinoma.

Methods: In the global, open-label, phase 3 IMbrave050 study, adult patients with high-risk surgically resected or ablated hepatocellular carcinoma were recruited from 134 hospitals and medical centres in 26 countries in four WHO regions (European region, region of the Americas, South-East Asia region, and Western Pacific region).

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Objective: To investigate the association between body composition and prognosis in patients with advanced hepatocellular carcinoma treated with atezolizumab plus bevacizumab.

Methods: This cohort study analysed 119 patients who received atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma. We investigated the association between body composition and progression-free survival and overall survival.

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Background And Aim: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is widely used in the management of biliary obstructions; however, literature on guidewire manipulation is lacking. This study aimed to assess the utility and optimal conditions of the loop technique for guidewire manipulation during EUS-HGS.

Methods: Consecutive patients who underwent EUS-HGS between April 2015 and January 2022 were included in this study.

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Article Synopsis
  • This study addresses the challenges of tracking kidney and liver organs during high-intensity focused ultrasound (HIFU) treatment, as respiratory movements can hinder precise cauterization and risk damage to surrounding tissues.
  • The researchers developed and tested three methods (AEMA, AEMAD, AEMAD++) for estimating organ angles in ultrasound images, using a phantom model to create a dataset by capturing various images of the kidney.
  • AEMAD++ was found to have the best performance in terms of accuracy (29.5%) and processing speed (3.20 FPS), indicating its potential for effective organ tracking in medical applications.
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Aim: We aimed to verify the therapeutic efficacy and safety of stereotactic body radiotherapy (SBRT) for previously untreated initial small hepatocellular carcinoma (HCC) in a multicenter, retrospective study.

Methods: Patients who underwent SBRT for HCC at the Japanese Society of Clinical Oncology (JCOG) member hospitals in Japan between July 2013 and December 2017 and met the following eligibility criteria were included: (1) initial HCC; (2) ≤3 nodules, ≤5 cm in diameter; (3) Child-Pugh score of A or B; and (4) unsuitability for or refusal of standard treatment. We analyzed the overall survival, recurrence-free survival, and cumulative incidence of local recurrence rate, and adverse events directly related to SBRT.

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  • Immune checkpoint inhibitors (ICIs) show promise for advanced hepatocellular carcinoma (HCC), but their link to immune-related adverse events (irAEs) and patient survival is not well-studied.
  • This study analyzed 150 advanced HCC patients who received atezolizumab plus bevacizumab, comparing those who experienced irAEs to those who did not.
  • Results indicated that patients with grade 1/2 irAEs had significantly better progression-free survival (273 days vs. 189 days) and overall survival compared to those without irAEs, indicating that these adverse events may correlate with improved survival outcomes.
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  • Cabozantinib demonstrated a favorable risk-benefit ratio for Japanese patients with advanced liver cancer (HCC) based on a phase II study that analyzed data before the final database lock.* -
  • Patients who had previously been treated with sorafenib experienced a median progression-free survival (PFS) of 7.4 months, while those who were naïve to sorafenib had a lower PFS of 3.6 months, with high disease control rates in both groups.* -
  • Overall, cabozantinib showed efficacy with a manageable safety profile, with the most common side effects being skin reactions, diarrhea, and appetite loss, while liver function remained stable for ongoing patients.*
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Objectives: Toinvestigate liver carcinogenesis and other causes of death by collecting clinical data, including the Fib-4 index, from patients with successfully eradicated hepatitis C virus (HCV) by direct-acting antivirals (DAA) treatment.

Methods: Patients ( n  = 690), who achieved a sustained virologic response (SVR) between 2014 and 2021, were identified and followed up for approximately 6.8 years; 71 incident hepatocellular carcinoma (HCC) cases were identified.

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Imaging methods have the overwhelming advantage of being non-invasive in the diagnosis of hepatic lesions and, thanks to technical developments in the field of ultrasound (US), radiation exposure can also be avoided in many clinical situations. In particular, contrast-enhanced US (CEUS) outperforms other radiological methods in regard to real-time images, repeatability, and prompt reporting and demonstrates relatively few contraindications and adverse reactions. In this study, we reported in detail a rare benign tumor: hepatic sclerosed hemangioma (HSH).

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