1,721,436 research outputs found
Patient Selection for Transarterial Chemoembolization in Hepatocellular Carcinoma: Importance of Benefit/Risk Assessment
No full textBackground: Liver cancer is the second most common cause of cancer-related death, with hepatocellular carcinoma (HCC) accounting for most primary liver cancers and most commonly arising from a history of advanced chronic liver disease. Among the available therapies, transarterial chemoembolization (TACE) is the most widely utilized and is considered the first-line treatment recommended for patients staged as intermediate HCC (Barcelona Clinic Liver Cancer stage B). If applied correctly, TACE can produce survival benefits without adversely affecting hepatic functional reserve. Summary: The aim of this nonsystematic review is to evaluate the evidence supporting TACE, with a special interest in intermediate HCC, for which this treatment is recommended in first line. However, intermediate HCC represents a broad and heterogeneous group of patients, not all of whom will benefit from TACE. This review highlights the importance of appropriate patient selection for initial TACE and for retreatment. It also evaluates evidence for the treatment of patients who become refractory to TACE. Some patients may, in fact, benefit from early switch (i.e., after 1 or 2 TACE treatments) to systemic therapies rather than continuing retreatments with TACE in order to preserve liver function, thus allowing sequential first- and second-line drug therapies. Key Messages: Careful assessment of an individual patient's benefit/risk ratio is recommended before any TACE session is considered to ensure optimal long-term outcomes in intermediate HCC
New perspectives on the use of artificial intelligence in the ultrasound evaluation of lung diseases
No full textNot presen
Different techniques for ultrasound liver elastography
No full textNo abstract is to provided with the types of articles to which this publication belongs (sort of Editorial or Brief commentary). Actually it is a brief graphical summary of medical situation
DAAs for HCV and risk of hepatocellular carcinoma: current standpoint
No full textIt is a commentary on a hot topic and according it does not have an abstrac
Contrast-enhanced harmonic endoscopic ultrasound-guided ethanol injection for a small hepatocellular carcinoma
No full textEU
Thinking outside the box: unconventional artificial intelligence algorithms in the detection and management of liver cirrhosis
No full textA significant proportion of liver patients present withadvanced stages at the time of diagnosis [1] leading toimpaired prognosis and reduced survival probabilities [2].Unsurprisingly, a diagnosis of cirrhosis is independently asso-ciated with all-cause in-hospital mortality [3]. Current path-ways rely on primary care physicians proactively screeningpatients for hepatic fibrosis using dedicated tools, which canbe suboptimal [4]. Artificial Intelligence (AI) is gaining globalattention in the medical field and beyond, with researchexpanding and evolving exponentially. Hence, leveragingeasily applicable AI models based on widely available routinetests may enhance early detection resulting in timely interven-tion and reduction in mortalit
Ultrasound, the handyman serving our whole populations in the post COVID-19 pandemic
No full textSince the introduction of the B-mode technology around 40 years ago the evolution of ultrasonography has been greatest and has surpassed the evolution of other imaging methods such as Computed Tomography or Magnetic Resonance from some points of view. Ultrasound now spans through an extremely wide range of regular uses, covering needs of the entire spectrum of our citizens. The articles published in this issue of the journal are a very
illustrative example of such versatility. For instance, if we consider the ages of the population, these articles show how ultrasound is
regularly utilized with great benefit at any time of the human life.
Its use spans from the very early times, like the prenatal intrauterine conditions, moving to the perinatal period, the adult
life, times at which CT or MRI are scantly of any use and finally to the disease of the elderly, such as Alzheimer’s dementia
Predictive role of microvesicles in cirrhotic patients: A promised land or a land of confusion? A narrative review
Full text linkMammalian cells release several membrane-enclosed vesicles called extracellular vesicles. Those vesicles can contain several molecules such as proteins, DNA and various RNA. Therefore, extracellular vesicles can act as a target delivery system and exert multiple biological effects. Several works demonstrated that extracellular vesicles are increased or dysregulated in patients with cirrhosis, and they can be predictive of disease progression, complications and mortality. This review aims to summarize and highlight the role of extracellular vesicles in the cirrhotic patient and how they correlate with the degree of disease and with complications, particularly with the development of portal thrombosis and hepatocellular carcinoma
Ongoing challenges in the diagnosis of hepatocellular carcinoma
No full textIn 2001, the European Association for the Study of the Liver (EASL) endorsed the possibility of achieving a non-invasive diagnosis of Hepatocellular Carcinoma (HCC) for the first time. Since then, various refinements of the criteria and techniques capable of achieving this diagnosis and the role of plasma and tissue oncomarkers have been reported in the literature and have been accepted to different extents in various geographical areas. Such tools can also potentially imply prognostic significance. The present article critically discusses some of the most relevant and debated challenges which have emerged in this field, including the role of contrast-enhanced ultrasound, and of hepatocyte-specific magnetic resonance contrast agents, the pitfall of transient hepatic attenuation differences, the reliability of biopsy and the status of biomarkers
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