Jump to content
RemedySpot.com

Alpha fetoprotein, ultrasound, CT and MRI for detection of hepatocellular carcin

Rate this topic

Guest guest

By Guest guest
in Health, Medicine and Natural Healing 07

 Share

Recommended Posts

Guest guest

Guest guest

Posted
Posted

Alimentary Pharmacology & Therapeutics (OnlineAccepted Articles).

doi:10.1111/j.1365-2036.2007.03498.x

Abstract

Alpha fetoprotein, ultrasound, CT and MRI for detection of hepatocellular

carcinoma in patients with advanced cirrhosis

N. SNOWBERGER11Department of Medicine, Baylor University Medical Center, S.

CHINNAKOTLA2,32Department of Surgery, Baylor University Medical

Center3Baylor Regional Transplant Institute, Dallas, Texas, USA., R. M.

LEPE-SUASTEQUI1,31Department of Medicine, Baylor University Medical

Center3Baylor Regional Transplant Institute, Dallas, Texas, USA., J.

PEATTIE33Baylor Regional Transplant Institute, Dallas, Texas, USA., R.

GOLDSTEIN2,32Department of Surgery, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA., G. B.

KLINTMALM2,32Department of Surgery, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA. & G. L.

DAVIS1,31Department of Medicine, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA.1Department of Medicine,

Baylor University Medical Center 2Department of Surgery, Baylor University

Medical Center 3Baylor Regional Transplant Institute, Dallas, Texas, USA.

Corresponding Author: G. L. DAVIS

4 , Hepatology

Baylor University Medical Center

3500 Gaston Avenue

Dallas, TX 75246

Phone: 214-820-1857

Fax: 214-820-8168

e-mail: garydav@...

SUMMARY

Background: Serum alpha fetoprotein (AFP), ultrasound, CT scanning, and MRI

are commonly used to screen for hepatocellular carcinoma (HCC) in patients

with cirrhosis. Aim: To assess the accuracy of screening in advanced

cirrhosis. Methods: The study group was 239 patients with proven HCC in the

explanted liver at the time of liver transplant (LTx). AFP and imaging were

done at referral and serially until transplant. Results: HCC was detected

before LTx in 78% and discovered incidentally in 22%. The cause of cirrhosis

was HCV (55%), HBV (17%), alcohol (9%), and other/unknown (19%). Although

AFP was elevated 62%, the median level was 15 ng/mL. Only 26%, 15% and 13%

were more than 100, 400 and 1000 ng/mL, respectively. By comparison, AFP was

elevated in 20% without HCC, but exceeded 100 ng/mL in only 3%. The overall

accuracy of AFP was poor regardless of the cutoff. MRI was more accurate

than CT or ultrasound in detecting tumor, particularly when performed within

3 months of transplant. Conclusions: MRI is most sensitive for imaging HCC

and best reflects actual tumor size. AFP is insensitive and adds little to

screening strategies, but has prognostic value when extremely elevated.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2036.2007.03498.x

_________________________________________________________________

Learn.Laugh.Share. Reallivemoms is right place!

http://www.reallivemoms.com?ocid=TXT_TAGHM & loc=us

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Alimentary Pharmacology & Therapeutics (OnlineAccepted Articles).

doi:10.1111/j.1365-2036.2007.03498.x

Abstract

Alpha fetoprotein, ultrasound, CT and MRI for detection of hepatocellular

carcinoma in patients with advanced cirrhosis

N. SNOWBERGER11Department of Medicine, Baylor University Medical Center, S.

CHINNAKOTLA2,32Department of Surgery, Baylor University Medical

Center3Baylor Regional Transplant Institute, Dallas, Texas, USA., R. M.

LEPE-SUASTEQUI1,31Department of Medicine, Baylor University Medical

Center3Baylor Regional Transplant Institute, Dallas, Texas, USA., J.

PEATTIE33Baylor Regional Transplant Institute, Dallas, Texas, USA., R.

GOLDSTEIN2,32Department of Surgery, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA., G. B.

KLINTMALM2,32Department of Surgery, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA. & G. L.

DAVIS1,31Department of Medicine, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA.1Department of Medicine,

Baylor University Medical Center 2Department of Surgery, Baylor University

Medical Center 3Baylor Regional Transplant Institute, Dallas, Texas, USA.

Corresponding Author: G. L. DAVIS

4 , Hepatology

Baylor University Medical Center

3500 Gaston Avenue

Dallas, TX 75246

Phone: 214-820-1857

Fax: 214-820-8168

e-mail: garydav@...

SUMMARY

Background: Serum alpha fetoprotein (AFP), ultrasound, CT scanning, and MRI

are commonly used to screen for hepatocellular carcinoma (HCC) in patients

with cirrhosis. Aim: To assess the accuracy of screening in advanced

cirrhosis. Methods: The study group was 239 patients with proven HCC in the

explanted liver at the time of liver transplant (LTx). AFP and imaging were

done at referral and serially until transplant. Results: HCC was detected

before LTx in 78% and discovered incidentally in 22%. The cause of cirrhosis

was HCV (55%), HBV (17%), alcohol (9%), and other/unknown (19%). Although

AFP was elevated 62%, the median level was 15 ng/mL. Only 26%, 15% and 13%

were more than 100, 400 and 1000 ng/mL, respectively. By comparison, AFP was

elevated in 20% without HCC, but exceeded 100 ng/mL in only 3%. The overall

accuracy of AFP was poor regardless of the cutoff. MRI was more accurate

than CT or ultrasound in detecting tumor, particularly when performed within

3 months of transplant. Conclusions: MRI is most sensitive for imaging HCC

and best reflects actual tumor size. AFP is insensitive and adds little to

screening strategies, but has prognostic value when extremely elevated.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2036.2007.03498.x

_________________________________________________________________

Learn.Laugh.Share. Reallivemoms is right place!

http://www.reallivemoms.com?ocid=TXT_TAGHM & loc=us

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Alimentary Pharmacology & Therapeutics (OnlineAccepted Articles).

doi:10.1111/j.1365-2036.2007.03498.x

Abstract

Alpha fetoprotein, ultrasound, CT and MRI for detection of hepatocellular

carcinoma in patients with advanced cirrhosis

N. SNOWBERGER11Department of Medicine, Baylor University Medical Center, S.

CHINNAKOTLA2,32Department of Surgery, Baylor University Medical

Center3Baylor Regional Transplant Institute, Dallas, Texas, USA., R. M.

LEPE-SUASTEQUI1,31Department of Medicine, Baylor University Medical

Center3Baylor Regional Transplant Institute, Dallas, Texas, USA., J.

PEATTIE33Baylor Regional Transplant Institute, Dallas, Texas, USA., R.

GOLDSTEIN2,32Department of Surgery, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA., G. B.

KLINTMALM2,32Department of Surgery, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA. & G. L.

DAVIS1,31Department of Medicine, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA.1Department of Medicine,

Baylor University Medical Center 2Department of Surgery, Baylor University

Medical Center 3Baylor Regional Transplant Institute, Dallas, Texas, USA.

Corresponding Author: G. L. DAVIS

4 , Hepatology

Baylor University Medical Center

3500 Gaston Avenue

Dallas, TX 75246

Phone: 214-820-1857

Fax: 214-820-8168

e-mail: garydav@...

SUMMARY

Background: Serum alpha fetoprotein (AFP), ultrasound, CT scanning, and MRI

are commonly used to screen for hepatocellular carcinoma (HCC) in patients

with cirrhosis. Aim: To assess the accuracy of screening in advanced

cirrhosis. Methods: The study group was 239 patients with proven HCC in the

explanted liver at the time of liver transplant (LTx). AFP and imaging were

done at referral and serially until transplant. Results: HCC was detected

before LTx in 78% and discovered incidentally in 22%. The cause of cirrhosis

was HCV (55%), HBV (17%), alcohol (9%), and other/unknown (19%). Although

AFP was elevated 62%, the median level was 15 ng/mL. Only 26%, 15% and 13%

were more than 100, 400 and 1000 ng/mL, respectively. By comparison, AFP was

elevated in 20% without HCC, but exceeded 100 ng/mL in only 3%. The overall

accuracy of AFP was poor regardless of the cutoff. MRI was more accurate

than CT or ultrasound in detecting tumor, particularly when performed within

3 months of transplant. Conclusions: MRI is most sensitive for imaging HCC

and best reflects actual tumor size. AFP is insensitive and adds little to

screening strategies, but has prognostic value when extremely elevated.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2036.2007.03498.x

_________________________________________________________________

Learn.Laugh.Share. Reallivemoms is right place!

http://www.reallivemoms.com?ocid=TXT_TAGHM & loc=us

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Alimentary Pharmacology & Therapeutics (OnlineAccepted Articles).

doi:10.1111/j.1365-2036.2007.03498.x

Abstract

Alpha fetoprotein, ultrasound, CT and MRI for detection of hepatocellular

carcinoma in patients with advanced cirrhosis

N. SNOWBERGER11Department of Medicine, Baylor University Medical Center, S.

CHINNAKOTLA2,32Department of Surgery, Baylor University Medical

Center3Baylor Regional Transplant Institute, Dallas, Texas, USA., R. M.

LEPE-SUASTEQUI1,31Department of Medicine, Baylor University Medical

Center3Baylor Regional Transplant Institute, Dallas, Texas, USA., J.

PEATTIE33Baylor Regional Transplant Institute, Dallas, Texas, USA., R.

GOLDSTEIN2,32Department of Surgery, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA., G. B.

KLINTMALM2,32Department of Surgery, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA. & G. L.

DAVIS1,31Department of Medicine, Baylor University Medical Center3Baylor

Regional Transplant Institute, Dallas, Texas, USA.1Department of Medicine,

Baylor University Medical Center 2Department of Surgery, Baylor University

Medical Center 3Baylor Regional Transplant Institute, Dallas, Texas, USA.

Corresponding Author: G. L. DAVIS

4 , Hepatology

Baylor University Medical Center

3500 Gaston Avenue

Dallas, TX 75246

Phone: 214-820-1857

Fax: 214-820-8168

e-mail: garydav@...

SUMMARY

Background: Serum alpha fetoprotein (AFP), ultrasound, CT scanning, and MRI

are commonly used to screen for hepatocellular carcinoma (HCC) in patients

with cirrhosis. Aim: To assess the accuracy of screening in advanced

cirrhosis. Methods: The study group was 239 patients with proven HCC in the

explanted liver at the time of liver transplant (LTx). AFP and imaging were

done at referral and serially until transplant. Results: HCC was detected

before LTx in 78% and discovered incidentally in 22%. The cause of cirrhosis

was HCV (55%), HBV (17%), alcohol (9%), and other/unknown (19%). Although

AFP was elevated 62%, the median level was 15 ng/mL. Only 26%, 15% and 13%

were more than 100, 400 and 1000 ng/mL, respectively. By comparison, AFP was

elevated in 20% without HCC, but exceeded 100 ng/mL in only 3%. The overall

accuracy of AFP was poor regardless of the cutoff. MRI was more accurate

than CT or ultrasound in detecting tumor, particularly when performed within

3 months of transplant. Conclusions: MRI is most sensitive for imaging HCC

and best reflects actual tumor size. AFP is insensitive and adds little to

screening strategies, but has prognostic value when extremely elevated.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2036.2007.03498.x

_________________________________________________________________

Learn.Laugh.Share. Reallivemoms is right place!

http://www.reallivemoms.com?ocid=TXT_TAGHM & loc=us

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
 Share
Go to topic listing
×
×
  • Create New...