Evolution of medical imaging -Role of imaging in informing clinical decisions: liver cancer Ken Shirabe Gunma University, Japan
My G My Gran randfat father er “Ra Raisu isuke Shi Shirabe abe” ” was was a s a survi rvivor or after ter Ato Atomic B ic Bomb omb in N in Naga agasaki aki More than 850 of medical students, staffs, and patients died . 414 of 580 students (71%) died. Nagasaki Medical College was completely destroyed.
HCC and hepatitis virus: world distribution Hepatocellular carcinoma (HCC) nonBnonC HBV and HCV positive (11%) (1%) HBV positive Incidence of HCC (11%) High Intermediate Low Hepatitis C virus (HCV) Hepatitis B virus (79%) (Japan Liver Cancer Society: Kanzo 41; Incidence of HBs Ag 799-811, 2000.) High Intermediate Low Number of suffers: more than 700, 000 people in the world per year.
Liver cancer (Hepatocellular carcinoma: HCC) often occurs in injured liver. ・ Liver is vital organ. ・ Functional limitation for resection in injured liver ・ Massive bleeding may occur during liver resection Liver Cirrhosis HCV For safe hepatectomy, HBV To simulate precise simulation Alcohol To reduce blood loss Fatty liver are essential. Cholestasis
Simulation before hepatic resection, using 3D imaging Estimated resection volume, and residual liver volume after hepatectomy, blood vessels, which would be cut during resection can be simulated.
Preoperative simulation of liver surgery, using Bio-Texture Modeling Forming of 3D model, using 3D printer DICOM data Left lateral segment graft ( Full-length ) 3D imaging LHV GV 277g PV GRWR 4.5% Joint research with Prof. Maki Sugimoto, Teikyo University
The making of 3D imaging
Changes in blood loss, transfusion rates and postoperative complication Mortality Blood Liver failure Blood loss 50 transfusion rates (ml) Bile leakage ( % ) 1500 500 40 1600 Ascites 50 Complication rates 1400 30 1130 130 52 40 1200 48 770 770 20 1000 656 656 800 10 555 55 20 600 400 (%) 0 275 275 14 91-96 200 97-03 (n=250) 04-08 8 (n=213) 09-14 (n=346) 0 0 15-18 (n=157) 85-90 91-96 97-03 04-08 09-14 (n=182) 15-18 (n=162) (n=250) (n=213) (n=346) (n=157) (n=182) Mort ortalit lity 0 %
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