Effect of ultrasonography surveillance in patients with liver cancer

Liver cancer is a growing global public health problem. Ultrasonography is an imaging tool widely used for the early diagnosis of liver cancer | BMJ Open

Image source: Nephron – Wikimedia // CC SA 3.0

Image shows low magnification micrograph of hepatocellular carcinoma the most common form of primary liver cancer.

Objective: The effect of ultrasonography surveillance (US) on the survival of patients with liver cancer is unknown. Therefore, this study examined the association between survival and US frequency during the 2 years preceding patients’ liver cancer diagnosis.

Methods: This population-based longitudinal study was conducted in Taiwan, a region with high liver cancer incidence, by using the National Health Insurance Research Database. We compared survival between patients who received US three times or more (≥3 group) and less than three times (<3 group) during the 2 years preceding their liver cancer diagnosis, and identified the predictors for the ≥3 group.

Results: This study enrolled 4621 patients with liver cancer who had died between 1997 and 2010. The median survival rate was higher in the ≥3 group (1.42 years) than in the <3 group (0.51 years). Five-year survival probability was also significantly higher in the ≥3 group (14.4%) than in the <3 group (7.7%). The multivariate logistic regression results showed that the three most common positive predictors for receiving three or more US sessions were indications of viral hepatitis, gallbladder diseases and kidney–urinary–bladder diseases; the most common negative predictors for receiving three or more US sessions were male sex and indications of abdominal pain.

Conclusion: Patients with liver cancer who received US three times or more during the 2 years preceding their liver cancer diagnosis exhibited a higher 5-year survival probability.

Full reference: Chiang, J. et al. (2017) Effect of ultrasonography surveillance in patients with liver cancer: a population-based longitudinal study. BMJ Open. 7:e015936

Survey highlights the age of scanners in hospitals

The Clinical Imaging Board has published Magnetic resonance imaging (MRI) equipment, operations and planning in the NHS.

Image source: http://www.rcr.ac.uk

This report is urging hospitals to formulate plans to replace outdated equipment, after a survey revealed half of healthcare organisations do not have set renewal plans, and more than a third of older magnetic resonance imaging (MRI) scanners are not scheduled for replacement.

While many hospitals are operating newer equipment, 58% of MRI systems used are at least five years old, meaning they may not be able to conduct state-of-the-art imaging, needed for certain types of heart and prostate cancer scanning.

‘Huge leap’ in prostate cancer testing

The biggest leap in diagnosing prostate cancer “in decades” has been made using new scanning equipment, say doctors and campaigners | BBC News


The trial, at 11 hospitals in the UK, used multi-parametric MRI on men with high PSA levels. It showed 27% of the men did not need a biopsy at all. And 93% of aggressive cancers were detected by using the MRI scan to guide the biopsy compared with just 48% when the biopsy was done at random.

Dr Ahmed, who works at University College London Hospitals, told the BBC News website:

“This is a significant step-change in the way we diagnose prostate cancer. We have to look at the long-term survival, but in my opinion by improving the detection of important cancers that are currently missed we could see a considerable impact. But that will need to be evaluated in future studies, and we may have to wait 10 to 15 years.”

Read the full news story here

Read the original research article here

Urgent investment called for to reduce long waits for cancer scans

Radiologists have written to prime minister Theresa May warning that NHS services are in a ‘dire state’ and demanding urgent investment to reduce delays for the 250,000 patients waiting more than a month for results of cancer scans. | GP Online


In a letter to the prime minister this week, the Royal College of Radiologists backs a warning earlier this week from another royal college. The letter said: ‘The Royal College of Physicians’ view that the NHS is underfunded, underdoctored and overstretched, is borne out in the 250,000 patients currently waiting over a month for the results of their imaging studies and the poor cancer outcomes in this country.’

It calls for a ‘sustained programme of investment in imaging and radiotherapy equipment’ to tackle the existing shortfall.

Full story via GP Online

High-tech scans spare lymphoma patients intensive chemo

Cancer Research UK. Published online: 22 June 2016

Image source: CRUK

Hodgkin lymphoma patients can be spared the serious side effects of chemotherapy  thanks to high-tech scans that can predict the outcome of treatment, according to a study published in the New England Journal of Medicine

Doctors – funded by Cancer Research UK and international partners in Europe and Australasia – used positron emission tomography (PET)  to scan more than 1200 patients with advanced Hodgkin lymphoma after they had been given two cycles of standard chemotherapy. Those who had a clear PET scan were split into two groups – one group continued with chemotherapy including the drug bleomycin and the other had chemotherapy without the drug. They found that patients who stopped having bleomycin had the same survival rates as those who continued it. But, importantly, they were spared side effects. Patients on the trial who did not have a clear PET scan after two rounds of chemotherapy, suggesting they had a more resistant form of the disease, were given more intense chemotherapy treatment.

Bleomycin has been an important drug to treat Hodgkin lymphoma for 30 years, but it has a potential risk of severe effects on the lungs, with the risk of scarring, even years later, that can lead to serious breathing problems. Due to these risks the researchers wanted to explore the potential of adapting treatment by stopping bleomycin for patients with a good outlook and escalating treatment only for those at highest risk of the treatment not working.

Read the full press release here

Read the original research article here


MRI shows slight edge over CT in detecting pancreatic tumours

Smyth, D. Cancer Nursing Practice. Vol 15(5). pp. 15-15. Published in print: 10 June 2016


C0000757FG07 MRI scanning
Image source: Wellcome Library // CC BY-NC-ND 4.0

Pancreatic cancer is a significant cause of cancer mortality, with a poor five-year survival rate: 5% compared with 85% or more for breast cancer. In this Chinese study, two independent examiners undertook a retrospective analysis of the records of 38 patients with pathologically proven disease and surgically treated curative or palliative disease. They looked at whether there was a difference in the rates of detection and staging of the disease in two non-invasive diagnostic measures: computed tomography (CT) and magnetic resonance imaging (MRI).

Read the abstract here

First cancer patient in Europe scanned in Cambridge using new technique showing whether drugs work

CRUK. Published online: 11th April 2016.

Image source: Khuloud T. Al-Jamal, Rebecca Klippstein & Izzat Suffian – Wellcome Images // CC BY-NC-ND 4.0

Image shows confocal micrograph of prostate cancer cells treated with curcumin.

The first cancer patient in Europe has been scanned with a revolutionary imaging technique that could enable doctors to see whether a drug is working within a day or two of starting treatment.

The patient is the first to take part in a new metabolic imaging trial* of patients across a wide range of cancer types to be carried out by Cancer Research UK-funded scientists at Addenbrooke’s Hospital, part of Cambridge University Hospitals. The study, which is funded by a Wellcome Trust Strategic Award, could show whether patients can stop taking drugs that aren’t working for them, try different ones and receive the best treatment for their cancer as quickly as possible.

The rapid scan will allow doctors to map out molecular changes in patients, opening up potential new ways to detect cancer and monitor the effects of treatment.

The technique uses a breakdown product of glucose called pyruvate. The pyruvate is labelled with a non-radioactive form of carbon, called carbon 13 (C-13) which makes it 10,000 times more likely to be detected in a magnetic resonance imaging (MRI) scan. Pyruvate is injected into the patient and tracked as the molecule moves around the body and enters cells. The scan monitors how quickly cancer cells break pyruvate down – a measure of how active the cells are that tells doctors whether or not a drug has been effective at killing them.

Read the article here