Journal of Liver Cancer

Joon Koo Han

3 Articles

Diagnostic Performance of Diffusion-weighted Imaging for Hepatic Neuroendocrine Tumor: Comparison with Combined Diffusion-weighted Imaging and Contrast-enhanced Magnetic Resonance Imaging: Suk Ki Jang, Jung Hoon Kim, Mi Hye Yu, Joon Koo Han; J Liver Cancer. 2016;16(2):92-100. Published online September 30, 2016; DOI: https://doi.org/10.17998/jlc.16.2.92

Abstract PDF: Background/Aim
s: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for hepatic neuroendocrine tumors (NET) compared with combined DWI and contrastenhanced magnetic resonance imaging (MRI) .
Methods
Fifteen patients with hepatic NET (n=128) underwent enhanced MRI and DWI with multiple-b values. We analyzed three different sets: Precontrast set; DWI set (added DWI); combined set (added enhanced image). Two reviewers rated possibility of NET using a 5-point scale for each image set. Their diagnostic performance was compared using Jackknife alternative free-response ROC (JAFROC).
Results
Diagnostic performance was better on the combined set (figure of merit [FOM]=0.852, 0.761) than the precontrast set (FOM=0.427, 0.572, P<0.05) and the DWI set (FOM=0.682, 0.620, P<0.05). However, DWI improved performance compared with precontrast set without statistical difference. In small NETs (<1 cm), all sets showed low sensitivity (10.7-65.9%) with high specificity (95.4-100%). Interobserver agreement was moderate in all image sets (k=0.521 to 0.589).
Conclusions
Combined DWI and enhanced MRI were more useful for detecting NET. Although statistically insignficant, there was a trend in improved diagnostic performance with DWI.

Spontaneous Total Necrotic Hepatocellular Carcinoma: Young Jun Kim, Jun Yong Jeong, Kyong Ho Lee, Se Hyung Kim, Joon Koo Han, Byung Ihn Choi; Journal of the Korean Liver Cancer Study Group. 2002;2(1):73-75. Published online July 31, 2002

Abstract PDF: Spontaneous total necrosis of hepatocellular carcinoma is extremely rare, with only 16 cases reported in the English literature. In this report, we describe a case of spontaneous totally necrotic hepatocellular carcinoma in a 53-year-old man who was previously healthy. The hepatic mass was incidentally found. The viral markers for hepatitis B and C were negative and alpha-fetoprotein was normal. Ultrasonography revealed hypoechoic mass with peripheral high echoic rim. On CT, the mass was hypodense in both hepatic arterial phase and portal venous phase. Subtle capsular enhancement was noted in portal venous phase CT. The patient underwent hepatic segmentectomy. The resected hepatic segment revealed 4.5 cm sized, well encapsulated, and nearly totally necrotic mass. On microscopic examination, the ghost cells of hepatocellular carcinoma were found in totally necrotic tissue, supporting diagnosis of hepatocellular carcinoma.

A case of Hepatocellular Carcinoma with Bile Duct Invasion Treated with Transcather Arterial Embolization and Surgical Resection: Joon Woo Lee, Joon Koo Han, Byung Ihn Choi; Journal of the Korean Liver Cancer Study Group. 2001;1(1):77-79. Published online June 30, 2001

Abstract PDF: A 51-year-old-male was admitted due to epigastric discomfort. He had history of alcoholism. Physical findings revealed that he had tenderness on right upper quadrant with jaundice. Total bilirubin was 8.3 mg/dL, AST/ALT was 40/53 IU/L, and AFP was 38,925 ng/ml. Computed tomography showed ill-defined mass in the right hepatic lobe and intraductal mass measuring 3cm in diameter in common bile duct. PTBD was performed via B3 and on cholangiogram, there was abrupt cut-off at confluence level of common hepatic duct. After PTBD, jaundice was relieved. After then, TACE and surgical resection was done. There was a large mass measuring 6cm in the right hepatic lobe with intraductal extention to common bile duct. After then, the patient survives 30 months up to date and is still alive.