Radiofrequency ablation is widely used for the treatment of hepatocellular carcinoma. However, to achieve successful ablation, it is important to have a clear view of the margins of the nodule. Although most larger

hepatocellular carcinomas are hypervascular, early carcinomas can be hypovascular and can be difficult to detect with contrast-enhanced US, contrast-enhanced CT or CT during hepatic arteriography. The recent introduction of contrast-enhanced MRI appears to have improved the detection of early liver tumors and may be helpful for the differentiation of early hepatocellular carcinoma from dysplastic nodules. Real-time virtual sonography is a system in which a B-mode US image can be synchronized

with CT images. To our knowledge, this find more is the first report of the successful use of real-time virtual sonography with enhanced MRI for the detection and treatment of an early hepatocellular carcinoma. This technology may facilitate the diagnosis and treatment of hepatocellular carcinoma at an earlier stage. Contributed by “
“Over 180 million people are infected with hepatitis C virus (HCV) worldwide. Despite significant advances in therapy, an alarmingly high number of patents remain both undiagnosed and untreated. Linkage to care is a significant barrier to HCV treatment due to ineffective risk-based screening and the asymptomatic nature of HCV until it reaches advanced selleck chemical stages of disease. Increasing

complexity of HCV therapy, largely due to individualization of treatment, has led to improvements in efficacy but also threatens to propagate and maintain a disparity in access to care. selleck chemicals llc Personalized, or individualized, medicine has been touted as the future of pharmaceutical innovation; however, in a global epidemic such as HCV, deconstructing and reversing this trend may be essential to more effectively combat this disease. In 1989, HCV therapy was simplistic and relatively ineffective. Interferon monotherapy given three times a week for 6 months yielded very few patients with sustained virologic response.[1] As our understanding of the hepatitis C virus improved, HCV therapy became “individualized” as viral and host characteristics were both used to risk stratify patients and optimize response to therapy. These characteristics included patient weight, histologic stage of disease, race, viral genotype, IL28b genetic polymorphism status, and on-treatment viral kinetics. In May 2011, the first direct-acting antiviral (DAA) agents, boceprevir and telaprevir, became available to be used in combination with peginterferon (PEG) and ribavirin (RBV). DAA-based triple therapy has boosted sustained virologic response (SVR) rates to ∼75% in genotype 1 patients; however, it requires detailed pretreatment evaluation and complex on-treatment monitoring.