Akiko Tonomura

Non-Invasive Evaluation of Hepatic Fibrosis for Type C Chronic Hepatitis

Objective: The aim of this study was to investigate liver fibrosis using non-invasive Real-time Tissue Elastography® (RTE) and transient elastography (FibroScan®) methods. Methods: RTE, FibroScan and percutaneous liver biopsy were all performed on patients with chronic liver disease, particularly hepatitis C, to investigate liver fibrosis. Results: FibroScan and RTE were compared for fibrous liver staging (F stage), which was pathologically classified using liver biopsy. In FibroScan, significant differences were observed between F1/F3 and F2/F4, but no such differences were observed between F1/F2, F2/F3 and F3/F4. In RTE, significant differences were observed between F1/F2, F2/F3 and F2/F4. But for F3/F4, no significant differences were observed. Conclusion: FibroScan and RTE correlated well with F staging of the liver. In particular RTE was more successful than FibroScan in diagnosing the degree of liver fibrosis.

Differential Inducibility of Human and Porcine Dental Pulp-Derived Cells into Odontoblasts

A robust method for generating odontoblasts from cultured dental pulp cells has not been established. In this study, efficient methods for deriving odontoblasts from cultured human and porcine dental pulp-derived cells were investigated with special attention to species differences. Cultured human cells showed relatively low alkaline phosphatase (ALP) activity in the presence of dexamethasone (Dex) and β-glycerophosphate (β-Gly). In contrast, the addition of 1,25-dihydroxyvitaminD3 (VitD3) significantly increased the ALP activity. In porcine cells, β-Gly alone or a combination of Dex and β-Gly significantly increased ALP activity; however, addition of VitD3 reduced this activity. RT-PCR and Western blotting analysis revealed that the combination of three induction reagents on human cells significantly upregulates the expression of osteocalcin mRNA, and dentin sialoprotein. We propose that the combination of Dex, β-Gly, and VitD3 is critical for differentiation of human dental pulp-derived cells into odontoblasts. In addition, the inducibility of dental pulp-derived cells presented remarkable species differences.

Noninvasive Diagnosis of Liver Fibrosis: Utility of Data Mining of Both Ultrasound Elastography and Serological Findings to Construct a Decision Tree

Objective: Although liver biopsy is the gold standard for viral liver disease management, it is invasive and the sampling error rate is problematic. Real-time tissue elastography (RTE), a recently developed method of ultrasound elastography, can be used to assess liver fibrosis noninvasively but the overlap between fibrosis stages limits its ability to assess liver fibrosis adequately when used alone. Methods: A multicenter collaborative study involving 542 patients with chronic viral hepatitis and cirrhosis who were scheduled to undergo liver biopsy compared the image features obtained from RTE image analysis, the liver fibrosis index (LFI), and pathological diagnosis. RTE and a blood test were performed on the same day as the liver biopsy. Data mining was also performed to construct a decision tree, and its diagnostic performance for assessing liver fibrosis was evaluated. Results: The LFI was higher in patients with chronic hepatitis C (CHC) than in those with chronic hepatitis B (CHB). When a decision tree was constructed by data mining of RTE and serological findings, the diagnostic accuracy was very high for all fibrosis stages, with respective rates at F1, F2, F3, and F4 of 94.4, 54.1, 38.7, and 81.3% for patients with CHC and of 97.1, 50.0, 43.8, and 80.6% for patients with CHB. Conclusions: The variation in LFI values between the different etiologies appears to reflect the difference in the development style of liver fibrosis. The decision tree for assessing liver fibrosis constructed by data mining of both RTE and serological findings had a high diagnostic performance in assessing liver fibrosis and shows promising clinical utility.

Development of Cad System for Diffuse Disease Based on Ultrasound Elasticity Images

It is well known that as hepatic cirrhosis progresses, hepatocyte fibrosis spreads and nodule increases. However, it is not easy to diagnosis its early stage by conventional B-mode image because we have to read subtle change of speckle pattern which is not sensitive to the stage of fibrosis. Ultrasonic tissue elasticity imaging can provide us novel diagnostic information based on tissue hardness. We recently developed commercial-based equipment for tissue elasticity imaging. In this work, we investigated to develop the CAD system based on elasticity image for diagnosing defused type diseases such as hepatic cirrhosis. The results of clinical data analysis indicate that the CAD system is promising as means for diagnosis of diffuse disease with simple criterion.