DIC

Rosa Gilabert MD.
Ultrasound Unit
Diagnosing Imaging Center
Hospital Clinic.
Villarroel 170.
08036 Barcelona

Spain
Telephone: 00 34 93 227 57 35
Fax: 00 34 93 227 97 17
gilabert@clinic.ub.es

Concepció Brú, M. D.

Hospital Clínic

Centre de Diagnòstic per la Imatge

Villarroel, 170

08036 BARCELONA

SPAIN

Telephone: 00 34 93 227 57 35

Fax: 00 34 93 227 97 17                   

cbru@clinic.ub.es

DIC: Clínic Hospital  of Barcelona - Diagnosing Imaging Center, Spain

The Clínic Hospital  of Barcelona (Spain)  is a third  level medical centre with a high level of clinic  a basic research.  In the area of liver disease  the Ultrasound Unit is included in the multidisciplinary  teams of  Hepatic Oncology  and  Hepatic Haemodynamics and Portal Hypertension. The results of  this collaboration is reflected in the CVs of the  investigators.

1. Hepatic Oncology Group

Strategic Objectives

This interdisciplinary group carries out research on both clinical and therapeutic aspects of hepatic cancer, as well as basic aspects concerning the mechanisms which regulate the progression of this disease.

Main Lines of Research

At a clinical level, work is carried out in the definition of optimum criteria for prescribing radical treatment (surgical resection, transplantation, percutaneous approach with alcohol injection or thermal ablation) to achieve the maximum effectiveness in terms of both survival and associated morbidity. In this area  the ultrasound unit  works in the hepatocellular carcinoma (HCC) screening program and HCC percutaneous ablative treatment.

At a basic level, an experimental model of human tumour in athymic mice has been characterised and cell lines from human hepatoma have been established. These tools, along with the tissue bank, will allow us to study the molecular mechanisms which regulate the biological behaviour of tumours. With this purpose, studies on microarrays have been started so as to characterise molecular abnormalities in initial stage tumours.

Challenges for the Future

1.   To continue the evaluation of IFN effectiveness in the primary prevention of hepatocellular carcinoma in patients with C virus cirrhosis.

2.   To assess new diagnosis and staging imaging techniques.

3.   To continue the prospective assessment of therapeutic options available for this neoplasia in the context of stage II,III and IV  studies.

4.   To continue the evaluation of new agents for the prevention of relapse after potentially curative treatment.

5.   To study the genetic alterations of pre-malignant lesions and hepatocellular carcinoma initial stages.

6.   To define the relationship between molecular abnormalities and the development, progression, dissemination and response to the treatment of patients affected this neoplasia.

2. Hepatic Haemodynamics and Portal  Hypertension Group

Strategic Objectives

To improve the understanding of mechanisms responsible of portal hypertension, which is the main complication of hepatic diseases, and to develop new treatments for this syndrome.

Main Lines of Research

1.      Characterisation of new adhesion molecules (cloning, chromosomal localisation, cellular expression, functionalism in knock-out animals).

2.   Factors which regulate the hepatic microcirculation in normal and cirrhotic conditions, using perfusion studies in isolated liver.

3.   Regulation of endothelial nitric oxide synthase activity (eNOS) and its clinical importance in the treatment of portal hypertension.

4.   Implication of angiogenic factors in the development of collateral circulation and in haemodynamic disorders in portal hypertension models in mice. Importance as a new therapeutic target.

5.      Characterisation of the factors which modulate the haemodynamic response to the treatment of portal hypertension.

6.   Clinical studies of randomised distribution of new portal hypertension treatments.

7.   Assessment with Doppler ultrasound  of portal hypertension treatment with TIPS in relation to the combined pharmacological treatment.

Concepció Brú, M. D.

Titles and experience: Licentiate in Medicine and Surgery, University of Barcelona 1972

Specialist in Gastroenterology. University of Barcelona, 1975

Doctor in Medicine, University of Barcelona, 1993

Specialist in Radiology. University of Barcelona, 1981   

Current Employment:            Head of  the Ultrasound lab. (since 1990)

Associate Professor in Radiology. University of Barcelona, Spain (since 1996)

Director of Imaging Department. Hospital Clínic of Barcelona, Spain (since 1998)

Rosa Gilabert, M. D.

Titles and experience: Licentiate in Medicine and Surgery, Autonomous University of Barcelona 1974-1980.

Radiology resident (1982-1985)

Specialist in Radiology 1986.

Doctor in Medicine, University of Barcelona, 1993

Current Employment:            Head of  the Ultrasound Unit. (since  2004)

DIC1.      JM. Llovet, C. Brú, J. Bruix; Prognosis of hepatocellular carcinoma: the BCLC staging classification.. SEM. LIVER DIS. 1999, 19: 329-338

DIC2.               JM.Llovet, J. Bustamante, A. Castells, R. Vilana, MC. Ayuso, M. Sala, C. Brú, J. Rodes, J. Bruix; Natural history  of untreated nonsurgical hepatocelular carcinoma: rationale for the design and evaluation of therapeutic trials. HEPATOLOGY, 1999, 29: 62-67

DIC3.      A. Perello, A. Escorsell, C. Brú, R. Gilabert, E. Moitinho, JC. García-Pagan, J. Bosch.; Wedged hepatic venous pressure adequately reflects portal pressure in hepatitis C virus-related cirrhosis. HEPATOLOGY, 1999, 30: 1393-1397                                                   

DIC4.      García-Criado A, Gilabert R, Nicolau C, Real I, Arguis P, Salmerón JM, García-Valdecasas JC, Brú C. Early detection of hepatic artery thrombosis after liver transplantation by Doppler-Ultrasound: prognostic implications. C. J. ULTRASOUND  MED. January 2001, 20 (1) 51-58 .

DIC5.      García-Criado A, Gilabert R, Nicolau C, Real I, Arguis P, Bianchi L, Vilana R, Salmerón JM, García-Valdecasas JC, Brú C, Early detection of hepatic artery thrombosis after liver transplantation by Doppler-Ultrasonography. Prognostic implications. J. ULTRASOUND  MED. 2001, 20: 51-58.

DIC6.      Llovet JM, Vilana R, Brú C, Bianchi L, Salmeron JM, Boix L, Ganau S, Sala M, Pagès M, Ayuso C, Solé M, Rodés J, Bruix J; Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma; HEPATOLOGY, 2001, 33: 1124-1129.

DIC7.               Caballeria Ll, Parés A, Castells A, Ginés A, Brú C, Rodés J; Hepatocellular Carcinoma in Primary Biliary Cirrhosis: similar incidence to that in hepatitis C virus-related cirrhosis. AM J GASTROENTEROL  2001;  96: 1160-1163.

DIC8.      Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs A, Christensen E, Pagliaro L, Colombo M, Rodés J, EASL Panel of experts (including Brú C) on HCC. Clinical Management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL Conference, J HEPATOL, 2001, 35: 421-430.

DIC9.  Vilana R, Llovet JM, Bianchi L, Sánchez M, Pagès M, Sala M, Gilabert R, Nicolau C, García Criado A, ayuso C, Bruix J, Brú C. Contrast-enhanced power doppler sonography and helical computed tomography foe assessment of vascularity of small hepatocellular carcinoma before and after percutaneous ablation; J. Clinical Ultrasonography, 31 (3),119-128 March-April 2003.

DIC10. Nicolau C, Catala V, Vilana R, Bianchi L, Gilabert R, Sole M, Bru C.    Characterization of hepatocellular carcinoma using sonovue, a second generation ultrasound contrast agent. Correlation with cellular differentiation.  Eur Radiol. 2004 Jun;14(6):1092-9.         

DIC11.  Bruc ,  Sans M,  Defelitto MM, Gilabert R,  Fuster D, Llach J, Lomeña  F, Bordas JM, Piqué JM ,  Panés J.  Hydrocolonic sonography for evaluating inflammatory bowel disease.  Am J Roentgenol  2000; 177 (1): 99-105.                                               

DIC12. Gilabert R,  Fernández-Cruz L,  Real M, Ricart  MJ, Astudillo E, Montaña X The treatment and outcome of  pancreatic  venous  graft thrombosis after  kidney - pancreas transplantation.. Br J Surg 2002, 89(3): 355-3

DIC13  Escorsell R, Bañares R, Garcia-Pagán JC, Gilabert R, Moitinho E, Piqueras B, Bru C, Echenagusia A, Granados A, Bosch J.TIPS Vs drug therapy in preventing variceal rebleeding  in advanced cirrhosis. A randomized controlled trial. Hepatology 2002, 35(2):385-92.

DIC14.  Perelló A, García-Pagán JC, Gilabert R, Suárez Y, Moitinho E, Cervantes F, Reverter JC, Escorsell A, Bosch J, Rodés TIPS is a useful long-term derivative therapy in patients with Budd-Chiari syndrome uncontrolled by medical therapy. Hepatology 2002, 35(1): 132-9