Clinical implications for imaging of vascular invasion in hepatocellular carcinoma

Baheti, Akshay D.; Dunham, Gregor M.; Ingraham, Christopher R.; Moshiri, Mariam; Lall, Chandana; Park, James O.; Li, David; Katz, Douglas S.; Madoff, David C.; Bhargava, Puneet

doi:10.1007/s00261-016-0763-2

Cited by 11 publications

(4 citation statements)

References 67 publications

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“…Thus, for such patients, tumor size should not be a limiting factor for LT. Preoperative examinations such as computed tomography (CT) scans or magnetic resonance imaging (MRI) could only identify macrovascular involvement, while microvascular invasion is conventionally confirmed by postoperative pathological examination. Nowadays, though technically immature, several advanced methods have been developed to predict vascular invasion in HCC patients . The further maturity of relevant technologies could possibly bring breakthroughs to clinical practice.…”

Section: Discussioncontrasting

confidence: 65%

The power of tumor sizes in predicting the survival of solitary hepatocellular carcinoma patients

et al. 2018

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BackgroundVascular invasion, rather than tumor size, was applied into the 7th edition of the AJCC TNM staging system to predict survival of solitary hepatocellular carcinoma (HCC) patients. However, does this mean tumor size is of little value in prognostic prediction? The current study was designed to explore the prognostic ability of tumor sizes in solitary HCC.MethodsA total of 18 591 patients with solitary HCC categorized as T1 and T2 were retrieved from the Surveillance Epidemiology and End Results (SEER) database. The Cox proportional hazards regression model was adopted to evaluate the impact of tumor sizes on overall survival (OS) and disease‐specific survival (DSS) in general and in subgroups stratified by vascular invasion and surgery type.ResultsLarge tumor sizes (>39 mm) were associated with unfavorable clinicopathologic characteristics. Compared with tumors ≤30 mm, tumors between 31‐50 mm and tumors >50 mm showed significantly worse OS and DSS in general using multivariate analysis (all P < 0.001). In subgroup analyses, for patients without vascular invasion, tumor size was a notable prognostic indicator for OS in the radiofrequency ablation group (P < 0.001), rather than in the liver resection or transplantation group. Nevertheless, for patients with vascular invasion, tumor sizes exhibited a notable impact on OS in the liver resection and transplantation group.ConclusionsThe AJCC TNM staging system for solitary HCC would be more comprehensive if tumor sizes were integrated into the T2 classification. Additionally, for T1 patients, tumor sizes play no role in the choice between resection and transplantation.

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Section: Discussioncontrasting

confidence: 65%

The power of tumor sizes in predicting the survival of solitary hepatocellular carcinoma patients

et al. 2018

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“…The transmission and dissemination route require passage through the portal venous system and are intimately associated with the tendency towards venous invasion (25). v) Baheti et al (26) reported that the invasion rate of liver cancer was greater in the hepatic portal veins than in the intrahepatic veins, and greater in the intrahepatic veins than in the hepatic arteries. They also suggested that liver cancer is mainly supplied by blood from the hepatic arteries, with the hepatic portal veins supplying only a small percentage of the blood.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging evaluation of characteristics of vascular invasion in intermediate and advanced hepatic alveolar echinococcosis

et al. 2019

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The objective of the present study was to provide a basis for the personalized treatment of intermediate and advanced hepatic alveolar echinococcosis (HAE) by elucidating the characteristics of vascular invasion and lesion growth. A total of 160 patients with intermediate and advanced HAE who were subjected to plain as well as contrast-enhanced 3.0-T magnetic resonance imaging prior to surgery were analyzed. Pathological and intra-operative observations of the subjects were also considered. The size and location of HAE lesions, vascular invasion characteristics and growth patterns were assessed. A total of 78 patients (48.75%) had lesions involving the S5-8 segment/partial right liver lobe, 21 (13.13%) had involvement in the S2-4 segment/partial left liver lobe and 61 (38.13%) had lesions that transcended the left and right liver lobes. Pathological examination revealed that the vascular invasion rates of the hepatic portal veins, intrahepatic veins (left, central and right vein, and inferior vena cava) and hepatic arteries were 51.88, 43.28 and 26.87%, respectively. Liver hilum invasion was observed in 128 patients (80.00%), 71 of which (44.38%) presented with invasion of the primary porta hepatis, 11 (6.88%) with invasion of the secondary porta hepatis and 46 (28.75%) with invasion of the primary as well as the secondary porta hepatis. In conclusion, the growth pattern of intermediate and advanced HAE is determined by the site, blood supply and activity of the lesion. The current study demonstrated that lesions tend to invade the intrahepatic venous system and porta hepatis, and to target veins rather than arteries.

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“…These advancements in imaging for MVI diagnosis have allowed for the transition from relying on subjective qualitative radiologic features to the more accurate quantitative radiomics analysis. This has been achieved via the modeling of simple sequences or techniques and the combination of multiple indexes and different techniques with clinical biomarkers, which has greatly improved the diagnostic efficiency of MVI ( 10 - 12 ). However, although the studies in this field have achieved excellent results, there is still no consistent imaging criteria for MVI diagnosis, which greatly impedes its clinical application.…”

Section: Introductionmentioning

confidence: 99%

Preoperative prediction of microvascular invasion: new insights into personalized therapy for early-stage hepatocellular carcinoma

Wang,

Liao,

Chen

et al. 2024

Quant Imaging Med Surg

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Owing to advances in diagnosis and treatment methods over past decades, a growing number of early-stage hepatocellular carcinoma (HCC) diagnoses has enabled a greater of proportion of patients to receive curative treatment. However, a high risk of early recurrence and poor prognosis remain major challenges in HCC therapy. Microvascular invasion (MVI) has been demonstrated to be an essential independent predictor of early recurrence after curative therapy. Currently, biopsy is not generally recommended before treatment to evaluate MVI in HCC according clinical guidelines due to sampling error and the high risk of tumor cell seeding following biopsy. Therefore, the postoperative histopathological examination is recognized as the gold standard of MVI diagnosis, but this lagging indicator greatly impedes clinicians in selecting the optimal effective treatment for prognosis. As imaging can now noninvasively and completely assess the whole tumor and host situation, it is playing an increasingly important role in the preoperative assessment of MVI. Therefore, imaging criteria for MVI diagnosis would be highly desirable for optimizing individualized therapeutic decision-making and achieving a better prognosis. In this review, we summarize the emerging image characteristics of different imaging modalities for predicting MVI. We also discuss whether advances in imaging technique have generated evidence that could be practice-changing and whether advanced imaging techniques will revolutionize therapeutic decision-making of early-stage HCC.

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Clinical implications for imaging of vascular invasion in hepatocellular carcinoma

Cited by 11 publications

References 67 publications

The power of tumor sizes in predicting the survival of solitary hepatocellular carcinoma patients

The power of tumor sizes in predicting the survival of solitary hepatocellular carcinoma patients

Magnetic resonance imaging evaluation of characteristics of vascular invasion in intermediate and advanced hepatic alveolar echinococcosis

Preoperative prediction of microvascular invasion: new insights into personalized therapy for early-stage hepatocellular carcinoma

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