Is surgical resection still the treatment of choice for early hepatocellular carcinoma?

Burak, Kelly W.; Bathe, Oliver F.

doi:10.1002/jso.21765

Cited by 4 publications

(1 citation statement)

References 6 publications

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“…Obwohl Transplantation oder Resektion beim operablen Patienten die Therapie der Wahl bleibt, sollte RFA bei kleinen Tumoren und erhöhtem Operationsrisiko als Alternative zur Operation diskutiert werden [29]. Die Wertigkeit der Mikrowellen-Koagulation und Laser-induzierten Thermotherapie (LITT) ist noch nicht hinreichend belegt [30].…”

Section: Lokalablative Verfahrenunclassified

Frühdiagnose, Staging und neue Therapieoptionen

Geier¹,

Schadde²,

Müllhaupt³

2012

MMW - Fortschritte der Medizin

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Section: Lokalablative Verfahrenunclassified

Frühdiagnose, Staging und neue Therapieoptionen

Geier¹,

Schadde²,

Müllhaupt³

2012

MMW - Fortschritte der Medizin

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Liver segmentation in contrast enhanced CT data using graph cuts and interactive 3D segmentation refinement methods

et al. 2012

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Purpose: Liver segmentation is an important prerequisite for the assessment of liver cancer treatment options like tumor resection, image-guided radiation therapy (IGRT), radiofrequency ablation, etc. The purpose of this work was to evaluate a new approach for liver segmentation. Methods: A graph cuts segmentation method was combined with a three-dimensional virtual reality based segmentation refinement approach. The developed interactive segmentation system allowed the user to manipulate volume chunks and=or surfaces instead of 2D contours in crosssectional images (i.e, slice-by-slice). The method was evaluated on twenty routinely acquired portal-phase contrast enhanced multislice computed tomography (CT) data sets. An independent reference was generated by utilizing a currently clinically utilized slice-by-slice segmentation method. After 1 h of introduction to the developed segmentation system, three experts were asked to segment all twenty data sets with the proposed method. Results: Compared to the independent standard, the relative volumetric segmentation overlap error averaged over all three experts and all twenty data sets was 3.74%. Liver segmentation required on average 16 min of user interaction per case. The calculated relative volumetric overlap errors were not found to be significantly different [analysis of variance (ANOVA) test, p ¼ 0.82] between experts who utilized the proposed 3D system. In contrast, the time required by each expert for segmentation was found to be significantly different (ANOVA test, p ¼ 0.0009). Major differences between generated segmentations and independent references were observed in areas were vessels enter or leave the liver and no accepted criteria for defining liver boundaries exist. In comparison, slice-by-slice based generation of the independent standard utilizing a live wire tool took 70.1 min on average. A standard 2D segmentation refinement approach applied to all twenty data sets required on average 38.2 min of user interaction and resulted in statistically not significantly different segmentation error indices (ANOVA test, significance level of 0.05). Conclusions: All three experts were able to produce liver segmentations with low error rates. User interaction time savings of up to 71% compared to a 2D refinement approach demonstrate the utility and potential of our approach. The system offers a range of different tools to manipulate segmentation results, and some users might benefit from a longer learning phase to develop efficient segmentation refinement strategies. The presented approach represents a generally applicable segmentation approach that can be applied to many medical image segmentation problems.

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Stage IV malignant melanoma of unknown primary site in a young man

Christopoulos¹,

Doulias

Koutelidakis³

et al. 2012

BMJ Case Reports

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Metastatic melanoma of unknown primary is a rare entity with low life expectancy. Inoperable metastatic malignant melanoma in lungs has a survival rate of <6%. Regression of the primary lesion is a well-documented theory in the literature, since melanoma is one of the tumours that can undergo regression. We present a case of a young man with metastatic malignant melanoma in lungs, whose survival duration is longer than expected even without metastasectomy.

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Is surgical resection still the treatment of choice for early hepatocellular carcinoma?

Cited by 4 publications

References 6 publications

Frühdiagnose, Staging und neue Therapieoptionen

Frühdiagnose, Staging und neue Therapieoptionen

Liver segmentation in contrast enhanced CT data using graph cuts and interactive 3D segmentation refinement methods

Stage IV malignant melanoma of unknown primary site in a young man

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