Overview of Functional Imaging Techniques for Liver Malignancies in Current Clinical Practice or in a Very Near Future

Luna, Antonio; Cunha, Guilherme Moura; Sánchez, R. Sánchez; Rodrı́guez-Fernández, Antonio

doi:10.1007/978-3-642-40582-2_16

Cited by 2 publications

(2 citation statements)

References 110 publications

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“…The liver plays a role in metabolism, synthesis, secretion, immunity, and many other functions (Luna et al 2014). Liver disease, including cirrhosis, fibrosis and tumors, can disrupt the functions of the liver by altering the biomechanical properties of the tissue, most notably by changing the tissue stiffness (Sandrasegaran 2014, Li et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Estimation and validation of patient-specific liver elasticity distributions derived from 4DMR for radiotherapy purposes

Hasse¹,

Han²,

Neylon³

et al. 2018

Biomed. Phys. Eng. Express

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Liver diseases, such as liver cancer and cirrhosis, are commonly associated with changes in the biomechanical properties of liver tissue. Functional imaging techniques such as elastography have shown great promise in measuring the biomechanical properties of liver tissue; however, current liver elastography techniques require additional equipment that is conventionally not available within the radiotherapy setup. We present a novel methodology for estimating liver elasticity derived from deformation observed during 0.35 T 4DMR ViewRay (MRIdian System™, ViewRay™, Cleveland, OH, USA) scans within a radiotherapy setup. Phase 1 and phase 8 datasets, categorized by diaphragm position, were first deformably registered. The resulting displacement maps were considered groundtruth. A GPU-based biomechanical model was then assembled from the segmented phase 8 liver dataset and, along with patient-specific boundary constraints, used to iteratively solve for the liver elasticity distribution. The liver elastography process presented here was performed for a set of 11 4DMR patients. Maximum liver deformation was observed to be between 3.99 and 9.04 mm. On average, 95% convergence within 1 mm was observed. A validation study using phase 4 liver datasets illustrated an accuracy of 86%. Normalized cross-correlation quantified high similarity between the results of the estimation and validation studies with their respective ground-truths. Overall, the results suggest that liver elasticity can be measured with approximately 95% convergence using 4DMR scans acquired within the radiotherapy workflow, indicating the potential for the implementation of liver elastography within the clinic.

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Section: Introductionmentioning

confidence: 99%

Estimation and validation of patient-specific liver elasticity distributions derived from 4DMR for radiotherapy purposes

Hasse¹,

Han²,

Neylon³

et al. 2018

Biomed. Phys. Eng. Express

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“…Gd-EOB-DTPA works as a liver-specific contrast agent allowing for both dynamic imaging and hepatobiliary phase imaging [109]. Gd-EOB-DTPA is taken up by hepatocytes and undergoes hepatobiliary excretion.…”

Section: Hepatocellular Agentsmentioning

confidence: 99%

Magnetic resonance characterisation of developing hepatocellular carcinoma in a diet induced model of liver cancer in the rat

Alghamdi¹

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Non-alcoholic fatty liver disease (NAFLD), a disorder associated with abnormal lipid accumulation within hepatocytes, is considered benign disorder in nature. However, in some cases it may progress to inflammation, nonalcoholic steatohepatitis (NASH), then cirrhosis, precancerous nodules and finally to hepatocellular carcinoma (HCC). NAFLD and NASH are both reversible with appropriate clinical intervention and lifestyle changes. In developed countries, the non-alcoholic fatty liver disease (NAFLD) is becoming one of the most common causes of precancerous and HCC lesions [1]. Unfortunately, most nodular lesions are detected too late with a poor prognosis. The discovery of markers that can predict which livers may progress to HCC would allow early intervention and potentially halting progress to HCC. This would be of great benefit at any stage up to precancerous lesions, however the earlier the better.Development of end stage liver malignancy would be decreased, resulting in decreased mortality from this disease.Histology is considered the reference standard for the assessment of fatty disease and nodular lesion in liver. However, there are significant drawbacks including invasiveness, small sample size and observer-dependence which limits its usefulness in evaluating liver disease.Magnetic resonance imaging is a non-invasive modality that can provide information on anatomical and physiological changes in the liver (e.g. fatty liver disease and HCC). MRI images are primarily assessed visually by expert radiologists looking for anatomical and contrast changes in the images compared to normal tissue. This qualitative method requires inspection of all datasets for abnormalities. Visual interpretation is subjective, labour intensive, and depends on the experience of the radiologist. This can introduce inter-observer variation and is suitable only when the pathology leads to sufficient contrast changes in the images acquired.MRI also allows the calculation of quantitative parameters like T1, T2 and diffusion values. These parameters are dependent on physical, chemical and microstructural properties of the tissue. When standard protocols are used, the calculation of these parameters should be independent of the observer. This has the potential for more precise characterization of changes that occur over time. Clinically, here has been limited utilization of these methods, as they generally require longer acquisition times and significant post processing of the images. Declaration by authorThis thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text.

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Overview of Functional Imaging Techniques for Liver Malignancies in Current Clinical Practice or in a Very Near Future

Cited by 2 publications

References 110 publications

Estimation and validation of patient-specific liver elasticity distributions derived from 4DMR for radiotherapy purposes

Estimation and validation of patient-specific liver elasticity distributions derived from 4DMR for radiotherapy purposes

Magnetic resonance characterisation of developing hepatocellular carcinoma in a diet induced model of liver cancer in the rat

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