Radioembolization for Hepatocellular Carcinoma in Downstaging and Bridging for Liver Transplantation

Kutlu, Ramazan; Karatoprak, Sinan

doi:10.1007/s12029-020-00492-y

Cited by 11 publications

(7 citation statements)

References 18 publications

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“…The inclusion criteria of patients were as follows. The clinical symptoms and histopathological examination results of the patients were in line with the diagnostic criteria for PHC formulated in PHC Diagnosis and Treatment Standards (Edition 2011) [ 18 ]. The patients were willing to undergo a DCE-MRI examination, and they all had the first-time onset.…”

Section: Methodsmentioning

confidence: 73%

Artificial Intelligence Algorithm in Classification and Recognition of Primary Hepatic Carcinoma Images under Magnetic Resonance Imaging

Huang

Liao

et al. 2022

Contrast Media & Molecular Imaging

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This study aimed to discuss the application value of the bias field correction algorithm in magnetic resonance imaging (MRI) images of patients with primary hepatic carcinoma (PHC). In total, 52 patients with PHC were selected as the experimental group and divided into three subgroups: mild (15 cases), moderate (19 cases), and severe (18 cases) according to pathological grading. Another 52 patients with hepatic nodules in the same period were included in the control group. All the patients underwent dynamic contrast-enhanced (DCE) MRI examination, and the image qualities of MRI before and after bias field correction were compared. The DCE-MRI perfusion parameters were measured, including the transport constant Ktrans, reverse rate constant Kep, extravascular extracellular volume fraction (Ve), plasma volume (Vp), microvascular density (MVD), hepatic artery perfusion index (HPI), mean transit time of contrast agent (MTT), time to peak (TTP), blood volume (BV), hepatic arterial perfusion (HAP), full perfusion (FP), and portal venous perfusion (PVP). It was found that the sensitivity (93.63%), specificity (71.62%), positive predictive value (95.63%), negative predictive value (71.62%), and accuracy (90.01%) of MRI examination processed by the bias field correction algorithm were all significantly greater than those before processing P < 0.05 . The Ktrans, Kep, Ve, Vp, and MVD of patients in the experimental group were significantly larger than those of the control group, and severe group> moderate group> mild group P < 0.05 . HPI, MTT, TTP, BV, and HAP of patients in the experimental group were also significantly greater than those of the control group, which was shown as severe group > moderate group > mild group P < 0.05 . FP and PVP of the experimental group were significantly lower than those of the control group, and severe group < moderate group < mild group P < 0.05 . It was suggested that in MRI images of patients with PHC, the bias field correction algorithm could significantly improve the diagnosis rate. Each perfusion parameter was related to the pathological grading, which could be used to evaluate the prognosis of patients.

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Section: Methodsmentioning

confidence: 73%

Artificial Intelligence Algorithm in Classification and Recognition of Primary Hepatic Carcinoma Images under Magnetic Resonance Imaging

Huang

Liao

et al. 2022

Contrast Media & Molecular Imaging

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“…[19][20][21] However, in the context of huge HCC in the cirrhotic liver, treatment options include liver resection, TACE, TARE and targeted therapy. [22][23][24][25] The current literature showed that in carefully selected patients with huge HCC would benefit from liver resection as upfront treatment approach. 10,[26][27][28] Likewise, several comparative studies documented the superiority of liver resection for huge HCC compared with TACE regarding overall and recurrence-free survival.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and safety of liver resection for huge hepatocellular carcinoma in cirrhotics

Aldardeer

El‐Badry

2021

Int Surg J

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Background: With the current high incidence of hepatocellular carcinoma (HCC), more patients even with large and huge HCC are considered for liver resection.Methods: Medical records of consecutive adult cirrhotic patients who underwent partial hepatectomy for huge HCC (≥10 cm, huge HCC group) versus small HCC (<5 cm, small HCC group) at Sohag university hospital (January 2016 to December 2020) were analyzed. Both groups were compared regarding postoperative morbidity and risk of mortality following post hepatectomy liver failure (PHLF) as defined by the 50-50 criteria (50% mortality occurs among patients who developed increased plasma bilirubin >50 μml/l and reduced prothrombin activity <50% on postoperative day 5 (POD-5).Results: Thirty two patients were enrolled (16 per group), with median age of 56 (range 38-81) years, 22 were males. In correlation with resection of more liver segments in the huge HCC group, post hepatectomy alteration of liver functions (bilirubin rise and reduction of albumin and prothrombin concentration) was significantly pronounced among patients who had resection for huge compared with small HCC (p<0.05). Huge HCC group exhibited significantly worse postoperative complication score (p< 0.05) and needed significantly prologed periods of hospital stay (p<0.05). Concurrent persistence of PHLF and thrombocytopenia until POD-5 occurred in 3 patients (2 with huge HCC and 1 with small HCC). Among those patients, only one from huge HCC group died (mortality 6%) postoperatively.Conclusions: Liver resection provides safe and effective treatment strategy for carefully selected cirrhotic patients with huge HCC.

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“…Bridging procedures are neoadjuvant therapeutic options that will prevent disease progression during the waiting time on the list and will prevent drop out of the patients with HCC[ 8 ]. Downstaging procedures are performed to the tumors that are beyond Milan criteria to downstage them to the limits of the Milan criteria or to United Organ Sharing (UNOS) T2 stage[ 48 , 80 ]. The studies have shown that LT for tumors already within Milan criteria and tumors downstaged to Milan criteria show similar results[ 81 , 82 ].…”

Section: The Bridging and Downstaging Proceduresmentioning

confidence: 99%

Liver transplantation for hepatocellular carcinoma: Historical evolution of transplantation criteria

Ince¹,

Şahin²,

Akbulut³

et al. 2022

World J Clin Cases

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Liver transplantation (LT) for hepatocellular carcinoma is still a hot topic, and the main factor that is associated with the success of treatment is to determine the patients who will benefit from LT. Milan criteria have been defined 25 years ago and still is being used for patient selection for LT. However, in living donor LT, the Milan criteria is being extended. Current criteria for patient selection do not only consider morphologic characteristics such as tumor size and number of tumor nodules but also biologic markers that show tumor aggressiveness is also being considered. In the present review article, we have summarized all the criteria and scoring systems regarding LT for hepatocellular carcinoma. All criteria have 5-year overall survival rates that were comparable to the Milan Criteria and ranged between 60%-85%. On the other hand, it was seen that the recurrence rates had increased as the Milan criteria were exceeded; the 5-year recurrence rates ranged between 4.9% to 39.9%. Treatment of hepatocellular carcinoma needs a multidisciplinary approach. Ideal selection criteria are yet to be discovered. The same is true for treatment modalities. The goal will be achieved by a harmonic interplay between basic science researchers and clinicians.

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Radioembolization for Hepatocellular Carcinoma in Downstaging and Bridging for Liver Transplantation

Cited by 11 publications

References 18 publications

Artificial Intelligence Algorithm in Classification and Recognition of Primary Hepatic Carcinoma Images under Magnetic Resonance Imaging

Artificial Intelligence Algorithm in Classification and Recognition of Primary Hepatic Carcinoma Images under Magnetic Resonance Imaging

Feasibility and safety of liver resection for huge hepatocellular carcinoma in cirrhotics

Liver transplantation for hepatocellular carcinoma: Historical evolution of transplantation criteria

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