Hepatic perfusion changes in patients with liver metastases: comparison with those patients with cirrhosis.

Leen, Edward; Goldberg, J. A.; Anderson, John R.; Robertson, John; Moule, B.; Cooke, Timothy G.; McArdle, C. S.

doi:10.1136/gut.34.4.554

Cited by 101 publications

(75 citation statements)

References 16 publications

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“…22 Recently, some studies pointed out the importance of dynamic CT scan approaches, especially using Ultrafast CT for the evaluation of hepatic perfusion changes in patients with liver diseases. 23,24 The use of a dynamic CT scan indeed allowed us to calculate the respective contribution of arterial and portal blood flow in delimited areas of the rat liver. In our experimental model of DEN-induced HCCs, we showed that, as reported for human HCCs, 20,25 the tumor vascularization was mostly dependent on the hepatic artery (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Enhanced in vivo adenovirus-mediated gene transfer to rat hepatocarcinomas by selective administration into the hepatic artery

et al. 1998

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Adenovirus-mediated gene therapy of experimental hepaarterial blood supply, 67% of the total liver blood supply. tocarcinoma is hindered by low transduction efficacy in Compared with intraportal administration, arterial injection vivo. We evaluated the extent of gene expression following improved gene transfer into tumors whereas that to the various routes of administration of recombinant adenovirus non-tumor areas was diminished. In addition, this route of AdCMVlacZ in diethylnitrosamine-induced rat hepatocarciinjection allowed the efficient transduction of dysplastic noma. We first characterized the vascularization of dinodules. Diethylnitrosamine-induced hepatocarcinoma in ethylnitrosamine-induced hepatocarcinomas using a comrats is a relevant model for the study of human hepatocarputerized tomography scanner approach. The efficacy of cinoma due to its vascularization. Arterial infusion gene transfer was then evaluated by three routes of adminimproved the ratio of transduced tumorous to nontumorous istration: intraportal, selective injection through the hepatic cells and allowed targeting of gene transfer to dysplastic artery and direct injection into the tumor. Diethylnitronodules. This will be useful in the design of gene therapy samine-induced hepatocarcinomas had predominantly an for hepatocarcinoma.

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Section: Discussionmentioning

confidence: 99%

Enhanced in vivo adenovirus-mediated gene transfer to rat hepatocarcinomas by selective administration into the hepatic artery

et al. 1998

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“…Haemodynamic derangement is detectable in patients with a very small hepatic tumour burden and is little affected by resection of the primary colorectal tumour. Also, comparison of the portal venous congestive index (ratio of cross-sectional area to blood velocity) in patients with liver metastases and those with hepatic cirrhosis suggests that the reduction in portal flow in the former is due to increased gastrointestinal rather than intrahepatic vascular resistance (Leen et al, 1993b). The existence of a humoral mediator would raise the possibility of biochemical detection of micrometastic disease.…”

Section: Discussionmentioning

confidence: 99%

Splanchnic blood flow changes in the presence of hepatic tumour: evidence of a humoral mediator

Carter

Anderson²,

Cooke³

et al. 1994

Br J Cancer

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Summary Intrahepatic tumour is associated with alterations in splanchnic haemodynamics. To investigate the hypothesis that these are the result of a circulating vasoactive agent, rat small bowel segments were cross-perfused with arterial blood from groups (n = 12) of paired tumour-bearing (intrahepatic HSN sarcoma) and control rats. The vascular resistance of the segment was significantly greater during perfusion by tumour-bearing animals (91.6 mmHg ml-' min, s.e. 21.5, vs 51.7 mmHg ml-'min, s.e. 7.4, P<0.05), suggesting that intrahepatic tumour may be associated with a circulating vasoactive agent. A similar mechanism may underlie changes in the hepatic perfusion index in patients with liver metastases.There has been interest for several years in the haemodynamic changes that accompany the development of liver metastases from colorectal carcinoma, and their potential role-in identifying patients with occult metastatic disease. In 1985, Leveson et al. reported that the hepatic perfusion index (HPI), the ratio of hepatic arterial to total liver blood flow as measured by dynamic scintigraphy, was abnormally elevated in patients with colorectal liver metastases. This occurred both in patients with overt metastases and in those who, despite having an ostensibly normal liver at the time of primary surgery, manifested hepatic tumour within 1 year of follow-up. We have recently confirmed these findings using the more direct and quantitative technique of duplex ultrasonography (Leen et al., 1991;1993a).The mechanisms underlying this effect are unknown. Liver metastases derive their blood supply predominantly from the hepatic artery (Breedis & Young, 1954), and initially it was assumed that the primary change was an increase in hepatic arterial flow to meet demand from rapidly growing tumour tissue. Quantitative flowmetry has confirmed that hepatic arterial flow is increased, but has shown that a substantial reduction in portal venous blood flow also contributes to the elevation of the perfusion index (Leen et al., 1991). Experiments in rat liver tumour models have demonstrated a similar rise in the HPI that is due entirely to reduced portal venous inflow secondary to increased splanchnic vascular resistance (Nott et al., 1989;Hemingway et al., 1991;1993). This suggests that the means by which the tumour influences hepatic haemodynamics may not be purely local in nature. In the present study we cross-perfused normal rat bowel segments with blood from tumour-bearing and control rats, to investigate the hypothesis that the increase in splanchnic vascular resistance is due to a circulating vasoactive agent.Materials and methods Tumour was induced in male hooded Lister rats (200-250 g) by bilobar intrahepatic injection of 106 HSN sarcoma cells. Experiments were performed 3 weeks later, when discrete tumours were apparent. In a given experiment, one such animal, together with a weight-matched normal control rat, provided arterial blood to perfuse the intestine of a third (normal) rat.The experimental arrangement is shown in F...

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“…Despite promising reports, current nuclear medicine techniques are limited by their low spatial and temporal resolution. Hepatic blood flow can also be measured with Doppler ultrasonography (8). This noninvasive and inexpensive method is widely available and can be safely repeated.…”

mentioning

confidence: 99%

Assessment of hepatic perfusion parameters with dynamic MRI

Materne

Smith

Peeters

et al. 2001

Magnetic Resonance in Med

213

247

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Hepatic perfusion changes in patients with liver metastases: comparison with those patients with cirrhosis.

Cited by 101 publications

References 16 publications

Enhanced in vivo adenovirus-mediated gene transfer to rat hepatocarcinomas by selective administration into the hepatic artery

Enhanced in vivo adenovirus-mediated gene transfer to rat hepatocarcinomas by selective administration into the hepatic artery

Splanchnic blood flow changes in the presence of hepatic tumour: evidence of a humoral mediator

Assessment of hepatic perfusion parameters with dynamic MRI

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