Perfusion Computed Tomographic Assessment of Early Hepatocellular Carcinoma in Cirrhotic Liver Disease

Abstract

Preliminary results suggest that in patients with cirrhosis and early HCC, perfusion CT is a feasible technique for noninvasive assessment of tumor vascularity.

Viable residual tumor tissue after radiofrequency ablation treatment in hepatocellular carcinoma: evaluation with CT perfusion

“…The differences of the cited parameters were statistically significant (P < 0.001), with the only exception of BV. As also reported in our previous studies [15,16], AP (the arterial fraction of blood flow) could be the most representative perfusion parameters for the evaluation of residual tumor-associated neoangiogenesis. Indeed, AP is directly related to the presence of residual or new arterial unpaired vessels within the ablated area, which sustain tumor regrowth after treatment.…”

“…Tissue enhancement depends on tissue iodine concentration and therefore is an indirect reflection of tissue vascularity and vascular physiology [13]. In recent years, CT-p has been shown to provide information useful for lesion characterization and assessment of tumor grade, providing an in vivo marker of neoangiogenesis [12,15]. Other studies have recently evaluated the potential usefulness of CT-p even for therapy monitoring, both after antiangiogenic drugs and transarterial chemoembolization (TACE) in several neoplastic diseases like HCC [13,[16][17][18][19].…”

Functional imaging techniques in hepatocellular carcinoma

“…Preliminary studies have shown that vascularization decreases with TACE treatment [42,46] and with targeted agents such as bevacizumab [47,48], with remaining viable tumour showing higher flow values [41] These changes may occur 10-12 days after treatment initiation and higher baseline extraction fraction may be found in responders [47]. The technique was reproducible with good correlation between repeat examinations (r00.9, p<0.01) in a small number of patients (n04) in one study [39].…”

“…Arterial blood flow was high with a sensitivity and specificity of detection of 86% and 65% within 11 weeks of tumour induction even though only 7% was visible by eye [38]. A small number of singlecentre human studies have shown the feasibility of DCE CT in HCC for detection and vascular response assessment [39][40][41][42][43][44][45][46][47]. HCC typically shows an increase in arterial liver perfusion (Fig.…”

Early Dynamic 18F-FDG PET to Detect Hyperperfusion in Hepatocellular Carcinoma Liver Lesions

“…However, this procedure is often used to help confirm liver transplant eligibility by excluding extrahepatic tumor (16,17).…”