Sequential Hemodynamic Change in Hepatocellular Carcinoma and Dysplastic  Nodules

Tajima, Tsuyoshi; Honda, Hiroshi; Taguchi, Kenichi; Asayama, Yoshiki; Kuroiwa, Takeharu; Yoshimitsu, Kengo; Irié, Hiroyuki; Aibe, Hitoshi; Shimada, Mitsuo; Masuda, Kouji

doi:10.2214/ajr.178.4.1780885

Cited by 143 publications

(103 citation statements)

References 32 publications

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“…The results obtained by ultra-fast MR perfusion scanning are consistent with those by invasive methods of CTAP or CTHA [18] . Moreover, hepatic artery segment of the perfusion curve in nodules declined slightly compared with surrounding parenchyma at the stage of HGDN and early HCC, suggesting that the preexisting hepatic artery is destructed in nodules.…”

Section: Discussionsupporting

confidence: 80%

Assessment of hemodynamics in precancerous lesion of hepatocellular carcinoma: Evaluation with MR perfusion

Guan

Zhao

Zhou

et al. 2007

WJG

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Section: Discussionsupporting

confidence: 80%

Assessment of hemodynamics in precancerous lesion of hepatocellular carcinoma: Evaluation with MR perfusion

Guan

Zhao

Zhou

et al. 2007

WJG

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“…The most sensitive modality capable of objectively depicting the early carcinogenesis process among currently available imaging systems is (1) CTAP, followed by (2) CTHA [239,240], (3) CEUS [241][242][243], and (4) SPIO-enhanced MRI [225,244]. Portal blood flow may be maintained in some cases of DN and early HCC but reduced in other nodules, although the pathology remains because of early HCC, in which arterial blood flow has not yet increased.…”

Section: Diagnostic Algorithm Of Hypovascular Hccmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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“…Li et al (12) and Ippolito et al (13) found that CT could provide sufficient information on tumor-related vessels and thus can be a good tool for evaluating the degree of tumor vascularization. Blood supply from hepatic artery and portal vein can be relatively insufficient during the rapid growth of HCC; as a result, the new vessels continuously form around the tumor, leading to the formation of tumors with good blood supply (14,15). The degree of arterial-phase enhancement on CT or MRI may be an important marker of tumor vascularization.…”

Section: Discussionmentioning

confidence: 99%

Arterial blood supply of hepatocellular carcinoma is associated with efficacy of sorafenib therapy

Zhang¹,

Zhu²,

Li³

et al. 2015

Hepatoma Res

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Results: Among these 38 patients [35 (92.1%) were males] treated with sorafenib, the median age was (53.3±11.1) years. Tumors in 17 patients had good arterial supply while those in the remained 21 patients had poor arterial supply. The median survival time (MST) was 10.7 months (95% CI, 8.7-12.7) and the 1-year overall survival (OS) was 41.0%. The MST and 1-year OS in patients with tumors with good arterial supply were 12 months (range, 4-20 months) and 52.9%, respectively, compared with those of 7 months (range, 1-16 months) and 23.8% in patients with tumors with poor arterial supply (P=0.002). Patients with BCLC stage B tumors had longer MST and higher OS than those with BCLC stage C tumors, although the differences were not statistically significant.Multivariate analysis showed that arterial supply of tumors remained statistically predictive for OS (HR =0.22; 95% CI, 0.07-0.67; P=0.008).Conclusions: Arterial blood supply is an independent predictor for survival in HCC patients treated with sorafenib, and patients with tumors with good arterial supply benefit more than those with tumors with poor arterial supply.Keywords: Hepatocellular carcinoma (HCC); sorafenib; arterial blood supply Submitted Dec 05, 2014. Accepted for publication Dec 05, 2014Dec 05, . doi: 10.3978/j.issn.2305Dec 05, -5839.2015 View this article at: http://dx.doi.org/10.3978/j.issn. 2305-5839.2015.10.24 Introduction Hepatocellular carcinoma (HCC) is a clinically common disease. As the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections increases worldwide, the incidence of HCC also gradually rise. HCC is now the third leading cause of cancer deaths (1). Only about 15% of HCC have a chance to be cured by surgery (e.g., liver resection or transplantation) or minimally invasive local treatment (e.g., radiofrequency ablation). For HCC at advanced stages, radical treatment is impossible and multidisciplinary treatment may be more feasible (2).As a multiple kinase inhibitor, sorafenib can selectively inhibit the vascular endothelial growth factor 2/plateletderived growth factor receptor pathway to prevent tumor angiogenesis and meanwhile suppress cell proliferation by targeting the mitogen-activated protein kinase signaling pathway. Two global phase III clinical trials [SHARP (3) and Asia-Pacific trial (4)] have demonstrated that sorafenib can improve the prognosis of patients with advanced HCC. Among studies focusing on the prognostic factors of HCC patients treated with sorafenib, many of them found that the prognosis of these patients may be associated with the computed tomography (CT) and magnetic resonance imaging (MRI) features (5-10). Hahn et al. (6) found that the area under the contrast concentration vs. time curve 90 s after contrast injection (IAUC90) and the volume transfer constant of contrast agent (Ktrans) are pharmacodynamic biomarkers for sorafenib. Hsu et al. (7) also found that, among the prognostic factors of HCC patients receiving sorafenib and tegafur/uracil treatment, Ktrans was closely cor...

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Sequential Hemodynamic Change in Hepatocellular Carcinoma and Dysplastic Nodules

Abstract: During hepatocarcinogenesis, most hepatocellular nodules show deterioration of arterial blood flow before loss of portal blood flow. Vascular imaging of hepatic nodules may predict malignant abnormality via the early loss of hepatic arterial flow seen before portal flow changes.

Cited by 143 publications

References 32 publications

Assessment of hemodynamics in precancerous lesion of hepatocellular carcinoma: Evaluation with MR perfusion

Assessment of hemodynamics in precancerous lesion of hepatocellular carcinoma: Evaluation with MR perfusion

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Arterial blood supply of hepatocellular carcinoma is associated with efficacy of sorafenib therapy

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