Trends in Utilization of Transarterial Treatments for Hepatocellular Carcinoma: Results of a Survey by the Italian Society of Interventional Radiology

Bargellini, Irene; Florio, F; Golfieri, Rita; Grosso, Maurizio; Lauretti, Dario Luca; Cioni, Roberto

doi:10.1007/s00270-013-0656-5

Cited by 49 publications

(34 citation statements)

References 29 publications

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“…In clinical practice, there is wide variation in the management of these patients. Single large nodules can be treated effectively by surgical resection, downstaging followed by LT (in highly selected patients), or by combining TACE and RFA [42]. Alternatively, patients with extensive tumor involvement might not benefit from TACE and should be considered as advanced-stage HCC patients [43,44].…”

Section: Intermediate Stagementioning

confidence: 98%

Imaging in Hepatocellular Carcinoma: Radiologic Assessment

Bargellini¹,

Battaglia²,

Caramella³

et al. 2015

An Information Technology Framework for Predictive, Preventive and Personalised Medicine

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In the context of Predictive, Preventive and Personalized Medicine (PPPM), radiologists play an essential role in patient management throughout the different phases of hepatocellular carcinoma (HCC). This includes diagnosis, staging, treatment planning, and evaluation of response to treatment. This chapter provides an in-depth examination of the fundamental pathophysiologic mechanisms underlying the radiologic diagnosis and assessment of HCC. Observations made in contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI), in conjunction with alpha-fetoprotein (AFP) can allow the diagnosis of HCC to be made with confidence without the need for biopsy, in many cases. Treatment decisions and prognosis are strongly influenced by the tumor extension, the number and size of lesions, tumor location, biliary dilatation, ascites, and the presence of macrovascular invasion and extrahepatic tumor spread. In addition, radiologic assessment of co-morbidities and response to previous treatments must be included in the overall assessment. The patient-specific findings from diagnostic imaging and interventional radiology identified in this chapter will be designated as Information Entities (IEs) in later chapters. These IEs will ultimately be used in the generation of Digital Patient Models (DPMs) to facilitate diagnosis, prognosis, and treatment selection, i.e. Model Guided Therapy (MGT) and PPPM.

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Section: Intermediate Stagementioning

confidence: 98%

Imaging in Hepatocellular Carcinoma: Radiologic Assessment

Bargellini¹,

Battaglia²,

Caramella³

et al. 2015

An Information Technology Framework for Predictive, Preventive and Personalised Medicine

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“…In practice, conventional TACE is still widely used [38] and the stability of an idarubicin-Lipiodol ® emulsion which has a release profile for the anticancer agent similar to that of the microspheres could lead to a resurgence in the use of the conventional technique [25].…”

Section: Tace With Microspheresmentioning

confidence: 99%

Transarterial chemoembolization for hepatocellular carcinoma: An old method, now flavor of the day

Boulin

Delhom

Pierredon-Foulongne

et al. 2015

Diagnostic and Interventional Imaging

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Transarterial chemoembolization (TACE) is the recommended treatment for patients suffering from intermediate, B stage, hepatocellular carcinoma. Despite an undisputed pharmacokinetic advantage, TACE with microspheres has not been shown to be superior in terms of survival compared to conventional TACE using Lipiodol(®). The best guarantee to reduce toxicity and maximize the efficacy of TACE is to strictly observe the contraindications for the procedure (Child-Pugh>B8, reduced portal flow, very large tumor, any technical contraindication and renal impairment), and rigorous application of the administration requirements for the Lipiodol(®) emulsion or loaded microspheres (assessment of hepatic vascularization investigating for accessory vascularization, injection methods). Tumor response should be assessed after four weeks by CT or MRI using the modified RECIST criteria.

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“…Despite the undeniable pharmacokinetic (PK) advantages of drug-eluting embolics (DEEs) [7,8], they have not demonstrated a benefit in overall survival so far [9], which might explain why conventional TACE (c-TACE) (i.e. intraarterial [IA] injection of an anticancer drug emulsified with lipiodol followed by the injection of embolic material) is still widely performed [10].…”

Section: Altmentioning

confidence: 99%