Early diagnosis of HCC is of paramount importance in order to enable the application of curative treatments. Among these, radiofrequency ablation (RFA) is actually considered the most effective ablative therapy for early stage hepatocellular carcinoma (HCC) not suitable for surgery. On the other hand, transarterial chemoembolization (TACE) represents the standard of care for intermediate stage HCC and compensated liver function. Finally, sorafenib, an oral antiangiogenic targeted drug, is the only approved systemic therapy for advanced HCC with vascular invasion, extrahepatic spread, and well-preserved liver function. Beside traditional radiological techniques, new functional imaging tools have been introduced in order to provide not only morphological information but also quantitative functional data. In this review, we analyze perfusion-CT (pCT) from a technical point of view, describing the main different mathematical analytical models for the quantification of tissue perfusion from acquired CT raw data, the most commonly acquired perfusion parameters, and the technical parameters required to perform a standard pCT examination. Moreover, a systematic review of the literature was performed to assess the role of pCT as an emerging imaging biomarker for HCC diagnosis, response evaluation to RFA, TACE, and sorafenib, and we examine its challenges in HCC management.

Ippolito, D., Pecorelli, A., Querques, G., Drago, S., Maino, C., Franzesi, C., et al. (2019). Dynamic Computed Tomography Perfusion Imaging: Complementary Diagnostic Tool in Hepatocellular Carcinoma Assessment From Diagnosis to Treatment Follow-up. ACADEMIC RADIOLOGY, 26(12), 1675-1685 [10.1016/j.acra.2019.02.010].

Dynamic Computed Tomography Perfusion Imaging: Complementary Diagnostic Tool in Hepatocellular Carcinoma Assessment From Diagnosis to Treatment Follow-up

Ippolito D.;Pecorelli A.
;
Querques G.;Drago S. G.;Maino C.;Sironi S.
2019

Abstract

Early diagnosis of HCC is of paramount importance in order to enable the application of curative treatments. Among these, radiofrequency ablation (RFA) is actually considered the most effective ablative therapy for early stage hepatocellular carcinoma (HCC) not suitable for surgery. On the other hand, transarterial chemoembolization (TACE) represents the standard of care for intermediate stage HCC and compensated liver function. Finally, sorafenib, an oral antiangiogenic targeted drug, is the only approved systemic therapy for advanced HCC with vascular invasion, extrahepatic spread, and well-preserved liver function. Beside traditional radiological techniques, new functional imaging tools have been introduced in order to provide not only morphological information but also quantitative functional data. In this review, we analyze perfusion-CT (pCT) from a technical point of view, describing the main different mathematical analytical models for the quantification of tissue perfusion from acquired CT raw data, the most commonly acquired perfusion parameters, and the technical parameters required to perform a standard pCT examination. Moreover, a systematic review of the literature was performed to assess the role of pCT as an emerging imaging biomarker for HCC diagnosis, response evaluation to RFA, TACE, and sorafenib, and we examine its challenges in HCC management.
Articolo in rivista - Review Essay
Scientifica
Computed tomography; Hepatocellular carcinoma; Perfusion imaging; Radiofrequency ablation; Sorafenib; Transarterial chemoembolization;
Computed tomography, Hepatocellular carcinoma, Perfusion imaging, Radiofrequency ablation, Sorafenib, Transarterial chemoembolization, Carcinoma, Hepatocellular, Combined Modality Therapy, Follow-Up Studies, Humans, Liver Neoplasms, Perfusion Imaging, Tomography, X-Ray Computed, Treatment Outcome, Early Diagnosis
English
Ippolito, D., Pecorelli, A., Querques, G., Drago, S., Maino, C., Franzesi, C., et al. (2019). Dynamic Computed Tomography Perfusion Imaging: Complementary Diagnostic Tool in Hepatocellular Carcinoma Assessment From Diagnosis to Treatment Follow-up. ACADEMIC RADIOLOGY, 26(12), 1675-1685 [10.1016/j.acra.2019.02.010].
Ippolito, D; Pecorelli, A; Querques, G; Drago, S; Maino, C; Franzesi, C; Hatzidakis, A; Sironi, S
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/280531
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