Current Imaging Diagnosis of Hepatocellular Carcinoma.
Current Imaging Diagnosis of Hepatocellular Carcinoma.
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基于多期增强CT或MRI检查的典型表现，影像在肝细胞癌(HCC)治疗中的作用已经显著地演变和扩展，超越了肿瘤的普通放射学确认。肝胆造影剂的引入使肝癌的早期诊断成为可能，而超声造影剂的应用则极大地提升了超声在诊断算法中的作用。在CT和MRI上评估血流灌注的新的定量技术不仅可以早期诊断并确定与其他病变的鉴别，而且它们还为评估治疗反应提供了生物标志物。随着不同的肝细胞癌亚型的确定，它们与特定的成像特征的相关性在评估肿瘤侵袭性和预后方面具有很大的希望。这篇综述介绍了目前成像的作用，并强调了它在肝细胞癌患者成功治疗中的关键作用。肝细胞癌是全球第四大癌症相关死亡原因。传统上，放射学在肝细胞癌的治疗中扮演着核心角色，从高危患者的筛查到非侵入性诊断，以及治疗反应的评估和治疗后的随访。从有或无对比的肝脏超声，到动态多期CT和动态磁共振弥散成像，在过去的十年里取得了很大的进步。在过去的几年里，病理学、生物学、遗传学和免疫化学分析揭示了几种具有不同生物学行为的肿瘤亚型，突出了重新评估现有放射学方法的必要性。考虑到这些变化，除了形态信息之外还提供功能和定量参数的新方法越来越多地被纳入现代肝细胞癌诊断方案。通过这种方式，在过去的几年里，鉴别诊断变得更加具有挑战性。使用肝脏特异性造影剂以及CT/MRI灌注技术，似乎不仅可以更早地发现和更准确地描述肝细胞癌的病变，而且还可以预测对治疗的反应和生存。然而，仍然存在一些限制和技术方面的考虑。本综述将描述和讨论所有这些成像方式及其在肝硬变和非肝硬变的肝细胞癌病变成像中的进展。将讨论灵敏度和特异率、方法限制和技术考虑。
The role of imaging in the management of hepatocellular carcinoma (HCC) has significantly evolved and expanded beyond the plain radiological confirmation of the tumor based on the typical appearance in a multiphase contrast-enhanced CT or MRI examination. The introduction of hepatobiliary contrast agents has enabled the diagnosis of hepatocarcinogenesis at earlier stages, while the application of ultrasound contrast agents has drastically upgraded the role of ultrasound in the diagnostic algorithms. Newer quantitative techniques assessing blood perfusion on CT and MRI not only allow earlier diagnosis and confident differentiation from other lesions, but they also provide biomarkers for the evaluation of treatment response. As distinct HCC subtypes are identified, their correlation with specific imaging features holds great promise for estimating tumor aggressiveness and prognosis. This review presents the current role of imaging and underlines its critical role in the successful management of patients with HCC. Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer related death worldwide. Radiology has traditionally played a central role in HCC management, ranging from screening of high-risk patients to non-invasive diagnosis, as well as the evaluation of treatment response and post-treatment follow-up. From liver ultrasonography with or without contrast to dynamic multiple phased CT and dynamic MRI with diffusion protocols, great progress has been achieved in the last decade. Throughout the last few years, pathological, biological, genetic, and immune-chemical analyses have revealed several tumoral subtypes with diverse biological behavior, highlighting the need for the re-evaluation of established radiological methods. Considering these changes, novel methods that provide functional and quantitative parameters in addition to morphological information are increasingly incorporated into modern diagnostic protocols for HCC. In this way, differential diagnosis became even more challenging throughout the last few years. Use of liver specific contrast agents, as well as CT/MRI perfusion techniques, seem to not only allow earlier detection and more accurate characterization of HCC lesions, but also make it possible to predict response to treatment and survival. Nevertheless, several limitations and technical considerations still exist. This review will describe and discuss all these imaging modalities and their advances in the imaging of HCC lesions in cirrhotic and non-cirrhotic livers. Sensitivity and specificity rates, method limitations, and technical considerations will be discussed.
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影响因子：
5.9
作者：
Basha, Mohammad Abd Alkhalik;AlAzzazy, Mohamad Zakarya;Abdelbary, Eman H.
通讯作者：
Abdelbary, Eman H.
影响因子：
19.7
作者：
Bae, Kyongtae T.
通讯作者：
Bae, Kyongtae T.
影响因子：
2.1
作者：
Alicioglu, Banu;Guler, OmerTolga;Comunoglu, Cem
通讯作者：
Comunoglu, Cem
影响因子：
1.4
作者：
Chaturvedi, Abhishek;Bhargava, Puneet;Maki, Jeffrey H.
通讯作者：
Maki, Jeffrey H.
DOI：
10.3390/diagnostics11071194
发表时间：
2021-06-30
期刊：
Diagnostics (Basel, Switzerland)
影响因子：
--
作者：
Castaldo A;De Lucia DR;Pontillo G;Gatti M;Cocozza S;Ugga L;Cuocolo R
通讯作者：
Cuocolo R