Evaluation Of Hepatocellular Carcinoma Research Articles

Application and prospects of magnetic resonance imaging techniques in the diagnosis and evaluation of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. MRI has become an important imaging method for non-invasive diagnosis and evaluation of HCC in clinics because of its advantageous aspects, such as its non-radiative nature, superior detection, and qualitative accuracy over CT and ultrasound. Various MRI techniques, including hepatobiliary-specific contrast agents, magnetic resonance elastography, diffusion-weighted imaging, and others, can diagnose HCC or evaluate its malignant biological behavior from different dimensions such as blood supply, cell function, tissue hardness, and water molecule diffusion. This article introduces the current status and prospects of various MRI techniques for HCC diagnosis and evaluation.

S2DA-Net: Spatial and spectral-learning double-branch aggregation network for liver tumor segmentation in CT images

Accurate liver tumor segmentation is crucial for aiding radiologists in hepatocellular carcinoma evaluation and surgical planning. While convolutional neural networks (CNNs) have been successful in medical image segmentation, they face challenges in capturing long-term dependencies among pixels. On the other hand, Transformer-based models demand a high number of parameters and involve significant computational costs. To address these issues, we propose the Spatial and Spectral-learning Double-branched Aggregation Network (S2DA-Net) for liver tumor segmentation. S2DA-Net consists of a double-branched encoder and a decoder with a Group Multi-Head Cross-Attention Aggregation (GMCA) module, Two branches in the encoder consist of a Fourier Spectral-learning Multi-scale Fusion (FSMF) branch and a Multi-axis Aggregation Hadamard Attention (MAHA) branch. The FSMF branch employs a Fourier-based network to learn amplitude and phase information, capturing richer features and detailed information without introducing an excessive number of parameters. The FSMF branch utilizes a Fourier-based network to capture amplitude and phase information, enriching features without introducing excessive parameters. The MAHA branch incorporates spatial information, enhancing discriminative features while minimizing computational costs. In the decoding path, a GMCA module extracts local information and establishes long-term dependencies, improving localization capabilities by amalgamating features from diverse branches. Experimental results on the public LiTS2017 liver tumor datasets show that the proposed segmentation model achieves significant improvements compared to the state-of-the-art methods, obtaining dice per case (DPC) 69.4 % and global dice (DG) 80.0 % for liver tumor segmentation on the LiTS2017 dataset. Meanwhile, the pre-trained model based on the LiTS2017 datasets obtain, DPC 73.4 % and an DG 82.2 % on the 3DIRCADb dataset.

Computer-Aided Color Parameter Imaging of Contrast-Enhanced Ultrasound Evaluates Hepatocellular Carcinoma Hemodynamic Features and Predicts Radiofrequency Ablation Outcome

Computer-aided color parameter imaging (CPI) is a novel technique for contrast-enhanced ultrasound (CEUS) that can highlight hemodynamic features of focal lesions. The purpose of the study was to investigate the role of CPI in evaluation of hepatocellular carcinoma (HCC) hemodynamic features and prognosis after radiofrequency ablation (RFA). One hundred twenty-one patients with HCC underwent CEUS with CPI analysis before RFA. Eighty-nine patients had pathologically proven well- to moderately differentiated HCC (WM-HCC), and 32 patients had poorly differentiated or undifferentiated HCC (PU-HCC). Perfusion features of CEUS and contrast-enhanced computed tomography/magnetic resonance imaging were compared with CPI parameters for WM-HCC and PU-HCC. The results indicated that 67.4% of WM-HCC had a centrifugal perfusion CPI pattern, whereas 84.4% of PU-HCC tumors had a centripetal pattern (p < 0.001, odds ratio = 11.2). The specificity, sensitivity and accuracy of the CPI perfusion pattern regarding HCC pathological grade were higher than those with routine CEUS (84.4% vs. 9.4%, p < 0.001; 67.4% vs. 3.4%, p < 0.001; 71.9% vs. 5.0%, p < 0.001). Moreover, multivariable analysis revealed that the CPI perfusion pattern was an independent risk factor for progression-free survival post-RFA (centripetal group: 28.3 ± 4.1 mo vs. centrifugal group: 45.8 ± 4.4 mo, p = 0.002). A novel CPI technique for CEUS could non-invasively provide valuable hemodynamic information and predict prognosis for HCC patients treated by RFA.

Role of gadoxetic acid-enhanced liver magnetic resonance imaging in the evaluation of hepatocellular carcinoma after locoregional treatment.

Locoregional treatments, as alternatives to surgery, play a key role in the management of hepatocellular carcinoma (HCC). Liver magnetic resonance imaging (MRI) enables a multiparametric assessment, going beyond the traditional dynamic computed tomography approach. Moreover, the use of hepatobiliary agents can improve diagnostic accuracy and are becoming important in the diagnosis and follow-up of HCC. However, the main challenge is to quickly identify classical responses to loco-regional treatments in order to determine the most suitable management strategy for each patient. The aim of this review is to provide a summary of the most common and uncommon liver MRI findings in patients who underwent loco-regional treatments for HCC, with a special focus on ablative therapies (radiofrequency, microwaves and cryoablation), trans-arterial chemoembolization, trans-arterial radio-embolization and stereotactic ablative radiotherapy techniques, considering the usefulness of gadoxetate disodium (Gd-EOB-DTPA) contrast agent.

Providing higher value care for hepatocellular carcinoma rather than diagnosis: What can current radiologists do?

Medical imaging is of great value for the comprehensive evaluation of hepatocellular carcinoma from diagnosis to prognosis, which contributes to optimal clinical management making.

The value of preoperative 18F-FDG PET metabolic and volumetric parameters in predicting microvascular invasion and postoperative recurrence of hepatocellular carcinoma.

Microvascular invasion (MVI) is very important in the evaluation of hepatocellular carcinoma (HCC), but diagnosis is determined by postoperative pathology; thus, preoperative noninvasive methods will play an active role. The purpose of the study was to assess the performance of metabolic parameters of preoperative 18F-fluorodeoxyglucose PET/computerized tomography (18F-FDG PET/CT) in the prediction of MVI and postoperative recurrence in primary hepatocellular carcinoma. We retrospectively collected 72 patients with HCC who have performed 18F-FDG PET/CT scan before partial hepatectomy between 2016 and 2019. We used both normal liver tissue and inferior vena cava as the reference background and combined with clinicopathological features, 18F-FDG PET/CT metabolic and volumetric indices to predict MVI and postoperative recurrence of primary HCC before surgery. Twenty-one of the 72 patients recurred, in recurrent cases showed higher maximum standard uptake value (SUVmax), TNR (ratio of tumor SUVmax to mean SUV [SUVmean] of the background tissue), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) than nonrecurrence cases (P < 0.001). All 18F-FDG PET metabolic and volumetric indices for predicting postoperative HCC recurrence were significant on receiver-operating-characteristic (ROC) curve analyses (P < 0.05). TNRIVC, TNRNL, MTVIVC, MTVNL TLGIVC and TLGNL were significant factors for predicting MVI in HCC (P < 0.05). On multivariate analyses, MVI, SUVmax, TNRIVC, TNRNL, MTVIVC, MTVNL, TLGIVC and TLGNL (P < 0.05) are independent risk factors for predicting postoperative HCC recurrence. TNRIVC is the most relevant PET/CT parameter for predicting MVI in HCC, and MTVIVC is the most valuable for predicting postoperative HCC recurrence. Moreover, the PET/CT parameters are more accurate for prognosis with inferior vena cava as a reference background than with normal liver tissue. 18F-FDG PET/CT metabolic and volumetric indices are effective predictors, and could noninvasively provide more comprehensive predictive information on MVI and postoperative recurrence of primary HCC before surgery.

Performance of Ultrasound Techniques and the Potential of Artificial Intelligence in the Evaluation of Hepatocellular Carcinoma and Non-Alcoholic Fatty Liver Disease.

Simple SummaryThe increasing prevalence of non-alcoholic fatty liver disease (NAFLD) represents a challenge for the current medical systems. If NAFLD is left undetected and untreated, it can progress towards fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). To date, ultrasonography (US) is the first-line examination indicated to NAFLD patients that also screens for other focal liver lesions (FLLs). The downside of conventional B-mode US is that it cannot accurately quantify steatosis and fibrosis and cannot further characterize FLL certainly—is it cancer or is it not? Ultrasound contrast agents (UCAs) allowed physicians to further evaluate the FLL for the diagnosis of HCC. This review discusses the performance of US techniques in NAFLD and NAFLD-related HCC diagnosis, as well as of artificial intelligence (AI)-based methods, specifically the usefulness and assistance of deep learning algorithms for improving liver US image processing.Global statistics show an increasing percentage of patients that develop non-alcoholic fatty liver disease (NAFLD) and NAFLD-related hepatocellular carcinoma (HCC), even in the absence of cirrhosis. In the present review, we analyzed the diagnostic performance of ultrasonography (US) in the non-invasive evaluation of NAFLD and NAFLD-related HCC, as well as possibilities of optimizing US diagnosis with the help of artificial intelligence (AI) assistance. To date, US is the first-line examination recommended in the screening of patients with clinical suspicion of NAFLD, as it is readily available and leads to a better disease-specific surveillance. However, the conventional US presents limitations that significantly hamper its applicability in quantifying NAFLD and accurately characterizing a given focal liver lesion (FLL). Ultrasound contrast agents (UCAs) are an essential add-on to the conventional B-mode US and to the Doppler US that further empower this method, allowing the evaluation of the enhancement properties and the vascular architecture of FLLs, in comparison to the background parenchyma. The current paper also explores the new universe of AI and the various implications of deep learning algorithms in the evaluation of NAFLD and NAFLD-related HCC through US methods, concluding that it could potentially be a game changer for patient care.

Diagnostic performance of intravascular perfusion based contrast-enhanced ultrasound LI-RADS in the evaluation of hepatocellular carcinoma.

The contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) is a relative new algorithm for hepatocellular carcinoma (HCC) assessment. To validate the diagnostic efficiency of the intravascular perfusion based CEUS LI-RADS for HCC. Archives of 873 patients with focal liver lesions (FLLs) undergoing CEUS were reviewed, and target images were read by two sonologists independently according to the CEUS LI-RADS. The diagnostic performance was calculated and compared. Assessment with reference to CEUS LI-RADS, 87 of 218 FLLs (39.9%) were categorized as LR-5, 131 of 218 FLLs (60.1%) were categorized as non-LR-5, 19 of 99 HCCs were categorized as non-LR-5, and 7 of 119 non-HCCs were categorized as LR-5. The sensitivity, specificity, AUROC, positive and negative predictive values of CEUS LI-RADS for diagnosing HCC were 80.81%(95%CI: 71.7%-88.0%), 94.1%(95%CI: 88.3%-97.6%), 0.87 (95%CI: 0.82-0.92), 91.9%(95%CI: 84.1%-96.7%), and 85.5%(95%CI: 78.3%-91.0%), respectively. The diagnostic efficiency of the intravascular perfusion based CEUS LI-RADS for the evaluation of HCCs is very good.

Evaluation of Hepatocellular Carcinoma by Gadolinium- Based Contrast Media on MRI

Hepatocellular carcinoma (HCC) is a big cause of death associated with cancer in the world and is the most common liver malignancy. More prevalence of chronic hepatitis virus (primarily chronic hepatitis B and hepatitis C) is attributed to high prevalence in Asia. Purpose: The purpose of this research was to test gadolinium-based contrast media for hepatocellular carcinoma on MRI.A total of 96 patients from Lahore who visited at radiology department of Al Razi Health Care Hospital from August 2020 to November 2020 for the evaluation of hepatocellular carcinoma by gadolinium based contrast media on MRI. Results: The study was conducted on 96 patients for the evaluation of hepatocellular carcinoma, out of which 62 were diagnosed with hepatocellular carcinoma. HCC have become a major burden in the world increasing mortality and morbidity. Early identification leads to early treatment and improved survival. Keywords : HCC, HCV, USG, MRI, Gadolinium DOI: 10.7176/JHMN/84-05 Publication date: December 31 st 2020

Role of 18-FDG/PET in evaluation of hepatocellular carcinoma managed locally by transarterial chemoembolization compared to triphasic computed tomography

BackgroundThis study was done to evaluate the role of FDG/PET compared to CECT in evaluating HCC after local interventional treatment. We evaluate forty-six patients with known history of TACE as a locoregional treatment of pathologically proved HCC. There were forty-three males and three females.ResultsThe collected data were statistically analyzed, and we found that FDG-PET has a sensitivity of 94%, specificity of 84%, positive predictive value of 86.7%, negative predictive value of 86.4%, and accuracy of 93.4% in the detection of residual or recurrent at the managed tumor bed compared to CECT which shows a sensitivity of 94%, specificity of 84%, positive predictive value of 86.7%, negative predictive value of 86.4%, and accuracy of 93.4 %). Combined views ( FDG-PET/CT ) are better in evaluation.ConclusionFDG-PET is better in the detection of residual or recurrence in HCC which is locally managed by TACE.

Application value of dynamic contrast-enhanced magnetic resonance imaging and conventional magnetic resonance imaging in evaluation of hepatocellular carcinoma before and after TACE treatment

Objective To compare the application of dynamic contrast-enhanced magnetic resonance imaging (MRI) and conventional MRI in the detection of hepatocellular carcinoma (HCC) lesions before and after transcatheter arterial chemoembolization (TACE) treatment and evaluation of the effect of TACE treatment, thus to judge its application value, and to provide guidance for early clinical diagnosis. Methods Seventy-six patients with HCC who underwent TACE in Pingyang Hospital Affiliated to Wenzhou Medical University from January 2018 to December 2018 were selected in the research.According to the random number table method, 76 patients were randomly divided into control group and study group, with 38 cases in each group.The control group was examined by conventional MRI, while the study group was examined by dynamic enhancement of MRI.The lesions were observed before and after treatment, and Ktrans, Kep and ve of the two groups were recorded before and after treatment.The accuracy, sensitivity and specificity of the two groups were compared. Results Before and after treatment, the total detection rates of the study group (92.05%, 100.00%) were significantly higher than those of the control group (80.85%, 71.43%) (χ2=16.489, 15.246, all P 0.05). After treatment, the Ktrans and Kep values of the two groups were significantly decreased, and the Ktrans[(0.419±0.101)min] and Kep[(1.073±0.237)min] values of the study group were significantly lower than those of the control group [(0.647±0.128)min, (1.158±0.221)min], the differences were statistically significant (t=9.485, 5.642, all P>0.05). There was no statistically significant difference in ve value between the two groups (t=1.025, P>0.05). The accuracy and sensitivity of detection in the study group (92.11%, 97.37%) were significantly higher than those in the control group (81.58%, 84.21%), and the specificity (94.74%) of the study group was significantly lower than that of the control group (97.37%) (χ2=17.186, 14.453, 6.489, all P<0.05). Conclusion Dynamic contrast-enhanced MRI is more effective in the detection of HCC patients before and after TACE treatment.It is convenient to provide guidance for treatment and has higher clinical application value.It is worthy of popularizing. Key words: Liver neoplasms; Chemoembolization, therapeutic; Magnetic resonance imaging; Dynamic enhancement; Conventional magnetic resonance; Quantitative parameters; Curative effect; Application value

Dynamic CT angiography for therapy evaluation after transarterial chemoembolization of hepatocellular carcinoma.

Background Liver dynamic computed tomography (CT) is an established method for pre- and post-interventional evaluation of hepatocellular carcinoma. To date only the liver parenchyma and perfusion information of dynamic CT has been evaluated widely. Purpose To evaluate the vascular information contained in dynamic CT datasets. Material and Methods Dynamic CT performed one day after transarterial chemoembolization (60 mL of contrast medium, 6 mL/s, 40 s scan duration) were retrospectively evaluated. Conventional slice and angiographic maximum-intensity-projection reconstructions were calculated on a multi-modality post-processing platform. Datasets were evaluated for viable tumor, anatomy of the vasculature, and potential tumor-feeding vessels. The results were compared to digital subtraction angiography images. Results In total, 94 treated hepatocellular carcinoma nodules were evaluated (62 dynamic CT scans, 46 patients [34 men; mean age = 69 years]). Forty-six partially viable tumors were diagnosed after transarterial chemoembolization. In all of these, tumor-feeding vessels were found in dynamic CT. Seventeen suspected extra-hepatic tumor feeders were reported, of which 14 had not been found during previous transarterial chemoembolization. Conclusion Dynamic CT is useful in post-interventional imaging of hepatocellular carcinoma after transarterial chemoembolization due to its ability to detect residual viable tumor parts and to show previously unknown intra- and extra-hepatic tumor-feeding vessels.

PET Imaging of Hepatocellular Carcinoma

Positron emission tomography has not traditionally played a major role in the evaluation of hepatocellular carcinoma (HCC). Owing to high background liver uptake and molecular mechanisms within HCC lesions, uptake of 18F-fluorodeoxyglucose (FDG) is variable and prior studies have shown only modest overall detection of intrahepatic disease. Tracers such as 18F- and 11C-choline as well as 11C-acetate have been explored either in isolation or together with 18F-FDG have shown greater promise in detection of intrahepatic lesions, but yet are not in widespread clinical use. 68 Ga-Prostate specific membrane antigen is a tracer developed for use in prostate cancer but a pilot study and several case reports have indicated that there may be the potential for use in the evaluation of HCC. Increased rates of lesion detection using 18F-FDG may be seen in poorly differentiated tumors and in the setting of metastatic disease or within recurrent tumor following loco-regional therapies and FDG uptake may indicate a greater risk of recurrence following transplantation. Further work will be required to elucidate the precise role of other non FDG tracers in the evaluation of patients at risk for or with HCC.

Accuracy of diagnostic evaluation of hepatocellular carcinoma with LI-RADS

Accuracy of diagnostic evaluation of hepatocellular carcinoma with LI-RADS

Role of dynamic contrast-enhanced and diffusion weighted MRI in evaluation of hepatocellular carcinoma after chemoembolization

PurposeTo assess the role of dynamic contrast- enhanced and diffusion-weighted (DWI) MRI in the evaluation of the response of hepatocellular carcinoma (HCC) after chemoembolization. Patient & method30 patients having 40 HCC lesions underwent transcatheter arterial chemoembolization (TACE). Ages ranged between 41 and 76 years. All examinations were performed using Philips 1.5 Tesla MRI (Achieva). Precontrast T1, T2, Dynamic contrast enhanced and respiratory triggered DWI MR images with (b = 50, 400, 800 mm/s). DWI MRI images and Contrast-enhanced MRI images after TACE are assessed to evaluate post treatment response. DWI was used to create ADC maps and ADC values were calculated looking for a cut off value using the ROC curve. ResultsDynamic MRI had a sensitivity of 94.1%, a specificity of 95.6%, PPV value of 94.1%, NPV of 95.6% and an overall agreement of 95% compared to 82%, 73.9%, 70%, 85% and 77.5% respectively of DWI MRI. The difference between the malignant residual and well ablated groups' ADC variables was statistically significant P value 0.009. ConclusionDynamic and diffusion MRI complete each other in assessment of HCC response to therapy, especially in those who cannot properly hold their breath that cause degradation of the dynamic MR quality.

The value of [11C]-acetate PET and [18F]-FDG PET in hepatocellular carcinoma before and after treatment with transarterial chemoembolization and bevacizumab

PurposeThis prospective study was to investigate the value of [11C]-acetate PET and [18F]-FDG PET in the evaluation of hepatocellular carcinoma (HCC) before and after treatment with transarterial chemoembolization (TACE) and vascular endothelial growth factor (VEGF) antibody (bevacizumab).MethodsTwenty-two patients (three women, 19 men; 62 ± 8 years) with HCC verified by histopathology were treated with TACE and bevacizumab (n = 11) or placebo (n = 11). [11C]-acetate PET and [18F]-FDG PET were performed before and after TACE with bevacizumab or placebo. Comparisons between groups were performed with t-tests and Chi-squared tests, where appropriate. Overall survival (OS) was defined as the time from start of bevacizumab or placebo until the date of death/last follow-up, respectively.ResultsThe patient-related sensitivity of [11C]-acetate PET, [18F]-FDG PET, and combined [11C]-acetate and [18F]-FDG PET was 68%, 45%, and 73%, respectively. There was a significantly higher rate of conversion from [11C]-acetate positive lesions to negative lesions in patients treated with TACE and bevacizumab as compared with that in patients with TACE and placebo (p < 0.05). In patients with negative acetate PET, the mean OS in patients treated with TACE and bevacizumab was 259 ± 118 days and was markedly shorter as compared with that (668 ± 217 days) in patients treated with TACE and placebo (p < 0.05). In patients treated with TACE and placebo, there was significant difference in mean OS in patients with positive FDG PET as compared with that in patients with negative FDG PET (p < 0.05). The HCC lesions had different tracer avidities showing the heterogeneity of HCC.ConclusionsOur study suggests that combining [18F]-FDG with [11C]-acetate PET could be useful for the management of HCC patients and might also provide relevant prognostic and molecular heterogeneity information.

Liver Transplant for Hepatocellular Carcinoma: Pathologic Point Of View.

Primary liver cancer is the fifth most common cancer overall and the second most common cause of cancer mortality worldwide. Hepatocellular carcinoma accounts for up to 90% of all primary hepatic malignancies and represents a major international health problem. It is a complex and heterogeneous malignancy, frequently occurs in the setting of a chronically diseased organ, and has multiple confounding factors. Liver transplant for hepatocellular carcinoma has been established as a standard treatment in selected patients. Liver resection and locoregional therapies could be other options for treatment. Pathologic evaluation of hepatocellular carcinoma is a complicated process that includes tumor grading and evaluation of microvascular invasion. Although macrovascular invasion can be detected with imaging techniques, microvascular invasion is diagnosed pathologically. Pathologic evaluation provides additional information about the tumor biology, using immunohistochemical and molecular methods to predict patient outcomes. Hepatocellular carcinoma requires a multidisciplinary approach to determine the most appropriate treatment, as well as requires accurate timing of various treatments for optimal outcomes.

Evaluation of Hepatocellular Carcinomas and Liver Metastases- How Far can we Go with Diffusion Weighted Imaging?

Objective: We aimed to determine the usefulness of the apparent diffusion coefficient (ADC) values for the differential diagnosis of hepatocellular carcinomas and most common metastatic liver tumors and we aimed to compare the characteristic properties. We also aimed to detect novel lesions on ADC maps before the lesion is clinically and radiologically detected by conventional methods. Materials and Methods: We evaluated characteristic properties, contrast enhancement patterns of liver metastasis of malignancies like adenocancer, renal cell carcinoma (RCC), gastrointestinal stromal tumor (GIST) and hepatocellular carcinoma (HCC) on magnetic resonance imaging (MRI) and diffusion weighted (DW) imaging. ADCs were measured both from the cystic and solid parts of the tumoral lesions. Solid and cystic parts were grouped seperately and compared individually. Results: 48 cases, (60% male and 40% female) with ages ranging between 48 and 81 were involved. 28 of them had liver metastasis and 20 of them had HCC. MRIs between the years 2009 and 2012 were analyzed. Among mean ADC values measured from solid contrast-enhancing parts, values of the HCC group were significantly higher than the metastasis group (p=0.004). Also, in metastasis group consisting of many distinct primaries, there were differences in ADC values. A retrospective analysis for follow-up cases showed that the ADC values of the parencyhma where a lesion will appear on later follow-up images were lower than the adjacent parenchyma. Conclusion: We believe that this method may be useful to detect early metastasis. Studies with larger patient groups could give more significant results which would enable diffusion imaging method to be used in this area.

Expressions and significances of Pyk2, VEGF and N-cadherin in hepatocellular carcinoma

Objective To investigate the expressions of proline-rich tyrosine kinase-2 (Pyk2), vascular endotheliar growth factor (VEGF), and N-cadherin in hepatocellular carcinomas and their clinical significances. Methods The expressions of Pyk2, VEGF, and N-cadherin proteins were tested with immunohistochemistry in 80 cases of hepatocellular carcinomas and adjacent paracancerous tissues. Results The positive rates of Pyk2, VEGF, and N-cadherin in hepatocellular carcinomas were significantly higher than adjacent paracancerous tissues (71.3% vs 12.0%; 63.8% vs 8.0%; 57.5% vs 10.0%, P<0.05). The differences in the expressions of Pyk2, VEGF, and N-cadherin in hepatocellular carcinoma of pathological grading, tumor differentiation, vascular invasion and clinical tumor node metastasis (TNM) stage were significant (P<0.05). Significantly positive correlation was found between Pyk2 and VEGF or N-cadherin with Spearman correlation analysis (all P<0.05). There was positive correlation between N-cadherin and VEGF (P<0.05). Conclusions The abnormal expressions of Pyk2, VEGF, and N-cadherin genes may promote tumor angiogenesis and progression of hepatocellular carcinoma. Pyk2 may provide an important reference for prognostic evaluation of hepatocellular carcinoma. Key words: Protein-tyrosine kinases/ME; Vascular endothelial growth factors/ME; Cadherins/ME; Carcinoma, hepatocellular/ME/PA

3:54 PMAbstract No. 65 - Evaluation of hepatocellular carcinoma after treatment with microwave ablation plus transarterial embolization versus radiofrequency ablation plus transarterial embolization: a single center experience

Do geometric features of hepatocellular carcinomas correlate with survival following radiofrequency ablation (RFA) with and without lyso-thermosensitive liposomal doxorubicin (LTLD/Thermodox)? M. Castro, S. Leonard, H. Celik, P. Wakim, J. Karanian, W. Pritchard, N. Borys, R. Lencioni, M. O’Neal, W. Tak, B. Wood; NIH, Bethesda, MD; FDA/CDRH Laboratory of Cardiovascular and Interventional Therapeutics, Laurel, MD; Food and Drug Administration, Rockville, MD; Celsion Corporation, Princeton, NJ; University of Miami Miller School of Medicine, Miami, FL; BioClinica,Inc., Princeton, NJ; Kyungpook National University Hospital, Jung-gu, Daegu.