Imaging Of Hepatocellular Carcinoma Research Articles

Abstract No. 540 Usefulness of Dyna computed tomography in hepatocellular carcinoma: transarterial chemoembolization for segment 1 of the liver

To evaluate usefulness of the Dyna-CT in hepatocellular carcinoma treated by transarterial chemoembolization (TACE) for segment 1 (S1) of the liver. Total 24 session of TACE was performed in 20 patients (mean age, 63.0; range, 48-86 years) to treat HCC in S1 from March 2017 to July 2019. Multiplanar reconstruction (MPR) images and embolization guidance program by 3-dimensional reconstruction of the Dyna-CT were used for diagnosis of HCC and superselection of the feeding artery with microcatheter set. TACE procedures were done by conventional method with doxorubicin, ethiodized oil, and gelatin sponge. Digital subtraction angiogram (DSA) and Dyna-CT Images obtained during TACE including medical records were reviewed to evaluate detection of the HCC, tumor size, characteristics of the feeding artery, superselected artery, and radiation dose for Dyna-CT. Follow-up liver dynamic CT images were also reviewed to evaluate success of treatment. HCCs were visualized 14 cases (58.3%) on DSA and all cases on MPR images of the Dyna-CT. Mean size of HCCs was 16.1 mm(range, 5-94 mm) on Dyna-CT. Numbers of the feeding artery were one in 22 cases (91.7%) and two in 2 cases (8.3%). Among of 26 feeding arteries, they were originated from territory of the right hepatic artery (RHA) in 14 and left hepatic artery (LHA) in 12. Most common origin of the segment 1 hepatic artery (S1HA) was RHA (n = 11, 42.3%). Superselective TACE of the S1HA was successful in 15 arteries (57.7%) and TACE was done at proximal artery to origin of the S1HA in 11 arteries (42.3%). Dense uptake of ethiodized oil was detected in all cases after superselective TACE of the S1HA and in 2 cases (18.1%) after proximal TACE. Mean cumulative dose of radiation by Dyna-CT was 201.9 mGy. Dyna-CT was useful to detect the HCC in S1 compared with DSA. Embolization guidance seems to be helpful for superselective TACE and uptake of the ethiodized oil in the HCC.

Visualization of microvasculature and thrombi by X-ray phase-contrast computed tomography in hepatocellular carcinoma.

Visualization of the microvascular network and thrombi in the microvasculature is a key step to evaluating the development of tumor growth and metastasis, and influences treatment selection. X-ray phase-contrast computed tomography (PCCT) is a new imaging technique that can detect minute changes of density and reveal soft tissues discrimination at micrometer-scale resolution. In this study, six human resected hepatocellular carcinoma (HCC) tissues were investigated with PCCT. A histological stain was added to estimate the accuracy of PCCT. The results showed that the fine structures of the microvasculature (measuring 30-100 µm) and thrombi in tiny blood vessels were displayed clearly on imaging the HCC tissues by PCCT. Moreover, density distributions of the thrombi were obtained, which could be reliably used to distinguish malignant from benign thrombi in HCC. In conclusion, PCCT can clearly show the three-dimensional subtle structures of HCC that cannot be detected by conventional absorption-based computed tomography and provides a new method for the imageology of HCC.

Correlation of magnetic resonance signal characteristics and perfusion parameters assessed by volume perfusion computed tomography in hepatocellular carcinoma: Impact on lesion characterization.

To find out if magnetic resonance (MR)-signal characteristics of hepatocellular carcinomas (HCC) correlate with perfusion parameters assessed by volume perfusion computed tomography (VPCT). From October 2009 to January 2014, 26 (mean age, 69.3 years) patients with 36 HCC lesions who underwent both VPCT and MR liver imaging were analysed. We compared signal intensity in the T1w- and T2w-images and wash-in/wash-out kinetics on post-contrast MR images with mean values of blood flow (BF, mL/100 mL per minute), blood volume (BV, mL/100 mL), k-trans (mL/100 mL per minute), arterial liver perfusion (mL/100 mL per minute), portal venous perfusion and hepatic perfusion index (HPI, %) obtained by VPCT. Signal intensity on magnetic resonance imaging (MRI) was classified hyper/iso/hypointense compared with surrounding liver parenchyma. Signal intensity on native T1w- and T2w-images was hyper/iso/hypo in 4/16/16 and 21/14/1 lesions, respectively. Wash-in and wash-out contrast kinetics were found on MRI in 33 of 36 lesions (91.7%) and 25 of 36 lesions (69.4%), respectively. The latter was observed significantly more often in higher graded lesions (P < 0.005). HPI was 94.7% ± 6.5%. There was no significant relationship between lesion's MR-signal intensity, MR signal combinations, size and any of the VPCT-perfusion parameters. However HPI was constantly high in all HCC lesions. VPCT parameters add limited value to MR-lesion characterization. However in HCC lesions with atypical MR signal characteristics HPI can add a parameter to ensure HCC diagnosis.

The emerging role of positron emission tomography in hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality worldwide. HCC a heterogeneous disease occurring on the background of cirrhosis. The presence of cirrhosis limits the sensitivity of conventional imaging modalities in differentiating HCC from surrounding cirrhotic parenchyma. Positron emission tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) is widely used for assessing a variety of malignancies, however, has poor sensitivity in the evaluation of HCC. This has led to the investigation of other radiotracers such as 11C-acetate and 11C-choline, with improved sensitivity in terms of detection and therapeutic response. In this review, we discuss the emerging field of PET imaging for the detection, staging and assessment of treatment response in HCC. In particular we discuss the role of 18F-FDG-PET in imaging hepatocellular cancer, the limitations of this PET tracer and emerging novel PET tracers being investigated that exploit key metabolic processes including fatty acid and lipid synthesis, choline kinase activity and gene expression.

Synthesis of CdTe/CdS/ZnS quantum dots and their application in imaging ofhepatocellular carcinoma cells and immunoassay for alpha fetoprotein

We report the imaging of hepatocellular carcinoma cells and the immunoassay for alphafetoprotein (AFP) using CdTe/CdS/ZnS core–shell–shell QDs. Stable and high PLQY(20%–48%) CdTe/CdS/ZnS core–shell–shell QDs were synthesized by a stepwise process.Bioconjugation of the core–shell–shell QDs with streptavidin (SA) was successfully appliedin immunofluorescent imaging of the human hepatocellular carcinoma (HCC) cell lineHepG2.2.15. Furthermore, the thioglycolic acid (TGA)-capped CdTe/CdS/ZnScore–shell–shell QDs fluorescence lifetime is longer than fluorescein, so it was first engagedto conjugate with antigen for the determination of protein (AFP) by fluorescencepolarization immunoassay.

Posttranscatheter embolization computed tomography in hepatocellular carcinoma. Evaluation of embolization effects.

The postcontrast CT scans and angiography of 26 lesions in 23 patients with hepatomas who underwent transcatheter arterial embolization therapy were reviewed. Newly developed low density and high density areas and gas were noted on CT scans of the tumors after embolization in 100, 8 and 58% of the lesions, respectively. The CT findings of residual tumors correlated well with those of follow-up angiography. When discrete smooth round low density zones were observed on CT, there was no residual neovascularity on follow-up arteriography. When there were nodular or thick septum-like structures in low density lesions, arteriography revealed residual tumor vascularity in the lesions. CT proved useful not only in evaluating the effects of embolization, but also in providing important information about residual tumors.