Imaging of metastatic liver disease
Source: Clujul Medical. Jun, Vol.
Abstract: Neoadjuvant image-guided therapies comprises all locoregional treatment administred to hepatocellular caricinoma patients in order to maintain eligibility during liver transplantation waiting time: transcatheter arterial chemoembolization TACEselective internal radiation therapy SIRTchemical alcohol injection CAIradio frequency ablation RFA. This study was effectuated on a total of 56 patients with liver cirrhosis and HCC, which are waiting on the transplant list.
According to imaging appearance, compared with imaging study before treatment, the results were interpreted as such: tumor regression, identical size and tumor progression. The treated HCC nodules were analyzed by pathology at the time of liver transplantation. The follow up was made clinically, biologically alpha-fetoprotein AFP level, and imaging at one month after treatment and every 3 months after transplantation.
The average time between treatments up the transplantation was Residual tumor or tumor progression at index nodule level was proven in 14 patients; 8 patients had new lesions. On pretransplant imaging followup 38 of 68 nodules were stable or in regression. Contrast imaging exams have a tendency of underestimating viable tumor fraction of the treated lesions and can omit new tumor sites.
Neoadjuvant therapy are palliative unable to provide a hepatic cancer ct for HCC. They are useful by improving outcomes and represents a bridge to liver transplantation.
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