Advertisement

Clinical Implications of Liver Malignancies

  • Elissaios A. Kontis
  • Georgios P. Fragulidis
Chapter

Abstract

A variety of imaging techniques can be used to identify liver lesions each one with their own sensitivity, specificity, and spatial resolution. Ultrasonography (US) remains the most readily available mode; its diagnostic potential within the context of liver neoplasms could further be enhanced with the addition of contrast administration (contrast-enhanced US (CEUS)). Computed tomography (CT) and magnetic resonance imaging (MRI) of the liver has been recognized as more reliable and reproducible techniques because of their dynamic and multiphasic imaging capacity. Contrast-enhanced multidetector CT (MDCT) and MRI are used for diagnostic purposes as well as to assess the tumor burden, vascular or biliary invasion, future liver remnant volume; finally, CT and/or MRI could give information for structural features of preexisting chronic liver disease (i.e., features of portal hypertension, liver contour, etc.). Other modalities, such as CT arterioportography (CTAP), CT hepatic arteriography (CTHA), and laparoscopy with or without intraoperative US, are also used depending on experience of the clinicians and radiologists. Finally, positron emission tomography with either 18-fluorodeoxyglucose (18-FDG-PET) or choline has also added a new dimension to functional liver imaging.

References

  1. 1.
    Wong P (2009) Further defining liver imaging— physician and radiologist in dialogue. Eur Gastroenterol Hepatol Rev 4(2):14–18Google Scholar
  2. 2.
    Tirumani SH, Kim KW, Nishino M, Howard SA, Krajewski KM, Jagannathan JP, Cleary JM, Ramaiya NH, Shinagare AB (2014) Update on the role of imaging in management of metastatic colorectal cancer. Radiographics 34(7):1908–1928.  https://doi.org/10.1148/rg.347130090 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Cutsem EV, Verheul HMW, Flamen P, Rougier P, Beets-Tan R, Glynne-Jones R, Seufferlein T (2016) Imaging in colorectal cancer: progress and challenges for the clinicians. Cancers 8:81.  https://doi.org/10.3390/cancers8090081 CrossRefPubMedCentralGoogle Scholar
  4. 4.
    Walker AS, Zwintscher NP, Johnson EK, Maykel JA, Stojadinovic A, Nissan A, Avital I, Brücher BL, Steele SR (2014) Future directions for monitoring treatment response in colorectal cancer. J Cancer 5(1):44–57.  https://doi.org/10.7150/jca.7809 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Benoist S, Brouquet A, Penna C, Julié C, El Hajjam M, Chagnon S, Mitry E, Rougier P, Nordlinger BJ (2006) Complete response of colorectal liver metastases after chemotherapy: does it mean cure? Clin Oncol 24(24):3939–3945CrossRefGoogle Scholar
  6. 6.
    Jones RP, Kokudo N, Folprecht G, Mise Y, Unno M, Malik HZ, Fenwick SW, Poston GJ (2016) Colorectal liver metastases: a critical review of state of the art. Liver cancer 6(1):66–71. Epub 2016 Nov 29CrossRefGoogle Scholar
  7. 7.
    Mise Y, Aloia TA, Brudvik KW, Schwarz L, Vauthey JN, Conrad C (2016) Parenchymal-sparing hepatectomy in colorectal liver metastasis improves Salvageability and survival. Ann Surg 263:146–152CrossRefGoogle Scholar
  8. 8.
    Weiss MJ, D’Angelica MI (2012) Patient selection for hepatic resection for metastatic colorectal cancer. J Gastrointest Oncol 3(1):3–10PubMedPubMedCentralGoogle Scholar
  9. 9.
    Frankel TL, Kinh Gian Do R, Jarnagin WR (2012) Preoperative imaging for hepatic resection of colorectal cancer metastasis. J Gastrointest Oncol 3:11–18PubMedPubMedCentralGoogle Scholar
  10. 10.
    Adam R, De Gramont A, Figueras J et al (2012) The oncosurgery approach to managing liver metastases from colorectal cancer: a multidisciplinary international consensus. Oncologist 17:1225–1239CrossRefGoogle Scholar
  11. 11.
    Sahani DV, Kalva SP, Tanabe KK et al (2004) Intraoperative US in patients undergoing surgery for liver neoplasms: comparison with MR imaging. Radiology 232:810–814CrossRefGoogle Scholar
  12. 12.
    Choi BI, Lee JM (2010) Advancement in HCC imaging: diagnosis, staging and treatment efficacy assessments imaging diagnosis and staging of hepatocellular carcinoma. J Hepatobiliary Pancreat Sci 17:369–373CrossRefGoogle Scholar
  13. 13.
    Willatt JM, Hussain HK, Adusumilli S et al (2008) MR imaging of hepatocellular carcinoma in the cirrhotic liver: challenges and controversies. Radiology 247(2):311–330CrossRefGoogle Scholar
  14. 14.
    Sun H, Song T (2015) Hepatocellular carcinoma: advances in diagnostic imaging. Drug Discov Ther Oct 9(5):310–318.  https://doi.org/10.5582/ddt.2015.01058 CrossRefGoogle Scholar
  15. 15.
    Ayuso C, Rimola J, Garcia-Criado A (2011) Imaging of HCC. Abdom Imaging 37:215–230CrossRefGoogle Scholar
  16. 16.
    Bruix J, Sherman M (2011) AASLD practice guideline management of hepatocellular carcinoma: an update. Hepatology 53(3):1020–1022.  https://doi.org/10.1002/hep.24199 CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Williams R (2012) Looking after the liver as well as the tumour. In: Williams R, Taylor-Robinson SD (eds) Clinical dilemmas in primary liver cancer. Wiley-Blackwell, UK, pp 67–72Google Scholar
  18. 18.
    Tan CH, Albert Low SC, Thng CH (2011) APASL and AASLD consensus guidelines on imaging diagnosis of hepatocellular carcinoma: a review. Int J Hepatol 519783:11.  https://doi.org/10.4061/2011/519783 CrossRefGoogle Scholar
  19. 19.
    American College of Radiology. Liver Imaging Reporting and Data System version 2014. http://www.acr.org/Quality-Safety/Resources/LIRADS
  20. 20.
    Llovet JM, Schwartz M, Mazzaferro V (2005) Resection and liver transplantation for hepatocellular carcinoma. Semin Liver Dis 25(2):181–200CrossRefGoogle Scholar
  21. 21.
    Ringe KI, Wacker F (2015) Radiological diagnosis in cholangiocarcinoma: application of computed tomography, magnetic resonance imaging, and positron emission tomography. Best Practice Research Clinical Gastroenterology 29(2):253–265.  https://doi.org/10.1016/j.bpg.2015.02.004 CrossRefGoogle Scholar
  22. 22.
    Blechacz B, Komura M, Roskams T, Gores GJ (2011) Clinical diagnosis and staging of cholangiocarcinoma. Nat Rev Gastroenterol Hepatol 8(9):512–522CrossRefGoogle Scholar
  23. 23.
    Cho SY et al (2010) Survival analysis of intrahepatic cholangiocarcinoma after resection. Ann Surg Oncol 17:1823–1830CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute of Liver StudiesKing’s College Hospital, NHS Foundation TrustLondonUK
  2. 2.2nd Department of Surgery, Aretaieio HospitalUniversity of Athens Medical SchoolAttica, AthensGreece

Personalised recommendations