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Overview of Functional Imaging Techniques for Liver Malignancies in Current Clinical Practice or in a Very Near Future

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Functional Imaging in Oncology

Abstract

There are a number of functional imaging techniques which are able to provide information from different characteristics of liver malignancies. Different levels of validation of all of these techniques have been accumulated in recent years. All of them offer quantitative parameters with potential to be used as imaging biomarkers in oncology. Currently, it is necessary to search the insights and biological meanings of the different measured parameters obtained with these techniques to determine their clinical applications. The use of 18FDG PET-CT in the evaluation of hepatic metastases and primary liver malignancies is highly introduced in the clinical setting. MRI has given a step forward from anatomy to function by the development of several functional approaches. The most extended in clinical practice is diffusion-weighted imaging (DWI), which has been proposed as an oncological imaging biomarker of interstitium occupancy and reflects cellular density, cell membrane integrity, presence of macromolecules, fluid viscosity, and even microcapillary perfusion. In addition, MRI allows analyzing tumor metabolism by means of 1H-MR spectroscopy, tumor hypoxia using blood-oxygen-level-dependent (BOLD), and angiogenesis using different approaches with (dynamic contrast-enhanced MRI) and without contrast agent injection (arterial spin labeling and intravoxel incoherent motion analysis of signal diffusion). Moreover, tumor angiogenesis can also be studied with CT perfusion and contrast-enhanced ultrasound (CEUS). Estimation of hepatic function with the injection of hepatobiliary contrast agent (HBCA) and hepatic parenchyma stiffness and elasticity with US and MRI elastography has also shown interesting applications in the evaluation of liver tumors.

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Abbreviations

18FDG:

F-18-fluoro-deoxy-glucose

ADC:

Apparent diffusion coefficient

ASL:

Arterial spin labeling

AUC:

Area under the curve

BF:

Regional blood flow

BOLD:

Blood-oxygen-level-dependent

BV:

Regional blood volume

CEUS:

Contrast-enhanced ultrasound

CHC:

Cholangiocarcinoma

CNR:

Contrast-to-noise ratio

CRC:

Colorectal carcinoma

CT:

Computed tomography

D :

Tissue diffusivity

D*:

perfusion contribution to signal decay

DCE-MRI:

Dynamic contrast enhanced-MRI

DWI:

Diffusion-weighted imaging

f :

Perfusion fraction

FE:

Extraction fraction

FNH:

Focal nodular hyperplasia

Gd-BOPTA:

Gadobenate dimeglumine

Gd-EOB-DTPA:

Gadolinium-ethoxibenzyl-diethylenetriamine pentaacetic acid

GE:

Gradient echo

HA:

Hepatic adenoma

HBCA:

Hepatobiliary contrast agent

HCC:

Hepatocellular carcinoma

IVIM:

Intravoxel incoherent motion

K ep :

Rate constant

K trans :

Efflux constant

MIP:

Maximum intensity projection

MRI:

Magnetic resonance imaging

OATP:

Organic anion transporting polypeptide

PET:

Positron emission tomography

PRESS:

Point-resolved spectroscopy

PS:

Permeability surface area product

SNR:

Signal to noise ratio

SPIO:

Super paramagnetic iron oxide nano-particles

SS SE EPI:

Single-shot spin-echo echo-planar imaging

STEAM:

Stimulated-echo acquisi-tion mode

STIR:

Short-tau inversion recovery

SUV:

Standard uptake value

TACE:

Transcatheter arterial chemoembolization

THRIVE:

T1-weighted high-resolution isotropic volume examination

TSE:

Turbo spin echo

US:

Ultrasound

V e :

Volume of extravascular extracellular space

Vp:

Plasma volume

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Author information

Authors and Affiliations

  1. Health Time Group, Jaén, Spain

    Antonio Luna MD (Chief of MRI)

  2. Department of Radiology, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA

    Antonio Luna MD (Chief of MRI)

  3. Body Imaging, CDPI, DASA, Rio de Janeiro, Brazil

    Guilherme Moura Cunha MD

  4. Nuclear Medicine Department, Virgen de las Nieves University Hospital, Granada, Spain

    Rocío Sánchez-Sánchez MD, PhD & Antonio Rodriguez-Fernández MD

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  1. Antonio Luna MD
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Correspondence to Antonio Luna MD .

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  1. Health Time Group, Jaén, Spain

    Antonio Luna

  2. Clinica Girona Hospital Sta. Caterina, Gerona, Spain

    Joan C. Vilanova

  3. CDPI and IRM, Botafongo - Rio de Janeiro/RJ, Brazil

    L. Celso Hygino Da Cruz Jr.

  4. Centro de Diagnóstico Dr. Enrique Rossi, Buenos Aires, Argentina

    Santiago E. Rossi

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Luna, A., Cunha, G.M., Sánchez-Sánchez, R., Rodriguez-Fernández, A. (2014). Overview of Functional Imaging Techniques for Liver Malignancies in Current Clinical Practice or in a Very Near Future. In: Luna, A., Vilanova, J., Hygino Da Cruz Jr., L., Rossi, S. (eds) Functional Imaging in Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40582-2_16

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  • DOI: https://doi.org/10.1007/978-3-642-40582-2_16

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