Abstract
With advances in imaging and surgical techniques, the number of patients undergoing partial hepatectomies for primary or secondary liver tumors have significantly increased during the past decade. Improvements in imaging modalities have contributed to early detection, precise localization and characterization of liver lesions (Meun 1998). Refinements in surgical techniques have reduced both the morbidity and the mortality rates from elective hepatectomy and have allowed surgeons to consider more extensive resections. Nevertheless, in most patients with liver tumors, surgery is not an appropriate option. Patients with primary hepatocellular carcinoma (HCC) are often poor surgical candidates, because of the lack of hepatic reserve resulting from coexisting liver cirrhosis or the presence of multiple lesions at the time of the diagnosis (Lencioni and Also, in most patients with hepatic metastases resec-tion is not feasible because the lesion is adjacent to critical vascular structures or too many segments are involved that resection would not leave enough liver tissue for survival (Steele and Ravikumar 1989).
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References
Allgaier HP, Deibert P, Olschewski M, et al (1998) Survival benefit of patients with inoperable hepatocellular carcinoma treated by a combination of transarterial chemoembolization and percutaneous ethanol injection - a single-center analysis including 132 patients. Int I Cancer 79:601–605
Bartolozzi C, Lencioni R (1996) Ethanol injection for the treatment of hepatic tumours. Eur Radiol 6:682–696
Bartolozzi C, Lencioni R, Caramella D, et al (1994a) Treatment of hepatocellular carcinoma with percutaneous ethanol injection: evaluation with contrast-enhanced MR imaging. AIR 162:827–831
Bartolozzi C, Lencioni R, Caramella D, et al (1994b) Hepatocellular carcinoma: CT and MR features after transcatheter arterial embolization and percutaneous ethanol injection. Radiology 191:123–128
Bartolozzi C, Lencioni R, Caramella D, et al (1995) Treatment of large hepatocellular carcinoma: transcatheter arterial chemoembolization combined with percutaneous ethanol injection versus repeated transcatheter arterial chemoembolization. Radiology 197:812–818
Bartolozzi C, Lencioni R, Ricci P, Paolicchi A, Rossi P, Passariello R (1998) Hepatocellular carcinoma treatment with percutaneous ethanol injection: evaluation with contrast-enhanced color Doppler US. Radiology 209:387–393
Becker CD, Grossholz M, Mentha G, et al (1997) Ablation of hepatocellular carcinoma by percutaneous ethanol injection: imaging findings. Cardiovasc Intervent Radiol 20:204–210
Castellano L, Calandra M, Del Vecchio Blanco C, De Sio I(1997) Predictive factors of survival and intrahepatic recurrence of hepatocellular carcinoma in cirrhosis after percutaneous ethanol injection: analysis of 71 patients. J Hepatol 27:862–870
Choi BI, Kim TK, Han JK, et al (1992) Therapeutic effect of transcatheter oily chemoembolization therapy for encapsulated nodular hepatocellular carcinoma: CT and pathologic findings. Radiology 182:709–713
Colombo M (1997) Treatment of hepatocellular carcinoma. J Viral Hepat 4:5125–5130
Dalla Palma L (1998) Diagnostic imaging and interventional therapy of hepatocellular carcinoma. Br J Radiol 71:808–818
De Sanctis IT, Goldberg SN, Mueller PR (1998) Percutaneous treatment of hepatic neoplasms: a review of current techniques. Cardiovasc Intervent Radiol 21:273–296
Fujita T, Honjo K,Ito K, et al (1998) Dynamic MR follow-up of small hepatocellular carcinoma after percutaneous etha-nol injection therapy.J Comput Assist Tomogr 22:379–386
Goldberg SN, Hahn PF, Tanabe KK, et al (1998a)Percutaneous radiofrequency tissue ablation: does perfusion-mediated tissue cooling limit coagulation necrosis? J Vasc Intery Radiol 9:101–111
Goldberg SN, Gazelle GS, Solbiati L, et al (1998b) Ablation of liver tumors using percutaneous RF therapy. AJR 170:1023–1028
Groupe d’Etude et de Traitement du Carcinome Hepatocellulaire (1995) A comparison of lipiodol chemoembolization and conservative treatment for unresectau e hepatocellular carcinoma. N Engl J Med 332:1256–1261
Ito K, Honjo K, Fujita T, Awaya H, Mastumoto T, Mastunaga N (1995) Enhanced MR imaging of the liver after ethanol treatment of hepatocellular carcinoma: evaluation of areas of hyperperfusion adjacent to the tumor. AJR 164:1413–1417
Johnson RC (1997) Hepatocellular carcinoma. Hepatogastroenterology 44:307–312
Joseph FB, Baumgartner DA, Bernardino ME (1993) Hepatocellular carcinoma: CT appearance after percutaneous ethanol ablation therapy. Radiology 186:553–556
Kim AY, Choi BI, Kim TK, et al (1998) Hepatocellular carcinoma: power Doppler US with a contrast agent - preliminary results. Radiology 209:135–140
Kim DE, Kim PN, Lee HJ, et al (1998) Vasculature in hepatocellular carcinoma after transcatheter arterial chemoembolization: comparison of power and color Doppler sonography. J Ultrasound Med 17:9–15
Kim TK, Choi BI, Han JK, Chung JW, Park JH, Han MC (1998) Nontumorous arterioportal shunt mimicking hyper-vascular tumor in cirrhotic liver: two-phase spiral CT findings. Radiology 208:597–603
Koda M, Okamoto K, Miyoshi Y, et al (1994) Combination therapy with transcatheter arterial embolization and per-cutaneous ethanol injection for advanced hepatocellular carcinoma. Hepatogastroenterology 41:25–29
Kubota Y, Nakano T, Seki T, et al (1989) Validity of MR imaging for monitoring effects of percutaneous ethanol injection for HCC. Hepatogastroenterology 36:262–265
Kumada T, Nakano S, Takeda I, et al (1997) Patterns of recurrence after initial treatment in patients with small hepatocellular carcinoma. Hepatology 25:87–92
Lencioni R, Bartolozzi C (1997) Nonsurgical treatment of hepatocellular carcinoma. Cancer J 10:17–23
Lencioni R, Caramella D, Bartolozzi C (1993) Response of hepatocellular carcinoma to percutaneous ethanol injection: CT and MR evaluation. J Comput Assist Tomogr 17: 723–729
Lencioni R, Caramella D, Vignali C, et al (1994a) Lipiodol-TC in the detection of tumor persistence in hepatocellular carcinoma treated with percutaneous ethanol injection therapy. Acta Radiol 35:323–328
Lencioni R, Vignali C, Caramella D, et al (1994b) Trans-catheter arterial embolization followed by percutaneous ethanol injection in the treatment of hepatocellular carcinoma. Cardiovasc Intervent Radiol 17:70–75
Lencioni R, Bartolozzi C, Caramella D, et al (1995a) Treatment of small hepatocellular carcinoma with percutaneous ethanol injection: analysis of prognostic factors in 105 Western patients. Cancer 76:1737–1746
Lencioni R, Caramella D, Bartolozzi C (1995b) Hepatocellular carcinoma: use of color Doppler US to evaluate response to treatment with percutaneous ethanol injection. Radiology 194:113–118
Lencioni R, Caramella D, Sanguinetti F, Battolla L, Fa.laschi I, Bartolozzi C (1995c) Portal vein thrombosis after percutaneous ethanol injection for hepatocellular carcinoma; value of color Doppler sonography in distinguishing chemical and tumor thrombi. AIR 164:1125–1130
Lencioni R, Pinto F, Armillotta N, Bartolozzi C (1996) Assess ment of tumor vascularity in hepatocellular carcinoma: comparison of power Doppler US and color Dop oler US. Radiology 201:353–358
Lencioni R, Pinto F, Armillotta N, et al (1997) Long-term results of percutaneous ethanol injection therapy for hepatocellular carcinoma in cirrhosis: a European experience. Eur Radiol 7:514–519
Lencioni R, Goletti O, Armillotta N, et al (1998a) Radio-frequency thermal ablation of liver metastases with a cooled-tip electrode needle: results of a pilot clinical trial. Eur Radiol 8:1205–1211
Lencioni R, Paolicchi A, Moretti M, et al (1998b) Combined transcatheter arterial chemoembolization and percutaneous ethanol injection for the treatment of large hepatoceIlular carcinoma: local therapeutic effect and long-term survival rate. Eur Radiol 8:439–444
Lin DY, Lin SM, Liaw YF (1997) Non-surgical treatment of hepatocellular carcinoma. I Gastroenterol Hepatol 12:5319–5328
Livraghi T (1998) Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis. Hepatogastroenterology 45(53):1248–1253
Livraghi T, Festi D, Monti M, et al (1986) US-guided pc rcuta-neous alcohol injection of small hepatic and abdominal tumors. Radiology 161:309–312
Livraghi T, Giorgio A, Marin G, et al (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. Radiology 197:101–108
Matsui O, Kadoya M, Yoshikawa J, et al (1993) Small hopatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization. Radiology 188:79–83
Menu Y (1998) Hepatocellular carcinoma: radiological findings. Hepatogastroenterology 45(S3):1232–1235
Murayama S, Tsukamoto Y, Watanabe H, Nakata H (1986) Computed tomography of residual hepatomas following transcatheterarterial embolization. J Comput Assist Tomogr 10:969–972
Nagel HS, Bernardino ME (1993) Contrast-enhances MR imaging of hepatic lesions treated with percutaneous ethanol ablation therapy. Radiology 189:265–270
Naik KS, Ward J, Guthrie JA, et al (1997) Hepatic lesions detection: a comparison of super-paramagnetic ferum oxide (SPIO) enhanced MR imaging and dual-phase helical CT with AFROC analysis. Radiology 205(P):372
Nishizaki T, Takenaka K, Yanaga K, et al (1997) Early datection of recurrent hepatocellular carcinoma.Hepatogastroenterology 44:508–513
Pompili M, Rapaccini GL, De Luca F, et al (1997) Risk factors for intrahepatic recurrence of hepatocellular carcinoma in cirrhotic patients treated by percutaneous ethanol injection. Cancer 79:1501–1508
Ros PR, Freeny PC, Harms SE, et al (1995) Hepatic MR imaging with ferumoxides: a multicenter clinical trial of the safety and efficacy in the detection of focal hepatic lesions. Radiology 196:481–488
Rossi S, Di Stasi M, Buscarini E, et al (1996) Percutaneom RF Imaging Evaluation of Tumor Response 487 interstitial thermal ablation in the treatment of hepatic cancer. AIR 167:759–768
Rossi S, Buscarini E, Garbagnati F, et al (1998) Percutaneous treatment of small hepatic tumors by using an expandable RF electrode needle. AIR 170:1015–1022
Sironi S, Livraghi T, Del Maschio A (1991) Small hepatocellular carcinoma treated with percutaneous ethanol injection. MR imaging findings. Radiology 180: 333–336
Sironi S, Livraghi T, Angeli E, et al (1993) Small hepatocellular carcinoma: MR follow-up of treatment with percutaneous ethanol injection. Radiology 187:119–123
Sironi S, De Cobelli F, Livraghi T, et al (1994) Small hepatocellular carcinoma treated with percutaneous ethanol injection: unenhanced and gadolinium-enhanced MR imaging follow-up. Radiology 192:407–412
Solbiati L (1998) New applications of ultrasonography: interventional ultrasound. Eur J Radiol 27:S200–S206
Solbiati L, Goldberg SN, Lerace T, et al (1997a) Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes. Radiology 205:367–373
Solbiati L, Ierace T, Goldberg SN, et al (1997b) Percutaneous US-guided radio-frequency tissue ablation of liver metastases: treatment and follow up in 16 patients. Radiology 202:195–203
Steele G Jr, Ravikumar TS (1989) Resection of hepatic me-tastases from colorectal cancer: biological perspectives. Ann Surg 210:127–138
Takayasu K, Moriyama N, Muramatsu Y, et al (1984) Hepatic artery embolization for hepatocellular carcinoma: comparison of CT scans and resected specimens. Radiology 150:661–665
Tanaka K, Nakamura S, Numata K, et al (1992) Hepatocellular carcinoma: treatment with percutaneous ethanol injection and transcatheter arterial embolization. Radiology 185:457–460
Tanaka K, Nakamura S, Numata K, et al (1998) The long term efficacy of combined transcatheter arterial embolization and percutaneous ethanol injection in the treatment of patients with large hepatocellular carcinoma and cirrhosis. Cancer 82:78–85
Ueno N, Tomiyama I, Tano S (1998) Color Doppler sonography-guided ethanol injection therapy for hepatocellular carcinoma. AIR 170:515–519
Yoshioka H, Nakagawa K, Shindou H, et al (1990) MR imaging of the liver before and after transcatheter hepatic chemoembolization for hepatocellular carcinoma. Acta Radiol 31:63–67
Yu JS, Kim KW, Sung KB, Lee JT,Yoo HS (1997) Small arterial-portal venous shunts: a cause of pseudolesions at hepatic imaging. Radiology 203:737–742
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Bartolozzi, C., Cioni, D., Donati, F., Granai, G., Lencioni, R. (1999). Imaging Evaluation of Tumor Response. In: Bartolozzi, C., Lencioni, R. (eds) Liver Malignancies. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58641-5_30
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DOI: https://doi.org/10.1007/978-3-642-58641-5_30
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