[Modern technologies of diagnosis and combined surgical treatment in liver tumors]

Modern technologies used at St. Petersburg Central Research Institute of Roentgenology and Radiotherapy of Russia's Ministry of Health in the diagnosis and treatment of malignant and benign liver cancers are surveyed in the paper. Apart from routine examinations, like ultrasound scanning, computer tomography, MRT, angiography, the below new technologies were widely used: multi-stratum spiral computer tomography, special MRT techniques and positron-emission tomography. The new methods enabled us to diagnose the tumor and its extension, to choose an optimal intervention technique, to make an objective assessment of the results and to correct the treatment strategy. Preoperative embolization of the portal-vein branches in the damaged hepatic lobe and postoperative adjuvant local chemotherapy of the hepatic artery and portal vein belong to the new combined surgical treatment scheme. The method of combined arterial-portal chemoembolization, used in unresectable malignant hepatic pathologies, extends the survival of patients by 3-5 times. Ferromagnetic embolization presupposes the administration of ferromagnetic, through the arterial bed or direct puncture, into the tumor with a subsequent SHF-current treatment which brings about a selective tumor hyperthermia without heating the normal hepatic parenchyma. Arterial embolization combined with local injection sclerotherapy in hemangiomas of the liver provides for a complete regeneration of benign tumors and can be regarded as a low-trauma alternative to liver resection. The use of new methods of diagnosis and treatment expands the possibilities of surgical care for patients with hepatic neoplasms and essentially improves the treatment results.