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Published on: August 4, 2012
[CT measurement of blood perfusion in hepatocellular carcinoma: from basic principle, measurement methods to clinical
Y K Li1, Q B Wang1, Y B Liang1
1Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China.
Insights
Hepatocellular carcinoma (HCC) blood perfusion measurement has evolved to non-invasive CT techniques. These CT methods, including semi-quantitative, relative quantitative, and absolute quantitative techniques, are vital for diagnosing and treating HCC.
Area of Science:
- Hepatology
- Medical Imaging
- Oncology
Background:
- Hepatocellular carcinoma (HCC) is a leading cause of cancer death, particularly in China.
- HCC alters liver blood supply from the portal vein to the hepatic artery.
- Understanding HCC vascularization is crucial for diagnosis and treatment.
Purpose of the Study:
- To review and categorize CT-based techniques for measuring HCC blood perfusion.
- To provide a reference for selecting appropriate CT methods in HCC management.
Main Methods:
- Categorization of CT measurement techniques into semi-quantitative, relative quantitative, and absolute quantitative.
- Discussion of the principles, scanning methods, and clinical applications of each technique.
Main Results:
- CT techniques offer accurate and relatively easy assessment of HCC perfusion.
- Technological advancements have shifted from invasive to non-invasive CT methods.
- Dynamic HCC blood perfusion changes show potential as biomarkers for treatment.
Conclusions:
- CT-based blood perfusion measurement is significant for guiding HCC diagnosis and treatment.
- Various CT techniques provide valuable data for clinical decision-making.
- Future applications may include AI and advanced radiotherapy modulation.
Abstract:
Hepatocellular carcinoma (HCC) is one of the common and fatal malignant tumors worldwide, and the burden of HCC is particularly severe in China. Physiologically, the blood supply to healthy liver is mainly from the portal vein, supplemented by the hepatic artery. While in the development of HCC, the main source of blood supply to HCC is changed from the portal vein to the hepatic artery. The characteristics of HCC vascularization are important for imaging, surgery, interventional therapy, targeted therapy, etc. Even in the future, with the development of radiation therapy technology, such as proton and heavy ion therapy and artificial intelligence technology, the dynamic changes in HCC blood perfusion can be used as a new biomarker of tumor activity to provide accurate information on the intensity modulation of radiotherapy, so that accurate measurements of HCC blood perfusion is of great significance in guiding the diagnosis and treatment of HCC. The technologies for measurement of HCC blood perfusion have developed from invasive techniques, such as inert gas scavenging, electromagnetic flowmeter, and radionuclide-labeled erythrocyte elution in the middle of the last century to the present non-invasive techniques of CT. With the development of CT imaging technology in the last 30 years, the CT-based imaging technology can assess the status of organ and tissue perfusion relatively easily and accurately. In this paper, the various CT measurement techniques of blood perfusion in HCC were categorized into three types: semi-quantitative technique, relative quantitative technique, and absolute quantitative technique. Their basic principle, scanning methods, and clinical applications were discussed to provide a reference for the diagnosis and treatment of HCC.
