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Artificial Intelligence in Cancer 2024年第1期5卷 1-12页

作者： Paola Tombesi Andrea Cutini Valentina Grasso Francesca Di Vece Ugo Politti Eleonora Capatti Florence Labb Stefano Petaccia Sergio Sartori Department of Internal Medicine Section of Interventional UltrasoundSt.Anna HospitalFerrara 44100Italy Esaote S.p.A. Genova 16100Italy

The first ablation procedures for small hepatocellular carcinomas were percutaneous ethanol injection under ultrasound(US)***,radiofrequency ablation was shown to achieve larger coagulation areas than percutaneous ethanol injection and became the most used ablation technique *** the past decade,microwave ablation systems have achieved larger ablation areas than radiofrequency ablation,suggesting that the 3-cm barrier could be broken in the treatment of liver ***,US techniques to guide percutaneous ablation have seen important ***-enhanced US(CEUS)can define and target the tumor better than US and can assess the size of the ablation area after the procedure,which allows immediate retreatment of the residual tumor ***,fusion imaging fuses real-time US images with computed tomography or magnetic resonance imaging with significant improvements in detecting and targeting lesions with low conspicuity on ***,software powered by artificial intelligence has been developed to allow three-dimensional segmentation and reconstruction of the anatomical structures,aiding in procedure planning,assessing ablation completeness,and targeting the residual viable foci with greater precision than ***,this could lead to the ablation of tumors up to 5-7 cm in size.

关键词： Artificial intelligence Fusion imaging Percutaneous thermal ablation Microwave ablation Radiofrequency ablation ultrasound Contrast-enhanced ultrasound

Application of interventional therapy via hepatic artery in pancreatic neuroendocrine neoplasms liver metastases

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胰腺病学杂志(英文) 2024年第2期7卷 141-144页

作者： Liu Haikuan Yu Hang Yang Dequan Yao Wang Wang Yu Department of interventional Oncology the First Affiliated Hospital Sun Yat-sen University Guangzhou China

Pancreatic neuroendocrine neoplasm (PNEN) is the second most common malignant tumor of the pancreas. It has the characteristic of high metastases rate, and the liver is the most common site for metastasis. Metastasis affects prognosis and survival seriously. A number of earlier studies have shown that the interventional therapy via hepatic artery could reduce hepatic tumor burden and hormone secretion safely and rapidly, significantly improve objective response rate (ORR), and enhance the efficacy and prolong the survival time when combined with system therapy. The interventional therapy via hepatic artery plays an important role in the treatment of PNEN liver metastases. interventional therapy via hepatic artery could possibly increase ORR, prolong progression-free survival, and even overall survival for appropriate patients.

关键词： interventional therapy liver metastases Neuroendocrine neoplasm Pancreas

Transarterial embolization is an acceptable bridging therapy to hepatocellular carcinoma prior to liver transplantation

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World Journal of Transplantation 2024年第2期14卷 126-134页

作者： Gabriel Lazzarotto-da-Silva Leandro A Scaffaro Mauricio Farenzena Lucas Prediger Rafaela K Silva Flávia Heinz Feier Tomaz J M Grezzana-Filho Pablo D Rodrigues Alexandre de Araujo Mario Reis Alvares-da-Silva Roberta C Marchiori Cleber Rosito Pinto Kruel Marcio Fernandes Chedid Department of liver Transplant and Hepatobiliary Surgery unit Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil Department of interventional Radiology unit Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil Department of Gastroenterology and Hepatology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil

BACKGROUND Hepatocellular carcinoma(HCC)is an aggressive malignant neoplasm that requires liver transplantation(LT).Despite patients with HCC being prioritized by most organ allocation systems worldwide,they still have to wait for long *** therapies(LRTs)are employed as bridging therapies in patients with HCC awaiting *** largely used in the past,transarterial embolization(TAE)has been replaced by transarterial chemoembolization(TACE).However,the superiority of TACE over TAE has not been consistently shown in the *** To compare the outcomes of TACE and TAE in patients with HCC awaiting *** All consecutive patients with HCC awaiting LT between 2011 and 2020 at a single center were *** patients underwent LRT with either TACE or *** patients also underwent percutaneous ethanol injection(PEI),concom-itantly or in different treatment *** choice of LRT for each HCC nodule was determined by a multidisciplinary *** primary outcome was waitlist dropout due to tumor progression,and the secondary outcome was the occurrence of adverse *** the subset of patients who underwent LT,complete pathological response and post-transplant recurrence-free survival were also *** Twelve(18.5%)patients in the TACE group(only TACE and TACE+PEI;n=65)and 3(7.9%)patients in the TAE group(only TAE and TAE+PEI;n=38)dropped out of the waitlist due to tumor progression(P log-rank test=0.29).Adverse events occurred in 8(12.3%)and 2(5.3%)patients in the TACE and TAE groups,respectively(P=0.316).Forty-eight(73.8%)of the 65 patients in the TACE group and 29(76.3%)of the 38 patients in the TAE group underwent LT(P=0.818).Among these patients,complete pathological response was detected in 7(14.6%)and 9(31%)patients in the TACE and TAE groups,respectively(P=0.145).Post-LT,HCC recurred in 9(18.8%)and 4(13.8%)patients in the TACE and TAE groups,respectively(P=0.756).Posttransplant recurrence-free survival was simila

关键词： Hepatocellular carcinoma Transarterial embolization Transarterial chemoembolization liver transplantation Locoregional therapy Bridging

Nomogram based on liver stiffness and spleen area with ultrasound for posthepatectomy liver failure:A multicenter study

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World Journal of Gastroenterology 2024年第27期30卷 3314-3325页

作者： Guang-Wen Cheng Yan Fang Li-Yun Xue Xiao-Hui Qiao Xue-Qi Li Yan Zhang Jia Guo Xiao-Yan Xie Hong Ding Department of ultrasound Huashan HospitalFudan UniversityShanghai 200040China Department of ultrasound Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Department of Medical Ultrasonics Institute of Diagnostic and Interventional UltrasoundSun Yat-sen University First Affiliated HospitalGuangzhou 510080Guangdong ProvinceChina Institute of ultrasound in Medicine and Engineering Shanghai Cancer CenterShanghai 200040China Department of ultrasound Eastern Hepatobiliary Surgical HospitalSecond Military Medical UniversityShanghai 200433China Department of ultrasound National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghai 200040China

BACKGROUND liver stiffness(LS)measurement with two-dimensional shear wave elastography(2D-SWE)correlates with the degree of liver fibrosis and thus indirectly reflects liver function *** size of the spleen increases due to tissue proliferation,fibrosis,and portal vein congestion,which can indirectly reflect the situation of liver fibrosis/*** was reported that the size of the spleen was related to posthepatectomy liver failure(PHLF).So far,there has been no study combining 2D-SWE measurements of LS with spleen size to predict *** prospective study aimed to investigate the utility of 2D-SWE assessing LS and spleen area(SPA)for the prediction of PHLF in hepatocellular carcinoma(HCC)patients and to develop a risk prediction *** To investigate the utility of 2D-SWE assessing LS and SPA for the prediction of PHLF in HCC patients and to develop a risk prediction *** This was a multicenter observational study prospectively analyzing patients who underwent hepatectomy from October 2020 to March *** 1 wk before partial hepatectomy,ultrasound examination was performed to measure LS and SPA,and blood was drawn to evaluate the patient’s liver function and other *** absolute shrinkage and selection operator logistic regression and multivariate logistic regression analysis was applied to identify independent predictors of PHLF and develop a *** performance was validated *** diagnostic performance of the nomogram was evaluated with receiver operating charac-teristic curve compared with the conventional models,including the model for end-stage liver disease(MELD)score and the albumin-bilirubin(ALBI)*** A total of 562 HCC patients undergoing hepatectomy(500 in the training cohort and 62 in the validation cohort)were enrolled in this *** independent predictors of PHLF were LS,SPA,range of resection,blood loss,international normalized ratio,and total *** diagnostic performanc

关键词： Shear-wave elastography Spleen Hepatectomy Posthepatectomy liver failure Hepatocellular carcinoma

Non-anatomical liver resection for hepatocellular carcinoma:the SegSubTe classification to overcome the problem of heterogeneity

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 265-271页

作者： Mattia Garancini Alessandro Fogliati Mauro Alessandro Scotti Cristina Ciulli Francesca Carissimi Antonio Rovere Luca Gianotti Fabrizio Romano unit of Hepatobiliopancreatic Surgery Department of SurgeryASST-MonzaSan Gerardo HospitalUniversity of Milano-Bicoccavia Pergolesi 33MonzaMB 20052Italy interventional Radiology Department of RadiologyASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 33MonzaMB 20052Italy

Background:The superiority of anatomical resection(AR)***-anatomical resection(NAR)in the surgical management of hepatocellular carcinoma(HCC)is *** are well-defined procedures,whereas the lack of NAR standardization results in heterogeneous *** study aimed to introduce the SegSubTe classification for NAR detailing the appropriateness of the level of surgical section of the Glissonean pedicles feeding the ***:A single-center retrospective analysis of pre-and postoperative imaging of consecutive patients treated with NAR for single HCC between 2012 and 2020 was *** quality of surgery was assessed classifying the type of vascular supply and the level of surgical section(segmental,subsegmental or terminal next to the tumor)of vascular pedicles feeding the HCCs;then,the population was divided in“SegSubTe-IN”or“SegSubTe-OUT”groups,and the tumor recurrence and survival were ***:Ninety-seven patients who underwent NAR were included;76%were SegSubTe-IN and 24%were *** disease recurrence,local recurrence and cut-edge recurrence in the SegSubTe-IN ***-OUT groups were 50%vs.83%(P=0.006),20%vs.52%(P=0.003)and 16%vs.39%(P=0.020),***-OUT odds ratio for local recurrence was 4.1 at univariate regression ***-,three-,and five-year disease-free survival rates in the SegSubTe-IN ***-OUT groups were 81%,58%and 35%vs.46%,21%and 11%,respectively(P<0.001).Conclusions:The SegSubTe classification is a useful tool to stratify and standardize NAR for HCC,aiming at improving long-term oncological outcomes and reducing the heterogeneity of quality of NAR for HCC.

关键词： Hepatocellular carcinoma Intraoperative ultrasound liver surgery Computed tomography Surgical procedure

Ultrasomics in liver cancer: Developing a radiomics model for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma using contrast-enhanced ultrasound

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World Journal of Radiology 2024年第7期16卷 247-255页

作者： Li-Ya Su Ming Xu Yan-Lin Chen Man-Xia Lin Xiao-Yan Xie Department of Medical ultrasound The First Affiliated HospitalInstitute of Diagnostic and Interventional UltrasoundSun Yat-Sen UniversityGuangzhou 510000Guangdong ProvinceChina

BACKGROUND Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC)represent the predominant histological types of primary liver cancer,comprising over 99%of *** their differing biological behaviors,prognoses,and treatment strategies,accurately differentiating between HCC and ICC is crucial for effective clinical ***,an emerging image processing technology,can automatically extract various quantitative image features that may elude the human *** on the application of ultrasound(US)-based radiomics methods in distinguishing HCC from ICC are *** In our retrospective study,we included a total of 280 patients who were diagnosed with ICC(n=140)and HCC(n=140)between 1999 and *** patients were divided into training(n=224)and testing(n=56)groups for *** images and relevant clinical characteristics were *** utilized the XGBoost method to extract and select radiomics features and further employed a random forest algorithm to establish ultrasomics *** compared the diagnostic performances of these ultrasomics models with that of *** Four distinct ultrasomics models were constructed,with the number of selected features varying between models:13 features for the US model;15 for the contrast-enhanced ultrasound(CEUS)model;13 for the combined US+CEUS model;and 21 for the US+CEUS+clinical data *** US+CEUS+clinical data model yielded the highest area under the receiver operating characteristic curve(AUC)among all models,achieving an AUC of 0.973 in the validation cohort and 0.971 in the test *** performance exceeded even the most experienced radiologist(AUC=0.964).The AUC for the US+CEUS model(training cohort AUC=0.964,test cohort AUC=0.955)was significantly higher than that of the US model alone(training cohort AUC=0.822,test cohort AUC=0.816).This finding underscored the significant benefit of incorporating CEUS information in accurately distin-guishing ICC from HC

关键词： Cholangiocarcinoma Hepatocellular carcinoma Contrast-enhanced ultrasound Radiomics Primary liver tumor

Selective internal radiation therapy segmentectomy:A new minimally invasive curative option for primary liver malignancies?

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World Journal of Gastroenterology 2024年第18期30卷 2379-2386页

作者： Riccardo Inchingolo Francesco Cortese Antonio Rosario Pisani Fabrizio Acquafredda Roberto Calbi Riccardo Memeo Fotis Anagnostopoulos Stavros Spiliopoulos unit of interventional Radiology “F.Miulli”Regional General HospitalBari 70021Italy Interdisciplinary Department of Medicine Section of Nuclear MedicineUniversity of Bari“Aldo Moro”Bari 70121Italy Department of Radiology General Regional Hospital“F.Miulli”Acquaviva delle Fonti 70021Italy unit of Hepato-Pancreatic-Biliary Surgery “F.Miulli”Regional General HospitalBari 70021Italy The Second Radiology Department National and Kapodistrian University of AthensChaidari Athens 12461Greece

Transarterial radioembolization or selective internal radiation therapy(SIRT)has emerged as a minimally invasive approach for the treatment of *** percutaneous technique involves the local,intra-arterial delivery of radioactive microspheres directly into the *** employed as a palliative measure for liver malignancies,SIRT has gained traction over the past decade as a potential curative option,mirroring the increasing role of radiation *** latest update of the BCLC hepatocellular carcinoma guidelines recognizes SIRT as an effective treatment modality comparable to other local ablative methods,particularly well-suited for patients where surgical resection or ablation is not *** segmentectomy is a more selective approach,aiming to deliver high-dose radiation to one to three specific hepatic segments,while minimizing damage to surrounding healthy *** research efforts in radiation segmentectomy should prioritize optimizing radiation dosimetry and refining the technique for super-selective administration of radiospheres within the designated hepatic segments.

关键词： Transarterial radioembolization Selective internal radiation therapy Radiation segmentectomy Hepatocellular carcinoma Primary liver malignancies Personalised dosimetry

Hemodialysis bilayer bionic blood vessels developed by the mechanical stimulation of hepatitis B viral X(HBX)genetransfected hepatic stellate cells

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2024年第6期25卷 499-512页

作者： Hongyi LIU Yuanyuan ZHOU Peng GUO Xiongwei ZHENG Weibin CHEN Shichao ZHANG Yu FU Xu ZHOU Zheng WAN Bin ZHAO Yilin ZHAO Department of Oncology and Vascular interventional Radiology Zhongshan Hospital Affiliated to Xiamen UniversitySchool of MedicineXiamen UniversityXiamen 361004China School of Medicine Xiamen UniversityXiamen 361102China Xiamen Health and Medical Big Data Center Xiamen 361008China Fujian Provincial Key Laboratory of Chronic liver Disease and Hepatocellular Carcinoma(Zhongshan Hospital Affiliated to Xiamen University) Xiamen 361004China Xiamen Key Laboratory of Cellular Intervention and interventional Medical Materials Xiamen 361004China

Artificial vascular graft(AVG)fistula is widely used for hemodialysis treatment in patients with renal ***,it has poor elasticity and compliance,leading to stenosis and *** ideal artificial blood vessel for dialysis should replicate the structure and components of a real artery,which is primarily maintained by collagen in the extracellular matrix(ECM)of arterial *** have revealed that in hepatitis B virus(HBV)-induced liver fibrosis,hepatic stellate cells(HSCs)become hyperactive and produce excessive ECM ***,mechanical stimulation can encourage ECM secretion and remodeling of a fiber *** on the above factors,we transfected HSCs with the hepatitis B viral X(HBX)gene for simulating the process of HBV ***,these HBX-HSCs were implanted into a polycaprolactonepolyurethane(PCL-PU)bilayer scaffold in which the inner layer is dense and the outer layer consists of pores,which was mechanically stimulated to promote the secretion of collagen nanofiber from the HBX-HSCs and to facilitate crosslinking with the *** obtained an ECM-PCL-PU composite bionic blood vessel that could act as access for dialysis after ***,the vessel scaffold was implanted into a rabbit’s neck arteriovenous fistula *** exhibited strong tensile strength and smooth blood flow and formed autologous blood vessels in the rabbit’s *** study demonstrates the use of human cells to create biomimetic dialysis blood vessels,providing a novel approach for creating clinical vascular access for dialysis.

关键词： Composite bilayer bionic blood vessel Extracellular matrix(ECM) Hepatic stellate cells(HSCs) Hepatitis B viral X(HBX)gene Mechanical force

Hepatolithiasis:Epidemiology,presentation,classification and management of a complex disease

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World Journal of Gastroenterology 2024年第13期30卷 1836-1850页

作者： Rodrigo V.Motta Francesca Saffioti Vasileios K Mavroeidis Translational Gastroenterology and liver unit Nuffield Department of MedicineUniversity of OxfordOxford OX39DUUnited Kingdom Department of Gastroenterology and Hepatology Oxford University Hospitals NHS Foundation TrustJohn Radcliffe HospitalOxford OX39DUUnited Kingdom UCL Institute for liver and Digestive Health and Sheila Sherlock liver unit Royal Free Hospital and University College LondonLondon NW32QGUnited Kingdom Department of HPB Surgery Bristol Royal InfirmaryUniversity Hospitals Bristol and Weston NHS Foundation TrustBristol BS28HWUnited Kingdom Department of Transplant Surgery North Bristol NHS TrustSouthmead HospitalBristol BS105NBUnited Kingdom Department of Gastrointestinal Surgery North Bristol NHS TrustSouthmead HospitalBristol BS105NBUnited Kingdom

The term hepatolithiasis describes the presence of biliary stones within the intrahepatic bile ducts,above the hilar confluence of the hepatic *** disease is more prevalent in Asia,mainly owing to socioeconomic and dietary factors,as well as the prevalence of biliary *** the last century,owing to migration,its global incidence has *** main pathophysiological mechanisms involve cholangitis,bile infection and biliary strictures,creating a self-sustaining cycle that perpetuates the disease,frequently characterised by recurrent episodes of bacterial infection referred to as syndrome of“recurrent pyogenic cholangitis”.Furthermore,long-standing hepatolithiasis is a known risk factor for development of intrahepatic *** classifications have aimed at providing useful insight of clinically relevant aspects and guidance for *** management of symptomatic patients and those with complications can be complex,and relies upon a multidisciplinary team of hepatologists,endoscopists,interventional radiologists and hepatobiliary surgeons,with the main goal being to offer relief from the clinical presentations and prevent the development of more serious *** comprehensive review provides insight on various aspects of hepatolithiasis,with a focus on epidemiology,new evidence on pathophysiology,most important clinical aspects,different classification systems and contemporary management.

关键词： Cholelithiasis Intrahepatic stones Cholangiocarcinoma Biliary parasites Recurrent pyogenic cholangitis Oriental cholangiohepatitis Hepatectomy Cholangioscopy liver transplant Paediatric

Application of subharmonic-aided pressure estimation in a patient with giant hepatic cyst:A case report

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Portal Hypertension & Cirrhosis 2024年第2期3卷 124-127页

作者： Xiuyun Lu Jiaying Cao Yaozu Liu Jingqin Ma Jianjun Luo Yi Dong Wenping Wang Shanghai Institute of Medical Imaging ShanghaiChina Department of ultrasound Zhongshan HospitalFudan UniversityShanghaiChina Department of ultrasound Xinhua Hospital Affiliated to Shanghai Jiaotong University School of MedicineShanghaiChina Department of interventional Radiology Zhongshan HospitalFudan UniversityShanghaiChina National Clinical Research Center for interventional Medicine Zhongshan HospitalFudan UniversityShanghaiChina

Giant hepatic cysts may lead to impaired liver function by compressing surrounding tissue,resulting in symptoms such as nausea or portal ***-aided pressure estimation(SHAPE)offers a noninvasive method for quantitatively estimating pressure and monitoring interstitial fluid pressure.A 55-year-old female patient with giant hepatic cysts was admitted to our hospital with elevated protein electrophoretic gamma levels,likely caused by compression of important liver vessels by the *** surgery,B-mode ultrasound(BMUS)revealed multiple anechoic cystic lesions with thin,smooth walls in the right *** SHAPE,the curve of the portal vein was lower than that of the hepatic vein,which is absolutely different from a healthy volunteer in our previous SHAPE *** suggested that the patient may have had portal *** days after laparoscopic fenestration and drainage of hepatic cysts,the size of the largest cyst had decreased on BMUS and protein electrophoretic gamma levels had *** the curve of the portal vein remained lower than that of the hepatic vein,the difference between them had decreased compared to presurgery *** shows promise as a tool for noninvasively estimating portal hypertension and improving prognosis assessment in patients.

关键词： hepatic admitted impaired