Imaging evaluation of liver cancer after local-regional therapy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DUAN Xiuping ,  HUANG Zixing

Department of Radiology, West China Hospital, Sichuan University & Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu 610041, P. R. China;

Corresponding author：

HUANG Zixing, Email: zixinghuang@hotmail.com

Keywords：

liver cancer; local-regional therapy; imaging evaluation; review

DOI：

10.7507/1007-9424.202111064

Video：

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Objective To summarize the common imaging features of liver cancer after local-regional therapy in order to more accurately evaluate the post-treatment response of it. Method The literatures of studies on imaging features after ablation, transcatheter therapy, and radiotherapy of liver cancer in recent years were searched and reviewed. Results It was not accurate to evaluate the response of liver cancer after treatment only by comparing the size of tumor before and after treatment. We should follow up and observe the changes of enhancement components after tumor treatment, and pay attention to identify the normal features after treatment. Conclusions Imaging evaluation after local-regional therapy of liver cancer is of great significance in management and clinical decision-making of patients with liver cancer. Standard response evaluation systems such as EASL or mRECIST should be carefully applied after local-regional therapy of liver cancer. Treatment response of patients should be comprehensively evaluated in combination with the characteristics of local-regional therapy methods and timing, so as to avoid delaying timing of secondary treatment and causing excessive treatment.

Citation： DUAN Xiuping, HUANG Zixing. Imaging evaluation of liver cancer after local-regional therapy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(1): 93-99. doi: 10.7507/1007-9424.202111064 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Nault JC, Sutter O, Nahon P, et al. Percutaneous treatment of hepatocellular carcinoma: state of the art and innovations. J Hepatol, 2018, 68(4): 783-797.
3.	Lee J, Shin IS, Yoon WS, et al. Comparisons between radiofrequency ablation and stereotactic body radiotherapy for liver malignancies: meta-analyses and a systematic review. Radiother Oncol, 2020, 145: 63-70.
4.	Kong L, Wei G, Lv T, et al. Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma. Sci Rep, 2021, 11(1): 696.
5.	Chen Z, Xie H, Hu M, et al. Recent progress in treatment of hepatocellular carcinoma. Am J Cancer Res, 2020, 10(9): 2993-3036.
6.	Anwanwan D, Singh SK, Singh S, et al. Challenges in liver cancer and possible treatment approaches. Biochim Biophys Acta Rev Cancer, 2020, 1873(1): 188314.
7.	Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis, 2010, 30(1): 52-60.
8.	Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol, 2001, 35(3): 421-430.
9.	Chernyak V, Fowler KJ, Kamaya A, et al. Liver Imaging Reporting and Data System (LI-RADS) version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology, 2018, 289(3): 816-830.
10.	Kim YS, Rhim H, Lim HK, et al. Coagulation necrosis induced by radiofrequency ablation in the liver: histopathologic and radiologic review of usual to extremely rare changes. Radiographics, 2011, 31(2): 377-390.
11.	Sainani NI, Gervais DA, Mueller PR, et al. Imaging after percutaneous radiofrequency ablation of hepatic tumors: part 1, normal findings. AJR Am J Roentgenol, 2013, 200(1): 184-193.
12.	Park MH, Rhim H, Kim YS, et al. Spectrum of CT findings after radiofrequency ablation of hepatic tumors. Radiographics, 2008, 28(2): 379-390.
13.	Makino Y, Imai Y, Igura T, et al. Usefulness of the multimodality fusion imaging for the diagnosis and treatment of hepatocellular carcinoma. Dig Dis, 2012, 30(6): 580-587.
14.	D’Onofrio M, Cardobi N, Ruzzenente A, et al. Unenhanced magnetic resonance imaging immediately after radiofrequency ablation of liver malignancy: preliminary results. Abdom Radiol (NY), 2018, 43(6): 1379-1385.
15.	Song KD, Rhim H, Lee MW, et al. Intrahepatic distant recurrence after radiofrequency ablation for hepatocellular carcinoma: precursor nodules on pre-procedural gadoxetic acid-enhanced liver magnetic resonance imaging. Acta Radiol, 2017, 58(7): 778-785.
16.	Fukuda K, Mori K, Hasegawa N, et al. Safety margin of radiofrequency ablation for hepatocellular carcinoma: a prospective study using magnetic resonance imaging with superparamagnetic iron oxide. Jpn J Radiol, 2019, 37(7): 555-563.
17.	Ahmed M, Solbiati L, Brace CL, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria—a 10-year update. J Vasc Interv Radiol, 2014, 25(11): 1691-1705.
18.	Yuan ZG, Wang ZY, Xia MY, et al. Comparison of diffusion kurtosis imaging versus diffusion weighted imaging in predicting the recurrence of early stage single nodules of hepatocellular carcinoma treated by radiofrequency ablation. Cancer Imaging, 2019, 19(1): 30.
19.	Bréhier G, Besnier L, Delagnes A, et al. Imaging after percutaneous thermal and non-thermal ablation of hepatic tumour: normal appearances, progression and complications. Br J Radiol, 2021, 94(1123): 20201327.
20.	Bartolozzi C, Lencioni R, Caramella D, et al. Hepatocellular carcinoma: CT and MR features after transcatheter arterial embolization and percutaneous ethanol injection. Radiology, 1994, 191(1): 123-128.
21.	Najmi Varzaneh F, Pandey A, Aliyari Ghasabeh M, et al. Prediction of post-TACE necrosis of hepatocellular carcinoma using volumetric enhancement on MRI and volumetric oil deposition on CT, with pathological correlation. Eur Radiol, 2018, 28(7): 3032-3040.
22.	Young S, Taylor AJ, Sanghvi T. Post locoregional therapy treatment imaging in hepatocellular carcinoma patients: a literature-based review. J Clin Transl Hepatol, 2018, 6(2): 189-197.
23.	Lim HS, Jeong YY, Kang HK, et al. Imaging features of hepatocellular carcinoma after transcatheter arterial chemoembolization and radiofrequency ablation. AJR Am J Roentgenol, 2006, 187(4): W341-W349.
24.	Thibodeau-Antonacci A, Petitclerc L, Gilbert G, et al. Dynamic contrast-enhanced MRI to assess hepatocellular carcinoma response to transarterial chemoembolization using LI-RADS criteria: a pilot study. Magn Reson Imaging, 2019, 62: 78-86.
25.	Shaghaghi M, Aliyari Ghasabeh M, Ameli S, et al. Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up. Eur Radiol, 2021, 31(3): 1378-1390.
26.	Mannelli L, Kim S, Hajdu CH, et al. Serial diffusion-weighted MRI in patients with hepatocellular carcinoma: prediction and assessment of response to transarterial chemoembolization. Preliminary experience. Eur J Radiol, 2013, 82(4): 577-582.
27.	Bryant MK, Dorn DP, Zarzour J, et al. Computed tomography predictors of hepatocellular carcinoma tumour necrosis after chemoembolization. HPB (Oxford), 2014, 16(4): 327-335.
28.	Budjan J, Sauter EA, Morelli JN, et al. Semi-automatic volumetric measurement of treatment response in hepatocellular carcinoma after trans-arterial chemoembolization. Anticancer Res, 2016, 36(8): 4353-4358.
29.	Marcacuzco Quinto A, Nutu OA, San Román Manso R, et al. Complications of transarterial chemoembolization (TACE) in the treatment of liver tumors. Cir Esp (Engl Ed), 2018, 96(9): 560-567.
30.	Fu Y, Xi M, Pan Y, et al. Stereotactic body radiotherapy as a salvage therapy after incomplete radiofrequency ablation for hepatocellular carcinoma: a retrospective cohort study. J Oncol, 2020, 2020: 4835653.
31.	Oldrini G, Huertas A, Renard-Oldrini S, et al. Tumor response assessment by MRI following stereotactic body radiation therapy for hepatocellular carcinoma. PLoS One, 2017, 12(4): e0176118.
32.	Song SH, Jeong WK, Choi D, et al. Evaluation of early treatment response to radiotherapy for HCC using pre- and post-treatment MRI. Acta Radiol, 2019, 60(7): 826-835.
33.	Mendiratta-Lala M, Masch W, Owen D, et al. Natural history of hepatocellular carcinoma after stereotactic body radiation therapy. Abdom Radiol (NY), 2020, 45(11): 3698-3708.
34.	Mendiratta-Lala M, Masch W, Shankar PR, et al. Magnetic resonance imaging evaluation of hepatocellular carcinoma treated with stereotactic body radiation therapy: long term imaging follow-up. Int J Radiat Oncol Biol Phys, 2019, 103(1): 169-179.
35.	Tétreau R, Llacer C, Riou O, et al. Evaluation of response after SBRT for liver tumors. Rep Pract Oncol Radiother, 2017, 22(2): 170-175.
36.	Kimura T, Takahashi S, Kenjo M, et al. Dynamic computed tomography appearance of tumor response after stereotactic body radiation therapy for hepatocellular carcinoma: how should we evaluate treatment effects? Hepatol Res, 2013, 43(7): 717-727.
37.	Shampain KL, Hackett CE, Towfighi S, et al. SBRT for HCC: overview of technique and treatment response assessment. Abdom Radiol (NY), 2021, 46(8): 3615-3624.
38.	Park MJ, Kim SY, Yoon SM, et al. Stereotactic body radiotherapy-induced arterial hypervascularity of non-tumorous hepatic parenchyma in patients with hepatocellular carcinoma: potential pitfalls in tumor response evaluation on multiphase computed tomography. PLoS One, 2014, 9(2): e90327.
39.	Mendiratta-Lala M, Gu E, Owen D, et al. Imaging findings within the first 12 months of hepatocellular carcinoma treated with stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys, 2018, 102(4): 1063-1069.
40.	Wahl DR, Stenmark MH, Tao Y, et al. Outcomes after stereotactic body radiotherapy or radiofrequency ablation for hepatocellular carcinoma. J Clin Oncol, 2016, 34(5): 452-459.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Nault JC, Sutter O, Nahon P, et al. Percutaneous treatment of hepatocellular carcinoma: state of the art and innovations. J Hepatol, 2018, 68(4): 783-797.
3. Lee J, Shin IS, Yoon WS, et al. Comparisons between radiofrequency ablation and stereotactic body radiotherapy for liver malignancies: meta-analyses and a systematic review. Radiother Oncol, 2020, 145: 63-70.
4. Kong L, Wei G, Lv T, et al. Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma. Sci Rep, 2021, 11(1): 696.
5. Chen Z, Xie H, Hu M, et al. Recent progress in treatment of hepatocellular carcinoma. Am J Cancer Res, 2020, 10(9): 2993-3036.
6. Anwanwan D, Singh SK, Singh S, et al. Challenges in liver cancer and possible treatment approaches. Biochim Biophys Acta Rev Cancer, 2020, 1873(1): 188314.
7. Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis, 2010, 30(1): 52-60.
8. Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol, 2001, 35(3): 421-430.
9. Chernyak V, Fowler KJ, Kamaya A, et al. Liver Imaging Reporting and Data System (LI-RADS) version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology, 2018, 289(3): 816-830.
10. Kim YS, Rhim H, Lim HK, et al. Coagulation necrosis induced by radiofrequency ablation in the liver: histopathologic and radiologic review of usual to extremely rare changes. Radiographics, 2011, 31(2): 377-390.
11. Sainani NI, Gervais DA, Mueller PR, et al. Imaging after percutaneous radiofrequency ablation of hepatic tumors: part 1, normal findings. AJR Am J Roentgenol, 2013, 200(1): 184-193.
12. Park MH, Rhim H, Kim YS, et al. Spectrum of CT findings after radiofrequency ablation of hepatic tumors. Radiographics, 2008, 28(2): 379-390.
13. Makino Y, Imai Y, Igura T, et al. Usefulness of the multimodality fusion imaging for the diagnosis and treatment of hepatocellular carcinoma. Dig Dis, 2012, 30(6): 580-587.
14. D’Onofrio M, Cardobi N, Ruzzenente A, et al. Unenhanced magnetic resonance imaging immediately after radiofrequency ablation of liver malignancy: preliminary results. Abdom Radiol (NY), 2018, 43(6): 1379-1385.
15. Song KD, Rhim H, Lee MW, et al. Intrahepatic distant recurrence after radiofrequency ablation for hepatocellular carcinoma: precursor nodules on pre-procedural gadoxetic acid-enhanced liver magnetic resonance imaging. Acta Radiol, 2017, 58(7): 778-785.
16. Fukuda K, Mori K, Hasegawa N, et al. Safety margin of radiofrequency ablation for hepatocellular carcinoma: a prospective study using magnetic resonance imaging with superparamagnetic iron oxide. Jpn J Radiol, 2019, 37(7): 555-563.
17. Ahmed M, Solbiati L, Brace CL, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria—a 10-year update. J Vasc Interv Radiol, 2014, 25(11): 1691-1705.
18. Yuan ZG, Wang ZY, Xia MY, et al. Comparison of diffusion kurtosis imaging versus diffusion weighted imaging in predicting the recurrence of early stage single nodules of hepatocellular carcinoma treated by radiofrequency ablation. Cancer Imaging, 2019, 19(1): 30.
19. Bréhier G, Besnier L, Delagnes A, et al. Imaging after percutaneous thermal and non-thermal ablation of hepatic tumour: normal appearances, progression and complications. Br J Radiol, 2021, 94(1123): 20201327.
20. Bartolozzi C, Lencioni R, Caramella D, et al. Hepatocellular carcinoma: CT and MR features after transcatheter arterial embolization and percutaneous ethanol injection. Radiology, 1994, 191(1): 123-128.
21. Najmi Varzaneh F, Pandey A, Aliyari Ghasabeh M, et al. Prediction of post-TACE necrosis of hepatocellular carcinoma using volumetric enhancement on MRI and volumetric oil deposition on CT, with pathological correlation. Eur Radiol, 2018, 28(7): 3032-3040.
22. Young S, Taylor AJ, Sanghvi T. Post locoregional therapy treatment imaging in hepatocellular carcinoma patients: a literature-based review. J Clin Transl Hepatol, 2018, 6(2): 189-197.
23. Lim HS, Jeong YY, Kang HK, et al. Imaging features of hepatocellular carcinoma after transcatheter arterial chemoembolization and radiofrequency ablation. AJR Am J Roentgenol, 2006, 187(4): W341-W349.
24. Thibodeau-Antonacci A, Petitclerc L, Gilbert G, et al. Dynamic contrast-enhanced MRI to assess hepatocellular carcinoma response to transarterial chemoembolization using LI-RADS criteria: a pilot study. Magn Reson Imaging, 2019, 62: 78-86.
25. Shaghaghi M, Aliyari Ghasabeh M, Ameli S, et al. Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up. Eur Radiol, 2021, 31(3): 1378-1390.
26. Mannelli L, Kim S, Hajdu CH, et al. Serial diffusion-weighted MRI in patients with hepatocellular carcinoma: prediction and assessment of response to transarterial chemoembolization. Preliminary experience. Eur J Radiol, 2013, 82(4): 577-582.
27. Bryant MK, Dorn DP, Zarzour J, et al. Computed tomography predictors of hepatocellular carcinoma tumour necrosis after chemoembolization. HPB (Oxford), 2014, 16(4): 327-335.
28. Budjan J, Sauter EA, Morelli JN, et al. Semi-automatic volumetric measurement of treatment response in hepatocellular carcinoma after trans-arterial chemoembolization. Anticancer Res, 2016, 36(8): 4353-4358.
29. Marcacuzco Quinto A, Nutu OA, San Román Manso R, et al. Complications of transarterial chemoembolization (TACE) in the treatment of liver tumors. Cir Esp (Engl Ed), 2018, 96(9): 560-567.
30. Fu Y, Xi M, Pan Y, et al. Stereotactic body radiotherapy as a salvage therapy after incomplete radiofrequency ablation for hepatocellular carcinoma: a retrospective cohort study. J Oncol, 2020, 2020: 4835653.
31. Oldrini G, Huertas A, Renard-Oldrini S, et al. Tumor response assessment by MRI following stereotactic body radiation therapy for hepatocellular carcinoma. PLoS One, 2017, 12(4): e0176118.
32. Song SH, Jeong WK, Choi D, et al. Evaluation of early treatment response to radiotherapy for HCC using pre- and post-treatment MRI. Acta Radiol, 2019, 60(7): 826-835.
33. Mendiratta-Lala M, Masch W, Owen D, et al. Natural history of hepatocellular carcinoma after stereotactic body radiation therapy. Abdom Radiol (NY), 2020, 45(11): 3698-3708.
34. Mendiratta-Lala M, Masch W, Shankar PR, et al. Magnetic resonance imaging evaluation of hepatocellular carcinoma treated with stereotactic body radiation therapy: long term imaging follow-up. Int J Radiat Oncol Biol Phys, 2019, 103(1): 169-179.
35. Tétreau R, Llacer C, Riou O, et al. Evaluation of response after SBRT for liver tumors. Rep Pract Oncol Radiother, 2017, 22(2): 170-175.
36. Kimura T, Takahashi S, Kenjo M, et al. Dynamic computed tomography appearance of tumor response after stereotactic body radiation therapy for hepatocellular carcinoma: how should we evaluate treatment effects? Hepatol Res, 2013, 43(7): 717-727.
37. Shampain KL, Hackett CE, Towfighi S, et al. SBRT for HCC: overview of technique and treatment response assessment. Abdom Radiol (NY), 2021, 46(8): 3615-3624.
38. Park MJ, Kim SY, Yoon SM, et al. Stereotactic body radiotherapy-induced arterial hypervascularity of non-tumorous hepatic parenchyma in patients with hepatocellular carcinoma: potential pitfalls in tumor response evaluation on multiphase computed tomography. PLoS One, 2014, 9(2): e90327.
39. Mendiratta-Lala M, Gu E, Owen D, et al. Imaging findings within the first 12 months of hepatocellular carcinoma treated with stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys, 2018, 102(4): 1063-1069.
40. Wahl DR, Stenmark MH, Tao Y, et al. Outcomes after stereotactic body radiotherapy or radiofrequency ablation for hepatocellular carcinoma. J Clin Oncol, 2016, 34(5): 452-459.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Imaging evaluation of liver cancer after local-regional therapy

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