Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
Nat Rev Clin Oncol. 2011 Feb;8(2):115-20. doi: 10.1038/nrclinonc.2010.153. Epub 2010 Oct 5.
Although the liver possesses a dual blood supply, arterial vessels deliver only a small proportion of blood to normal parenchyma, but they deliver the vast majority of blood to primary and secondary cancers of the liver. This anatomical discrepancy is the basis for intra-arterial brachytherapy of liver cancers using radioactive microspheres, termed radio-embolization (RE). Radioactive microspheres implant preferentially in the terminal arterioles of tumors. Although biological models of the flow dynamics and distribution of microspheres are currently in development, there is a need to improve the imaging biomarkers of flow dynamics used to plan RE. Since a direct consequence of RE is vascular disruption and necrosis, we suggest that imaging protocols sensitive to changes in vasculature are highly likely to represent useful early biomarkers for treatment efficacy. We propose dynamic contrast-enhanced CT as the most appropriate imaging modality for studying vascular parameters in clinical trials of RE treatment.
尽管肝脏具有双重血液供应，但动脉血管仅向正常实质输送一小部分血液，但它们向原发性和继发性肝癌输送绝大多数血液。这种解剖学差异是使用放射性微球进行肝癌经动脉内近距离治疗（简称放射性栓塞，RE）的基础。放射性微球优先植入肿瘤的终末小动脉。尽管目前正在开发用于模拟微球流动动力学和分布的生物学模型，但仍需要改进用于规划 RE 的流动动力学成像生物标志物。由于 RE 的直接后果是血管破坏和坏死，因此我们认为，对血管变化敏感的成像方案很可能成为治疗效果的有用早期生物标志物。我们建议，动态对比增强 CT 是研究 RE 治疗临床试验中血管参数的最合适成像方式。
