Division of Abdominal Imaging and Intervention, Harvard Medical School and Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA.
J Hepatol. 2013 Jan;58(1):169-77. doi: 10.1016/j.jhep.2012.08.022. Epub 2012 Aug 31.
The management of hepatocellular carcinoma (HCC) is evolving because of recently introduced novel therapeutic approaches. There is growing recognition that optimal outcome requires choosing treatment tailored to suit each individual patient, necessitating an early and accurate assessment of tumor response to therapy. The established and adapted image biomarkers based on size for tumor burden measurement continues to be applied to HCC as size measurement can easily be used in any clinical practice. However, in the setting of novel targeted therapies and liver directed treatments, simple tumor anatomical changes can be less informative and usually appear later than biological changes. Therefore the importance of image biomarkers such as tumor viability measurement, functional perfusion and diffusion imaging for response assessment is increasingly being recognized. Although promising, these imaging biomarkers have not gone through all the required steps of standardization and validation. In this review, we discuss various established, evolving and emerging imaging biomarkers and the criteria of response evaluation and their challenges in HCC.
由于最近引入了新的治疗方法，肝细胞癌 (HCC) 的治疗管理正在不断发展。人们越来越认识到，要获得最佳疗效，需要根据每个患者的具体情况选择治疗方法，这就需要及早、准确地评估肿瘤对治疗的反应。基于大小的肿瘤负荷测量的既定和适应性影像学生物标志物继续应用于 HCC，因为大小测量在任何临床实践中都很容易进行。然而，在新型靶向治疗和肝脏定向治疗的背景下，简单的肿瘤解剖学变化可能信息量较少，并且通常比生物学变化出现得更晚。因此，越来越多的人认识到肿瘤活力测量、功能灌注和扩散成像等影像学生物标志物在评估反应中的重要性。尽管这些影像学生物标志物很有前途，但它们尚未经过标准化和验证的所有必要步骤。在这篇综述中，我们讨论了各种已建立、正在发展和新兴的影像学生物标志物以及反应评估的标准及其在 HCC 中的挑战。
