Agnello Francesco, Salvaggio Giuseppe, Cabibbo Giuseppe, Maida Marcello, Lagalla Roberto, Midiri Massimo, Brancatelli Giuseppe
Francesco Agnello, Giuseppe Salvaggio, Roberto Lagalla, Massimo Midiri, Giuseppe Brancatelli, Section of Radiological Sciences, DIBIMEF, University of Palermo, 90127 Palermo, Italy.
World J Hepatol. 2013 Aug 27;5(8):417-24. doi: 10.4254/wjh.v5.i8.417.
Surgical resection and imaging guided treatments play a crucial role in the management of hepatocellular carcinoma (HCC). Although the primary end point of treatment of HCC is survival, radiological response could be a surrogate end point of survival, and has a key role in HCC decision-making process. However, radiological assessment of HCC treatment efficacy is often controversial. There are few doubts on the evaluation of surgical resection; in fact, all known tumor sites should be removed. However, an unenhancing partial linear peripheral halo, in most cases, surrounding a fluid collection reducing in size during follow-up is demonstrated in successfully resected tumor with bipolar radiofrequency electrosurgical device. Efficacy assessment of locoregional therapies is more controversial and differs between percutaneous ablation (e.g., radiofrequency ablation and percutaneous ethanol injection) and transarterial treatments (e.g., conventional transarterial chemoembolization, transarterial chemoembolization with drug eluting beads and radioembolization). Finally, a different approach should be used for new systemic agent that, though not reducing tumor mass, could have a benefit on survival by delaying tumor progression and death. The purpose of this brief article is to review HCC imaging appearance after treatment.
手术切除和影像引导治疗在肝细胞癌（HCC）的管理中起着关键作用。虽然HCC治疗的主要终点是生存，但放射学反应可能是生存的替代终点，并且在HCC决策过程中起关键作用。然而，HCC治疗疗效的放射学评估常常存在争议。对于手术切除的评估几乎没有疑问；事实上，所有已知的肿瘤部位都应被切除。然而，在使用双极射频电外科设备成功切除的肿瘤中，在大多数情况下，会显示出一个无强化的部分线性周边晕圈，其围绕着一个在随访期间尺寸缩小的液性聚集区。局部区域治疗的疗效评估更具争议性，在经皮消融（如射频消融和经皮乙醇注射）和经动脉治疗（如传统经动脉化疗栓塞、载药微球经动脉化疗栓塞和放射性栓塞）之间存在差异。最后，对于新的全身治疗药物应采用不同的方法，这些药物虽然不会缩小肿瘤体积，但可能通过延缓肿瘤进展和死亡而对生存有益。这篇简短文章的目的是回顾治疗后HCC的影像学表现。
