Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hepatol Commun. 2022 Apr;6(4):652-664. doi: 10.1002/hep4.1850. Epub 2021 Nov 5.
Liver cancer is one of the leading causes of cancer deaths worldwide. Among all primary liver cancers, hepatocellular carcinoma (HCC) is the most common type, representing 75%-85% of all primary liver cancer cases. Median survival following diagnosis of HCC is approximately 6 to 20 months due to late diagnosis in its course and few effective treatment options. Interventional therapy with minimal invasiveness is recognized as a promising treatment for HCC. However, due to the heterogeneity of HCC and the complexity of the tumor microenvironment, the long-term efficacy of treatment for HCC remains a challenge in the clinic. Tumor microenvironment, including factors such as hypoxia, angiogenesis, low extracellular pH, interstitial fluid pressure, aerobic glycolysis, and various immune responses, has emerged as a key contributor to tumor residual and progression after locoregional treatment for HCC. New approaches to noninvasively assess the treatment response and assist in the clinical decision-making process are therefore urgently needed. Molecular imaging tools enabling such an assessment may significantly advance clinical practice by allowing real-time optimization of treatment protocols for the individual patient. This review discusses recent advances in the application of molecular imaging technologies for noninvasively assessing changes occurring in the microenvironment of HCC after locoregional treatment.
肝癌是全球癌症死亡的主要原因之一。在所有原发性肝癌中，肝细胞癌 (HCC) 最为常见，占所有原发性肝癌病例的 75%-85%。由于 HCC 病程中诊断较晚，且治疗选择有限，因此诊断后中位生存期约为 6 至 20 个月。微创介入治疗被认为是 HCC 的一种有前途的治疗方法。然而，由于 HCC 的异质性和肿瘤微环境的复杂性，HCC 治疗的长期疗效仍然是临床中的一个挑战。肿瘤微环境包括缺氧、血管生成、低细胞外 pH 值、间质液压力、有氧糖酵解和各种免疫反应等因素，这些因素是 HCC 局部治疗后肿瘤残留和进展的关键因素。因此，迫切需要新的非侵入性评估治疗反应的方法，并协助临床决策过程。能够进行这种评估的分子成像工具可以通过实时优化针对个体患者的治疗方案，从而显著推进临床实践。本综述讨论了分子成像技术在非侵入性评估 HCC 局部治疗后微环境变化中的最新应用进展。
