Diab Mahmoud, Wang Mindy X, Ramprasad Aarya, Shi Ann A, Ahmed Imran, Klimkowski Sergio, Wong Vincenzo K, Elsayes Khaled M
The University of Texas MD Anderson Cancer Center, Houston, USA.
Department of Radiology, Suez Canal University, Ismailia, Egypt.
Abdom Radiol (NY). 2025 Jun 23. doi: 10.1007/s00261-025-05078-5.
Liver tumor resection remains the mainstay of treatment for patients with primary and secondary hepatic malignancies and can potentially be a curative option. With advances in surgical techniques, systemic therapies, and perioperative management, resectability criteria have expanded over time yet operative planning must still be carefully weighed between oncologic benefit and surgical risks along with residual liver function. While tumor detection is critical, radiologists also have an essential role in assessing tumor resectability, evaluating background liver disease, identifying surgically relevant vascular and biliary anatomy, and estimating future liver remnant adequacy. This review article aims to provide a practical guide for radiologists involved in the preoperative evaluation of patients with liver tumors. It highlights key surgical indications and contraindications for common hepatic malignancies, outlines essential preoperative imaging findings relevant to surgical planning and reviews the types of surgical resections.
肝肿瘤切除术仍然是原发性和继发性肝恶性肿瘤患者的主要治疗方法,并且可能是一种治愈性选择。随着手术技术、全身治疗和围手术期管理的进步,可切除性标准随着时间的推移而扩大,但手术规划仍必须在肿瘤学获益、手术风险以及残余肝功能之间仔细权衡。虽然肿瘤检测至关重要,但放射科医生在评估肿瘤可切除性、评估背景肝病、识别与手术相关的血管和胆道解剖结构以及估计未来肝残余量是否充足方面也起着至关重要的作用。这篇综述文章旨在为参与肝肿瘤患者术前评估的放射科医生提供一份实用指南。它强调了常见肝恶性肿瘤的关键手术适应症和禁忌症,概述了与手术规划相关的重要术前影像学表现,并回顾了手术切除的类型。