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Cancers
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Radiology for Diagnosis and Treatment of Liver Cancer
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Radiology for Diagnosis and Treatment of Liver Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: closed (20 July 2024) | Viewed by 5864

Special Issue Editors

Prof. Dr. Takahito Nakajima

E-Mail Website
Guest Editor
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
Interests: diagnostic imaging; interventional radiology; artificial intelligence; radiomics; radiogenomics; photoimmunotherapy; cancer-bearing animal model; dual-energy CT
Special Issues, Collections and Topics in MDPI journals
Dr. Wenchao Gu

E-Mail Website
Guest Editor
Department of Diagnostic and Interventional Radiology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Japan
Interests: radiomics; bioinformatics; deep learning; molecular imaging; DNA damage repair

Special Issue Information

Dear Colleagues,

With the latest advances in medical technology, we are expanding the possibilities for the diagnosis and treatment of liver cancer. Radiology is positioned at the center of these advances. Therefore, in this Special Issue, we explore innovative approaches in the diagnosis and treatment of liver cancer, focusing on advances and applications of state-of-the-art radiology.

We are currently seeking abstracts for this Special Issue on the following topics: 1) recent advances in hepatocellular carcinoma imaging techniques, 2) new possibilities for hepatocellular carcinoma treatment with radiation therapy including particle beams, 3) combining artificial intelligence (AI) and diagnostic radiology to improve outcomes for hepatocellular carcinoma patients, 4) new radiological approaches to 4) the optimization of liver cancer treatment by integrating new radiation technologies with existing therapies, and 5) personalized treatment strategies based on advances in imaging technologies and molecular radiation therapy.

Your research results, insights, and new perspectives will enhance our knowledge and understanding and open new avenues in the diagnosis and treatment of patients with liver cancer. Please share your latest research, new perspectives, or new suggestions for moving forward. We sincerely welcome your contributions.

Prof. Dr. Takahito Nakajima
Dr. Wenchao Gu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • liver cancer
  • hepatocellular carcinoma
  • diagnostic imaging
  • radiotherapy
  • artificial intelligence in radiology
  • treatment optimization
  • integrated therapies
  • personalized medicine
  • review for Li-RADS

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Published Papers (5 papers)

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Research

31 pages, 2237 KiB  
Article
Initial Trans-Arterial Chemo-Embolisation (TACE) Is Associated with Similar Survival Outcomes as Compared to Upfront Percutaneous Ablation Allowing for Follow-Up Treatment in Those with Single Hepatocellular Carcinoma (HCC) ≤ 3 cm: Results of a Real-World Propensity-Matched Multi-Centre Australian Cohort Study
by Jonathan Abdelmalak, Simone I. Strasser, Natalie L. Ngu, Claude Dennis, Marie Sinclair, Avik Majumdar, Kate Collins, Katherine Bateman, Anouk Dev, Joshua H. Abasszade, Zina Valaydon, Daniel Saitta, Kathryn Gazelakis, Susan Byers, Jacinta Holmes, Alexander J. Thompson, Jessica Howell, Dhivya Pandiaraja, Steven Bollipo, Suresh Sharma, Merlyn Joseph, Rohit Sawhney, Amanda Nicoll, Nicholas Batt, Myo J. Tang, Stephen Riordan, Nicholas Hannah, James Haridy, Siddharth Sood, Eileen Lam, Elysia Greenhill, John Lubel, William Kemp, Ammar Majeed, John Zalcberg and Stuart K. Robertsadd Show full author list remove Hide full author list
Cancers 2024, 16(17), 3010; https://doi.org/10.3390/cancers16173010 - 29 Aug 2024
Viewed by 680
Abstract
Percutaneous ablation is recommended in Barcelona Clinic Liver Cancer (BCLC) stage 0/A patients with HCC ≤3 cm as a curative treatment modality alongside surgical resection and liver transplantation. However, trans-arterial chemo-embolisation (TACE) is commonly used in the real-world as an initial treatment in [...] Read more.
Percutaneous ablation is recommended in Barcelona Clinic Liver Cancer (BCLC) stage 0/A patients with HCC ≤3 cm as a curative treatment modality alongside surgical resection and liver transplantation. However, trans-arterial chemo-embolisation (TACE) is commonly used in the real-world as an initial treatment in patients with single small HCC in contrast to widely accepted clinical practice guidelines which typically describe TACE as a treatment for intermediate-stage HCC. We performed this real-world propensity-matched multi-centre cohort study in patients with single HCC ≤ 3 cm to assess for differences in survival outcomes between those undergoing initial TACE and those receiving upfront ablation. Patients with a new diagnosis of BCLC 0/A HCC with a single tumour ≤3 cm first diagnosed between 1 January 2016 and 31 December 2020 who received initial TACE or ablation were included in the study. A total of 348 patients were included in the study, with 147 patients receiving initial TACE and 201 patients undergoing upfront ablation. After propensity score matching using key covariates, 230 patients were available for analysis with 115 in each group. There were no significant differences in overall survival (log-rank test p = 0.652) or liver-related survival (log-rank test p = 0.495) over a median follow-up of 43 months. While rates of CR were superior after ablation compared to TACE as a first treatment (74% vs. 56%, p < 0.004), there was no significant difference in CR rates when allowing for further subsequent treatments (86% vs. 80% p = 0.219). In those who achieved CR, recurrence-free survival and local recurrence-free survival were similar (log rank test p = 0.355 and p = 0.390, respectively). Our study provides valuable real-world evidence that TACE when offered with appropriate follow-up treatment is a reasonable initial management strategy in very early/early-stage HCC, with similar survival outcomes as compared to those managed with upfront ablation. Further work is needed to better define the role for TACE in BCLC 0/A HCC. Full article
(This article belongs to the Special Issue Radiology for Diagnosis and Treatment of Liver Cancer)
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14 pages, 1534 KiB  
Article
CCL2 Predicts Survival in Patients with Inoperable Hepatocellular Carcinoma Undergoing Selective Internal Radiotherapy
by Florian Haag, Severin Gylstorff, Jasmin Bujok, Maciej Pech and Borna Relja
Cancers 2024, 16(16), 2832; https://doi.org/10.3390/cancers16162832 - 12 Aug 2024
Viewed by 841
Abstract
Purpose: Hepatocellular carcinoma (HCC) is the largest subgroup of primary liver tumors. Ablative therapies, such as selective internal radiation therapy (SIRT), are used in late stages for patients with unresectable liver metastases and no response to other therapies. CCL2 (C-C motif chemokine ligand [...] Read more.
Purpose: Hepatocellular carcinoma (HCC) is the largest subgroup of primary liver tumors. Ablative therapies, such as selective internal radiation therapy (SIRT), are used in late stages for patients with unresectable liver metastases and no response to other therapies. CCL2 (C-C motif chemokine ligand 2) is a potent monocyte chemoattractant. It is associated with tumor progression and metastasis. The role of circulating CCL2 as a biomarker in HCC undergoing selective internal radiation therapy remains unclear. Methods: A total of 41 patients (8 female, 33 male) suffering from HCC and undergoing SIRT were enrolled. Pre- and post-therapy changes in circulating CCL2 levels were determined by bead-based immunoassay and compared with clinical laboratory parameters and patient data. Results: A total of 32 patients exhibited survival beyond 60 days. It was observed that levels of CCL2 correlated with scores indicating a higher likelihood of non-survival and with the severity of the disease. Moreover, a significant inverse correlation was discovered between CCL2 levels and the survival of patients over 60 days in relation to counts of leukocytes, granulocytes, monocytes, and C-reactive protein. Conclusions: CCL2 may serve as a potential marker for patient survival after SIRT. The prediction of which HCC patients are likely to benefit from SIRT may be helpful in guiding therapeutic management. Full article
(This article belongs to the Special Issue Radiology for Diagnosis and Treatment of Liver Cancer)
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17 pages, 2765 KiB  
Article
Intrahepatic Mass-Forming Cholangiocarcinoma: Is There Additional Prognostic Value in Using Gd-EOB Enhanced MRI?
by Sebastian Halskov, Felix Krenzien, Laura Segger, Dominik Geisel, Bernd Hamm, Uwe Pelzer, Jana Ihlow, Wenzel Schöning, Timo Alexander Auer and Uli Fehrenbach
Cancers 2024, 16(7), 1314; https://doi.org/10.3390/cancers16071314 - 28 Mar 2024
Cited by 1 | Viewed by 1108
Abstract
Objective: To investigate the prognostic value of enhancement patterns of intrahepatic mass-forming cholangiocarcinomas (IMCCs) during the hepatobiliary phase (HBP) in gadoxetic acid (Gd-EOB)-enhanced MRI. Methods: We retrospectively identified 66 consecutive patients with histopathologically proven IMCCs (reference standard: resection) and preoperative Gd-EOB-enhanced MRI. Gd-EOB [...] Read more.
Objective: To investigate the prognostic value of enhancement patterns of intrahepatic mass-forming cholangiocarcinomas (IMCCs) during the hepatobiliary phase (HBP) in gadoxetic acid (Gd-EOB)-enhanced MRI. Methods: We retrospectively identified 66 consecutive patients with histopathologically proven IMCCs (reference standard: resection) and preoperative Gd-EOB-enhanced MRI. Gd-EOB retention area was subjectively rated based on areas of intermediate signal intensity. Lesions were classified as either hypointense (0–25% retention area) or significantly-retaining (>25% retention area). Clinical, radiological, and prognostic features were compared between these groups. The primary endpoints were recurrence-free survival (RFS) and overall survival (OS) after primary surgical resection. Results: 73% (48/66) of lesions were rated as hypointense and 29% (19/66) as significantly-retaining. While the hypointense subgroup more frequently featured local and distant intrahepatic metastases (p = 0.039 and p = 0.022) and an infiltrative growth pattern (p = 0.005), RFS, OS, and clinical features did not differ significantly with estimated Gd-EOB retention area or quantitatively measured HBP enhancement ratios. Lymph node metastasis was an independent predictor of poor RFS (p = 0.001). Conclusions: Gd-EOB-enhanced MRI revealed two subtypes of IMCC in the HBP: hypointense and signal-retaining. The hypointense subtype is associated with more frequent intrahepatic metastases and an infiltrative growth pattern, indicating potential tumor aggressiveness. However, this did not result in a significant difference in survival after the primary resection of IMCC. Full article
(This article belongs to the Special Issue Radiology for Diagnosis and Treatment of Liver Cancer)
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Graphical abstract

12 pages, 6451 KiB  
Article
Tumor Response on Diagnostic Imaging after Proton Beam Therapy for Hepatocellular Carcinoma
by Hikaru Niitsu, Masashi Mizumoto, Yinuo Li, Masatoshi Nakamura, Toshiki Ishida, Takashi Iizumi, Takashi Saito, Haruko Numajiri, Hirokazu Makishima, Kei Nakai, Yoshiko Oshiro, Kazushi Maruo and Hideyuki Sakurai
Cancers 2024, 16(2), 357; https://doi.org/10.3390/cancers16020357 - 14 Jan 2024
Cited by 1 | Viewed by 1320
Abstract
Background: Follow-up after treatment for hepatocellular carcinoma (HCC) can be mostly performed using dynamic CT or MRI, but there is no common evaluation method after radiation therapy. The purpose of this study is to examine factors involved in tumor reduction and local recurrence [...] Read more.
Background: Follow-up after treatment for hepatocellular carcinoma (HCC) can be mostly performed using dynamic CT or MRI, but there is no common evaluation method after radiation therapy. The purpose of this study is to examine factors involved in tumor reduction and local recurrence in patients with HCC treated with proton beam therapy (PBT) and to evaluate HCC shrinkage after PBT. Methods: Cases with only one irradiated lesion or those with two lesions irradiated simultaneously were included in this study. Pre- and post-treatment lesions were evaluated using Response Evaluation Criteria in Solid Tumors (RECIST) by measuring the largest diameter. Results: The 6-, 12-, and 24-month CR + PR rates after PBT were 33.1%, 57.5%, and 76.9%, respectively, and the reduction rates were 25.1% in the first 6 months, 23.3% at 6–12 months, and 14.5% at 13–24 months. Cases that reached CR/PR at 6 and 12 months had improved OS compared to non-CR/non-PR cases. Conclusions: It is possible that a lesion that reached SD may subsequently transition to PR; it is reasonable to monitor progress with periodic imaging evaluations even after 1 year of treatment. Full article
(This article belongs to the Special Issue Radiology for Diagnosis and Treatment of Liver Cancer)
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13 pages, 1174 KiB  
Article
Complementary Role of CEUS and CT/MR LI-RADS for Diagnosis of Recurrent HCC
by Mei-Qing Cheng, Hui Huang, Si-Min Ruan, Ping Xu, Wen-Juan Tong, Dan-Ni He, Yang Huang, Man-Xia Lin, Ming-De Lu, Ming Kuang, Wei Wang, Shao-Hong Wu and Li-Da Chen
Cancers 2023, 15(24), 5743; https://doi.org/10.3390/cancers15245743 - 7 Dec 2023
Cited by 1 | Viewed by 1252
Abstract
Purpose: We retrospectively compared the diagnostic performance of contrast-enhanced ultrasonography (CEUS) and contrast-enhanced computer tomography–magnetic resonance imaging (CT/MRI) for recurrent hepatocellular carcinoma (HCC) after curative treatment. Materials and methods: After curative treatment with 421 ultrasound (US) detected lesions, 303 HCC patients underwent both [...] Read more.
Purpose: We retrospectively compared the diagnostic performance of contrast-enhanced ultrasonography (CEUS) and contrast-enhanced computer tomography–magnetic resonance imaging (CT/MRI) for recurrent hepatocellular carcinoma (HCC) after curative treatment. Materials and methods: After curative treatment with 421 ultrasound (US) detected lesions, 303 HCC patients underwent both CEUS and CT/MRI. Each lesion was assigned a Liver Imaging Reporting and Data System (LI-RADS) category according to CEUS and CT/MRI LI-RADS. Receiver-operating characteristic (ROC) curves were computed to determine the optimal diagnosis algorithms for CEUS, CT and MRI. The diagnostic accuracy, sensitivity, specificity, and area under the curve (AUC) were compared between CEUS and CT/MRI. Results: Among the 421 lesions, 218 were diagnosed as recurrent HCC, whereas 203 lesions were diagnosed as benign. In recurrent HCC, CEUS detected more arterial hyperenhancement (APHE) and washout than CT and more APHE than MRI. CEUS yielded better diagnostic performance than CT (AUC: 0.981 vs. 0.958) (p = 0.024) comparable diagnostic performance to MRI (AUC: 0.952 vs. 0.933) (p > 0.05) when using their optimal diagnostic criteria. CEUS missed 12 recurrent HCCs, CT missed one, and MRI missed none. The detection rate of recurrent HCC on CEUS (94.8%, 218/230) was lower than that on CT/MRI (99.6%, 259/260) (p = 0.001). Lesions located on the US blind spots and visualization score C would hinder the ability of CEUS to detect recurrent HCC. Conclusion: CEUS demonstrated excellent diagnostic performance but an inferior detection rate for recurrent HCC. CEUS and CT/MRI played a complementary role in the detection and characterization of recurrent HCC. Full article
(This article belongs to the Special Issue Radiology for Diagnosis and Treatment of Liver Cancer)
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