New approaches for precise response evaluation in hepatocellular carcinoma.
With the increasing clinical use of cytostatic and novel biologic targeted agents, conventional morphologic tumor burden assessments, including World Health Organization criteria and Response Evaluation Criteria in Solid Tumors, are confronting limitations because of their difficulties in distinguishing viable tumor from necrotic or fibrotic tissue. Therefore, the investigation for reliable quantitative biomarkers of therapeutic response such as metabolic imaging or functional imaging has been desired. In this review, we will discuss the conventional and new approaches to assess tumor burden. Since targeted therapy or locoregional therapies can induce biological changes much earlier than morphological changes, these functional tumor burden analyses are very promising. However, some of them have not gone thorough all steps for standardization and validation. Nevertheless, these new techniques and criteria will play an important role in the cancer management, and provide each patient more tailored therapy.
Koichi Hayano, Jorge M Fuentes-Orrego, Dushyant V Sahani, Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, United States.
Koichi
K
Hayano
Koichi Hayano, Jorge M Fuentes-Orrego, Dushyant V Sahani, Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, United States.
Jorge M
JM
Fuentes-Orrego
Koichi Hayano, Jorge M Fuentes-Orrego, Dushyant V Sahani, Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, United States.
Dushyant V
DV
Sahani
D015415:Biomarkers / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D002470:Cell Survival; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008495:Medical Oncology / Q000379:methods* / Q000592:standards; D009336:Necrosis / Q000473:pathology; D010477:Perfusion; D049268:Positron-Emission Tomography; D012984:Software; D016896:Treatment Outcome; D047368:Tumor Burden
D015415:Biomarkers; D003287:Contrast Media
Computed tomography perfusion; Diffusion-weighted imaging; Dynamic contrast-enhanced-magnetic resonance imaging; European Association for the Study of Liver; Hepatocellular carcinoma; Positron emission tomography; Response Evaluation Criteria in Solid Tumors; World Health Organization criteria