title: Tumour-related neoangiogenesis: functional dynamic perfusion computed tomography for diagnosis and treatment efficacy assessment in hepatocellular carcinoma.
abstract: BACKGROUND
  Aim of the study was to determine the value of perfusion computed tomography in the quantitative assessment of tumour-related neoangiogenesis for the diagnosis and treatment of hepatocellular carcinoma lesions.
  
  
  METHODS
  Overall, 47 consecutive patients with cirrhotic liver disease, with a high risk of hepatocellular carcinoma, and undergoing standard surveillance (six-month intervals) were eligible for inclusion in this prospective study; based on Barcelona Clinic Liver Cancer guidelines, 27 patients were enrolled. Perfusion computed tomography was performed in 29 biopsy-proven hepatocellular carcinoma lesions before and after treatment with transarterial chemoembolization or radiofrequency ablation. The dynamic study was performed with a 256-slice multidetector-computed tomography scanner; the following parameters were measured: hepatic perfusion, arterial perfusion, blood volume, hepatic perfusion index, and time-to-peak in all patients.
  
  
  RESULTS
  Hepatocellular carcinoma lesions had the following median perfusion values: perfusion 46.3mL/min/100g; blood volume 20.4mL/100mg; arterial perfusion 42.9mL/min; hepatic perfusion index 92.5%; time to peak 18.7s. Significantly lower perfusion values were obtained in correctly treated lesions or surrounding parenchyma than in viable hepatocellular carcinoma tissue.
  
  
  CONCLUSIONS
  In hepatocellular carcinoma, perfusion computed tomography could contribute to a non-invasive quantification of tumour blood supply related to the formation of new arterial structures, and enable the assessment of therapeutic response.
authors.affiliation: School of Medicine, University of Milano-Bicocca, Milan, Monza, MB, Italy; Department of Diagnostic Radiology, H. S. Gerardo, Monza, MB, Italy. Electronic address: davide.atena@tiscalinet.it.
authors.forename: Davide
authors.initials: D
authors.lastname: Ippolito
authors.affiliation: School of Medicine, University of Milano-Bicocca, Milan, Monza, MB, Italy; Department of Diagnostic Radiology, H. S. Gerardo, Monza, MB, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Fior
authors.affiliation: School of Medicine, University of Milano-Bicocca, Milan, Monza, MB, Italy; Department of Diagnostic Radiology, H. S. Gerardo, Monza, MB, Italy.
authors.forename: Cammillo Talei
authors.initials: CT
authors.lastname: Franzesi
authors.affiliation: School of Medicine, University of Milano-Bicocca, Milan, Monza, MB, Italy; Department of Diagnostic Radiology, H. S. Gerardo, Monza, MB, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Capraro
authors.affiliation: School of Medicine, University of Milano-Bicocca, Milan, Monza, MB, Italy; Department of Diagnostic Radiology, H. S. Gerardo, Monza, MB, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Casiraghi
authors.affiliation: Department of Interventional Radiology, H. S. Gerardo, Monza, MB, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Leni
authors.affiliation: Department of Interventional Radiology, H. S. Gerardo, Monza, MB, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Vacirca
authors.affiliation: Department of Interventional Radiology, H. S. Gerardo, Monza, MB, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Corso
authors.affiliation: School of Medicine, University of Milano-Bicocca, Milan, Monza, MB, Italy; Department of Diagnostic Radiology, H. S. Gerardo, Monza, MB, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Sironi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic / Q000379:methods; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: CT-perfusion; Hepatocellular carcinoma; MDCT; Neoangiogenesis; Radiofrequency ablation; Trans-arterial chemoembolization