title: Image-guided Treatment in the Hepatobiliary System: Role of Imaging in Treatment Planning and Posttreatment Evaluation.
abstract: In the past decade, image-guided targeted treatments such as percutaneous ablation, intra-arterial embolic therapies, and targeted radiation therapy have shown substantial promise in management of hepatobiliary malignancies. Imaging is integral to patient selection, treatment delivery, and assessment of treatment effectiveness. Preprocedural imaging is crucial and allows local tumor staging, evaluation of surrounding structures, and selection of suitable therapeutic options and strategies for treatment delivery. Postprocedural imaging is required to monitor therapeutic success, detect residual or recurrent disease, and identify procedure-related complications to guide appropriate future therapy. Technical innovations in cross-sectional imaging techniques such as computed tomography (CT) and magnetic resonance (MR) imaging, combined with advances in image postprocessing and new types of contrast agents, allow precise morphologic assessment and functional evaluation of hepatobiliary tumors. Advanced postprocessing techniques such as image fusion and volumetric assessment not only facilitate procedural planning and treatment delivery but also enhance posttreatment imaging surveillance. In addition, molecular imaging techniques such as fluorodeoxyglucose positron emission tomography (PET), PET/CT, and PET/MR imaging offer opportunities to evaluate various physiologic properties of tumors.
authors.affiliation: From the Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114.
authors.forename: Surabhi
authors.initials: S
authors.lastname: Bajpai
authors.affiliation: From the Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114.
authors.forename: Avinash
authors.initials: A
authors.lastname: Kambadakone
authors.affiliation: From the Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Guimaraes
authors.affiliation: From the Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Arellano
authors.affiliation: From the Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Gervais
authors.affiliation: From the Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114.
authors.forename: Dushyant
authors.initials: D
authors.lastname: Sahani
mesh_terms: D001661:Biliary Tract Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D017115:Catheter Ablation; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008279:Magnetic Resonance Imaging; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods; D011300:Preoperative Care; D061766:Proton Therapy; D019275:Radiopharmaceuticals; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18