Primary Carcinomas of the Liver (Contemporary Issues in Cancer Imaging)

Primary carcinomas of the liver are increasing in incidence in the developed world, probably due to dietary and environmental factors as well as the known role of infective agents such as Hepatitis C. They are usually diagnosed in the advanced stages and carry high morbidity and mortality. This volume summarises the latest developments in imaging of primary hepatic carcinomas, emphasising the multidisciplinary approach to the care of patients. In addition to extensive chapters on the radiological issues surrounding diagnosis and staging of the malignancies, individual chapters on epidemiology, pathology, and surgical and non-surgical treatment options are included. All treatment options are considered for both HCC and cholangiocarcinoma, including newer techniques such as TACE. Only by a well orchestrated multidisciplinary team approach including epidemiologists, diagnostic radiologists, hepatologists, oncologic surgeons, radiation oncologists, and pathologists can these complex malignancies be managed successfully. Half-title......Page 3 Series-title......Page 4 Title......Page 5 Copyright......Page 6 Contents......Page 7 Contributors......Page 9 Series foreword......Page 11 Preface to Primary Carcinomas of the Liver......Page 13 Hepatocellular carcinoma......Page 15 Risk factors......Page 16 Cholangiocarcinoma......Page 19 Risk factors......Page 20 REFERENCES......Page 21 2 Surveillance and screening for hepatocellular carcinoma......Page 24 REFERENCES......Page 28 Macroscopic features......Page 30 Microscopic features......Page 31 Morphologic patterns of hepatocellular carcinoma......Page 32 Immunohistochemical study in the biopsy diagnosis of hepatocellular carcinoma......Page 36 Fine-needle aspiration diagnosis of hepatocellular carcinoma......Page 39 Macroscopic features......Page 40 Histologic variants......Page 41 Differential diagnosis and immunohistochemistry......Page 42 Fine-needle aspiration diagnosis of cholangiocarcinoma......Page 43 REFERENCES......Page 44 Ultrasound......Page 47 Computed tomography and magnetic resonance imaging......Page 49 Lesions greater than or equal to 2cm in diameter......Page 52 Lesions 1 to less than 2cm in diameter......Page 55 Diagnostic accuracy......Page 57 New magnetic resonance imaging techniques......Page 59 Summary......Page 60 REFERENCES......Page 61 5 Staging of hepatocellular carcinoma......Page 65 REFERENCES......Page 69 6 Surgical treatment of hepatocellular carcinoma: resection and transplantation......Page 71 Patient selection......Page 72 Preoperative imaging......Page 73 Resection......Page 74 Transplantation......Page 75 REFERENCES......Page 77 Vascular anatomy of the liver......Page 80 Rationale for transarterial chemoembolization......Page 82 Preprocedure evaluation......Page 83 Patient selection criteria......Page 84 Transarterial chemoembolization procedural steps......Page 85 Chemotherapy and embolization protocols......Page 87 Complications......Page 90 Efficacy of transarterial chemoembolization......Page 91 Conclusion......Page 92 REFERENCES......Page 93 History......Page 98 Mechanism of destruction......Page 106 Improving technology/techniques......Page 107 The role of imaging......Page 108 Complications......Page 111 Efficacy: Survival rates......Page 112 Efficacy: Intrahepatic recurrence of hepatocellular carcinoma......Page 113 REFERENCES......Page 114 Liver tolerance to radiation......Page 118 Three-dimensional conformal radiotherapy – technique......Page 120 External beam radiotherapy – Clinical trials......Page 121 Intensity-modulated radiotherapy......Page 123 Stereotactic body radiotherapy......Page 124 Proton beam and heavy ion therapy......Page 126 Selective internal radiotherapy with radioactive isotopes......Page 127 Conclusions and future directions......Page 128 REFERENCES......Page 129 Cytotoxic agents......Page 134 Biotherapy......Page 135 Targeted therapy......Page 136 Further considerations and conclusions......Page 137 REFERENCES......Page 138 Background......Page 143 Protocol......Page 144 Imaging after ablative therapy......Page 145 Imaging after transarterial therapy......Page 149 REFERENCES......Page 155 9 Radiological diagnosis of cholangiocarcinoma......Page 157 Peripheral intrahepatic cholangiocarcinoma......Page 158 Hilar intrahepatic cholangiocarcinoma (Klatskin tumor)......Page 159 Ultrasound......Page 160 Computed tomography techniques and accuracy for detection and staging of hilar cholangiocarcinoma (Klatskin tumor)......Page 161 Magnetic resonance imaging......Page 164 Associated findings......Page 168 Positron emission tomography......Page 173 Summary......Page 175 REFERENCES......Page 176 Perihilar extrahepatic cholangiocarcinoma......Page 181 Staging and assessment of resectability......Page 191 Staging and assessment of resectability......Page 193 REFERENCES......Page 194 Extrahepatic cholangiocarcinoma......Page 198 Intrahepatic cholangiocarcinoma......Page 201 Proximal extrahepatic cholangiocarcinoma......Page 202 Operative treatment......Page 204 Proximal extrahepatic bile-duct cancer......Page 205 Mid bile-duct extrahepatic cholangiocarcinoma......Page 206 Distal extrahepatic bile-duct cholangiocarcinoma......Page 207 Intrahepatic cholangiocarcinoma......Page 208 Transplantation for cholangiocarcinoma......Page 209 Summary......Page 211 REFERENCES......Page 212 Intrahepatic cholangiocarcinoma......Page 216 Perihilar cholangiocarcinoma......Page 217 Distal cholangiocarcinoma......Page 218 Adjuvant radiotherapy: Conclusions......Page 219 Neoadjuvant treatment and transplantation......Page 220 Radiotherapy considerations......Page 221 Summary and future directions......Page 223 REFERENCES......Page 224 Chemotherapy for resected cholangiocarcinoma......Page 227 Fluoropyrimidine-based regimens......Page 228 Gemcitabine-based regimens......Page 230 Conclusion......Page 231 REFERENCES......Page 232 Angiomyolipoma......Page 235 Inflammatory pseudotumor......Page 239 Mesenchymal hamartoma......Page 241 Biliary hamartoma......Page 243 Hepatic epithelioid hemangioendothelioma......Page 245 Biliary cystadenoma......Page 248 REFERENCES......Page 250 Index......Page 254 Epidemiology hepatocellular carcinoma (HCC) and cholangiocarcinoma / Jorge A. Marrero Surveillance screening for heptocellular carcinoma / Jorge A. Marrero, Hero K. Hussain Pathology of hepatocellular carcinoma, cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma / Barbara McKenna and Sharon Bihlmeyer Radiological diagnosis of HCC / Jonathon M. Willatt, Hero K. Hussain, and Isaac R. Francis Staging of hepatocellular carcinoma / Jorge A. Marerro and Hero K. Hussain Surgical treatment of HCC : resection and transplantation / Sean Kumer and Shawn J. Pelletier Non-surgical treatment of HCC Radiological identification of recurrent or residual hepatocellular carcinoma / Peter S. Liu, Ajaykumar C. Morani, and Hero K. Hussain Radiological diagnosis of cholangiocarcinoma / Hero K. Hussain and Isaac R. Francis Staging of cholangiocarcinoma / Hero K. Hussain and James A. Knol Treatment of cholangiocarcinoma Uncommon hepatic tumors / Peter S. Liu and Hero K. Hussain. "Primary carcinomas of the liver are increasing in incidence in the developed world, probably due to dietary and environmental factors as well as the known role of infective agents such as Hepatitis C. They are usually diagnosed in the advanced stages and carry high morbidity and mortality." "This volume summarises the latest developments in imaging of primary hepatic carcinomas, emphasising the multidisciplinary approach to the care of patients. In addition to extensive chapters on the radiological issues surrounding diagnosis and staging of these malignancies, individual chapters on epidemiology, pathology, and surgical and non-surgical treatment options are also included. All treatment options are considered for both hepatocellular carcinoma and cholangiocarcinoma, including newer techniques with intra-arterial therapy such as selective internal radiation with radioactive isotopes."--Jacket