Top

Published in:

01-02-2012 | Review Article

Interventional Radiological Treatment of Hepatocellular Carcinoma: An Update

Authors: Anurag Shrimal, Madhu Prasanth, A. V. Kulkarni

Published in: Indian Journal of Surgery | Issue 1/2012

Abstract

Hepatocellular carcinoma is the commonest primary liver tumor and its incidence is on an increase.Transplantation and surgical resection are the gold standard curative treatment options but less than 20%patients are surgical candidates because of advanced liver disease and/or co-morbidities.Various interventional radiological procedures have been developed and intensively investigated for treatment of inoperable HCC.This review summarizes the various interventional radiological treatments in HCC including patient selection, procedural considerations and response evaluation. Transarterial chemoembolization, radioembolization and radiofrequency ablation are mainly discussed.

El-Serag HB, Mason AC, Key C (2009) Trends in survival of patients with hepatocellular carcinoma between 1977 and 1996 in the United States. Heptology 33(1):62–65CrossRef

Altekruse SF, McGylnn KA, Reichman ME (2009) Hepatocellular carcinoma incidence, mortality, and survival trends in the United States from 1975 to 2005. J Clin Oncol 27(9):1485–1491PubMedCrossRef

Pawlik TM, Delman KA, Vauthey JN, Nagorney DM, Ng IO, Ikai I et al (2005) Tumor size predicts vascular invasion and histologic grade: implications for selection of surgical treatment for Hepatocellular carcinoma. Liver Transpl 11(9):1086–1092PubMedCrossRef

Otto G, Heuschen U, Hofmann WJ, Krumm G, Hinz U, Herfarth C (1998) Survival and recurrence after liver transplantation versus liver resection for Hepatocellular carcinoma: a retrospective analysis. Ann Surg 227(3):424–432PubMedCrossRef

Poon RT, Fan ST, Lo CM, Liu CL, Wong J (2002) Long term survival and pattern of recurrence after resection of small Hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation. Ann Surg 235(3):373–382PubMedCrossRef

Dodd GD 3rd, Soulen MC, Kane RA, Livraghi T, Lees WR, Yamashita Y et al (2000) Minimally invasive treatment of malignant hepatic tumors: at the threshold of a major breakthrough. Radiographics 20:9–27PubMed

Sakamoto I, Aso N, Nagaoki K, Matsuoka Y, Uetani M, Ashizawa K et al (1998) Complications associated with transcatheter arterial embolization for hepatic tumors. Radiographics 18(3):605–619PubMed

Kan Z, McCuskey PA, Wright KC, Wallace S (1994) Role of Kupffer cells in iodized oil embolization. Invest Radiol 29(11):990–993PubMedCrossRef

Konno T (1990) Targeting cancer chemotherapeutic agents by the use of lipiodol contrast medium. Cancer 29(11):990–993

10.

Sasaki Y, Imoka S, Kasugai H, Fujita M, Kawamoto S, Ishiguro S et al (1987) A new approach to chemoembolization therapy for hepatoma using ethiodized oil, cisplatin, and gelatin sponge. Cancer 60(6):1194–1203PubMedCrossRef

11.

Varela M, Real MI, Burrel FA, Sala M, Brunet M et al (2007) Chemoembolization of Hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics. J Hepatol 46(3):474–481PubMedCrossRef

12.

Olweny CL, Katongole-Mbidde E, Mugerwa J, Kyalwazi SK, Cohen H (1975) Treatment of hepatocellular carcinoma with adriamycin. Preliminary communication. Cancer 36(4):1250–1257PubMedCrossRef

13.

Olweny CL, Kantongole-Mbidde E, Bahendeka S, Otim D, Mugerwa J, Kyalwazi SK (1980) Further experience in treating patients with hepatocellular carcinoma in Uganda. Cancer 46(12):2717–2722PubMedCrossRef

14.

Lai CL, Wu PC, Chan GC et al (1988) Doxorubicin versus no antitumor therapy in inoperable Hepatocellular carcinoma. A prospective randomized trial. Cancer 62(3):479–483PubMedCrossRef

15.

Ramsey DE, Kernagis LY, Soulen MC, Geschwind JF (2002) Chemoembolization of hepatocellular carcinoma. J Vasc Interv Radiol 13(9 Pt 2):S211–S221PubMedCrossRef

16.

Liapi E, Geogiades CC, Hong K, Geschwind JF (2007) Transcatheter arterial chemoembolization: current technique and future promise. Tech Vasc Interv Radiol 10(1):2–11PubMedCrossRef

17.

Liu DM, Salem R, Bui JT et al (2005) Angiographic and technical considerations in patients undergoing liver-directed therapy. J Vasc Interv Radiol 16(7):911–935PubMedCrossRef

18.

Virmani S, Ryu RK, Sato KT, Lewandowski RJ, Kulik L, Mulcahy MF (2007) Effect of C-arm angiographic CT on transcatheter arterial chemoembolization of liver tumors. J Vasc Interv Radiol 18(10):1305–1309PubMedCrossRef

19.

Wallace MJ, Murthy R, Kamat PP, Moore T, Rao SH, Ensor J et al (2007) Impact of C-arm CT on hepatic arterial interventions for hepatic malignancies. J Vasc Interv Radiol 18(12):1500–1507PubMedCrossRef

20.

Convey AM, Brody LA, Maluccio MA, Getrajdman GI, Brown KT (2002) Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology 224(2):542–547CrossRef

21.

Song SY, Chung JW, Lim HG, Park JH (2006) Nonhepatic arteries originating from hepatic arteries: angiographic analysis in 250 patients. J Vasc Interv Radiol 17(3):461–469PubMedCrossRef

22.

Brown DB, Cardella JF, Sacks D, Goldberg SN, Gervais DA, Rajan DK et al (2009) Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy. J Vasc Interv Radiol 20(Suppl 7):S219–S226, e1–e10PubMedCrossRef

23.

Takayasu K, Arii S, Ikai I, Omata M, Okita K, Ichida T et al (2006) Prospective cohort study of transarterial chemoembolization for unresectable Hepatocellular carcinoma in 8510 patients. Gastroenterology 131(2):461–469PubMedCrossRef

24.

Brown DB, Geschwind JF, Soulen MC, Millward SF, Sacks D (2009) Society of Interventional Radiology position statement on chemoembolization of hepatic malignancies. J Vasc Interv Radiol 20(Suppl 7):S317–S323PubMedCrossRef

25.

Llovet JM, Real MI, Montana X, Planas R, Coll S, Aponte J et al (2002) Arterial embolization or chemoembolization versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomized controlled trial. Lancet 359(9319):1734–1739PubMedCrossRef

26.

Lo CM, Ngan H, Tso WK, Liu CL, Lam CM, Poon RT et al (2002) Randomized controlled trial of Transarterial lipiodol chemoembolization for unresectable Hepatocellular carcinoma. Hepatology 35(5):1164–1171PubMedCrossRef

27.

Llovet JM, Bruix J (2003) Systematic review of randomized trials for unresectable Hepatocellular carcinoma: chemoembolization improves survival. Hepatology 37(2):429–442PubMedCrossRef

28.

Camma C, Schepis F, Orlando A, Albanese M, Shahied L, Trevisani F et al (2002) Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. Radiology 224(1):47–54PubMedCrossRef

29.

Lammer J, Malagari K, Vogl T, Pilleul F, Denys A, Watkinson A et al (2010) Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol 33(1):41–52PubMedCrossRef

30.

Malagari K, Pomoni M, Kelekis A, Pomoni A, Dourakis S, Spyridopoulos T et al (2010) Prospective randomized comparison of chemoembolization with doxorubicin-eluting beads and bland embolization with BeadBlock for hepatocellular carcinoma. Cardiovasc Intervent Radiol 33(3):541–551PubMedCrossRef

31.

Salem R, Lewandowski R, Roberts C, Goin J, Thurston K, Abouljoud M et al (2004) Use of Yttrium-90 glass microspheres (TheraSphere) for the treatment of unresectable hepatocellular carcinoma with portal vein thrombosis. J Vasc Interv Radiol 15(4):335–345PubMedCrossRef

32.

Riaz A, Lewandowski R, Kulik L (2009) Complications following radioembolization with yttrium-90 microspheres: a comprehensive literature review. J Vasc Interv Radiol 20(9):1121–1130PubMedCrossRef

33.

Salem R, Lewandowski RJ, Mulcahy MF, Riaz A, Ryu RK, Ibrahim S et al (2010) Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology 138(1):52–64PubMedCrossRef

34.

Kooby DA, Egnatashivili V, Srinivasan S, Chamsuddin A, Delman KA, Kauh J et al (2010) Comparison of yttrium-90 radioembolization and transcatheter arterial chemoembolization for treatment of unresectable hepatocellular carcinoma. J Vasc Interv Radiol 21(2):224–230PubMedCrossRef

35.

Ishii H, Okada S, Nose H, Okusaka T, Yoshimori M, Takayama T et al (1996) Local recurrence of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 77(9):1792–1976PubMedCrossRef

36.

Lencioni RA, Allgaier HP, Cioni D, Olschewski M, Deibert P, Crocetti L et al (2003) Small hepatocellular carcinoma in cirrhosis: randomized comparison of radiofrequency thermal ablation versus percutaneous ethanol injection. Radiology 228(1):235–240PubMedCrossRef

37.

Shiina S, Teratani T, Obi S, Sato S, Tateishi R, Fujishima T et al (2005) A randomized controlled trial of radiofrequency ablation with ethanol injection for small hepatocellular carcinoma. Gastroenterology 129(1):122–130PubMedCrossRef

38.

Lin SM, Lin CJ, Lin CC, Hsu CW, Chen YC (2005) Randomized controlled trial comparing percutaneous radiofrequency thermal ablation, percutaneous ethanol injection, and percutaneous acetic acid injection to treat hepatocellular carcinoma of 3 cm or less. Gut 54(8):1151–1156PubMedCrossRef

39.

Orlando A, Leandro G, Olivo M, Andriulli A, Cottone M (2009) Radiofrequency thermal ablation vs. percutaneous ethanol injection for small hepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlled trials. Am J Gastroenterol 104(2):514–524PubMedCrossRef

40.

Crocetti L, de Baere T, Lencioni R (2010) Quality improvement guidelines for radiofrequency ablation of liver tumors. Cardiovasc Intervent Radiol 33:11–17PubMedCrossRef

41.

Livraghi T, Solbiati L, Meloni MF, Gazelle GS, Halpern EF, Goldberg SN (2003) Treatment of focal liver tumors with percutaneous radiofrequency ablation: complications encountered in a multicenter study. Radiology 226:441–451PubMedCrossRef

42.

Latteri F, Sandonato L, Di Marco V, Parisi P, Cabibbo G, Lombardo G et al (2008) Seeding after radiofrequency ablation of hepatocellular carcinoma in patients with cirrhosis: a prospective study. Dig Liver Dis 40:684–689PubMedCrossRef

43.

Mulier S, Mulier P, Ni Y, Miao Y, Dupas B, Marchal G et al (2002) Complications of radiofrequency coagulation of liver tumors. Br J Surg 89:1206–1222PubMedCrossRef

44.

Lu DS, Raman SS, Limanond P, Aziz D, Economou J, Busuttil R et al (2003) Influence of large peritumoral vessels on outcome of radiofrequency ablation of liver tumors. J Vasc Interv Radiol 14(10):1267–1274PubMedCrossRef

45.

Chang I, Mikityansky I, Wary-Cahen D, Pritchard WF, Karanian JW, Wood BJ (2004) Effects of perfusion on radiofrequency ablation in swine kidneys. Radiology 231(2):500–505PubMedCrossRef

46.

Pompili M, Mirante VG, Rondinara G, Fassati LR, Piscaglia F, Agnes S et al (2005) Percutaneous ablation procedures in cirrhotic patients with hepatocellular carcinoma submitted to liver transplantation: assessment of efficacy at explant analysis and of safety for tumor recurrence. Liver Transpl 11(9):1117–1126PubMedCrossRef

47.

Choi H, Evelyne M, Charnsangavej C (2007) Radiographic imaging following radiofrequency ablation of liver tumors. In: Ellis LM, Curley SA, Tanabe KK (eds) Radiofrequency ablation for cancer: current indications, techniques, and outcomes. Springer, New York, pp 253–267

48.

Lim HK, Choi D, Lee WJ, Kim SH, Lee SJ, Jang HJ et al (2001) Hepatocellular carcinoma treated with percutaneous radiofrequency ablation: evaluation with follow-up multiphase helical CT. Radiology 221:447–454PubMedCrossRef

49.

Goldberg SN, Gazelle GS, Solbiati L, Livraghi T, Tanabe KK, Hahn PF et al (1998) Ablation of liver tumors using percutaneous RF therapy. AJR Am J Roentgenol 170:1023–1028PubMed

50.

McGhana JP, Dodd GD 3rd (2001) Radiofrequency ablation of liver: current status. AJR Am J Roentgenol 176:3–16PubMed

51.

deBaere T, Risse O, Kuonch V, Dromain C, Sengel C, Smayra T et al (2003) Adverse events during radiofrequency treatment of 582 hepatic tumors. AJR Am J Roentgenol 181:695–700

52.

Kim YS, Rhim H, Lim HK (2009) Imaging after radiofrequency ablation of hepatic tumor. Semin Ultrasound CT MR 30:49–66PubMedCrossRef

53.

Choi D, Lim HK, Kim MJ, Kim SJ, Kim SH, Lee WJ et al (2005) Liver abscess after percutaneous radiofrequency ablation for hepatocellular carcinomas: frequency and risk factors. AJR Am J Roentgenol 184:1860–1867PubMed

54.

Akahane M, Koga H, Kato N, Yamada H, Uozumi K, Tateishi R et al (2005) Complications of percutaneous radiofrequency ablation for hepato-cellular carcinoma: imaging spectrum and management. Radiographics 25(Suppl 1):S57–S68PubMedCrossRef

55.

Tamai F, Furuse J, Maru Y, Yoshino M (2002) Intrahepatic pseudoaneurysm: a complication following radiofrequency ablation therapy for hepatocellular carcinoma. Eur J Radiol 44:40–43PubMedCrossRef

56.

Kim YS, Rhim H, Lim HK, Choi D, Lee WJ, Kim SH (2007) Hepatic infarction after radiofrequency ablation of hepatocellular carcinoma with internally cooled electrode. J Vasc Interv Radiol 18:1126–1133PubMedCrossRef

57.

Kim MD, Kim H, Kang SW, Jeong BG (2002) Nontraumatic hepatic artery pseudoaneurysm associated with acute leukemia: a possible complication of pyogenic liver abscess. Abdom Imaging 27:458–460PubMedCrossRef

58.

Jaskolka JD, Asch MR, Kachura JR, Ho CS, Ossip M, Wong F et al (2005) Needle tract seeding after radiofrequency ablation of hepatic tumors. J Vasc Interv Radiol 16(4):485–491PubMedCrossRef

59.

Sung GT, Gill IS, Hsu TH, Meraney AM, Skacel M, Brainard JA et al (2003) Effect of intentional cryo-injury to the renal collecting system. J Urol 170(2 Pt 1):619–622PubMedCrossRef

Title: Interventional Radiological Treatment of Hepatocellular Carcinoma: An Update
Authors: Anurag Shrimal
Madhu Prasanth
A. V. Kulkarni
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Indian Journal of Surgery / Issue 1/2012
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI: https://doi.org/10.1007/s12262-011-0377-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Interventional Radiological Treatment of Hepatocellular Carcinoma: An Update

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2012

Management of Post-Cholecystectomy Benign Bile Duct Strictures: Review

Management of Pancreaticoduodenal Injuries

Diagnosis and Management of Choledochal Cysts

Pathology for the HPB Surgeon

Issues in Surgery for Hilar Cholangiocarcinoma

Management of Severe Acute Pancreatitis