演題抄録

FACO Symposium

開催概要
開催回
第53回・2015年・京都
 

Application of New Imaging Modalities for Multidisciplinary Treatment of Advanced HCC

演題番号 : FS2-4

[筆頭演者]
Hatano Etsuro:1 
[共同演者]
Seo Satoru:1、Taura Kojiro:1、Yasuchika Kentaro:1、Uemoto Shinji:1

1:Department of Surgery, Kyoto University

 

Hepatectomy is one of the most effective treatment options for patients with hepatocellular carcinoma (HCC). Recent development of imaging modalities for management of HCC could improve outcome of the patients with advanced HCC. MRI with Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA); EOB-MRI is useful for detecting early HCC. EOB-MRI before the operation might show the small intrahepatic metastasis and could reduce early recurrence after the operation. Acoustic Radio Force Impulse (ARFI); Post hepatectomy liver failure (PHLF) might be a fatal complication after liver resection. An accurate prediction of PHLF based on preoperative liver function is essential. Liver stiffness measurement (LSM) has been widely accepted as a noninvasive assessment for liver fibrosis. LSM was performed by acoustic radiation force impulse (ARFI) imaging. Preoperative risk assessments that incorporate LSM are useful for predicting PHLF. Multi-detector raw CT (MD-CT); Three-dimensional simulation from MD-CT facilitates intraoperative identification of the vascular anatomy and predicts the resected liver volume and surgical margin. This simulation should contribute to preoperative planning for safe and curative hepatectomy. FDG-PET; Preoperative FDG-PET predicts HCC recurrences within the Milan criteria or no recurrence and recurrences after 1 year or later. FDG-PET is useful for assessing the malignant potential of advanced HCC and selecting appropriate patients for liver resection but not for liver transplantation as an initial surgical strategy. Sonazoid; To improve diagnostic accuracy of intraoperative ultrasonography (IOUS), we use new contrast medium of microbubble agent, Sonazoid. Sonazoid-IOUS is a promising useful tool to detect the precise tumor margin and small tumors, hence allowing curative hepatectomy. We make the best use of such new imaging modalities to perform curative treatment for advanced HCC.

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