DETECTION OF HEPATOCELLULAR CARCINOMA USING PERFUSION COMPUTED TOMOGRAPHY OF THE LIVER
Keywords:
hepatocellular carcinoma, computed tomography, liverAbstract
Hepatocellular carcinoma is the seventh most prevalent cancer globally and the second leading cause of cancer-related deaths, with its incidence markedly increasing with age. Chronic infections with hepatitis B and C, exposure to aflatoxin B1, and alcohol consumption, with tumor development are often linked to chromosomal abnormalities in cirrhotic livers. The use of perfusion computed tomography is a promising diagnostic tool that assesses tissue perfusion and provides insights into blood flow and capillary permeability within the liver, though its exact diagnostic and prognostic capabilities, especially for early-stage tumors, remain uncertain. Challenges in accurately quantifying perfusion parameters arise from the liver's dual blood supply, and current methods have limitations in practical application. The objective of this study is to assess the diagnostic capabilities of perfusion computed tomography in detecting hepatocellular carcinoma and assess the effectiveness of visual analysis of perfusion maps, ultimately seeking to improve diagnostic accuracy and inform therapeutic decisions for patients with this condition. The work was conceived as a scientific review of the literature, various databases from journals, scientific research, scientific and professional papers obtained from Cochrane Library, Crossref, Google Scholar, and PubMed were used, focusing on studies published between 2015 and 2021 that analyzed the potential of perfusion computed tomography in detecting this type of cancer. The review included English-language studies involving patients over 20 years old with suspected hepatocellular carcinoma while excluding children, pregnant or breastfeeding women, and studies not related to human subjects. Hepatocellular carcinoma exhibits unique vascular characteristics that enhance the diagnostic and prognostic capabilities of this imaging technique. The condition is characterized by complex angiogenesis and vascularization from the portal vein, highlighting the method's diagnostic and prognostic potential. Research indicates that this approach effectively distinguishes hepatocellular carcinoma from benign lesions through the use of perfusion maps and maximum intensity projection reconstructions. Studies have demonstrated that it is more sensitive than dual-phase computed tomography in detecting lesions and can also serve as an alternative to tri-phase computed tomography for therapy monitoring. Overall, this imaging method provides crucial insights into diagnosis, tumor behavior, and treatment response, establishing it as a crucial method in the management of individuals with this type of cancer. This systematic literature review highlights the significance of perfusion computed tomography in the non-invasive detection of this cancer, confirming its effectiveness in tumor assessment, neoangiogenesis monitoring and staging, while analysis of the imaging results indicates promising outcomes in disease identification.
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