肝细胞癌立体定向放射治疗后肿瘤反应影像学评价  

Imaging Evaluation of Tumor Response after Stereotactic Radiotherapy for Hepatocellular Carcinoma

作　　者：尹加伟 曹桢斌[1] 黄宝胜 苏维玲 YIN Jia-wei;CAO Zhen-bin;HUANG Bao-sheng;SU Wei-ling(Department of Medical Imaging,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Guangxi 530000,China;Center of Cyber Knife Treatment for Tumor,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Guangxi 530000,China)

机构地区：[1]广西中医药大学附属瑞康医院医学影像科,广西530000 [2]广西中医药大学附属瑞康医院射波刀肿瘤治疗中心,广西530000

出　　处：《影像技术》2023年第6期75-80,共6页Image Technology

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题项目(Z-A20220923)。

摘　　要：随着现代精准放射治疗技术的高速发展,立体定向放射治疗(SRT)逐渐成为肝细胞癌(HCC)一线局部区域治疗(LRT)模式。LRT治疗HCC的模式选择需要多学科评估,主要取决于实际的临床环境,同时为了精确指导临床治疗,准确评估治疗后的肿瘤反应十分必要。接受SRT的HCC患者需要持续的影像学评价,以及时帮助了解治疗反应和复发情况。因此,准确理解预期SRT后的成像结果对于避免将治疗后的正常变化误解为局部进展或存活肿瘤至关重要。SRT治疗后HCC表现出独特的成像结果,与其他LRT治疗模式表现存在相当大的差异。特别是SRT治疗后HCC可以在短期随访成像中显示出持续性的动脉期高强化(APHE)和强化廓清(WO)。本文总结了目前使用SRT治疗后HCC预期肿瘤反应、肿瘤邻近肝实质影像学表现,以及可以帮助预测肿瘤反应的影像学生物标志物,以帮助临床更好、更准确地评估疗效。With the rapid development of modern precision radiotherapy technology,stereotactic radiotherapy(SRT)has gradually become a first-line local regional therapy(LRT)model for hepatocellular carcinoma(HCC).The choice of LRT treatment mode for HCC requires multidisciplinary evaluation,which mainly depends on the actual clinical environment.At the same time,in order to accurately guide clinical treatment,it is necessary to accurately evaluate the tumor response after treatment.HCC patients receiving SRT need continuous imaging evaluation to help understand treatment response and recurrence in a timely manner.Therefore,an accurate understanding of the expected imaging results after SRT is essential to avoid misunderstanding the normal changes after treatment as local progression or survival of the tumor.After SRT treatment,HCC showed unique imaging results,which was quite different from other LRT treatment modes.In particular,HCC after SRT treatment can show persistent arterial phase hyperenhancement(APHE)and wash-out(WO)in short-term follow-up imaging.This article summarizes the expected tumor response after SRT treatment,the imaging findings of the tumor adjacent to the liver parenchyma,and the imaging biomarkers that can help predict the tumor response,in order to help the clinical better and more accurately evaluate the curative effect.

关 键 词：肝细胞癌 立体定向放射治疗 影像学评估 

分 类 号：R445[医药卫生—影像医学与核医学]