Intraarterial Liver-Directed Therapies: The Role of Interventional Oncology.

Background: Since the early 1990s, the minimally invasive image-guided therapies used in interventional oncology to treat hepatocellular carcinoma have continued to evolve. Additionally, the range of applications has been expanded to the treatment of hepatic metastases from colorectal cancer, neuroendocrine tumors, cholangiocarcinoma, breast cancer, melanoma, and sarcoma.

Methods: We searched the literature to identify publications from 1990 to the present on various image-guided intraarterial therapies and their efficacy, as well as their role in the management of primary and secondary liver malignancies.

Assessment of Response to Transcatheter Arterial Chemoembolization with Doxorubicin-eluting Microspheres: Tumor Biology and Hepatocellular Carcinoma Recurrence in a 5-year Transplant Cohort.

Purpose To assess response to transcatheter arterial chemoembolization (TACE) based on immune markers and tumor biology in patients with hepatocellular carcinoma (HCC) who were bridged to liver transplantation, and to produce an optimized pretransplantation model for posttransplantation recurrence risk. Materials and Methods In this institutional review board-approved HIPAA-compliant retrospective analysis, 93 consecutive patients (73 male, 20 female; mean age, 59.6 years; age range, 23-72 years) underwent TACE with doxorubicin-eluting microspheres (DEB) (hereafter, DEB-TACE) and subsequently underwent transplantation over a 5-year period from July 7, 2011, to May 16, 2016.

Elevated Lung Shunt Fraction as a Prognostic Indicator for Disease Progression and Metastasis in Hepatocellular Carcinoma.

Purpose: To evaluate lung shunt fraction (LSF) as an early predictor for local disease progression or the development of metastatic disease.

Materials And Methods: Retrospective analysis was performed on 52 patients with hepatocellular carcinoma who underwent preradioembolization assessment, including the calculation of LSF. Comparison of preprocedural and postprocedural surveillance imaging was performed.

Collateral transformation of the hepatic artery after liver transplantation.

Objective: A high rate of false-negative sonographic examinations for evaluation for hepatic artery thrombosis in the setting of collateral artery vessel formation has been documented. Subacute hepatic artery compromise with collateral vessel formation can be subclinical, and we believe that this phenomenon may occur more commonly than currently appreciated.

Conclusion: We discuss two cases of subacute hepatic artery compromise with collateral artery vessel formation that were prospectively diagnosed in July 2007 by sonography and confirmed by angiography.