Liver cancer

Summary

Liver cancer (also known as hepatic cancer, primary hepatic cancer, or primary hepatic malignancy) is cancer that starts in the liver. Liver cancer can be primary (starts in liver) or secondary (meaning cancer which has spread from elsewhere to the liver, known as liver metastasis). Liver metastasis is more common than that which starts in the liver. Liver cancer is increasing globally. Primary liver cancer is globally the sixth-most frequent cancer and the fourth-leading cause of death from cancer. In 2018, it occurred in 841,000 people and resulted in 782,000 deaths globally. Higher rates of liver cancer occur where hepatitis B and C are common, including Asia and sub-Saharan Africa. Males are more often affected with hepatocellular carcinoma (HCC) than females. Diagnosis is most frequent among those 55 to 65 years old. The leading cause of liver cancer is cirrhosis due to hepatitis B

Official source

https://en.wikipedia.org/wiki/Liver_cancer

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Visualization of hepatic arteries with 3D ultrasound during intra-arterial therapies

Anaïs Laure Marie-Thérèse Badoual, Alexandre Bigot, François Michaud

Liver cancer represents the second most common cause of cancer-related mortality worldwide. The prognosis is poor with an overall mortality of 95%. Moreover, most hepatic tumors are unresectable due to their advanced stage at discovery or poor underlying liver function. Tumor embolization by intra-arterial approaches is the current standard of care for advanced cases of hepatocellular carcinoma. These therapies rely on the fact that the blood supply of primary hepatic tumors is predominantly arterial. Feedback on blood flow velocities in the hepatic arteries is crucial to ensure maximal treatment efficacy on the targeted masses. Based on these velocities, the intra-arterial injection rate is modulated for optimal infusion of the chemotherapeutic drugs into the tumorous tissue. While Doppler ultrasound is a well-documented technique for the assessment of blood flow, 3D visualization of vascular anatomy with ultrasound remains challenging. In this paper we present an image-guidance pipeline that enables the localization of the hepatic arterial branches within a 3D ultrasound image of the liver. A diagnostic Magnetic resonance angiography (MRA) is first processed to automatically segment the hepatic arteries. A non-rigid registration method is then applied on the portal phase of the MRA volume with a 3D ultrasound to enable the visualization of the 3D mesh of the hepatic arteries in the Doppler images. To evaluate the performance of the proposed workflow, we present initial results from porcine models and patient images.

Spie-Int Soc Optical Engineering2016

Purpose Liver cancer is the 5 most common cancer and shows poor prognosis. Surgical removal of liver tumours, the only existing curative treatment, can merely be used in 10-20% of the case. Increasing surgical precision is a key-challenge to give more patients access to a potentially curative treatment. Recent progress in computer science enables the use of instrument guidance systems for open liver surgery by providing improved orientation and guidance support during planning and intraoperative realization. However, challenge remains when precise alignment between preoperative image data and the intraoperative situation is required, since the liver is subject to deformation and movements during the surgical treatment. The CASOne liver navigation system (CAScination AG, Switzerland) applies a landmark based registration technic to perform the alignment. Major drawbacks of this technic reside in the difficulties of identifying accurately correspondences between the preoperative image data and the intraoperative situation. In a recent study, including more than 50 surgeries performed with the CALS system, the authors measure a median alignment precision of 6.3 mm. We present a framework to improve such alignment using intraoperative ultrasound imaging (US) and preoperative computed tomography (MeVis-CT) data.

2012

3D Vascular Path Planning of Chemo-Embolizations Using Segmented Hepatic Arteries from MR Angiography

Anaïs Laure Marie-Thérèse Badoual

Transcatheter arterial chemo-embolization (TACE) is a therapeutic procedure to treat primary and metastatic liver cancer. It requires prior delineation of the hepatic arteries on magnetic resonance angiography (MRA) data and identification of the vessels supplying the tumor. Manual segmentation is extremely challenging and time consuming, thereby increasing the risk of wrongfully identifying the feeding vessels. We present a vascular path planning tool for TACE procedures by automatically segmenting the hepatic arteries on MRA. The proposed method first detects the celiac trunk from the aorta, then localizes and tags bifurcations throughout the arterial network for path planning. The algorithm is based on a multiple hypothesis tracking approach used to propagate deformable mesh surfaces. We validated the proposed framework on 20 liver-cancer-patients using abdominal MRA with 20 seconds delay after contrast injection. We show that the algorithm improves the selectivity of the arterial segments and outperforms two state-of-the-art methods with respect to manual segmentation, yielding mesh geometries with a mean absolute distance of 0.61 ± 0.10 mm for 3D mesh models.

IEEE2016