Although Starzl designed in the 1960’s liver transplantation(LT)to treat unresectable primary and also secondary liver tumors,transplantation still occupies a(too)small place in the respec-tive therapeutic algorithms...Although Starzl designed in the 1960’s liver transplantation(LT)to treat unresectable primary and also secondary liver tumors,transplantation still occupies a(too)small place in the respec-tive therapeutic algorithms[1].Due to the lack of(any)selec-tion criteria,the concept of transplantation became rapidly chal-lenged because of the prohibitively high incidence of tumor recur-rence[1–3].展开更多
In recent days,Deep Learning(DL)techniques have become an emerging transformation in the field of machine learning,artificial intelligence,computer vision,and so on.Subsequently,researchers and industries have been hi...In recent days,Deep Learning(DL)techniques have become an emerging transformation in the field of machine learning,artificial intelligence,computer vision,and so on.Subsequently,researchers and industries have been highly endorsed in the medical field,predicting and controlling diverse diseases at specific intervals.Liver tumor prediction is a vital chore in analyzing and treating liver diseases.This paper proposes a novel approach for predicting liver tumors using Convolutional Neural Networks(CNN)and a depth-based variant search algorithm with advanced attention mechanisms(CNN-DS-AM).The proposed work aims to improve accuracy and robustness in diagnosing and treating liver diseases.The anticipated model is assessed on a Computed Tomography(CT)scan dataset containing both benign and malignant liver tumors.The proposed approach achieved high accuracy in predicting liver tumors,outperforming other state-of-the-art methods.Additionally,advanced attention mechanisms were incorporated into the CNN model to enable the identification and highlighting of regions of the CT scans most relevant to predicting liver tumors.The results suggest that incorporating attention mechanisms and a depth-based variant search algorithm into the CNN model is a promising approach for improving the accuracy and robustness of liver tumor prediction.It can assist radiologists in their diagnosis and treatment planning.The proposed system achieved a high accuracy of 95.5%in predicting liver tumors,outperforming other state-of-the-art methods.展开更多
An ultrasonic filter detects signs of malignant tumors by analysing the image’s pixel quality fluctuations caused by a liver ailment.Signs of malignant growth proximity are identified in an ultrasound filter through ...An ultrasonic filter detects signs of malignant tumors by analysing the image’s pixel quality fluctuations caused by a liver ailment.Signs of malignant growth proximity are identified in an ultrasound filter through image pixel quality variations from a liver’s condition.Those changes are more common in alcoholic liver conditions than in other etiologies of cirrhosis,suggesting that the cause may be alcohol instead of liver disease.Existing Two-Dimensional(2D)ultrasound data sets contain an accuracy rate of 85.9%and a 2D Computed Tomography(CT)data set of 91.02%.The most recent work on designing a Three-Dimensional(3D)ultrasound imaging system in or close to real-time is examined.In this article,a Deep Learning(DL)model is implemented and modified to fit liver CT segmentation,and a semantic pixel classification of road scenes is recommended.The architecture is called semantic pixel-wise segmentation and comprises a hierarchical link of encoder-decoder layers.A standard data set was used to test the proposed model for liver CT scans and the tumor accuracy in the training phase.For the normal class,we obtained 100%precision for chronic cirrhosis hepatitis(73%),offset cirrhosis(59.26%),and offensive cirrhosis(91.67%)for chronic hepatitis or cirrhosis(73,0%).The aim is to develop a Computer-Aided Detection(CAD)screening tool to detect steatosis.The results proved 98.33%exactness,94.59%sensitivity,and 92.11%case with Convolutional Neural Networks(CNN)classification.Although the classifier’s performance did not differentiate so clearly at this level,it was recommended that CNN generally perform better due to the good relationship between Area under the Receiver Operating Characteristics Curve(AUC)and accuracy.展开更多
Liver cancer is the second leading cause of cancer death worldwide.Early tumor detection may help identify suitable treatment and increase the survival rate.Medical imaging is a non-invasive tool that can help uncover...Liver cancer is the second leading cause of cancer death worldwide.Early tumor detection may help identify suitable treatment and increase the survival rate.Medical imaging is a non-invasive tool that can help uncover abnormalities in human organs.Magnetic Resonance Imaging(MRI),in particular,uses magnetic fields and radio waves to differentiate internal human organs tissue.However,the interpretation of medical images requires the subjective expertise of a radiologist and oncologist.Thus,building an automated diagnosis computer-based system can help specialists reduce incorrect diagnoses.This paper proposes a hybrid automated system to compare the performance of 3D features and 2D features in classifying magnetic resonance liver tumor images.This paper proposed two models;the first one employed the 3D features while the second exploited the 2D features.The first system uses 3D texture attributes,3D shape features,and 3D graphical deep descriptors beside an ensemble classifier to differentiate between four 3D tumor categories.On top of that,the proposed method is applied to 2D slices for comparison purposes.The proposed approach attained 100%accuracy in discriminating between all types of tumors,100%Area Under the Curve(AUC),100%sensitivity,and 100%specificity and precision as well in 3D liver tumors.On the other hand,the performance is lower in 2D classification.The maximum accuracy reached 96.4%for two classes and 92.1%for four classes.The top-class performance of the proposed system can be attributed to the exploitation of various types of feature selection methods besides utilizing the ReliefF features selection technique to choose the most relevant features associated with different classes.The novelty of this work appeared in building a highly accurate system under specific circumstances without any processing for the images and human input,besides comparing the performance between 2D and 3D classification.In the future,the presented work can be extended to be used in the huge dataset.Then,it can be a reliable,efficient Computer Aided Diagnosis(CAD)system employed in hospitals in rural areas.展开更多
Liver cancer has the second highest incidence rate among all types of malignant tumors,and currently,its diagnosis heavily depends on doctors’manual labeling of CT scan images,a process that is time-consuming and sus...Liver cancer has the second highest incidence rate among all types of malignant tumors,and currently,its diagnosis heavily depends on doctors’manual labeling of CT scan images,a process that is time-consuming and susceptible to subjective errors.To address the aforementioned issues,we propose an automatic segmentation model for liver and tumors called Res2Swin Unet,which is based on the Unet architecture.The model combines Attention-Res2 and Swin Transformer modules for liver and tumor segmentation,respectively.Attention-Res2 merges multiple feature map parts with an Attention gate via skip connections,while Swin Transformer captures long-range dependencies and models the input globally.And the model uses deep supervision and a hybrid loss function for faster convergence.On the LiTS2017 dataset,it achieves better segmentation performance than other models,with an average Dice coefficient of 97.0%for liver segmentation and 81.2%for tumor segmentation.展开更多
To the Editor:Liver tumor may occur in any hepatic segment or lobe,and thus the liver resection is individualized as per the location and size of the tumor.In addition,the resection of the posterior and caudate lobes ...To the Editor:Liver tumor may occur in any hepatic segment or lobe,and thus the liver resection is individualized as per the location and size of the tumor.In addition,the resection of the posterior and caudate lobes of the liver is especially difficult amongst all types of hepatectomy.Kawaguchi et al.believed that the laparoscopic resection of right posterior liver lobe was a difficult surgical procedure[1].展开更多
Liver tumors are rare in children,but the incidence may increase in some circumstances and particularly in chronic liver diseases.Most liver tumors consequent to chronic liver diseases are malignant hepatocellular car...Liver tumors are rare in children,but the incidence may increase in some circumstances and particularly in chronic liver diseases.Most liver tumors consequent to chronic liver diseases are malignant hepatocellular carcinoma.Other liver tumors include hepatoblastoma,focal nodular hyperplasia,adenoma,pseudotumor,and nodular regenerative hyperplasia.Screening of suspected cases is beneficial.Imaging and surrogate markers of alpha-fetoprotein are used initially as noninvasive tools for surveillance.However,liver biopsy for histopathology evaluation might be necessary for patients with inconclusive findings.Once the malignant liver tumor is detected in children with cirrhosis,liver transplantation is currently considered the preferred option and achieves favorable outcomes.Based on the current evidence,this review focuses on liver tumors with underlying chronic liver disease,their epidemiology,pathogenesis,early recognition,and effective management.展开更多
Benign liver tumors are common lesions that are usually asymptomatic and are often found incidentally due to recent advances in imaging techniques and their widespread use.Although most of these tumors can be managed ...Benign liver tumors are common lesions that are usually asymptomatic and are often found incidentally due to recent advances in imaging techniques and their widespread use.Although most of these tumors can be managed conservatively or treated by surgical resection,liver transplantation(LT)is the only treatment option in selected patients.LT is usually indicated in patients that present with life-threatening complications,when the lesions are diffuse in the hepatic parenchyma or when malignant transformation cannot be ruled out.However,due to the significant postoperative morbidity of the procedure,scarcity of available donor liver grafts,and the benign course of the disease,the indications for LT are still not standardized.Hepatic adenoma and adenomatosis,hepatic hemangioma,and hepatic epithelioid hemangioendothelioma are among the most common benign liver tumors treated by LT.This article reviews the role of LT in patients with benign liver tumors.The indications for LT and long-term outcomes of LT are presented.展开更多
AIM: To conduct a single-stage, combined computed tomography (CT) arterial portography (CTAP) and CT arteriography (CTA) imaging operation, we used Y-shaped sheaths with 2 valves, which allowed the insertion of 2 cath...AIM: To conduct a single-stage, combined computed tomography (CT) arterial portography (CTAP) and CT arteriography (CTA) imaging operation, we used Y-shaped sheaths with 2 valves, which allowed the insertion of 2 catheters simultaneously. METHODS: Of 1254 patients who underwent abdominal angiography for transarterial embolization and/or intraarterial chemotherapy in our department from May 2002 to November 2009, 664 patients in whom Y-shaped sheaths with 2 valves were used underwent CT angiography using a combination of CTA and CTAP. The Seldinger method was used to insert a 10 cm Y-shaped short sheath with 2 valves into the femoral artery. Under radiographic guidance, a 3.2 French (Fr) catheter was placed in the celiac artery or proper hepatic artery, and a second 3.2 Fr catheter was then placed distal to the inferior pancreaticoduodenal artery of the superior mesenteric artery. CTAP was then performed followed by CTA 10 min later. Photographs were taken during the early and late phases of the procedure.RESULTS: Insertion of 3.2 Fr catheters was not possible in 6 of 664 (0.9%) patients with strong curvature of the femoral artery and 4 of 664 (0.6%) patients with strong curvature of the abdominal aorta. In addition, performing CTAP and CTA as a single-stage combined intervention was not possible in 14 of 664 (2.1%) patients whose right hepatic artery originated from the superior mesenteric artery and in 8 of 664 (1.2%) patients whose left hepatic artery branched from the left gastric artery. There were no sheath-related complications such as those related to arterial dissection or hemostasis. CONCLUSION: Although transfers to and from the CT room were necessary for anatomically variant patients, CT angiography using the Y-shaped sheath for combined CTAP and CTA was considered useful.展开更多
In the recent days, the segmentation of Liver Tumor (LT) has beendemanding and challenging. The process of segmenting the liver and accuratelyspotting the tumor is demanding due to the diversity of shape, texture, and...In the recent days, the segmentation of Liver Tumor (LT) has beendemanding and challenging. The process of segmenting the liver and accuratelyspotting the tumor is demanding due to the diversity of shape, texture, and intensity of the liver image. The intensity similarities of the neighboring organs of theliver create difficulties during liver segmentation. The manual segmentation doesnot provide an accurate segmentation because the results provided by differentmedical experts can vary. Also, this manual technique requires a large numberof image slices and time for segmentation. To solve these issues, the Fully Automatic Segmentation (FAS) technique is proposed. In this proposed Multi-AngleTexture Active Contour Model (MAT-ACM) method, the input Computed Tomography (CT) image is preprocessed by Contrast Enhancement (CE) with Non-Linear Mapping Technique (NLMT), in which the liver is differentiated from itsneighbouring soft tissues with related strength. Then, the filtered images are givenas the input to Adaptive Edge Modeling (AEM) with Canny Edge Detection(CED) technique, which segments the Liver Region (LR) from the given CTimages. An AEM with a CED model is implemented, which increases the convergence speed of the iterative process for decreasing the Volumetric Overlap Error(VOE) is 6.92% rates when compared with the traditional Segmentation Techniques (ST). Finally, the Liver Tumor Segmentation (LTS) is developed by applyingthe MAT-ACM, which accurately segments the LR from the segmented LRs. Theevaluation of the proposed method is compared with the existing LTS methodsusing various performance measures to prove the superiority of the proposedMAT-ACM method.展开更多
Also if rarely,hepatocellular carcinoma,cholangiocarcinoma,and metastatic carcinoma can invade the retrohepatic portion of the inferior vena cava(IVC),because of the proximity of this vessel to the liver.^([1]) Innova...Also if rarely,hepatocellular carcinoma,cholangiocarcinoma,and metastatic carcinoma can invade the retrohepatic portion of the inferior vena cava(IVC),because of the proximity of this vessel to the liver.^([1]) Innovative vascular exclusion techniques and new surgical resection methods,derived from improvements in liver surgery and transplantation,have allowed us展开更多
Objective: The purpose of this study was to evaluate the correlation between CT perfusion parameters and the hypoxia-inducible factor-1 alpha (HIF-1α), vascular en-dothelial growth factor (VEGF), matrix metalloprotei...Objective: The purpose of this study was to evaluate the correlation between CT perfusion parameters and the hypoxia-inducible factor-1 alpha (HIF-1α), vascular en-dothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2) and microvessel density (MVD) marked by CD34 molecular of rabbit VX2 liver tumors and to investigate the value of CT perfusion imaging in evaluating tumor angiogenesis. Material and methods: Twenty-four cases of rabbit VX2 liver tumor were performed by CT perfusion scanning. Hepatic artery perfusion (HAP), portal vein perfusion (PVP), total hepatic blood flow (THBF) and hepatic perfusion index (HPI) were measured by perfusion software. HIF-1α, VEGF and MMP-2 expression and MVD were detected in the 24 rabbit VX2 liver tumor tissue samples using immunohistochemical method. The correlation between the HIF-1α, VEGF, MMP-2 expression and MVD and CT perfusion parameters were analyzed. Results: Correlation analysis revealed that the expression of HIF-1α, MMP-2, MVD were positively related to the HAP, THBF, HPI (p < 0.01), but no relations with PVP (p > 0.05);and correlation analysis revealed that the expression of VEGF was positively related to the HAP, HPI (p 0.05). There was a positive relationship between the expression of HIF-1α, VEGF, MMP-2 and MVD (p < 0.01). Conclusions: CT perfusion imaging can reflect the blood perfusion of the rabbit VX2 liver tumors and evaluate the information of angiogenesis about tumors.展开更多
BACKGROUND: Local ablative procedures such as cryo-surgery and thermo-ablation are increasingly employed as a supplement to liver resection for the therapy of primary and secondary liver tumors. It is still unclear if...BACKGROUND: Local ablative procedures such as cryo-surgery and thermo-ablation are increasingly employed as a supplement to liver resection for the therapy of primary and secondary liver tumors. It is still unclear if the survival time can be extended through local ablative procedures. This prospective study shows operative actions, complications and long-term follow-up of 19 patients undergoing cryotherapy. METHODS: Between 1997 and 1998, 19 patients underwent cryotherapy due to a non-resectable malignant liver tumor (17 patients with metastases of a colon carcinoma, 2 patients with a hepatocellular carcinoma). Twelve patients (63.2%) received cryotherapy only and seven patients (36.8%) received a combination of resection and cryotherapy. The median follow-up period was 23 months. RESULTS: In a total of 59 liver tumors (18 were resected and 41 received cryotherapy), 12 had cryotherapy only, and 7 had a combination of cryotherapy and resection. The 30-day lethality was 0%, and the rate of major complications was 21%. After one year, 27.3% of the patients were still recurrence- free. The recurrence rate for all tumors treated was 58.8%. The median survival time for all patients was 21 months. The one- and three-year survival rates were 62. 5% and 15.8%, respectively. CONCLUSIONS: The mortality for cryotherapy is low, but there is a high rate of complications and long-term tumor control is not sufficient. If local ablative procedures of hepatic lesions are to be performed, not laparotomy but percutaneous, percutaneous thermoablation should be discussed as an alternative therapeutic measure.展开更多
BACKGROUND:CT perfusion has been reported to have great advantages in detecting hepatic diseases.However, currently there are no studies showing the potential value of multi-slice CT perfusion with the deconvolution m...BACKGROUND:CT perfusion has been reported to have great advantages in detecting hepatic diseases.However, currently there are no studies showing the potential value of multi-slice CT perfusion with the deconvolution model method in diagnosing early hemodynamic changes caused by liver tumors.This study was undertaken to determine if early hemodynamic changes caused by liver tumors can be depicted with the perfusion imaging of multi-slice CT. METHODS:Ten New Zealand white rabbits before and after VX2 liver tumor inoculation served as the experimental animals.Ten normal rabbits served as controls.All underwent multi-slice CT perfusion for the measurement of hepatic blood flow(HBF),hepatic blood volume(HBV), mean transit time(MTT),permeability of capillary vessel surface(PS)and hepatic artery index(HAI). RESULTS:With the exception of MTT,which decreased significantly at the tumor periphery,HBF,HBV,PS and HAI increased significantly compared with the surrounding normal tissue.All these changes occurred at days 5-9 after tumor inoculation.Statistically significant changes in these values were detected with tumor growth. CONCLUSIONS:The hemodynamic changes in the liver caused by rabbit VX2 liver tumor can be detected after tumor inoculation,and functional CT can evaluate the physiological characteristics of early tumor angiogenesis.展开更多
AIM:To investigate the major complications after radiofrequency ablation(RFA) for the treatment of liver tumors and analyze possible risk factors that precipitate these complications.METHODS:From March 2001 to April 2...AIM:To investigate the major complications after radiofrequency ablation(RFA) for the treatment of liver tumors and analyze possible risk factors that precipitate these complications.METHODS:From March 2001 to April 2008,255 patients with liver tumors(205 male,50 female;age range,18-89 years;mean age,56.0 years) who received RFA were enrolled in this study.Of these patients,212 had hepatocellular carcinoma,39 had metastatic liver tumors and four had cholangiocellular carcinoma.One hundred and forty eight patients had a single tumor,and 107 had multiple tumors.Maximum diameter of the tumors ranged 1.3-20 cm(mean,5.1 cm).All patients were treated with a cooled-tip perfusion electrode attached to a radiofrequency generator(Radionics,Burlington,MA,USA).RFA was performed via the percutaneous approach(n = 257),laparoscopy(n = 7),or open surgical treatment(n = 86).The major complications related to RFA were recorded.The resultant data were analyzed to determine risk factors associated these complications.RESULTS:Among the 255 patients,425 liver tumors were treated and 350 RFA sessions were performed.Thirty-seven(10%) major complications were observed which included 13 cases of liver failure,10 cases of hydrothorax requiring drainage,three casesof tumor seeding,one case of upper gastrointestinal bleeding,one case ofintrahepatic abscess,one case of bile duct injury,one case of cardiac arrest,and five cases of hyperglycemia.Seven patients had more than two complications.Liver failure was the most severe complication and was associated with the highest mortality.Eleven patients died due to worsening liver decompensation.Child-Pugh classification(P = 0.001) and choice of approach(P = 0.045) were related to post-treatment liver failure,whereas patient age,tumor size and number were not significant factors precipitating this complication.CONCLUSION:RFA can be accepted as a relatively safe procedure for the treatment of liver tumors.However,attention should be paid to possible complications even though the incidences of these complications are rare.Careful patient selection and the best approach choice(percutaneous,laparoscopy,or laparotomy) will help to minimize the incidence and morbidity rate of complications which occur after RFA.展开更多
In recent years, the results of several studies suggest that human liver tumors can be derived from hepatic progenitor cells rather than from mature cell types. The available data indeed strongly suggest that most com...In recent years, the results of several studies suggest that human liver tumors can be derived from hepatic progenitor cells rather than from mature cell types. The available data indeed strongly suggest that most combined hepatocellular-cholangiocarcinomas arise from hepatic progenitor cells that retained their potential to differentiate into the hepatocytic and biliary lineages. Hepatic progenitor cells could also be the basis for some hepatocellular carcinomas and hepatocellular adenomas, although it is very difficult to determine the origin of an individual hepatocellular carcinoma. There is currently not enough data to make statements regarding a hepatic progenitor cell origin of cholangiocarcinoma. The presence of hepatic progenitor cell markers and the presence and extent of the cholangiocellular component are factors that are related to the prognosis of hepatocellular carcinomas and combined hepatocellular- cholangiocarcinomas, respectively.展开更多
BACKGROUND:Early detection and treatment of hepatocellular carcinoma is crucial to improving the patients' survival.The hemodynamic changes caused by tumors can be serially measured using CT perfusion.In this stud...BACKGROUND:Early detection and treatment of hepatocellular carcinoma is crucial to improving the patients' survival.The hemodynamic changes caused by tumors can be serially measured using CT perfusion.In this study,we used a CT perfusion technique to demonstrate the changes of hepatic hemodynamics in early tumor growth,as a proof-of-concept study for human early hepatocellular carcinoma.METHODS:VX2 tumors were implanted in the liver of ten New Zealand rabbits.CT perfusion scans were made 1 week(early) and 2 weeks(late) after tumor implantation.Ten normal rabbits served as controls.CT perfusion parameters were obtained at the tumor rim,normal tissue surrounding the tumor,and control liver;the parameters were hepatic blood flow,hepatic blood volume,mean transit time,permeability of capillary vessel surface,hepatic arterial index,hepatic arterial perfusion and hepatic portal perfusion.Microvessel density and vascular endothelial growth factor were correlated.RESULTS:At the tumor rim,compared to the controls,hepatic blood flow,hepatic blood volume,permeability of capillary vessel surface,hepatic arterial index,and hepatic arterial perfusion increased,while mean transit time and hepatic portal perfusion decreased on both early and late scans(P<0.05).Hepatic arterial index increased(135%,P<0.05),combined with a sharp increase in hepatic arterial perfusion(182%,P<0.05) and a marked decrease in hepatic portal perfusion(-76%,P<0.05) at 2 weeks rather than at 1 week(P<0.05).Microvessel density and vascular endothelial growth factor showed significant linear correlations with hepatic blood flow,permeability of capillary vessel surface and hepatic arterial index,but not with hepatic blood volume or mean transit time.CONCLUSION:The CT perfusion technique demonstrated early changes of hepatic hemodynamics in this tumor model as proof-of-concept for early hepatocellular carcinoma detection in humans.展开更多
Curative therapies for hepatocellular carcinoma(HCC),such as resection and liver transplantation,can only be applied in selected patients with early tumors.More advanced stages require local or systemic therapies.Rese...Curative therapies for hepatocellular carcinoma(HCC),such as resection and liver transplantation,can only be applied in selected patients with early tumors.More advanced stages require local or systemic therapies.Resection of HCC offers the only hope for cure.Even in patients undergoing resection,recurrences are common.Chemoembolization,a technique combining intraarterial chemotherapy with selective tumor ischemia,has been shown by randomized controlled trials to be efficacious in the palliative setting.There is now renewed interest in transarterial embolization/transarterial chemoembolization(TACE) with regards to its use as a palliative tool in a combined modality approach,as a neoadjuvant therapy,in bridging therapy before transplantation,for symptomatic indications,and even as an alternative to resection.There have also been rapid advances in the agents being embolized trans-arterially(genes,biological response modifiers,etc.).The current review provides an evidence-based overview of the past,present and future trends of TACE in patients with HCC.展开更多
文摘Although Starzl designed in the 1960’s liver transplantation(LT)to treat unresectable primary and also secondary liver tumors,transplantation still occupies a(too)small place in the respec-tive therapeutic algorithms[1].Due to the lack of(any)selec-tion criteria,the concept of transplantation became rapidly chal-lenged because of the prohibitively high incidence of tumor recur-rence[1–3].
文摘In recent days,Deep Learning(DL)techniques have become an emerging transformation in the field of machine learning,artificial intelligence,computer vision,and so on.Subsequently,researchers and industries have been highly endorsed in the medical field,predicting and controlling diverse diseases at specific intervals.Liver tumor prediction is a vital chore in analyzing and treating liver diseases.This paper proposes a novel approach for predicting liver tumors using Convolutional Neural Networks(CNN)and a depth-based variant search algorithm with advanced attention mechanisms(CNN-DS-AM).The proposed work aims to improve accuracy and robustness in diagnosing and treating liver diseases.The anticipated model is assessed on a Computed Tomography(CT)scan dataset containing both benign and malignant liver tumors.The proposed approach achieved high accuracy in predicting liver tumors,outperforming other state-of-the-art methods.Additionally,advanced attention mechanisms were incorporated into the CNN model to enable the identification and highlighting of regions of the CT scans most relevant to predicting liver tumors.The results suggest that incorporating attention mechanisms and a depth-based variant search algorithm into the CNN model is a promising approach for improving the accuracy and robustness of liver tumor prediction.It can assist radiologists in their diagnosis and treatment planning.The proposed system achieved a high accuracy of 95.5%in predicting liver tumors,outperforming other state-of-the-art methods.
基金The authors are grateful to the Taif University Researchers Supporting Project number(TURSP-2020/36),Taif University,Taif,Saudi Arabia.
文摘An ultrasonic filter detects signs of malignant tumors by analysing the image’s pixel quality fluctuations caused by a liver ailment.Signs of malignant growth proximity are identified in an ultrasound filter through image pixel quality variations from a liver’s condition.Those changes are more common in alcoholic liver conditions than in other etiologies of cirrhosis,suggesting that the cause may be alcohol instead of liver disease.Existing Two-Dimensional(2D)ultrasound data sets contain an accuracy rate of 85.9%and a 2D Computed Tomography(CT)data set of 91.02%.The most recent work on designing a Three-Dimensional(3D)ultrasound imaging system in or close to real-time is examined.In this article,a Deep Learning(DL)model is implemented and modified to fit liver CT segmentation,and a semantic pixel classification of road scenes is recommended.The architecture is called semantic pixel-wise segmentation and comprises a hierarchical link of encoder-decoder layers.A standard data set was used to test the proposed model for liver CT scans and the tumor accuracy in the training phase.For the normal class,we obtained 100%precision for chronic cirrhosis hepatitis(73%),offset cirrhosis(59.26%),and offensive cirrhosis(91.67%)for chronic hepatitis or cirrhosis(73,0%).The aim is to develop a Computer-Aided Detection(CAD)screening tool to detect steatosis.The results proved 98.33%exactness,94.59%sensitivity,and 92.11%case with Convolutional Neural Networks(CNN)classification.Although the classifier’s performance did not differentiate so clearly at this level,it was recommended that CNN generally perform better due to the good relationship between Area under the Receiver Operating Characteristics Curve(AUC)and accuracy.
文摘Liver cancer is the second leading cause of cancer death worldwide.Early tumor detection may help identify suitable treatment and increase the survival rate.Medical imaging is a non-invasive tool that can help uncover abnormalities in human organs.Magnetic Resonance Imaging(MRI),in particular,uses magnetic fields and radio waves to differentiate internal human organs tissue.However,the interpretation of medical images requires the subjective expertise of a radiologist and oncologist.Thus,building an automated diagnosis computer-based system can help specialists reduce incorrect diagnoses.This paper proposes a hybrid automated system to compare the performance of 3D features and 2D features in classifying magnetic resonance liver tumor images.This paper proposed two models;the first one employed the 3D features while the second exploited the 2D features.The first system uses 3D texture attributes,3D shape features,and 3D graphical deep descriptors beside an ensemble classifier to differentiate between four 3D tumor categories.On top of that,the proposed method is applied to 2D slices for comparison purposes.The proposed approach attained 100%accuracy in discriminating between all types of tumors,100%Area Under the Curve(AUC),100%sensitivity,and 100%specificity and precision as well in 3D liver tumors.On the other hand,the performance is lower in 2D classification.The maximum accuracy reached 96.4%for two classes and 92.1%for four classes.The top-class performance of the proposed system can be attributed to the exploitation of various types of feature selection methods besides utilizing the ReliefF features selection technique to choose the most relevant features associated with different classes.The novelty of this work appeared in building a highly accurate system under specific circumstances without any processing for the images and human input,besides comparing the performance between 2D and 3D classification.In the future,the presented work can be extended to be used in the huge dataset.Then,it can be a reliable,efficient Computer Aided Diagnosis(CAD)system employed in hospitals in rural areas.
文摘Liver cancer has the second highest incidence rate among all types of malignant tumors,and currently,its diagnosis heavily depends on doctors’manual labeling of CT scan images,a process that is time-consuming and susceptible to subjective errors.To address the aforementioned issues,we propose an automatic segmentation model for liver and tumors called Res2Swin Unet,which is based on the Unet architecture.The model combines Attention-Res2 and Swin Transformer modules for liver and tumor segmentation,respectively.Attention-Res2 merges multiple feature map parts with an Attention gate via skip connections,while Swin Transformer captures long-range dependencies and models the input globally.And the model uses deep supervision and a hybrid loss function for faster convergence.On the LiTS2017 dataset,it achieves better segmentation performance than other models,with an average Dice coefficient of 97.0%for liver segmentation and 81.2%for tumor segmentation.
基金supported by grants from the National Natural Science Foundation of China(81660489)Hainan Province Science and Technology Special Fund(ZDYF2020134)+1 种基金the Specific Research Fund of The Innovation Platform for Academicians of Hainan Province(YSPTZX202005)the Innovative Research Project for Postgraduates of Hainan Province(Hys2020-355)。
文摘To the Editor:Liver tumor may occur in any hepatic segment or lobe,and thus the liver resection is individualized as per the location and size of the tumor.In addition,the resection of the posterior and caudate lobes of the liver is especially difficult amongst all types of hepatectomy.Kawaguchi et al.believed that the laparoscopic resection of right posterior liver lobe was a difficult surgical procedure[1].
文摘Liver tumors are rare in children,but the incidence may increase in some circumstances and particularly in chronic liver diseases.Most liver tumors consequent to chronic liver diseases are malignant hepatocellular carcinoma.Other liver tumors include hepatoblastoma,focal nodular hyperplasia,adenoma,pseudotumor,and nodular regenerative hyperplasia.Screening of suspected cases is beneficial.Imaging and surrogate markers of alpha-fetoprotein are used initially as noninvasive tools for surveillance.However,liver biopsy for histopathology evaluation might be necessary for patients with inconclusive findings.Once the malignant liver tumor is detected in children with cirrhosis,liver transplantation is currently considered the preferred option and achieves favorable outcomes.Based on the current evidence,this review focuses on liver tumors with underlying chronic liver disease,their epidemiology,pathogenesis,early recognition,and effective management.
文摘Benign liver tumors are common lesions that are usually asymptomatic and are often found incidentally due to recent advances in imaging techniques and their widespread use.Although most of these tumors can be managed conservatively or treated by surgical resection,liver transplantation(LT)is the only treatment option in selected patients.LT is usually indicated in patients that present with life-threatening complications,when the lesions are diffuse in the hepatic parenchyma or when malignant transformation cannot be ruled out.However,due to the significant postoperative morbidity of the procedure,scarcity of available donor liver grafts,and the benign course of the disease,the indications for LT are still not standardized.Hepatic adenoma and adenomatosis,hepatic hemangioma,and hepatic epithelioid hemangioendothelioma are among the most common benign liver tumors treated by LT.This article reviews the role of LT in patients with benign liver tumors.The indications for LT and long-term outcomes of LT are presented.
文摘AIM: To conduct a single-stage, combined computed tomography (CT) arterial portography (CTAP) and CT arteriography (CTA) imaging operation, we used Y-shaped sheaths with 2 valves, which allowed the insertion of 2 catheters simultaneously. METHODS: Of 1254 patients who underwent abdominal angiography for transarterial embolization and/or intraarterial chemotherapy in our department from May 2002 to November 2009, 664 patients in whom Y-shaped sheaths with 2 valves were used underwent CT angiography using a combination of CTA and CTAP. The Seldinger method was used to insert a 10 cm Y-shaped short sheath with 2 valves into the femoral artery. Under radiographic guidance, a 3.2 French (Fr) catheter was placed in the celiac artery or proper hepatic artery, and a second 3.2 Fr catheter was then placed distal to the inferior pancreaticoduodenal artery of the superior mesenteric artery. CTAP was then performed followed by CTA 10 min later. Photographs were taken during the early and late phases of the procedure.RESULTS: Insertion of 3.2 Fr catheters was not possible in 6 of 664 (0.9%) patients with strong curvature of the femoral artery and 4 of 664 (0.6%) patients with strong curvature of the abdominal aorta. In addition, performing CTAP and CTA as a single-stage combined intervention was not possible in 14 of 664 (2.1%) patients whose right hepatic artery originated from the superior mesenteric artery and in 8 of 664 (1.2%) patients whose left hepatic artery branched from the left gastric artery. There were no sheath-related complications such as those related to arterial dissection or hemostasis. CONCLUSION: Although transfers to and from the CT room were necessary for anatomically variant patients, CT angiography using the Y-shaped sheath for combined CTAP and CTA was considered useful.
基金funded by Dirección General de Investigaciones of Universidad Santiago de Cali under call No.01-2021.
文摘In the recent days, the segmentation of Liver Tumor (LT) has beendemanding and challenging. The process of segmenting the liver and accuratelyspotting the tumor is demanding due to the diversity of shape, texture, and intensity of the liver image. The intensity similarities of the neighboring organs of theliver create difficulties during liver segmentation. The manual segmentation doesnot provide an accurate segmentation because the results provided by differentmedical experts can vary. Also, this manual technique requires a large numberof image slices and time for segmentation. To solve these issues, the Fully Automatic Segmentation (FAS) technique is proposed. In this proposed Multi-AngleTexture Active Contour Model (MAT-ACM) method, the input Computed Tomography (CT) image is preprocessed by Contrast Enhancement (CE) with Non-Linear Mapping Technique (NLMT), in which the liver is differentiated from itsneighbouring soft tissues with related strength. Then, the filtered images are givenas the input to Adaptive Edge Modeling (AEM) with Canny Edge Detection(CED) technique, which segments the Liver Region (LR) from the given CTimages. An AEM with a CED model is implemented, which increases the convergence speed of the iterative process for decreasing the Volumetric Overlap Error(VOE) is 6.92% rates when compared with the traditional Segmentation Techniques (ST). Finally, the Liver Tumor Segmentation (LTS) is developed by applyingthe MAT-ACM, which accurately segments the LR from the segmented LRs. Theevaluation of the proposed method is compared with the existing LTS methodsusing various performance measures to prove the superiority of the proposedMAT-ACM method.
文摘Also if rarely,hepatocellular carcinoma,cholangiocarcinoma,and metastatic carcinoma can invade the retrohepatic portion of the inferior vena cava(IVC),because of the proximity of this vessel to the liver.^([1]) Innovative vascular exclusion techniques and new surgical resection methods,derived from improvements in liver surgery and transplantation,have allowed us
文摘Objective: The purpose of this study was to evaluate the correlation between CT perfusion parameters and the hypoxia-inducible factor-1 alpha (HIF-1α), vascular en-dothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2) and microvessel density (MVD) marked by CD34 molecular of rabbit VX2 liver tumors and to investigate the value of CT perfusion imaging in evaluating tumor angiogenesis. Material and methods: Twenty-four cases of rabbit VX2 liver tumor were performed by CT perfusion scanning. Hepatic artery perfusion (HAP), portal vein perfusion (PVP), total hepatic blood flow (THBF) and hepatic perfusion index (HPI) were measured by perfusion software. HIF-1α, VEGF and MMP-2 expression and MVD were detected in the 24 rabbit VX2 liver tumor tissue samples using immunohistochemical method. The correlation between the HIF-1α, VEGF, MMP-2 expression and MVD and CT perfusion parameters were analyzed. Results: Correlation analysis revealed that the expression of HIF-1α, MMP-2, MVD were positively related to the HAP, THBF, HPI (p < 0.01), but no relations with PVP (p > 0.05);and correlation analysis revealed that the expression of VEGF was positively related to the HAP, HPI (p 0.05). There was a positive relationship between the expression of HIF-1α, VEGF, MMP-2 and MVD (p < 0.01). Conclusions: CT perfusion imaging can reflect the blood perfusion of the rabbit VX2 liver tumors and evaluate the information of angiogenesis about tumors.
文摘BACKGROUND: Local ablative procedures such as cryo-surgery and thermo-ablation are increasingly employed as a supplement to liver resection for the therapy of primary and secondary liver tumors. It is still unclear if the survival time can be extended through local ablative procedures. This prospective study shows operative actions, complications and long-term follow-up of 19 patients undergoing cryotherapy. METHODS: Between 1997 and 1998, 19 patients underwent cryotherapy due to a non-resectable malignant liver tumor (17 patients with metastases of a colon carcinoma, 2 patients with a hepatocellular carcinoma). Twelve patients (63.2%) received cryotherapy only and seven patients (36.8%) received a combination of resection and cryotherapy. The median follow-up period was 23 months. RESULTS: In a total of 59 liver tumors (18 were resected and 41 received cryotherapy), 12 had cryotherapy only, and 7 had a combination of cryotherapy and resection. The 30-day lethality was 0%, and the rate of major complications was 21%. After one year, 27.3% of the patients were still recurrence- free. The recurrence rate for all tumors treated was 58.8%. The median survival time for all patients was 21 months. The one- and three-year survival rates were 62. 5% and 15.8%, respectively. CONCLUSIONS: The mortality for cryotherapy is low, but there is a high rate of complications and long-term tumor control is not sufficient. If local ablative procedures of hepatic lesions are to be performed, not laparotomy but percutaneous, percutaneous thermoablation should be discussed as an alternative therapeutic measure.
基金grants from the Natural Science Foundation of Heilongjiang(D2006-07)the Heilongjiang Educational Committee(1511181).
文摘BACKGROUND:CT perfusion has been reported to have great advantages in detecting hepatic diseases.However, currently there are no studies showing the potential value of multi-slice CT perfusion with the deconvolution model method in diagnosing early hemodynamic changes caused by liver tumors.This study was undertaken to determine if early hemodynamic changes caused by liver tumors can be depicted with the perfusion imaging of multi-slice CT. METHODS:Ten New Zealand white rabbits before and after VX2 liver tumor inoculation served as the experimental animals.Ten normal rabbits served as controls.All underwent multi-slice CT perfusion for the measurement of hepatic blood flow(HBF),hepatic blood volume(HBV), mean transit time(MTT),permeability of capillary vessel surface(PS)and hepatic artery index(HAI). RESULTS:With the exception of MTT,which decreased significantly at the tumor periphery,HBF,HBV,PS and HAI increased significantly compared with the surrounding normal tissue.All these changes occurred at days 5-9 after tumor inoculation.Statistically significant changes in these values were detected with tumor growth. CONCLUSIONS:The hemodynamic changes in the liver caused by rabbit VX2 liver tumor can be detected after tumor inoculation,and functional CT can evaluate the physiological characteristics of early tumor angiogenesis.
文摘AIM:To investigate the major complications after radiofrequency ablation(RFA) for the treatment of liver tumors and analyze possible risk factors that precipitate these complications.METHODS:From March 2001 to April 2008,255 patients with liver tumors(205 male,50 female;age range,18-89 years;mean age,56.0 years) who received RFA were enrolled in this study.Of these patients,212 had hepatocellular carcinoma,39 had metastatic liver tumors and four had cholangiocellular carcinoma.One hundred and forty eight patients had a single tumor,and 107 had multiple tumors.Maximum diameter of the tumors ranged 1.3-20 cm(mean,5.1 cm).All patients were treated with a cooled-tip perfusion electrode attached to a radiofrequency generator(Radionics,Burlington,MA,USA).RFA was performed via the percutaneous approach(n = 257),laparoscopy(n = 7),or open surgical treatment(n = 86).The major complications related to RFA were recorded.The resultant data were analyzed to determine risk factors associated these complications.RESULTS:Among the 255 patients,425 liver tumors were treated and 350 RFA sessions were performed.Thirty-seven(10%) major complications were observed which included 13 cases of liver failure,10 cases of hydrothorax requiring drainage,three casesof tumor seeding,one case of upper gastrointestinal bleeding,one case ofintrahepatic abscess,one case of bile duct injury,one case of cardiac arrest,and five cases of hyperglycemia.Seven patients had more than two complications.Liver failure was the most severe complication and was associated with the highest mortality.Eleven patients died due to worsening liver decompensation.Child-Pugh classification(P = 0.001) and choice of approach(P = 0.045) were related to post-treatment liver failure,whereas patient age,tumor size and number were not significant factors precipitating this complication.CONCLUSION:RFA can be accepted as a relatively safe procedure for the treatment of liver tumors.However,attention should be paid to possible complications even though the incidences of these complications are rare.Careful patient selection and the best approach choice(percutaneous,laparoscopy,or laparotomy) will help to minimize the incidence and morbidity rate of complications which occur after RFA.
文摘In recent years, the results of several studies suggest that human liver tumors can be derived from hepatic progenitor cells rather than from mature cell types. The available data indeed strongly suggest that most combined hepatocellular-cholangiocarcinomas arise from hepatic progenitor cells that retained their potential to differentiate into the hepatocytic and biliary lineages. Hepatic progenitor cells could also be the basis for some hepatocellular carcinomas and hepatocellular adenomas, although it is very difficult to determine the origin of an individual hepatocellular carcinoma. There is currently not enough data to make statements regarding a hepatic progenitor cell origin of cholangiocarcinoma. The presence of hepatic progenitor cell markers and the presence and extent of the cholangiocellular component are factors that are related to the prognosis of hepatocellular carcinomas and combined hepatocellular- cholangiocarcinomas, respectively.
基金supported by a grant from the Educational Committee of Heilongjiang Province (11541166)
文摘BACKGROUND:Early detection and treatment of hepatocellular carcinoma is crucial to improving the patients' survival.The hemodynamic changes caused by tumors can be serially measured using CT perfusion.In this study,we used a CT perfusion technique to demonstrate the changes of hepatic hemodynamics in early tumor growth,as a proof-of-concept study for human early hepatocellular carcinoma.METHODS:VX2 tumors were implanted in the liver of ten New Zealand rabbits.CT perfusion scans were made 1 week(early) and 2 weeks(late) after tumor implantation.Ten normal rabbits served as controls.CT perfusion parameters were obtained at the tumor rim,normal tissue surrounding the tumor,and control liver;the parameters were hepatic blood flow,hepatic blood volume,mean transit time,permeability of capillary vessel surface,hepatic arterial index,hepatic arterial perfusion and hepatic portal perfusion.Microvessel density and vascular endothelial growth factor were correlated.RESULTS:At the tumor rim,compared to the controls,hepatic blood flow,hepatic blood volume,permeability of capillary vessel surface,hepatic arterial index,and hepatic arterial perfusion increased,while mean transit time and hepatic portal perfusion decreased on both early and late scans(P<0.05).Hepatic arterial index increased(135%,P<0.05),combined with a sharp increase in hepatic arterial perfusion(182%,P<0.05) and a marked decrease in hepatic portal perfusion(-76%,P<0.05) at 2 weeks rather than at 1 week(P<0.05).Microvessel density and vascular endothelial growth factor showed significant linear correlations with hepatic blood flow,permeability of capillary vessel surface and hepatic arterial index,but not with hepatic blood volume or mean transit time.CONCLUSION:The CT perfusion technique demonstrated early changes of hepatic hemodynamics in this tumor model as proof-of-concept for early hepatocellular carcinoma detection in humans.
文摘Curative therapies for hepatocellular carcinoma(HCC),such as resection and liver transplantation,can only be applied in selected patients with early tumors.More advanced stages require local or systemic therapies.Resection of HCC offers the only hope for cure.Even in patients undergoing resection,recurrences are common.Chemoembolization,a technique combining intraarterial chemotherapy with selective tumor ischemia,has been shown by randomized controlled trials to be efficacious in the palliative setting.There is now renewed interest in transarterial embolization/transarterial chemoembolization(TACE) with regards to its use as a palliative tool in a combined modality approach,as a neoadjuvant therapy,in bridging therapy before transplantation,for symptomatic indications,and even as an alternative to resection.There have also been rapid advances in the agents being embolized trans-arterially(genes,biological response modifiers,etc.).The current review provides an evidence-based overview of the past,present and future trends of TACE in patients with HCC.
