Journal
NATURE REVIEWS CLINICAL ONCOLOGY
Volume 8, Issue 2, Pages 115-120Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/nrclinonc.2010.153
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Funding
- Higher Education Funding Council for England
- Bobby Moore Fund of Cancer Research UK
- NiHR Biomedical Research Centre, Oxford, UK
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Although the liver possesses a dual blood supply, arterial vessels deliver only a small proportion of blood to normal parenchyma, but they deliver the vast majority of blood to primary and secondary cancers of the liver. This anatomical discrepancy is the basis for intra-arterial brachytherapy of liver cancers using radioactive microspheres, termed radio-embolization (RE). Radioactive microspheres implant preferentially in the terminal arterioles of tumors. Although biological models of the flow dynamics and distribution of microspheres are currently in development, there is a need to improve the imaging biomarkers of flow dynamics used to plan RE. Since a direct consequence of RE is vascular disruption and necrosis, we suggest that imaging protocols sensitive to changes in vasculature are highly likely to represent useful early biomarkers for treatment efficacy. We propose dynamic contrast-enhanced CT as the most appropriate imaging modality for studying vascular parameters in clinical trials of RE treatment.
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