Imaging in Hyperthermic Intraperitoneal Chemotherapy.

IF 5.2 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Radiographics Pub Date : 2025-05-01 DOI:10.1148/rg.240124
Shravya Srinivas Rao, Nikitha Uma Baskaran, Jinjin Cao, Onofrio A Catalano, James A Brink, James C Cusack, Avinash R Kambadakone
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引用次数: 0

Abstract

Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery (CRS) (CRS-HIPEC) has revolutionized the management of peritoneal malignancies, pivoting from a palliative care approach to a treatment strategy tailored to improve overall survival. This procedure is based on the principle that local instillation of heated chemotherapeutic agents augments their cytotoxic effects, which target and eradicate microscopic disease. Imaging is integral to the management of patients undergoing HIPEC, having multiple roles that range from patient selection, preoperative assessment, and determining treatment effectiveness to postprocedural surveillance. Various imaging modalities can be used for radiologic assessment and include CT, dual-energy CT, MRI, fluorine 18-fluorodeoxyglucose PET/CT, and PET/MRI. A crucial step in assessing the feasibility of CRS-HIPEC is estimation of the peritoneal carcinomatosis index, which enables one to determine the total peritoneal disease burden and is essential for effective multidisciplinary management. Following HIPEC, the completeness of cytoreduction score and residual disease score provide a robust framework for assessing treatment efficacy and strategically guiding subsequent management and surveillance protocols. Imaging facilitates accurate evaluation of complications, as well as early recognition of residual or recurrent peritoneal disease. The authors provide a comprehensive overview of HIPEC therapy, focusing on the role of imaging in the management of patients with peritoneal malignancies, delving into the nuances of this procedure, and discussing crucial aspects related to patient selection, surgical complexity, and prediction of outcomes. ©RSNA, 2025 See the invited commentary by Wasif in this issue.

腹腔高温化疗的影像学分析。
高温腹腔化疗(HIPEC)联合细胞减少手术(CRS) (CRS-HIPEC)彻底改变了腹膜恶性肿瘤的管理,从姑息治疗方法转向量身定制的治疗策略,以提高总体生存率。该程序的原理是,局部灌注加热的化疗药物可增强其细胞毒性作用,从而靶向并根除微观疾病。影像学是HIPEC患者管理中不可或缺的一部分,具有多种作用,从患者选择、术前评估、确定治疗效果到术后监测。多种成像方式可用于放射学评估,包括CT、双能CT、MRI、氟18-氟脱氧葡萄糖PET/CT和PET/MRI。评估CRS-HIPEC可行性的关键步骤是估计腹膜癌指数,这使人们能够确定腹膜总疾病负担,对于有效的多学科管理至关重要。HIPEC后,细胞减少评分和残留疾病评分的完整性为评估治疗效果和战略性指导后续管理和监测方案提供了一个强大的框架。成像有助于准确评估并发症,以及早期识别残留或复发的腹膜疾病。作者提供了HIPEC治疗的全面概述,重点是成像在腹膜恶性肿瘤患者治疗中的作用,深入研究了该手术的细微差别,并讨论了与患者选择、手术复杂性和结果预测相关的关键方面。©RSNA, 2025参见本期Wasif特邀评论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Radiographics
Radiographics 医学-核医学
CiteScore
8.20
自引率
5.50%
发文量
224
审稿时长
4-8 weeks
期刊介绍: Launched by the Radiological Society of North America (RSNA) in 1981, RadioGraphics is one of the premier education journals in diagnostic radiology. Each bimonthly issue features 15–20 practice-focused articles spanning the full spectrum of radiologic subspecialties and addressing topics such as diagnostic imaging techniques, imaging features of a disease or group of diseases, radiologic-pathologic correlation, practice policy and quality initiatives, imaging physics, informatics, and lifelong learning. A special issue, a monograph focused on a single subspecialty or on a crossover topic of interest to multiple subspecialties, is published each October. Each issue offers more than a dozen opportunities to earn continuing medical education credits that qualify for AMA PRA Category 1 CreditTM and all online activities can be applied toward the ABR MOC Self-Assessment Requirement.
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