iLIVER最新文献

{"title":"Integrating mixed reality, augmented reality, and artificial intelligence in complex liver surgeries: Enhancing precision, safety, and outcomes","authors":"Xianxing Wang ,&nbsp;Jiali Yang ,&nbsp;Beichuan Zhou ,&nbsp;Li Tang ,&nbsp;Yongxing Liang","doi":"10.1016/j.iliver.2025.100167","DOIUrl":"10.1016/j.iliver.2025.100167","url":null,"abstract":"<div><div>Hepatobiliary surgeries, particularly hepatectomy and liver transplantation, are critical interventions for hepatic malignancies and end-stage liver diseases. These complex procedures face challenges due to the liver's intricate anatomy and vascularization. The integration of Mixed Reality (MR), Augmented Reality (AR), and Artificial Intelligence (AI) is increasingly enhancing the precision, safety, and outcomes of these surgeries. MR and AR improve visualization of anatomical structures, assist in preoperative planning, and support patient education through immersive 3D models. AI-driven technologies provide real-time intraoperative feedback and navigation, optimizing surgical decisions and minimizing risks. Postoperatively, these technologies aid in patient education and recovery management, ultimately improving outcomes. This review explores the applications of MR, AR, and AI in liver surgeries and their potential to transform surgical practice by enhancing precision, safety, and patient engagement.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 2","pages":"Article 100167"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of PD-1 inhibitors for advanced intrahepatic cholangiocarcinoma with or without MAFLD","authors":"Teng Long ,&nbsp;Zhenyun Yang ,&nbsp;Weijie Wu ,&nbsp;Minshan Chen ,&nbsp;Dandan Hu","doi":"10.1016/j.iliver.2025.100169","DOIUrl":"10.1016/j.iliver.2025.100169","url":null,"abstract":"<div><h3>Background</h3><div>This study sought to evaluate the efficacy and safety of programmed cell death protein-1 (PD-1) inhibitor immunotherapy specifically in metabolic dysfunction-associated fatty liver disease (MAFLD)-associated intrahepatic cholangiocarcinoma (ICC) patients, in comparison to those without MAFLD.</div></div><div><h3>Methods</h3><div>We retrospectively included 161 ICC patients, both with and without MAFLD, who underwent PD-1 inhibitors between March 2019 and August 2024. Subsequent locoregional interventions (e.g., hepatic arterial infusion chemotherapy) and second-line systemic agents (e.g., lenvatinib) were allowed. The primary endpoints included overall survival (OS) and progression-free survival (PFS), while the secondary endpoints comprised objective response rate (ORR), disease control rate (DCR), and adverse events (AEs).</div></div><div><h3>Results</h3><div>The MAFLD group included 20 patients, while the Non-MAFLD group comprised 141 patients. The OS was 18.0 months for the MAFLD group and 20.1 months for the Non-MAFLD group, while the median PFS was 8.0 and 11.5 months, respectively. According to the modified RECIST (mRECIST) criteria, the Non-MAFLD group exhibited a greater clinical benefit, reflected in higher ORR and DCR (45.4% vs. 20.0%, <em>p</em> = 0.031; 92.9% vs. 75.0%, <em>p</em> = 0.024). Multivariate Cox proportional hazard analysis identified carcinoembryonic antigen (CEA), tumor number, and C-reactive protein (CRP) as independent prognostic factors for OS, whereas CEA and tumor number were significant predictors of PFS. Additionally, the overall incidence of AEs was notably lower in the Non-MAFLD group compared to the MAFLD group.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that PD-1 inhibitors resulted in similarly prolonged OS and PFS between ICC patients with and without MAFLD, but a superior tumor response was observed in patients without MAFLD. Additionally, the Non-MAFLD group experienced a significantly lower incidence of AEs than the MAFLD group undergoing PD-1 inhibitors.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 2","pages":"Article 100169"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in magnetic resonance imaging for the evaluation of colorectal liver metastases in context of individualized precision medicine","authors":"Yidi Chen ,&nbsp;Yu Zhang ,&nbsp;Yi Wei ,&nbsp;Hanyu Jiang ,&nbsp;Ling Zhang ,&nbsp;Liling Long ,&nbsp;Bin Song ,&nbsp;Tao Peng","doi":"10.1016/j.iliver.2025.100168","DOIUrl":"10.1016/j.iliver.2025.100168","url":null,"abstract":"<div><div>Colorectal liver metastases (CRLM) represent a significant clinical challenge, as they are a leading cause of morbidity and mortality in patients with colorectal cancer (CRC). Early detection, accurate diagnosis, and precise treatment planning are crucial for improving patient outcomes. Magnetic resonance imaging (MRI) has emerged as a cornerstone in evaluating CRLM. This article provides a comprehensive review of recent innovations in MRI for CRLM diagnosis and treatment, with a particular focus on precision surgical models. Additionally, the application of artificial intelligence (AI) and radiomics is explored, highlighting their potential in automating lesion detection, evaluating treatment response, and predicting patient survival. The integration of these advanced imaging techniques and AI-based models holds promise for enhancing clinical decision-making, enabling personalized treatment strategies, and improving patient outcomes in CRLM. As these technologies continue to evolve, they could revolutionize the management of CRLM, offering non-invasive, accurate, and cost-effective solutions for early detection, monitoring, and prognosis prediction in CRC patients.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 2","pages":"Article 100168"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiphase MRI radiomics model for predicting microvascular invasion in HCC: Development and clinical validation","authors":"Yue Peng ,&nbsp;Songxiong Wu ,&nbsp;Bing Xiong ,&nbsp;Fuqiang Chen ,&nbsp;Nazar Zaki ,&nbsp;Ruodai Wu ,&nbsp;Wenjian Qin","doi":"10.1016/j.iliver.2025.100165","DOIUrl":"10.1016/j.iliver.2025.100165","url":null,"abstract":"<div><h3>Background and aims</h3><div>Accurate preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) is crucial for treatment planning. This study aimed to develop and validate a multi-phase magnetic resonance imaging (MRI)-based radiomics model for predicting MVI in HCC patients.</div></div><div><h3>Methods</h3><div>This retrospective study included 110 HCC patients (training: <em>n</em> = 77; validation: <em>n</em> = 33) who underwent preoperative multi-phase MRI. Radiomics features were extracted from four MRI phases (non-contrast, arterial, portal, and hepatobiliary). Feature selection was performed using least absolute shrinkage and selection operator regression, and five machine learning classifiers were evaluated. Model performance was assessed using standard metrics including area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy.</div></div><div><h3>Results</h3><div>The four-phase radiomics model with logistic regression classifier showed optimal performance in both the training (AUC = 0.896; 95% confidence interval, 0.792–0.963) and validation cohorts (AUC = 0.889, 95% confidence interval, 0.781–0.982), outperforming the single-phase (AUC = 0.789), two-phase (AUC = 0.815), and three-phase models (AUC = 0.848) in the validation cohort. In the validation cohort, the model achieved balanced performance with sensitivity, specificity, accuracy, and precision all reaching 0.857.</div></div><div><h3>Conclusions</h3><div>The multi-phase MRI-based radiomics model significantly improves MVI prediction accuracy in HCC patients. This non-invasive approach could enhance preoperative assessment and treatment planning.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 2","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing postoperative chemotherapy for ampullary cancer: A risk-driven approach to precision care","authors":"Di Zhang ,&nbsp;Yuan Zheng ,&nbsp;Mingru Liu ,&nbsp;Jiaoyang Lu","doi":"10.1016/j.iliver.2025.100166","DOIUrl":"10.1016/j.iliver.2025.100166","url":null,"abstract":"<div><h3>Background and aims</h3><div>This research aimed to develop an innovative predictive model for estimating overall survival (OS) in patients with ampullary carcinoma and to evaluate the clinical benefits of postoperative chemotherapy (POCT) tailored to individual risk profiles.</div></div><div><h3>Methods</h3><div>Data from patients with ampullary carcinoma were retrospectively analyzed. Multivariable analysis identified key prognostic factors, which were incorporated into a predictive nomogram. The impact of POCT on OS was assessed within risk groups stratified by the nomogram.</div></div><div><h3>Results</h3><div>Data for 3921 patients were included, with 2744 in the training cohort and 1177 in the validation cohort. A nomogram incorporating age, sex, tumor grade, T stage, N stage, and tumor size outperformed the TNM staging system, with areas under the curve for 3-year, 5-year, and 8-year OS of 0.755 vs 0.687, 0.752 vs 0.694, and 0.750 vs 0.694, respectively, in the training cohort and 0.705 vs 0.664, 0.717 vs 0.679, and 0.734 vs 0.703 in the validation cohort. Calibration plots showed excellent agreement between predicted and observed survival outcomes. Decision curve analysis indicated a net benefit across threshold probabilities above that of TNM staging. Risk stratification based on the model indicated that high-risk patients had a significantly increased mortality risk (<em>p</em> &lt; 0.001). Notably, POCT significantly improved OS in high-risk patients (<em>p</em> &lt; 0.001) but not in low-risk patients.</div></div><div><h3>Conclusion</h3><div>Not all patients benefit from POCT. The proposed nomogram predicts survival effectively and can guide treatment decisions, optimizing outcomes by providing additional chemotherapy for high-risk patients while sparing low-risk patients from unnecessary treatment.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 2","pages":"Article 100166"},"PeriodicalIF":0.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice revolution in local interventional therapy for liver metastases","authors":"Hongjun Yuan ,&nbsp;Hongli Yu ,&nbsp;Ying Guan ,&nbsp;Wenjing Wang ,&nbsp;Qiang Yu ,&nbsp;Yinying Lu ,&nbsp;Fengyong Liu","doi":"10.1016/j.iliver.2025.100164","DOIUrl":"10.1016/j.iliver.2025.100164","url":null,"abstract":"<div><div>The treatment of liver metastases is undergoing a transformation from single-modality therapy to multimodal combination therapy, with local interventional treatments playing an increasingly important role. This review explores the synergistic effects between local interventional therapy and systemic treatment, the reconstruction of interventional therapy indications driven by advances in systemic treatment, and the impact of local interventional therapy on systemic treatment “switching” strategies. Through multidisciplinary collaboration and innovative interventional materials and techniques, local interventional therapy has evolved from a traditional palliative approach to become an essential component in the comprehensive treatment system for liver metastases.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 2","pages":"Article 100164"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy analysis of hepatic arterial infusion chemotherapy combined with sintilimab and bevacizumab for initially unresectable hepatocellular carcinoma","authors":"Zhu Chen,&nbsp;Xingyu Chen,&nbsp;Haiyang Hu,&nbsp;Kai Chen,&nbsp;Chengyou Du,&nbsp;Heng Xiao,&nbsp;Xiang Lan","doi":"10.1016/j.iliver.2025.100163","DOIUrl":"10.1016/j.iliver.2025.100163","url":null,"abstract":"<div><h3>Background and aims</h3><div>Hepatocellular carcinoma (HCC) presents a significant challenge in tumor management because of its low resection rates. Conversion therapy aims to transform unresectable tumors into resectable ones through local treatments, thereby providing surgical options for some patients with HCC. However, the overall strategies and efficacy of conversion therapy for HCC remain inadequately defined. This study was performed to evaluate the efficacy of hepatic arterial infusion chemotherapy (HAIC) combined with sintilimab and bevacizumab in patients with unresectable liver cancer.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of patients with initially unresectable HCC who received HAIC in conjunction with sintilimab and bevacizumab. Preoperative demographic data, tumor markers, tumor size, tumor count, conversion outcomes, and surgery-related clinical data were collected and analyzed before and after treatment.</div></div><div><h3>Results</h3><div>Twelve patients were included in this study. All patients exhibited satisfactory antitumor effects. Ten patients underwent one or two treatment cycles, while two completed four cycles. The mean alpha-fetoprotein level decreased from 73,471 ± 138,239 to 2374 ± 6325 ng/mL, and the mean tumor size decreased from 11.4 ± 2.2 to 7.6 ± 1.0 cm. Following evaluation, 10 patients were successfully converted, with 6 ultimately undergoing curative liver cancer resection; of these 6 patients, 4 achieved a pathological complete response.</div></div><div><h3>Conclusion</h3><div>The combination of HAIC with sintilimab and bevacizumab represents a safe and effective strategy for tumor conversion. This approach can achieve significant tumor reduction and favorable effects on portal vein tumor thrombus within a short timeframe, facilitating curative resection of liver cancer.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 2","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and progress in techniques of precision liver surgery","authors":"Si-Yuan Wang,&nbsp;Tao Zhang,&nbsp;Tian Yang,&nbsp;Jia-Hong Dong","doi":"10.1016/j.iliver.2025.100158","DOIUrl":"10.1016/j.iliver.2025.100158","url":null,"abstract":"","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 2","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated intrahepatic bile duct injury secondary to blunt abdominal trauma: A case report and literature review","authors":"Shengming Zhang ,&nbsp;Yifeng He ,&nbsp;Daiwei Zhou ,&nbsp;Jianhong Jiang,&nbsp;Jianfan Wen,&nbsp;Deqin Zeng","doi":"10.1016/j.iliver.2025.100156","DOIUrl":"10.1016/j.iliver.2025.100156","url":null,"abstract":"<div><div>Closed trauma-induced extrahepatic bile duct injuries have been occasionally reported. However, isolated intrahepatic bile duct injuries are extremely rare due to the deep location of the intrahepatic bile ducts and the protection provided by surrounding vital blood vessels and organs.</div><div>We report a case of a 50-year-old female who sustained an incomplete rupture of the left hepatic bile duct following a car accident. The patient was urgently transferred to a nearby hospital for treatment after the incident. On the 15th day of hospitalization, she developed abdominal distension, nausea, indigestion, and white stool. Large volumes of dark green ascitic fluid were drained via ultrasound-guided abdominal paracentesis. The patient requested further specialized diagnosis and treatment and was subsequently transferred to our hospital. Ultimately, percutaneous transhepatic cholangiography (PTC) revealed contrast agent extravasation from the left intrahepatic bile duct, confirming a traumatic bile duct injury. The patient underwent left hemihepatectomy on the 30th day post-injury and was discharged on the 12th postoperative day following a successful recovery.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 2","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring emerging frontiers in hepatology: iLIVER's continuing journey","authors":"Ming-Da Wang ,&nbsp;Xin-Fei Xu ,&nbsp;Lei Cai,&nbsp;Tian Yang","doi":"10.1016/j.iliver.2025.100148","DOIUrl":"10.1016/j.iliver.2025.100148","url":null,"abstract":"","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 1","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}