原发性肝癌是我国常见高发恶性肿瘤,严重威胁人民的生命健康。医学影像学在肝癌的诊疗过程中发挥着重要作用,近十年来中国肝癌影像研究发展取得了显著成效,以人工智能(artificial intelligence,AI)为代表的现代科技的迅猛发展以及超高...原发性肝癌是我国常见高发恶性肿瘤,严重威胁人民的生命健康。医学影像学在肝癌的诊疗过程中发挥着重要作用,近十年来中国肝癌影像研究发展取得了显著成效,以人工智能(artificial intelligence,AI)为代表的现代科技的迅猛发展以及超高磁场、多核MRI、光子CT等影像新技术的不断涌现为肝癌患者的早筛、早诊、早治和全程优化管理提供了可靠的技术保障。运用AI结合多维度组学(影像组学、基因组学、蛋白组学等)将会进一步揭示肝癌的“临床-影像-病理-分子”核心关联机制,为无创性评估肝癌的病理特点、基因特征、免疫表型、分子亚型、疗效及预后带来新的机遇,为肝癌患者更加精细化和个体化的临床管理提供技术支持。本文以影像技术为脉络主线,归纳总结了近年来MRI肝脏影像报告和数据系统(Liver Imaging Reporting and Data System,LI-RADS)的应用及肝胆特异性对比剂使用、扩散MRI技术、功能MRI技术、影像组学与AI、CT影像等在中国的临床研究与转化应用成果,展现了这些年我国肝癌影像领域的蓬勃发展和辉煌成就,同时也提出了当前肝癌影像研究的局限性,未来需要根据国内患者的发病特点及人群特征进行有针对性的研究设计,建立涵盖人群广、代表性强的多中心研究队列,建设同质化、高质量的全国肝癌影像数据库;同时需要注重原创性影像新技术的开发和应用,未来将运用AI结合影像组学、基因组学、蛋白组学深入研究肝癌的病理特征、基因表型和预后转归,促进医学影像深度参与肝癌患者的全流程临床管理,为精准医疗提供技术支持,助力实现国民大健康的战略目标。展开更多
Hepatocellular carcinoma(HCC)is the sixth most common malignancy and the fourth leading cause of cancer related death worldwide.China covers over half of cases,leading HCC to be a vital threaten to public health.Despi...Hepatocellular carcinoma(HCC)is the sixth most common malignancy and the fourth leading cause of cancer related death worldwide.China covers over half of cases,leading HCC to be a vital threaten to public health.Despite advances in diagnosis and treatments,high recurrence rate remains a major obstacle in HCC management.Multi-omics currently facilitates surveillance,precise diagnosis,and personalized treatment decision making in clinical setting.Non-invasive radiomics utilizes preoperative radiological imaging to reflect subtle pixel-level pattern changes that correlate to specific clinical outcomes.Radiomics has been widely used in histopathological diagnosis prediction,treatment response evaluation,and prognosis prediction.High-throughput sequencing and gene expression profiling enabled genomics and proteomics to identify distinct transcriptomic subclasses and recurrent genetic alterations in HCC,which would reveal the complex multistep process of the pathophysiology.The accumulation of big medical data and the development of artificial intelligence techniques are providing new insights for our better understanding of the mechanism of HCC via multi-omics,and show potential to convert surgical/intervention treatment into an antitumorigenic one,which would greatly advance precision medicine in HCC management.展开更多
原发性肝癌是全球范围内发病率居第6位、死亡率居第3位的恶性肿瘤,肝细胞癌(hepatocellular carcinoma,HCC)是其中最主要的组织病理学亚型。肝脏影像报告及数据系统(Liver Imaging Reporting and Data System,LI-RADS)旨在规范高危患者...原发性肝癌是全球范围内发病率居第6位、死亡率居第3位的恶性肿瘤,肝细胞癌(hepatocellular carcinoma,HCC)是其中最主要的组织病理学亚型。肝脏影像报告及数据系统(Liver Imaging Reporting and Data System,LI-RADS)旨在规范高危患者肝脏病变的影像术语、图像采集、征象判读、报告书写及数据收集,实现局灶性肝脏病变的可靠分类,现已应用于包括诊断、生物学行为评估、预后预测、疗效评价等在内的HCC诊疗全程。本文旨在综述近期CT/MRI LI-RADS在HCC诊断、生物学行为评估及预后评价中的关键应用,浅析相关领域的现存挑战及未来可能的发展方向。展开更多
文摘原发性肝癌是我国常见高发恶性肿瘤,严重威胁人民的生命健康。医学影像学在肝癌的诊疗过程中发挥着重要作用,近十年来中国肝癌影像研究发展取得了显著成效,以人工智能(artificial intelligence,AI)为代表的现代科技的迅猛发展以及超高磁场、多核MRI、光子CT等影像新技术的不断涌现为肝癌患者的早筛、早诊、早治和全程优化管理提供了可靠的技术保障。运用AI结合多维度组学(影像组学、基因组学、蛋白组学等)将会进一步揭示肝癌的“临床-影像-病理-分子”核心关联机制,为无创性评估肝癌的病理特点、基因特征、免疫表型、分子亚型、疗效及预后带来新的机遇,为肝癌患者更加精细化和个体化的临床管理提供技术支持。本文以影像技术为脉络主线,归纳总结了近年来MRI肝脏影像报告和数据系统(Liver Imaging Reporting and Data System,LI-RADS)的应用及肝胆特异性对比剂使用、扩散MRI技术、功能MRI技术、影像组学与AI、CT影像等在中国的临床研究与转化应用成果,展现了这些年我国肝癌影像领域的蓬勃发展和辉煌成就,同时也提出了当前肝癌影像研究的局限性,未来需要根据国内患者的发病特点及人群特征进行有针对性的研究设计,建立涵盖人群广、代表性强的多中心研究队列,建设同质化、高质量的全国肝癌影像数据库;同时需要注重原创性影像新技术的开发和应用,未来将运用AI结合影像组学、基因组学、蛋白组学深入研究肝癌的病理特征、基因表型和预后转归,促进医学影像深度参与肝癌患者的全流程临床管理,为精准医疗提供技术支持,助力实现国民大健康的战略目标。
文摘Hepatocellular carcinoma(HCC)is the sixth most common malignancy and the fourth leading cause of cancer related death worldwide.China covers over half of cases,leading HCC to be a vital threaten to public health.Despite advances in diagnosis and treatments,high recurrence rate remains a major obstacle in HCC management.Multi-omics currently facilitates surveillance,precise diagnosis,and personalized treatment decision making in clinical setting.Non-invasive radiomics utilizes preoperative radiological imaging to reflect subtle pixel-level pattern changes that correlate to specific clinical outcomes.Radiomics has been widely used in histopathological diagnosis prediction,treatment response evaluation,and prognosis prediction.High-throughput sequencing and gene expression profiling enabled genomics and proteomics to identify distinct transcriptomic subclasses and recurrent genetic alterations in HCC,which would reveal the complex multistep process of the pathophysiology.The accumulation of big medical data and the development of artificial intelligence techniques are providing new insights for our better understanding of the mechanism of HCC via multi-omics,and show potential to convert surgical/intervention treatment into an antitumorigenic one,which would greatly advance precision medicine in HCC management.
文摘原发性肝癌是全球范围内发病率居第6位、死亡率居第3位的恶性肿瘤,肝细胞癌(hepatocellular carcinoma,HCC)是其中最主要的组织病理学亚型。肝脏影像报告及数据系统(Liver Imaging Reporting and Data System,LI-RADS)旨在规范高危患者肝脏病变的影像术语、图像采集、征象判读、报告书写及数据收集,实现局灶性肝脏病变的可靠分类,现已应用于包括诊断、生物学行为评估、预后预测、疗效评价等在内的HCC诊疗全程。本文旨在综述近期CT/MRI LI-RADS在HCC诊断、生物学行为评估及预后评价中的关键应用,浅析相关领域的现存挑战及未来可能的发展方向。
