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The macroscopic vascular supply of liver tumors varies considerably according to histological subtype, lesion size, and disease stage. Current clinical imaging modalities primarily characterize liver tumors based on their macroscopic vascular perfusion patterns. Conventional color Doppler ultrasonography enables qualitative assessment of tumor vascularity, facilitates the differentiation of benign from malignant hepatic lesions, delineates the anatomical relationship between tumors and major intrahepatic vessels, and detects vascular invasion. Nevertheless, these macroscopic vascular characteristics arise from complex microvascular architectures, including vascular distribution patterns, microvessel density, vessel morphology and tortuosity, blood flow velocity, and flow direction. Despite the critical role of tumor microcirculation in tumor progression and therapeutic response, the heterogeneity of microvascular hemodynamics among different liver tumors remains inadequately characterized.
The emergence of Super Resolution Ultrasound Imaging (SRUS) has markedly advanced ultrasound imaging by overcoming the acoustic diffraction limit, enabling visualization of microvessels with diameters as small as approximately 20 μm. Unlike conventional ultrasound techniques, SRUS preserves the inherent advantages of ultrasound, including deep tissue penetration and a large field of view, while achieving an approximately tenfold improvement in spatial resolution. This unique combination effectively bridges the long-standing gap between imaging depth and spatial resolution in vascular imaging. Furthermore, by localizing and tracking individual circulating microbubbles,SRUS enables quantitative assessment of microvascular blood flow velocity over a broad dynamic range without Doppler angle dependence. Consequently, super-resolution ultrasound imaging offers an unprecedented opportunity to characterize and compare the microvascular hemodynamic features of benign and malignant liver lesions, thereby improving the accuracy of preoperative differential diagnosis, tumor staging, therapeutic response assessment, and prognostic evaluation.
The macroscopic vascular supply of liver tumors varies considerably according to histological subtype, lesion size, and disease stage. Current clinical imaging modalities primarily characterize liver tumors based on their macroscopic vascular perfusion patterns. Conventional color Doppler ultrasonography enables qualitative assessment of tumor vascularity, facilitates the differentiation of benign from malignant hepatic lesions, delineates the anatomical relationship between tumors and major intrahepatic vessels, and detects vascular invasion. Nevertheless, these macroscopic vascular characteristics arise from complex microvascular architectures, including vascular distribution patterns, microvessel density, vessel morphology and tortuosity, blood flow velocity, and flow direction. Despite the critical role of tumor microcirculation in tumor progression and therapeutic response, the heterogeneity of microvascular hemodynamics among different liver tumors remains inadequately characterized.
The emergence of Super Resolution Ultrasound Imaging (SRUS) has markedly advanced ultrasound imaging by overcoming the acoustic diffraction limit, enabling visualization of microvessels with diameters as small as approximately 20 μm. Unlike conventional ultrasound techniques, SRUS preserves the inherent advantages of ultrasound, including deep tissue penetration and a large field of view, while achieving an approximately tenfold improvement in spatial resolution. This unique combination effectively bridges the long-standing gap between imaging depth and spatial resolution in vascular imaging. Furthermore, by localizing and tracking individual circulating microbubbles,SRUS enables quantitative assessment of microvascular blood flow velocity over a broad dynamic range without Doppler angle dependence. Consequently, super-resolution ultrasound imaging offers an unprecedented opportunity to characterize and compare the microvascular hemodynamic features of benign and malignant liver lesions, thereby improving the accuracy of preoperative differential diagnosis, tumor staging, therapeutic response assessment, and prognostic evaluation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Observation group | Patients newly diagnosed with benign or malignant liver tumors |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Perform super-resolution ultrasound imaging on the study population | Diagnostic Test | Perform super-resolution ultrasound imaging on the study population, record and calculate characteristic hemodynamic and morphological parameters, and analyze microvascular flow patterns. |
| Measure | Description | Time Frame |
|---|---|---|
| Vascular parameters in different types of benign and malignant liver tumors | Assessing the differences in vascular parameters between different types of benign and malignant liver tumors | At the time of initial diagnostic imaging (baseline), with pathological confirmation from subsequent surgical resection or biopsy obtained during the same hospitalization period. |
| Measure | Description | Time Frame |
|---|---|---|
| Differences in treatment effectiveness between patient subgroups | Treatment effectiveness is assessed using two different methods depending on the treatment modality: Pathological assessment (for patients who undergo surgical resection): A. Pathological complete response (pCR): no viable tumor cells detected in the postoperative specimen; B. Major pathological response (MPR): ≥50% reduction in the proportion of viable tumor cells compared to the baseline pretreatment specimen; Imaging assessment based on mRECIST criteria (for patients who do not undergo surgery): A. Complete Response (CR): disappearance of any intratumoral arterial enhancement in all target lesions B. Partial Response (PR): ≥30% decrease in the sum of diameters of viable target lesion C. Progressive Disease (PD): ≥20% increase in the sum of diameters of viable target lesions, taking as reference the smallest sum of diameters recorded since treatment started D. Stable Disease (SD): insufficient decrease to qualify for PR, and insufficient increase to qualify for PD |
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Inclusion Criteria:
Any gender, 18 years or older;
People newly diagnosed with liver tumors, including:
①Hepatocellular carcinoma; ② Cholangiocarcinoma; ③ Liver metastases; ④ Liver hemangioma; ⑤ Focal nodular hyperplasia of the liver.
Need to have a contrast-enhanced ultrasound as part of routine care;
Willing to join this study and sign the informed consent after discussing it with the doctor.
Exclusion Criteria:
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Liver tumor patients treated in the outpatient and inpatient departments of the Third Affiliated Hospital of the Naval Medical University.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Wenli Zhang, PhD | Contact | +86 18817583752 | zhangwl9287@163.com | |
| Jing He | Contact | +86 18244242460 | G174265@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Hui Liu, Professor | Eastern Hepatobiliary Surgery Hospital | Study Chair |
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| From date of treatment initiation until the date of first documented pathological or imaging response assessment, assessed up to 12 months |
| ID | Term |
|---|---|
| D006528 | Carcinoma, Hepatocellular |
| D020518 | Focal Nodular Hyperplasia |
| ID | Term |
|---|---|
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008113 | Liver Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
| D008107 | Liver Diseases |
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