The liver is supplied by a dual blood flow system consisting of the portal vein and hepatic artery. Imaging techniques for diagnosing hepatocellular carcinoma (HCC) have been developed along with blood flow imaging, which visualizes the amount of arterial and portal blood flow. The diagnosis of HCC differentiation is important for early-stage liver cancer screening and determination of treatment strategies. Dynamic computed tomography/magnetic resonance imaging (MRI) includes blood flow imaging and MRI with contrast-enhanced ultrasound and liver-specific contrast agents are used in combination. In addition, unlike the Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.1), which is the standard for determining treatment efficacy for solid tumors in general, tumor necrosis is generally considered a treatment effect in HCC, and the modified RECIST and Liver Cancer Direct Effectiveness Criteria (RECICL) are widely used. Familiarity with the definitions, criteria, and potential challenges of the mRECIST and RECICL is essential for their effective application in clinical practice. This review integrates the latest advancements in systemic treatments and imaging techniques, including the role of LI-RADS and updates on molecular-targeted therapies such as regorafenib, supported by some systematic review and meta-analysis.
肝脏由门静脉和肝动脉构成双重血流供应系统。随着血流成像技术的发展，能够可视化动脉与门静脉血流量的影像学技术已被应用于肝细胞癌（HCC）的诊断。HCC分化程度的判断对早期肝癌筛查及治疗策略制定具有重要意义。动态计算机断层扫描/磁共振成像（MRI）包含血流成像技术，临床上常将增强超声与肝脏特异性造影剂MRI联合应用。此外，与实体瘤疗效评价标准（RECIST 1.1版）不同，肿瘤坏死通常被视为HCC的治疗效果体现，因此改良版RECIST（mRECIST）及肝癌直接疗效标准（RECICL）被广泛采用。熟练掌握mRECIST和RECICL的定义、标准及潜在挑战对其在临床实践中的有效应用至关重要。本综述整合了系统治疗与影像学技术的最新进展，包括肝脏影像报告和数据系统（LI-RADS）的作用，以及瑞戈非尼等分子靶向治疗药物的更新信息，部分内容得到系统综述和荟萃分析的支持。
肿瘤(癌症)患者之家