Pathophysiological mechanisms of ALPPS: experimental model

Author:

Wang Ruifeng123,Quan Zhen12,Zheng Tongsen4,Wang Kai12,Liu Yang12,Han Zhaoguo125,Wang Xiance12,Ma Shiling12,Liu Lianxin67,Lau Wan Yee8,Sun Xilin12

Affiliation:

1. NHC and CAMS Key Laboratory of Molecular Probe and Targeted Theranostics, Molecular Imaging Research Center (MIRC), Harbin Medical University , Harbin, Heilongjiang, China

2. Department of Nuclear Medicine, The Fourth Hospital of Harbin Medical University , Harbin, Heilongjiang 150028, China

3. Department of Gastroenterology, The Fourth Hospital of Harbin Medical University , Harbin, Heilongjiang 150001, China

4. Department of Gastrointestinal Medical Oncology, The Affiliated Tumour Hospital of Harbin Medical University , Harbin, Heilongjiang 150001, China

5. Biomedical Research Imaging Center, Department of Radiology, and UNC Lineberger Comprehensive Cancer Center, University of North Carolina–Chapel Hill , Chapel Hill, North Carolina, USA

6. Department of Hepatic Surgery, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Hepatosplenic Surgery, Ministry of Education , Harbin, Heilongjiang Province 150001, China

7. Department of Hepatobiliary Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China , Hefei, China

8. Faculty of Medicine, The Chinese University of Hong Kong , Shatin, Hong Kong SAR 999077, China

Abstract

Abstract Background Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a two-stage strategy that may increase hepatic tumour resectability and reduce postoperative liver failure rate by inducing rapid hypertrophy of the future liver remnant (FLR). Pathophysiological mechanisms after the first stage of ALPPS are poorly understood. Methods An ALPPS model was established in rabbits with liver VX2 tumour. The pathophysiological mechanisms after the first stage of ALPPS in the FLR and tumour were assessed by multiplexed positron emission tomography (PET) tracers, dynamic contrast-enhanced MRI (DCE-MRI) and histopathology. Results Tumour volume in the ALPPS model differed from post-stage 1 ALPPS at day 14 compared to control animals. 18F-FDG uptake of tumour increased from day 7 onwards in the ALPPS model. Valid volumetric function measured by 18F-methylcholine PET showed good values in accurately monitoring dynamics and time window for functional liver regeneration (days 3 to 7). DCE-MRI revealed changes in the vascular hyperpermeability function, with a peak on day 7 for tumour and FLR. Conclusion Molecular and functional imaging are promising non-invasive methods to investigate the pathophysiological mechanisms of ALPPS with potential for clinical application.

Funder

National Natural Science Foundation of China

Natural Science Foundation of Heilongjiang Province

HMU Marshal Initiative Funding

Tou-Yan Innovation Team Program of the Heilongjiang Province

Publisher

Oxford University Press (OUP)

Subject

Surgery

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