PhD ceremony Ms. P.G. Serbanescu-Kele: Radiological assessment of the postoperative liver

PhD ceremony: Ms. P.G. Serbanescu-Kele, 14.30 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Radiological assessment of the postoperative liver

Promotor(s): prof. E.J. van der Jagt, prof. R.J. Porte

Faculty: Medical Sciences

Certain types of cancer, especially of colorectal origin, often metastasize to the liver. Surgical resection offers the best chance of cure, but unfortunately most patients are not suitable candidates for liver surgery. Thermoablation, for example radiofrequency ablation and microwave ablation, is a well-established alternative therapy in which tumor cells are destroyed by heat. Imaging, often performed with computed tomography (CT), is indispensable for assessing the success of thermoablation and in the follow-up. Part one of this thesis describes that the anatomical comparability of preprocedural and postprocedural CT-scans is highly important for assessment of the success of thermoablation. Volume measurements of the ablation zones proved to be valuable in the follow-up, but should not be performed on immediate postprocedural scans, since these measurements are unreliable.

The liver is a unique organ due to its remarkable regenerative capacity. Healthy liver tissue is a prerequisite for optimal liver regeneration and many other factors influence it. Animal studies revealed that platelets seem to have a pivotal role in the process of liver regeneration. Part two of this thesis describes liver regeneration after surgical resection. The regenerated volume depends strongly on the amount of resected liver tissue. Hepatic steatosis or fatty liver – an increasingly occurring condition of the liver parenchyma – negatively affects the regenerative capacity of the liver. For the first time it was shown in humans that patients with high regeneration have a stronger decrease in postoperative platelet counts than patients with poor regeneration.