Chengzhan Zhu

By Chengzhan Zhu, Bingzi Dong and Qian Dong

Imaging plays crucial roles in the management of pediatric patients with suspected liver malignant tumors. Three-dimensional (3D) imaging could significantly improve the resection rate of pediatric tumors and increase the safety of the surgery. With the development of medical imaging, 3D reconstruction technology, the innovation of liver surgery and the proposal of precise hepatectomy, the intrahepatic vascular anatomy of the liver and liver segmentectomy based on that vascular anatomy have become well developed. With the analysis of 3D digital liver, we proposed a new type of liver classification system: Dong’s digital liver classification system. And we measured the normal total liver volume from neonate to aging making a reference for surgeons all around the world. And the Human Digital Liver Database was established by the Affiliated Hospital of Qingdao University and Hisense Company, aiming to collect digital liver from neonates, children, adults, and the elderly, from normal livers, livers with cancer, and simulated livers resected using Hisense CAS. Then we showed one case report of patient with giant liver tumor. With the application of Hisense CAS and our data, we successfully removed the tumor. We believe that the new techniques in imaging will help surgeons to accomplish better operations.

Part of the book: Liver Research and Clinical Management

By Chengzhan Zhu, Bingzi Dong, Xin Chen and Qian Dong

Hepatoblastoma is a rare but the most common solid tumor in children. The incidence is gradually increasing. The international collaboration among four centers in the world has greatly improved the prognosis of hepatoblastoma. They formed the Children’s Hepatic Tumor International Collaboration (CHIC) to standardize the staging system (2017 PRETEXT system) and the risk factors for tumor stratification. Multimodal therapy has become the standard for the management of hepatoblastoma, including surgical resection, liver transplantation, chemotherapy, and so on. Surgery is the primary treatment of early stage hepatoblastoma. Three-dimensional reconstruction is helpful for preoperative evaluation of large tumors, assisting extended hepatectomy for patients in PRETEXT III or IV. Neoadjuvant therapy is useful for reducing the tumor volume and increasing the resectability. Primary liver transplantation is recommended for advanced hepatoblastoma. The lungs are the most common metastatic organ, the treatment of which is critical for the patient’s long-term survival. We reviewed the recent progress in the diagnosis and treatment of hepatoblastoma.

Part of the book: Liver Pathology