**1.5 The specific rationale study with a solid description**

*Canine Genetics, Health and Medicine*

administration ease [6, 7].

**1.4 The innovative features of this study**

**Classification Stage**

week [17].

treatment.

Regional lymph nodes (N)

Distant metastasis

*Source: doi:10.3390/cancers12051272*

(M)

**1.3 Background review and rationale study with reference**

Liver carcinoma can be diagnosed or detected by using multiple methods. Histological findings are considered the most robust for canine patients. The TNM staging system for canine hepatocellular carcinoma (HCC) is summarized in **Table 3** [20]. Veterinary surgeons may perform additional blood examinations to look for signs of liver dysfunction. Surgery is one of the treatments for all liver tumors. However, right-sided tumors are more challenging to resect because the resection lesion is related to the vena cava [2]. For massive hepatic carcinoma, surgical resection via lobectomy is the treatment when complete resection is accepted [10, 11]. The mass ligation for complete lobectomy is not recommended for large dogs, or central or right divisional liver tumors, because this method will increase the risk of complications, such as bleeding or bile leakage. Surgical stapling devices are recommended to perform liver lobectomy; in these devices, overlapping rows of staples are quickly placed to attenuate vascular and biliary structures within the liver lobe's hilus. If stages T3, N1, or M1 in **Table 3** are confirmed by clinicalstage evaluations, no surgical resection is recommended [20] because it would not remove some malignant liver tumors. Therefore, chemotherapy becomes an alternative treatment. Unfortunately, according to many clinical practices and references, chemotherapy is not very effective liver carcinoma treatment. Thus, HCC treatment with intravenous gemcitabine or carboplatin is no longer performed. Instead, in the last decade, the Metronomic chemotherapy and Sorafenib treatment (5 mg/kg, twice daily) became widely used due to lower-dose usage and

Alternatively, radiotherapy is sometimes used to make the liver tumor smaller or incapsulate it. However, it is not applicable to most liver tumor cases because of its side-effects. The major complication is a radiation heat-induced damage to the adjacent unaffected liver tissue. A 3D-CRT (three-dimensional conformal radiation therapy) is introduced as a new viable treatment option for canine patients with an inoperable massive liver carcinoma. From 6 to 10 Gy per fraction are prescribed on the planning target volume, and the total dose is 18–42 Gy with 1 to 2 fractions per

This study is the first attempt to apply the biokinetic Ga-67 model to canine liver carcinoma. The aim is to identify the best routine for detecting the metastatic or primary hepatic carcinoma and substantiating the optimal further

Primary tumor (T) T0: no evidence of primary tumor Tl: solitary tumor of any size involving one lobe T2: multiple tumors of any size involving multiple lobes

> N0: no regional lymph nodes metastasis Nl: regional lymph node metastasis N2: lymph node metastasis Distant metastasis

M0: no distant metastasis Ml: distant metastasis

*The TNM staging system for canine hepatocellular carcinoma.*

T3: tumor(s) with direct invasion of adjacent organs regional lymph nodes

**160**

**Table 3.**

The biokinetic model of Ga-67 evolution was elaborated in this study for the case–control group of canine liver carcinoma via in-vivo gamma camera/8-slice CT technique. The circulation of time-dependent concentrations of Ga-67 among organs was monitored and simulated. The obtained quantitative data for organs and branching ratios among organs were incorporated into the biokinetic model of Ga-67 radionuclide administered during the hepatic survey.
