2014 KLCSG-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma: HCC Diagnostic Algorithm

Abstract

Hepatocellular carcinoma (HCC) is the fifth most commonly occurring cancer in Korea and typically has a poor prognosis with a 5-year survival rate of only 28.6%. Therefore, it is of paramount importance to achieve the earliest possible diagnosis of HCC and to recommend the most up-to-date optimal treatment strategy in order to increase the survival rate of patients who develop this disease. After the establishment of the Korean Liver Cancer Study Group (KLCSG) and the National Cancer Center (NCC), Korea jointly produced for the first time the Clinical Practice Guidelines for HCC in 2003, revised them in 2009, and published the newest revision of the guidelines in 2014, including changes in the diagnostic criteria of HCC and incorporating the most recent medical advances over the past 5 years. In this review, we will address the noninvasive diagnostic criteria and diagnostic algorithm of HCC included in the newly established KLCSG-NCC guidelines in 2014, and review the differences in the criteria for a diagnosis of HCC between the KLCSG-NCC guidelines and the most recent imaging guidelines endorsed by the European Organisation for Research and Treatment of Cancer (EORTC), the Liver Imaging Reporting and Data System (LI-RADS), the Organ Procurement and Transplantation Network (OPTN) system, the Asian Pacific Association for the Study of the Liver (APASL) and the Japan Society of Hepatology (JSH).

A comprehensive literatures update of clinical researches of superparamagnetic resonance iron oxide nanoparticles for magnetic resonance imaging

“…Some studies show SPIO-enhanced MRI is less efficient than standard Gadolinium-enhanced dynamic MRI in the detection and characterization of HCC (122). Currently, hepatocyte-specific contrast agent Gd-EOB-DTPA (Primovist ® , Europe; Eovist ® , USA; Bayer HealthCare) enhanced liver MRI is emerging as the leading method for diagnosis and staging of HCC (123). Moreover, Nishie et al (124) reported that the uptake of Gd-EOB-DTPA in the liver parenchyma decreased as the liver fibrosis progressed, however, no significant correlation was obtained between the parameters on Resovist ® -enhanced MRI and the histological findings of the liver parenchyma.…”

Use of gadobenate dimeglumine dynamic MRI for detection of early hepatocellular carcinoma in atypical hepatic focal lesions

“…Seven out of these 8 lesions were diagnosed by gadobenate dimeglumine-enhanced MRI (multihance) as HCC, showing hyperintensity in the arterial phase and hypointensity in the HBP (according to the latest guidelines for diagnosis of HCC including those of the Japan Society of Hepatology (JSH), [12] the Korean Liver Cancer Study Group (KLCSG), the National Cancer Center (NCC), [13] and the Liver Imaging Reporting and Data System (LI-RADS).…”

Effectiveness of on-site education for quality assurance of screening ultrasonography for hepatocellular carcinoma

“…However, for optimal screening examination results, high-quality imaging studies are also crucial. US surveillance of HCC every six months in populations at an elevated risk has been proven to reduce HCC related deaths and is recommended as a standard protocol in many countries, including the United States, Europe, Japan, and Korea [6][7][8][9][10]. Recent guidelines for the management of HCC from the American Association for the Study of Liver Disease (AASLD) and the European Association for the Study of Liver (EASL) recommended maintaining high-quality US examinations for optimal surveillance [6,7].…”