Diagnosis and staging of hepatocellular carcinoma (HCC): current guidelines

Ayuso, Carmen; Rimola, Jordi; Vilana, R.; Burrel, Marta; Darnell, Anna; García-Criado, Ángeles; Bianchi, Luís; Belmonte, Ernest; Caparroz, Carla; Barrufet, Marta; Bruix, Jordi; Brú, C.

doi:10.1016/j.ejrad.2018.01.025

Cited by 301 publications

(245 citation statements)

References 63 publications

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“…AS THE MOST COMMON primary liver neoplasm, hepatocellular carcinoma (HCC) is the sixth most common cancer and the fourth leading cause of cancer‐related deaths worldwide in 2018 . If diagnosed at an early stage, HCC can be treated with resection, percutaneous ablation, or orthotopic liver transplantation, and the 5‐year survival rate can be as high as more than 50% . For HCC diagnosis, imaging plays a critical role, especially for multiphase contrast‐enhanced computed tomography (CT) and magnetic resonance imaging (MRI) .…”

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confidence: 99%

“…[1][2][3] If diagnosed at an early stage, HCC can be treated with resection, percutaneous ablation, or orthotopic liver transplantation, and the 5-year survival rate can be as high as more than 50%. [4][5][6] For HCC diagnosis, imaging plays a critical role, especially for multiphase contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI). [7][8][9] MRI has a higher per-lesion sensitivity than CT (80% vs. 68%) with a specificity of 94%, and should be used as the preferred imaging modality for HCC diagnosis in patients at high risk.…”

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Diagnostic performance of MR for hepatocellular carcinoma based on LI‐RADS v2018, compared with v2017

Ren

Zhao

Yang

et al. 2019

Magnetic Resonance Imaging

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Background The Liver Imaging Reporting and Data System (LI‐RADS) is widely adopted for noninvasive diagnosis of hepatocellular carcinoma (HCC). It's updated to version 2018 recently, with some major changes compared with v2017. However, the diagnostic performance of LI‐RADS v2018 and its difference with v2017 are yet to be validated. Purpose To compare the diagnostic performances of LI‐RADS on MR for diagnosing HCC between v2017 and v2018. Study Type Retrospective. Subjects In all, 181 patients with 217 hepatic observations (146 HCCs, 16 non‐HCC malignancies and 55 benign lesions) with liver MRI and pathological or follow‐up imaging diagnoses. Field Strength/Sequence 1.5 T or 3 T MRI. Dual‐echo T1WI, T2WI, diffusion‐weighted imaging, and a liver acquisition with volume acceleration. AssessmentImages were independently interpreted by three radiologists, and then in consensus for observations with different LR categories, according to LI‐RADS v2017 and v2018, separately. Statistical Tests Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+LR), and Youden index. Results When adopting LR‐5 as a predictor of HCC, the sensitivity (80.8% vs. 71.2%), NPV (69.6% vs. 60.7%), and accuracy (83.9% vs. 77.9%) were all increased for LI‐RADS v2018 compared with v2017, with a greater Youden index (0.709 vs. 0.627). However, the diagnostic performances of MRI for diagnosing HCC were not changed while adopting LR‐4/5 as a predictor. The threshold growths of 76% (19/25) observations in v2017 were revised to subthreshold growth in v2018, and 16 LR‐4 observations in v2017 were changed to LR‐5 based on v2018. Data Conclusion The diagnostic performance of LI‐RADS v2018 for diagnosing HCC is superior to v2017, with a greater sensitivity, NPV, and accuracy. The revisions in v2018 mainly affect the categorization when adopting LR‐5 as a predictor of HCC. Level of Evidence: 4 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:746–755.

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confidence: 99%

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Diagnostic performance of MR for hepatocellular carcinoma based on LI‐RADS v2018, compared with v2017

Ren

Zhao

Yang

et al. 2019

Magnetic Resonance Imaging

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“…One effective strategy to improve the prognosis of liver cancer is to find the tumor in the early stage, when the patients have no obvious symptoms so that liver function can be preserved as much as possible and more effective treatments can be applied. Early diagnosis and treatment are the most effective ways to prevent and treat cancer and reduce mortality [2] .…”

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confidence: 99%

Early changes in the urine proteome in a rat liver tumor model

Zhang

Gao

2019

Preprint

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Urine, as a potential biomarker source among the body fluids, can accumulate many changes in the body due to the lack of a mechanism to maintain a homeostatic state. Previous studies have demonstrated that proteomic technology can find many potential biomarkers to reflect different diseases in the urine.This study aims to detect early changes in the urinary proteome in a rat liver tumor model. The tumor model was established with the Walker-256 carcinosarcoma cell line (W256). Compared to before the injection, ninety-five differential proteins were significantly changed in the experimental rats. At day 3, twelve proteins were identified in the absence of pathological changes, and four of them were altered at all four time-points (B2MG, VCAM1, HA11, and LG3BP). Seven had previously been associated with liver cancer. At day 5, fifty-two differential proteins were identified. At day 7 and day 11, there was a significant decrease in the body weight of the rats, and tumor tissue was observed in the liver. Fifty-two and forty differential proteins were changed significantly at day 7 and day 11, respectively. Of the proteins that were identified at these three time-points, and twenty-four were reported to be associated with liver cancer. Comparing the differential urinary proteins and biological processes of liver tumor model with those in different models of W256 grown in other organs, specific differential protein patterns were found among the four models, which indicates that the differential urinary proteins can reflect the differences when the same tumor cell grown in different organs.Significance: This study demonstrated that (1) the rat liver tumor model caused early changes in urinary proteins may give new insight into the early diagnosis of liver cancer; (2) the same tumor cell grown in different organs can be reflected in differential urinary proteins.All rats were housed under a standard 12-h light/12-h dark cycle, and the room temperature and humidity were maintained at a standard level (22 ± 1 °C, 65-70%). Tumor cell line and CultureWalker 256 tumor cells were cultured in the ascitic fluid of Wistar rats. All cells were harvested from the rats who were given an intraperitoneal injection of 107 Walker 256 carcinoma cells after two cycles of 7 d cell passage. Then, W256 cells were resuspended in phosphate-buffered saline (PBS) before injection. The viability of the cells was detected by the Trypan blue exclusion test using a Neubauer chamber. Rat models of liver cancerA tumor-bearing animal model was established in this study. All Wistar rats were randomly divided into different groups: the control group (n =5), and the Walker-256 (W256) tumor-bearing group (n =12).After anesthesia, the left medial lobe of the liver was exposed. W256 cells (2.5× 10 5 ) were visually injected under the hepatic capsule into this lobe. The injection volume is 0.1 ml. An equal volume of PBS was also injected into the same location of the control rats. Histological analysisIn the W256 model, the livers of the experimental and cont...

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“…Recurrence and metastasis after operation of liver cancer are not only important causes affecting its treatment effects, but also one of the most complex problems in the prevention and treatment of liver cancer. In addition to drug therapy, regular follow-up and close monitoring after liver cancer operation are important measures of early detection of recurrence and intrahepatic metastasis; and this is the key to improving the post-operative curative effect for liver cancer [5].…”

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Correlations of ultrasonic features with severity of liver cancer and p16 expression in patients with liver cancer

Yan

Xiao

et al. 2019

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This paper analyzes the correlations of ultrasonic features with clinical-pathological manifestations and p16 expression in patients with liver cancer. A total of 84 patients with primary liver cancer were randomly enrolled. The characteristics of liver cancer were examined via conventional ultrasound and contrast-enhanced ultrasound (CEUS) before operation. The p16 protein expressions in liver cancer and para-carcinoma tissues were detected via immunohistochemistry (IHC), and the correlations of p16 positive expression with ultrasound parameters were also analyzed. It was manifested via ultrasound that 6.4% (3/47) of stage I-II liver cancer showed the equal-echo change in portal phase, while others faded and showed the equal-echo change with 32.4% (12/37) of stage III-IV liver cancer. There were no statistically significant differences in ultrasonic features of patients in stage I-II and stage III-IV in the arterial and delayed phases (p>0.05). The positive expression rate of p16 protein in para-carcinoma tissues was 85.71% (72/84) which was significantly higher than that in liver cancer tissues (30.95%, 26/84) (p<0.05). Maximum intensity (IMAX), time to peak (TTP) and mean transit time (mTT) had no statistically significant differences between the p16 positive and negative groups, but there were statistically significant differences in rising slope (RS) and washout time (WT) (p<0.05). Correlation analyses revealed that the positive expression of p16 had no significant correlations with IMAX, mTT and TTP (p>0.05), but it positively correlated with RS (correlation coefficient r=0.377, p<0.05) and negatively correlated with WT (r=-0.410, p<0.05).Conventional ultrasound and CEUS can evaluate the expression of p16 protein in liver cancer repeatedly and non-invasively. The evaluations therefore have great significance in clinical treatment of liver cancer.

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Diagnosis and staging of hepatocellular carcinoma (HCC): current guidelines

Cited by 301 publications

References 63 publications

Diagnostic performance of MR for hepatocellular carcinoma based on LI‐RADS v2018, compared with v2017

Diagnostic performance of MR for hepatocellular carcinoma based on LI‐RADS v2018, compared with v2017

Early changes in the urine proteome in a rat liver tumor model

Correlations of ultrasonic features with severity of liver cancer and p16 expression in patients with liver cancer

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