Imaging Diagnosis of Hepatocellular Carcinoma: A State-of-the-Art Review

Abstract

Hepatocellular carcinoma (HCC) remains not only a cause of a considerable part of oncologic mortality, but also a diagnostic and therapeutic challenge for healthcare systems worldwide. Early detection of the disease and consequential adequate therapy are imperative to increase patients’ quality of life and survival. Imaging plays, therefore, a crucial role in the surveillance of patients at risk, the detection and diagnosis of HCC nodules, as well as in the follow-up post-treatment. The unique imaging characteristics of HCC lesions, deriving mainly from the assessment of their vascularity on contrast-enhanced computed tomography (CT), magnetic resonance (MR) or contrast-enhanced ultrasound (CEUS), allow for a more accurate, noninvasive diagnosis and staging. The role of imaging in the management of HCC has further expanded beyond the plain confirmation of a suspected diagnosis due to the introduction of ultrasound and hepatobiliary MRI contrast agents, which allow for the detection of hepatocarcinogenesis even at an early stage. Moreover, the recent technological advancements in artificial intelligence (AI) in radiology contribute an important tool for the diagnostic prediction, prognosis and evaluation of treatment response in the clinical course of the disease. This review presents current imaging modalities and their central role in the management of patients at risk and with HCC.

Radiomics Applications in Spleen Imaging: A Systematic Review and Methodological Quality Assessment

“…Cirrhosis is the final endpoint of multiple liver diseases, such as viral infections and alcoholic or non-alcoholic steatohepatitis, and it has become one of the most common causes of death worldwide [ 36 ]. Given the significance and healthcare burden associated with this condition, radiomics has been employed to enhance the diagnosis and staging of cirrhosis and liver diffuse diseases [ 11 , 37 ]. However, cirrhosis is characterized by complex crosstalk between the spleen and liver, as the development of portal hypertension induces alterations in the splenic parenchyma, leading to hypersplenism and splenomegaly [ 5 ].…”

“…The escalating interest in radiomics research has led to an increase in its applications across various medical imaging domains, particularly in the field of oncology [ 10 , 11 , 12 , 13 , 14 , 15 ]. Nevertheless, the translation of radiomics within clinical practice is hindered by actual limitations of current research, due to the heterogeneity in all the above-mentioned key steps of the radiomic pipeline, but also the lack of external validation, prospective design, and large-scale multicenter datasets [ 16 , 17 ].…”

Recent Advances in Liver Tissue Engineering as an Alternative and Complementary Approach for Liver Transplantation

“…Lu and coworkers reported the usage of a histomorphometric-based image classifier of nuclear morphology to risk stratify squamous cell carcinoma patients [64]. Recently, Candita et al reviewed the potential advantage of artificial intelligence in supporting radiologists to distinguish HCC (hepatocellular carcinoma) from other liver diseases [65].…”

Imaging Investigation of Hepatocellular Carcinoma Progress via Monitoring γ-Glutamyltranspeptidase Level with a Near-Infrared Fluorescence/Photoacoustic Bimodal Probe

“…8,9 On one hand, since the small-sized tumor nodules are more sensitive to pragmatic approaches such as ablation and resection, the accurate early diagnosis can effectively improve the treatment success rate within the ideal curative time as well as the prognosis consequently. 10 On the other hand, despite the pathological examination, traditional techniques including magnetic resonance imaging (MRI) and multiphasic contrast computed tomography (CT) require sophisticated instruments, whereas there remains room for the improvement on accuracy, convenience, and radiation avoidance. 11,12 The recent hotspot of monitoring molecular biomarkers seems potential for realizing the description of the HCC development at an early stage due to the progress in accuracy and practicality.…”

“…All over the world, liver cancers rank fourth among the principal causes of cancer death, while over 80% of liver cancers are identified as hepatocellular carcinoma (HCC). − Typically, in approximately 80–90% of the HCC cases, the coupled liver cirrhosis (LC) has been observed, and the process of hepatic fibrosis has been considered as the premonitory event. , The high risk and low survival rate of HCC, to some extent, is due to the late definite diagnosis and thus the limited therapeutic approaches. , Accordingly, early diagnosis, with a sufficient understanding of the HCC development, is significant for the patients whereas facing currently difficult to guarantee the accuracy. , On one hand, since the small-sized tumor nodules are more sensitive to pragmatic approaches such as ablation and resection, the accurate early diagnosis can effectively improve the treatment success rate within the ideal curative time as well as the prognosis consequently . On the other hand, despite the pathological examination, traditional techniques including magnetic resonance imaging (MRI) and multiphasic contrast computed tomography (CT) require sophisticated instruments, whereas there remains room for the improvement on accuracy, convenience, and radiation avoidance. , The recent hotspot of monitoring molecular biomarkers seems potential for realizing the description of the HCC development at an early stage due to the progress in accuracy and practicality .…”