Non-invasive diagnosis of hepatocellular carcinoma revisited

Mueller, C.; Waldburger, Nina; Kauczor, Hans‐Ulrich; Schirmacher, Peter; Sommer, Christof M.; Longerich, Thomas

doi:10.1136/gutjnl-2017-314981

Cited by 19 publications

(12 citation statements)

References 9 publications

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“…Imaging-based diagnosis relies on the peculiar vascular derangement occurring during hepatic carcinogenesis 157 and of the high pre-test probability of HCC in the setting of cirrhosis, [158][159][160][161] although the frequency of intrahepatic cholangiocarcinoma (CC) and combined HCC/CC is also increased in cirrhosis. 162 The higher pre-test probability is also the reason why a non-invasive diagnosis is only accepted by the European Association for the Study of the Liver (EASL) in cirrhotic patients, appreciating that there are non-cirrhotic patients at significant risk of developing HCC. Contrastenhanced imaging methods are necessary for the diagnosis of HCC and are based on vascular phases (lesion appearance in the late arterial phase, in the portal venous phase, and in the delayed phase).…”

Section: Imaging-based Diagnosismentioning

confidence: 99%

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

Galle¹,

Forner²,

Llovet³

et al. 2018

Journal of Hepatology

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6,592

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Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death globally. Hepatocellular carcinoma represents about 90% of primary liver cancers and constitutes a major global health problem. The following Clinical Practice Guidelines will give up-to-date advice for the clinical management of patients with hepatocellular carcinoma, as well as providing an in-depth review of all the relevant data leading to the conclusions herein.

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Section: Imaging-based Diagnosismentioning

confidence: 99%

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

Galle¹,

Forner²,

Llovet³

et al. 2018

Journal of Hepatology

Self Cite

6,592

4,351

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“…The role of tumor biopsy for the management of patients with HCC is one of the most active debates in the liver cancer community . European Association for the Study of the Liver and American Association for the Study of Liver Diseases guidelines currently do not require histological confirmation due to the reported excellent diagnostic performance of imaging procedures .…”

Section: Discussionmentioning

confidence: 99%

“…(28) The role of tumor biopsy for the management of patients with HCC is one of the most active debates in the liver cancer community. (30)(31)(32)(33) European Association for the Study of the Liver and American Association for the Study of Liver Diseases guidelines currently do not require histological confirmation due to the reported excellent diagnostic performance of imaging procedures. (34,35) Moreover, although numerous histological tumor variants have been reported over the last decades, they did not demonstrate robust clinical impact and have thus aroused no or very little interest for physicians involved in the clinical care of patients with HCC.…”

Section: Discussionmentioning

confidence: 99%

Macrotrabecular‐massive hepatocellular carcinoma: A distinctive histological subtype with clinical relevance

et al. 2018

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“…[11][12][13][14] LI-RADS is recommended to be used in clinical practice, as its performance for noninvasive HCC diagnosis is better than some classical algorithms. 6,15 In 2018, LI-RADS is consistent with and fully integrated into the American Association for the Study of Liver Diseases (AASLD) 2018 HCC clinical practice guidance. 6,16 In LI-RADS v2018, the definition of threshold growth was revised and simplified to ≥50% diameter increase in <6 months to achieve concordance with definitions advocated by AASLD and the Organ Procurement and Transplantation Network (OPTN).…”

mentioning

confidence: 98%

“…Since 2011 the American College of Radiology has published and updated the guidelines of CT/MRI Liver Imaging Reporting and Data System (CT/MRI LI‐RADS) in 2013, 2014, and 2017 for standardizing the acquisition, interpretation, and reporting of liver imaging . LI‐RADS is recommended to be used in clinical practice, as its performance for noninvasive HCC diagnosis is better than some classical algorithms . In 2018, LI‐RADS is consistent with and fully integrated into the American Association for the Study of Liver Diseases (AASLD) 2018 HCC clinical practice guidance .…”

mentioning

confidence: 99%

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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Non-invasive diagnosis of hepatocellular carcinoma revisited

Cited by 19 publications

References 9 publications

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

Macrotrabecular‐massive hepatocellular carcinoma: A distinctive histological subtype with clinical relevance

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

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