Predictors of adequate ultrasound quality for hepatocellular carcinoma surveillance in patients with cirrhosis

Simmons, Okeefe L.; Fetzer, David T.; Yokoo, Takeshi; Marrero, Jorge A.; Yopp, Adam C.; Kono, Yuko; Parikh, Neehar D.; Browning, Travis; Singal, Amit G.

doi:10.1111/apt.13841

Cited by 255 publications

(250 citation statements)

References 24 publications

Supporting

Mentioning

240

Contrasting

Unclassified

Order By: Relevance

“…Elevated AFP levels should be cautiously interpreted in these patients, although AFP‐adjusted algorithms or tailoring AFP cutoff by liver disease etiology may help reduce rates of unnecessary diagnostic imaging . Increased liver nodularity in patients with advanced Child Pugh class and thrombocytopenia can impair radiologists' ability to definitively exclude liver lesions, leading to recommendations for cross‐sectional imaging . Alternative surveillance tools for these patients are particularly needed given both lower sensitivity and specificity related to poor visualization.…”

Section: Discussionmentioning

confidence: 99%

An assessment of benefits and harms of hepatocellular carcinoma surveillance in patients with cirrhosis

et al. 2016

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

An assessment of benefits and harms of hepatocellular carcinoma surveillance in patients with cirrhosis

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Computed tomography (CT) and magnetic resonance imaging (MRI) have been widely used for HCC diagnosis, and are less affected by the limitations of ultrasound, e.g., inter-operator variation, and likely yield better performance [13, 29]. However, these modalities have been deemed unsuitable as tools for surveillance due to the high costs and irradiation (for CT) [6].…”

Section: Experimental Hcc Surveillance Modalitiesmentioning

confidence: 99%

Tailored Algorithms for Hepatocellular Carcinoma Surveillance: Is One-Size-Fits-All Strategy Outdated?

Goossens

Bian

Hoshida

2017

Curr Hepatology Rep

View full text Add to dashboard Cite

Purpose of review Current clinical practice guidelines recommend regular hepatocellular carcinoma (HCC) surveillance with biannual ultrasound with or without serum alpha-fetoprotein uniformly applied to all patients with cirrhosis. However, clinical implementation of this one-size-fits-all strategy has been challenging as evidenced by very low application rate below 20% due to various reasons, including suboptimal performance of the surveillance modalities. Recent findings Newly emerging imaging techniques such as abbreviated MRI (AMRI) and molecular HCC risk biomarkers have increasingly become available for clinical evaluation and implementation. These technologies may have a potential to reshape HCC surveillance by enabling tailored strategies. This would involve performing optimized surveillance tests according to individual HCC risk, and allocating limited medical resources for HCC surveillance based on cost-effectiveness. Summary Tailored HCC surveillance could lead to achievement of precision HCC care and substantial improvement of the current dismal patient prognosis.

show abstract

“…Further, recent studies also suggest that performance of liver US, which has been considered the more sensitive and specific screening modality, may not be as high in real-life practice as previously thought [16]. US appears to have lower performance in imaging of individuals with central obesity, in whom it is difficult to accurately image the deeper parts of the liver, and for more aggressive, infiltrative and metastatic HCCs with high AFP that do not form distinct nodules in the liver [17, 18]. For many clinicians, these factors appear to justify use of US and AFP in combination for surveillance for HCC.…”

Section: Introductionmentioning

confidence: 99%

Should AFP (or Any Biomarkers) Be Used for HCC Surveillance?

Mohammed

Roberts

2017

Curr Hepatology Rep

View full text Add to dashboard Cite

a) Purpose of review To address the controversy around the use of biomarkers for hepatocellular carcinoma (HCC) surveillance in individuals with cirrhosis or chronic hepatitis B who are at risk for development of liver cancer. b) Recent findings Recent studies suggest that surveillance for hepatocellular carcinoma is beneficial, even after adjustment for lead time and other biases. Alpha fetoprotein (AFP) is complementary to ultrasound (US) in surveillance, particularly in obese patients and patients with infiltrative tumors. US and AFP are both associated with harms to patients from false positive over-diagnosis, with US appearing to cause greater harms. Including patient demographic characteristics and additional biomarkers into diagnostic models is beneficial. Recent studies emphasize the advantage of time trends in biomarkers over single cross-sectional measurements. c) Summary AFP and other biomarkers are complementary to US in surveillance for HCC, especially when applied in models including patient variables and incorporating time trends in biomarker levels. With advances in genetic and molecular analysis of tumors, we may be poised at the cusp of a revolution in HCC surveillance.

show abstract

Predictors of adequate ultrasound quality for hepatocellular carcinoma surveillance in patients with cirrhosis

Abstract: SUMMARY BackgroundAbdominal ultrasound fails to detect over one-fourth of hepatocellular carcinoma (HCC) at an early stage in patients with cirrhosis. Identifying patients in whom ultrasound is of inadequate quality can inform interventions to improve surveillance effectiveness.

Cited by 255 publications

References 24 publications

An assessment of benefits and harms of hepatocellular carcinoma surveillance in patients with cirrhosis

An assessment of benefits and harms of hepatocellular carcinoma surveillance in patients with cirrhosis

Tailored Algorithms for Hepatocellular Carcinoma Surveillance: Is One-Size-Fits-All Strategy Outdated?

Should AFP (or Any Biomarkers) Be Used for HCC Surveillance?

Contact Info

Product

Resources

About