Prognostic Role of Molecular and Imaging Biomarkers for Predicting Advanced Hepatocellular Carcinoma Treatment Efficacy

Abstract

Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide and the fourth cause of tumor-related death. Imaging biomarkers are based on computed tomography, magnetic resonance, and contrast-enhanced ultrasound, and are widely applied in HCC diagnosis and treatment monitoring. Unfortunately, in the field of molecular biomarkers, alpha-fetoprotein (AFP) is still the only recognized tool for HCC surveillance in both diagnostic and follow-up purposes. Other molecular biomarkers have little roles in clinical practice regarding HCC, mainly for the detection of early-stage HCC, monitoring the response to treatments and analyzing tumor prognosis. In the last decades no important improvements have been achieved in this field and imaging biomarkers maintain the primacy in HCC diagnosis and follow-up. Despite the still inconsistent role of molecular biomarkers in surveillance and early HCC detection, they could play an outstanding role in prognosis estimation and treatment monitoring with a potential reduction in health costs faced by standard radiology. An important challenge resides in identifying sufficiently sensitive and specific biomarkers for advanced HCC for prognostic evaluation and detection of tumor progression, overcoming imaging biomarker sensitivity. The aim of this review is to analyze the current molecular and imaging biomarkers in advanced HCC.

A new biomarker panel for differential diagnosis of cholangiocarcinoma: Results from an exploratory analysis

“…7 Imaging modalities, including endoscopic ultrasound (endoscopic ultrasound and endoscopic retrograde cholangiopancreatography), multiparametric ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), continue to play a key role in the diagnosis, differential diagnosis, and staging of CCA. [9][10][11] However, obtaining tissue samples via biopsy remains mandatory to confirm the diagnosis. 7 Unfortunately, CCA tumors can be very difficult to access, particularly those in the perihilar region, and as a result cytology sensitivity may be as low as 20-40%.…”