Ultrasound screening for hepatocellular carcinoma in patients with advanced liver fibrosis. An overview

Dănilă, Mirela; Sporea, Ioan

doi:10.11152/mu.201.3.2066.162.md1is2

Cited by 17 publications

(8 citation statements)

References 28 publications

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“…US is an inexpensive and noninvasive surveillance method without any risk or radiation exposure for the patient. US detection of HCC in a cirrhotic liver is limited by several factors including hepatic features such as abnormal liver texture, patient characteristics such as obesity and technical limitations such as quality of US and experience of ultrasonographer[44]. A meta-analysis looking at the performance characteristics of surveillance US to detect early HCC found a sensitivity of 94% for detecting HCC lesions at any stage and sensitivity of 63% for early stage tumors.…”

Section: Surveillance Methodsmentioning

confidence: 99%

Hepatocellular carcinoma surveillance: An evidence-based approach

Harris

Hansen

Gray

et al. 2019

WJG

168

128

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Hepatocellular carcinoma (HCC) makes up 75%-85% of all primary liver cancers and is the fourth most common cause of cancer related death worldwide. Chronic liver disease is the most significant risk factor for HCC with 80%-90% of new cases occurring in the background of cirrhosis. Studies have shown that early diagnosis of HCC through surveillance programs improve prognosis and availability of curative therapies. All patients with cirrhosis and high-risk hepatitis B patients are at risk for HCC and should undergo surveillance. The recommended surveillance modality is abdominal ultrasound (US) given that it is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with non-alcoholic fatty liver disease (NAFLD). With the current obesity epidemic and rise in the prevalence of NAFLD, abdominal computed tomography or magnetic resonance imaging may be indicated as the primary screening modality in these patients. The addition of alpha-fetoprotein to a surveillance regimen is thought to improve the sensitivity of HCC detection. Further investigation of serum biomarkers is needed. Semiannual screening is the suggested surveillance interval. Surveillance for HCC is underutilized and low adherence disproportionately affects certain demographics such as non-Caucasian race and low socioeconomic status.

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Section: Surveillance Methodsmentioning

confidence: 99%

Hepatocellular carcinoma surveillance: An evidence-based approach

Harris

Hansen

Gray

et al. 2019

WJG

168

128

View full text Add to dashboard Cite

show abstract

“…The current guidelines for HCC surveillance recommend ultrasonography (US) as a screening imaging test [ 2 , 9 – 11 ]. US is highly cost-effective, non-invasive, and radiation free [ 12 ]. However, in certain patient and under certain operator conditions, US exhibits a low sensitivity for tumor detection [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of biannual ultrasonography and annual non-contrast liver magnetic resonance imaging as surveillance tools for hepatocellular carcinoma in patients with liver cirrhosis (MAGNUS-HCC): a study protocol

Kim

Choi

et al. 2017

BMC Cancer

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BackgroundUltrasonography (US) is recommended as a standard surveillance tool for patients with a high risk of developing hepatocellular carcinoma (HCC). However, the low sensitivity of US for small HCC can lead to surveillance failure, resulting in advanced stage tumor presentations. For the early detection of HCC in high-risk patients and to improve survival and prognosis, a new efficient imaging tool with a high sensitivity for HCC detection is needed. The purpose of this study is to evaluate and compare the feasibility and efficacy of non-contrast magnetic resonance imaging (MRI) with US as a surveillance tool for HCC in patients with liver cirrhosis.MethodsMAGNUS-HCC is a prospective, multicenter clinical trial with a crossover design for a single arm of patients. This study was approved by six Institutional Review Boards, and informed consent was obtained from all participants. All patients will undergo liver US every 6 months and non-contrast liver MRI every 12 months during a follow-up period of 3 years. If a focal liver lesion suspected of harboring HCC is detected, dynamic liver computed tomography (CT) will be performed to confirm the diagnosis. After the last surveillance round, patients without suspicion of HCC or who are not diagnosed with HCC will be evaluated with a dynamic liver CT to exclude false-negative findings. The primary endpoint is to compare the rate of detection of HCC by US examinations performed at 6-month intervals with that of yearly non-contrast liver MRI studies during a 3-year follow-up. The secondary endpoint is the survival of the patients who developed HCC within the 3-year follow-up period.DiscussionMAGNUS-HCC is the first study to compare the feasibility of non-contrast MRI with US as a surveillance tool for the detection of HCC in high-risk patients. We anticipate that the evidence presented in this study will establish the efficacy of non-contrast MRI as a surveillance tool for HCC in high-risk patients.Trial registrationThe date of trial registration (NCT02551250) in this study was September 15, 2015, and follow-up is still ongoing.

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“…Follow-up after treatment includes checking the viral load 12 weeks after the cessation of therapy to evaluate for a sustained virologic response [8]. Patients with advanced fibrosis or cirrhosis also warrant ongoing screening for hepatocellular carcinoma with liver ultrasonography every six months [9], regardless of antiviral treatment outcome [10]. However, our patient’s HCV was treated successfully but the patient was lost to follow-up after HCV treatment.…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular Carcinoma After Successful Treatment of Hepatitis C Virus with Ledipasvir/Sofosbuvir Presenting as Acute Pulmonary Tumor Embolism

Habib¹,

Azam²,

Siddiqui³

et al. 2019

Cureus

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Hepatitis C virus (HCV)-induced cirrhosis is a major cause of hepatocellular carcinoma (HCC) worldwide. HCC is an aggressive malignancy in which tumor thrombus can invade portal vein, hepatic veins and inferior vena cava (IVC) in the later stages. Our case brings to attention, HCV patient population who might need long-term follow-up to ensure HCV clearance. Physicians should ensure appropriate follow-up after treatment of HCV and should emphasize on the ongoing screening for HCC in patients with cirrhosis or advanced fibrosis, regardless of antiviral treatment outcome.

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Ultrasound screening for hepatocellular carcinoma in patients with advanced liver fibrosis. An overview

Cited by 17 publications

References 28 publications

Hepatocellular carcinoma surveillance: An evidence-based approach

Hepatocellular carcinoma surveillance: An evidence-based approach

Comparison of biannual ultrasonography and annual non-contrast liver magnetic resonance imaging as surveillance tools for hepatocellular carcinoma in patients with liver cirrhosis (MAGNUS-HCC): a study protocol

Hepatocellular Carcinoma After Successful Treatment of Hepatitis C Virus with Ledipasvir/Sofosbuvir Presenting as Acute Pulmonary Tumor Embolism

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