Skip to main content
SpringerLink
Log in

Diagnosis and Evaluation of Hepatocellular Carcinoma

  • Reference work entry
  • First Online:
Hepato-Pancreato-Biliary Malignancies

  • 676 Accesses

Abstract

Hepatocellular carcinoma (HCC) is the fastest growing malignancy in the USA with a steady uptrend in the incidence and its associated mortality. This poses a significant burden to public healthcare. It is essential to have efficient and accurate tools to establish a diagnosis of HCC in a timely manner. As a result of surveillance protocols for patients at high risk for HCC, diagnostic algorithms can be initiated to allow for earlier confirmation of an HCC diagnosis. This in turn ensures the timely implementation of therapeutic strategies with the ultimate goal to improve patient centered outcomes and overall survival. In this chapter we discuss the measures for HCC surveillance which opens the door to diagnostic evaluation. We detail the diagnostic tools and approach favored, staging of diagnosed HCCs, and the importance of having a multidisciplinary approach at the center of this process of diagnosis and evaluation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 329.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AASLD:

American Association for the Study of Liver Diseases

ACR:

American College of Radiology

AFP:

Alpha fetoprotein

BCLC:

Barcelona Clinic Liver Cancer

bm-JIS:

Biomarker combined Japan Integrated Staging

CEUS:

Contrast enhanced ultrasound

CHB:

Chronic hepatitis B

CK19:

Cytokeratin 19

CLIP:

Cancer of the Liver Italian Program

CT:

Computed tomography

CUPI:

Chinese University Prognostic Index

DAA:

Direct acting antivirals

DCP:

Des gamma carboxy prothrombin

EASL:

European Association for the Study of the Liver

ECOG:

Eastern Cooperative Group

FDA:

Food and Drug Administration

FDG:

Fluorodeoxyglucose

GPC3:

Glypican 3

GS:

Glutamine synthetase

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

HSP70:

Heat shock protein 70

LI-RADS:

Liver Imaging Reporting and Data System

MELD:

Model for end-stage liver disease

MRI:

Magnetic resonance imaging

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

OATP:

Organic anion transporting polypeptides

OLT:

Orthotopic liver transplantation

OPTN:

Organ Procurement and Transplantation Network

PET:

Positron emission tomography

PS:

Performance status

SVR:

Sustained virologic response

TACE:

Transarterial chemoembolization

TIV:

Tumor in vein

TNM:

Tumor node metastasis

UCSF:

University of California San Francisco

UNOS:

United Network for Organ Sharing

US:

Ultrasound

USA:

United States

WHO:

World Health Organization

References

  1. Globocan. Liver Cancer Global WHO Report. Iarc. 2018;876:2018–9. Available from: http://gco.iarc.fr/today

    Google Scholar 

  2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30.

    Google Scholar 

  3. Seer. SEER Cancer Statistics Review 1975–2006. National Cancer Institute SEER cancer statistics review 1975–2006 National Cancer Institute. Cancer. 2008:1975–2006.

    Google Scholar 

  4. El-Serag HB, Kanwal F. Epidemiology of hepatocellular carcinoma in the United States: where are we? Where do we go? Hepatology. 2014;60(5):1767–75.

    Google Scholar 

  5. Galle PR, Forner A, Llovet JM, Mazzaferro V, Piscaglia F, Raoul JL, et al. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182–236. Available from: https://doi.org/10.1016/j.jhep.2018.03.019.

  6. Naimark D, DA Naglie G. The meaning of life expectancy: what is a clinically significant gain? J Gen Intern Med. 1994;9(12):702–7.

    CAS  Google Scholar 

  7. Laupacis A, Feeny D, Detsky AS, Tugwell PX. How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations. CMAJ. 1992;146(4):473–81. Available from: https://pubmed.ncbi.nlm.nih.gov/1306034

    CAS  Google Scholar 

  8. Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet. 2018;391(10127):1301–1314. Available from: https://doi.org/10.1016/S0140-6736(18)30010-2.

  9. Sarasin FP, Giostra E, Hadengue A. Cost-effectiveness of screening for detection of small hepatocellular carcinoma in western patients with Child-Pugh class A cirrhosis. Am J Med. 1996;101(4):422–434. Available from: https://doi.org/10.1016/S0002-9343(96)00197-0.

  10. Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2018;68(2):723–50.

    Google Scholar 

  11. Wong VWS, Janssen HLA. Can we use HCC risk scores to individualize surveillance in chronic hepatitis B infection? J Hepatol. 2015;63(3):722–32. Available from:. https://doi.org/10.1016/j.jhep.2015.05.019.

    Article  Google Scholar 

  12. Chen C-J, Iloeje UH, Yang H-I. Long-term outcomes in hepatitis B: the REVEAL-HBV study. Clin Liver Dis. 2007;11(4):797–816. Available from: http://www.sciencedirect.com/science/article/pii/S1089326107000852

    Google Scholar 

  13. Loomba R, Liu J, Yang HI, Lee MH, Lu SN, Wang LY, et al. Synergistic effects of family history of hepatocellular carcinoma and hepatitis b virus infection on risk for incident hepatocellular carcinoma. Clin Gastroenterol Hepatol. 2013;11(12):1636–1645.e3.

    Google Scholar 

  14. Lok AS-F. Does antiviral therapy for hepatitis B and C prevent hepatocellular carcinoma? J Gastroenterol Hepatol. 2011;26(2):221–227. Available from: https://doi.org/10.1111/j.1440-1746.2010.06576.x.

  15. Lok AS, Seeff LB, Morgan TR, di Bisceglie AM, Sterling RK, Curto TM, et al. Incidence of hepatocellular carcinoma and associated risk factors in hepatitis C-related advanced liver disease. Gastroenterology 2009;136(1):138–148. Available from: https://doi.org/10.1053/j.gastro.2008.09.014

  16. Singal AK, Singh A, Jaganmohan S, Guturu P, Mummadi R, Kuo Y-F, et al. Antiviral therapy reduces risk of hepatocellular carcinoma in patients with hepatitis C virus-related cirrhosis. Clin Gastroenterol Hepatol. 2010;8(2):192–9. Available from. https://doi.org/10.1016/j.cgh.2009.10.026.

    Article  Google Scholar 

  17. Kanwal F, Kramer J, Asch SM, Chayanupatkul M, Cao Y, El-Serag HB. Risk of hepatocellular cancer in HCV patients treated with direct-acting antiviral agents. Gastroenterology. 2017;153(4):996–1005.e1. Available from: https://doi.org/10.1053/j.gastro.2017.06.012

  18. Calleja JL, Crespo J, Rincón D, Ruiz-Antorán B, Fernandez I, Perelló C, et al. Effectiveness, safety and clinical outcomes of direct-acting antiviral therapy in HCV genotype 1 infection: results from a Spanish real-world cohort. J Hepatol. 2017;66(6):1138–48. Available from: http://www.sciencedirect.com/science/article/pii/S0168827817300636

    CAS  Google Scholar 

  19. Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease—meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84.

    Google Scholar 

  20. Kanwal F, Kramer JR, Mapakshi S, Natarajan Y, Chayanupatkul M, Richardson PA, et al. Risk of hepatocellular cancer in patients with non-alcoholic fatty liver disease. Gastroenterology. 2018;155(6):1828–1837.e2. Available from: https://doi.org/10.1053/j.gastro.2018.08.024.

  21. Piscaglia F, Svegliati-Baroni G, Barchetti A, Pecorelli A, Marinelli S, Tiribelli C, et al. Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: a multicenter prospective study. Hepatology. 2016;63(3):827–38.

    Google Scholar 

  22. Paradis V, Zalisnski S, Chelbi E, Guedj N, Degos F, Vilgrain V, et al. Hepatocellular carcinomas in patients with metabolic syndrome often develop without significant liverfibrosis: a pathological analysis. Hepatology. 2009;49(3):851–9.

    Google Scholar 

  23. Omata M, Cheng AL, Kokudo N, Kudo M, Lee JM, Jia J, et al. Asia–Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int. 2017;11(4):317–70.

    Google Scholar 

  24. Padhya KT, Marrero JA, Singal AG. Recent advances in the treatment of hepatocellular carcinoma. Curr Opin Gastroenterol. 2013;29(3) Available from: https://journals.lww.com/co-gastroenterology/Fulltext/2013/05000/Recent_advances_in_the_treatment_of_hepatocellular.9.aspx

  25. Singal AG, Pillai A, Tiro J. Early detection, curative treatment, and survival rates for hepatocellular carcinoma surveillance in patients with cirrhosis: a meta-analysis. PLoS Med. 2014;11(4)

    Google Scholar 

  26. Chen VL, Singal AG, Tapper EB, Parikh ND. Hepatocellular carcinoma surveillance, early detection and survival in a privately insured US cohort. Liver Int. 2020;40(4):947–955. Available from: https://doi.org/10.1111/liv.14379.

  27. Andersson KL, Salomon JA, Goldie SJ, Chung RT. Cost effectiveness of alternative surveillance strategies for hepatocellular carcinoma in patients with cirrhosis. Clin Gastroenterol Hepatol. 2008;6(12):1418–24.

    Google Scholar 

  28. Singal A, Volk ML, Waljee A, Salgia R, Higgins P, Rogers MAM, et al. Meta-analysis: surveillance with ultrasound for early-stage hepatocellular carcinoma in patients with cirrhosis. Aliment Pharmacol Ther. 2009;30(1):37–47.

    CAS  Google Scholar 

  29. Pocha C, Dieperink E, McMaken KA, Knott A, Thuras P, Ho SB. Surveillance for hepatocellular cancer with ultrasonography vs. computed tomography – a randomised study. Aliment Pharmacol Ther. 2013;38(3):303–12.

    CAS  Google Scholar 

  30. Gupta S, Bent S, Kohlwes J. Test characteristics of α-fetoprotein for detecting hepatocellular carcinoma in patients with hepatitis C. Ann Intern Med [Internet]. 2003;139(1):46–50. Available from: https://www.acpjournals.org/doi/abs/10.7326/0003-4819-139-1-200307010-00012

    CAS  Google Scholar 

  31. Marrero JA, Feng Z, Wang Y, Nguyen MH, Befeler AS, Roberts LR, et al. α-fetoprotein, des-γ Carboxyprothrombin, and lectin-bound α-fetoprotein in early hepatocellular carcinoma. Gastroenterology. 2009;137(1):110–8. Available from: http://www.sciencedirect.com/science/article/pii/S0016508509005460

    CAS  Google Scholar 

  32. Fetzer DT, Rodgers SK, Harris AC, Kono Y, Wasnik AP, Kamaya A, Sirlin C. Screening and surveillance of hepatocellular carcinoma: an introduction to ultrasound liver imaging reporting and data system. Radiol Clin N Am. 2017;55:1197–209.

    Google Scholar 

  33. Rodgers SK, Fetzer DT, Gabriel H, Seow JH, Choi HH, Maturen KE, et al. Role of US LI-RADS in the LI-RADS algorithm. Radiographics. 2019;39(3):690–708.

    Google Scholar 

  34. Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL Conference. J Hepatol. 2001;35(3):421–30. Available from: http://www.sciencedirect.com/science/article/pii/S0168827801001301

    CAS  Google Scholar 

  35. Choi JY, Lee JM, Sirlin CB. CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part I. Development, growth, and spread: key pathologic and imaging aspects. Radiology. 2014;272(3):635–54.

    Google Scholar 

  36. Purysko AS, Remer EM, Coppa CP, Leão Filho HM, Thupili CR, Veniero JC. LI-RADS: a case-based review of the new categorization of liver findings in patients with end-stage liver disease. Radiographics. 2012;32(7):1977–95.

    Google Scholar 

  37. Chernyak V, Fowler KJ, Kamaya A, Kielar AZ, Elsayes KM, Bashir MR, et al. Liver imaging reporting and data system (LI-RADS) version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology. 2018;289(3):816–30.

    Google Scholar 

  38. Elsayes KM, Kielar AZ, Chernyak V, Morshid A, Furlan A, Masch WR, et al. LI-RADS: a conceptual and historical review from its beginning to its recent integration into AASLD clinical practice guidance. J Hepatocell Carcinoma. 2019;6:49–69.

    Google Scholar 

  39. Hanna RF, Miloushev VZ, Tang A, Finklestone LA, Brejt SZ, Sandhu RS, et al. Comparative 13-year meta-analysis of the sensitivity and positive predictive value of ultrasound, CT, and MRI for detecting hepatocellular carcinoma. Abdom Radiol. 2016;41(1):71–90. Available from: https://doi.org/10.1007/s00261-015-0592-8.

  40. Roberts LR, Sirlin CB, Zaiem F, Almasri J, Prokop LJ, Heimbach JK, et al. Imaging for the diagnosis of hepatocellular carcinoma: a systematic review and meta-analysis. Hepatology. 2018;67(1):401–21.

    Google Scholar 

  41. Pascual S, Miralles C, Bernabé JM, Irurzun J, Planells M. Surveillance and diagnosis of hepatocellular carcinoma: a systematic review. World J Clin Cases. 2019;7(16):2269–22286.

    Google Scholar 

  42. Lee YJ, Lee JM, Lee JS, Lee HY, Park BH, Kim YH, et al. Hepatocellular carcinoma: diagnostic performance of multidetector CT and MR imaging-a systematic review and meta-analysis. Radiology. 2015;275(1):97–109.

    Google Scholar 

  43. Quaia E. State of the art: LI-RADS for contrast-enhanced US. Radiology. 2019.;293(1):4–14. Available from: https://doi.org/10.1148/radiol.2019190005.

  44. Maruyama H, Sekimoto T, Yokosuka O. Role of contrast-enhanced ultrasonography with Sonazoid for hepatocellular carcinoma: evidence from a 10-year experience. J Gastroenterol. 2016;51(5):421–433. Available from: https://doi.org/10.1007/s00535-015-1151-3.

  45. Kokudo N, Takemura N, Hasegawa K, Takayama T, Kubo S, Shimada M, et al. Clinical practice guidelines for hepatocellular carcinoma: The Japan Society of Hepatology 2017 (4th JSH-HCC guidelines) 2019 update. Hepatol Res. 2019 1;49(10):1109–1113. Available from: https://doi.org/10.1111/hepr.13411.

  46. Bolondi L, Cillo U, Colombo M, Craxì A, Farinati F, Giannini EG, et al. Position paper of the Italian Association for the Study of the liver (AISF): the multidisciplinary clinical approach to hepatocellular carcinoma. Dig Liver Dis. 2013;45(9):712–23.

    Google Scholar 

  47. Zhang J, Yu Y, Li Y, Wei L. Diagnostic value of contrast-enhanced ultrasound in hepatocellular carcinoma: a meta-analysis with evidence from 1998 to 2016. Oncotarget. 2017;8(43):75418–26.

    Google Scholar 

  48. Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018;67(1):358–80.

    Google Scholar 

  49. Forner A, Vilana R, Ayuso C, Bianchi L, Solé M, Ayuso JR, et al. Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology. 2008;47(1):97–104.

    Google Scholar 

  50. Kondo Y, Niwa Y, Akikusa B, Takazawa HOA. A histopathologic study of early hepatocellular carcinoma. Cancer. 1983;52(4):687–92.

    CAS  Google Scholar 

  51. Kojiro M, Wanless IR, Alves V, Badve S, Balabaud C, Bedosa P, et al. Pathologic diagnosis of early hepatocellular carcinoma: a report of the International Consensus Group for Hepatocellular Neoplasia. Hepatology. 2009;49(2):658–64.

    Google Scholar 

  52. Pittman ME, Brunt EM. Anatomic pathology of hepatocellular carcinoma: histopathology using classic and new diagnostic tools. Clin Liver Dis. 2015;19(2):239–59. Available from: http://www.sciencedirect.com/science/article/pii/S1089326115000045

    Google Scholar 

  53. Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumours of the digestive system, WHO-OMS. 4th ed. IARC Press; 2010.

    Google Scholar 

  54. Di Tommaso L, Destro A, Seok JY, Balladore E, Terracciano L, Sangiovanni A, et al. The application of markers (HSP70 GPC3 and GS) in liver biopsies is useful for detection of hepatocellular carcinoma. J Hepatol. 2009;50(4):746–54. Available from: http://www.sciencedirect.com/science/article/pii/S0168827808007812

    Google Scholar 

  55. Di Tommaso L, Franchi G, Young NP, Fiamengo B, Destro A, Morenghi E, et al. Diagnostic value of HSP70, glypican 3, and glutamine synthetase in hepatocellular nodules in cirrhosis. Hepatology. 2007;45(3):725–34.

    Google Scholar 

  56. Tung W-C, Huang Y-J, Leung SW, Kuo F-Y, Tung H-D, Wang J-H, et al. Incidence of needle tract seeding and responses of soft tissue metastasis by hepatocellular carcinoma postradiotherapy. Liver Int. 2007;27(2):192–200. Available from: https://doi.org/10.1111/j.1478-3231.2006.01399.x.

  57. Szpakowski J-L, Drasin TE, Lyon LL. Rate of seeding with biopsies and ablations of hepatocellular carcinoma: a retrospective cohort study. Hepatol Commun. 2017;1(9):841–51.

    Google Scholar 

  58. Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver biopsy. Hepatology. 2009;49(3):1017–44.

    Google Scholar 

  59. Maturen KE, Nghiem HV, Marrero JA, Hussain HK, Higgins EG, Fox GA, et al. Lack of tumor seeding of hepatocellular carcinoma after percutaneous needle biopsy using coaxial cutting needle technique. Am J Roentgenol. 2006;187(5):1184–7.

    Google Scholar 

  60. Silva MA, Hegab B, Hyde C, Guo B, Buckels JAC, Mirza DF. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut. 2008;57(11):1592 LP–1596. Available from: http://gut.bmj.com/content/57/11/1592.abstract

    Google Scholar 

  61. Manghisi G, Elba S, Mossa A, Giorgio A, Aloisio V, Perrotta A, et al. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients. Hepatology. 1998;28(3):751–5.

    Google Scholar 

  62. Cabibbo G, Enea M, Attanasio M, Bruix J, Craxí A, Camm̀a C. A meta-analysis of survival rates of untreated patients in randomized clinical trials of hepatocellular carcinoma. Hepatology 2010;51(4):1274–1283.

    Google Scholar 

  63. John BV, Aubuchon S, Dahman B, Konjeti VR, Heuman D, Hubert J, et al. Addition of [18F]Fluorodeoxyglucose positron emission tomography with computed tomography to cross-sectional imaging improves staging and alters management in hepatocellular carcinoma. Liver Transplant. 2020;26(6):774–84.

    Google Scholar 

  64. Marrero JA, Kudo M, Bronowicki J. The challenge of prognosis and staging for hepatocellular carcinoma. Oncologist. 2010;15(S4):23–33.

    CAS  Google Scholar 

  65. Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis [Internet]. 1999;19(3):329–338. Available from: https://doi.org/10.1055/s-2007-1007122.

  66. Forner A, Reig M BJ. Hepatocellular carcinoma. Lancet [Internet]. 2018;391(10127):1301–1314. Available from: https://doi.org/10.1016/S0140-6736(18)30010-2.

  67. Marrero JA, Fontana RJBA, et al. Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort. Hepatology. 2005;41:707–16.

    Google Scholar 

  68. Cillo U, Vitale AGF, et al. Prospective validation of the Barcelona clinic liver cancer staging system. J Hepatol. 2006;44:723–31.

    Google Scholar 

  69. Wang JH, Changchien CSHT, et al. The efficacy of treatment schedules according to Barcelona clinic liver cancer staging for hepatocellular carcinoma: survival analysis of 3892 patients. Eur J Cancer. 2008;44:1000–6.

    Google Scholar 

  70. Roayaie S, Obeidat K, Sposito C, Mariani L, Bhoori S, Pellegrinelli A, et al. Resection of hepatocellular cancer ≤2 cm: results from two Western centers. Hepatology. 2013;57(4):1426–35.

    Google Scholar 

  71. Bismuth H, Chiche L, Adam R, Castaing D, Diamond T, Dennison A. Liver resection versus transplantation for hepatocellular carcinoma in cirrhotic patients. Ann Surg. 1993;218(2):145–51.

    CAS  Google Scholar 

  72. Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, et al. Carcinomas in patients with cirrhosis. N Engl J Med. 1996;334(11):693–9.

    CAS  Google Scholar 

  73. HRSA/OPTN. Policy 3.6 organ distribution: allocation of livers. http://optn.transplant. hrsa.gov/policiesAndBylaws/policies.asp. Published 2012.Accessed 8 Aug 2020.

  74. Yao FY, Ferrell L, Bass NM, Watson JJ, Bacchetti P, Venook A, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology. 2001;33(6):1394–403. Available from: http://www.sciencedirect.com/science/article/pii/S0270913901475495

    CAS  Google Scholar 

  75. Patel SS, Arrington AK, McKenzie S, Mailey B, Ding M, Lee W, et al. Milan criteria and UCSF criteria: a preliminary comparative study of liver transplantation outcomes in the United States. Int J Hepatol. 2012;2012:1–7.

    Google Scholar 

  76. Henrique J, De Sousa B, Calil IL, Tustumi F, Khalil C, Eduardo G, et al. Comparison between Milan and UCSF criteria for liver transplantation in patients with hepatocellular carcinoma : a systematic review and meta-analysis. Transl Gastroenterol Hepatol. 2020:1–11.

    Google Scholar 

  77. HRSA/OPTN. Policy 9.5.I requirements for hepatocellular carcinoma MELD or PELD score exceptions. Available from: https://optn.transplant.hrsa.gov/media/1200/optn_policies.pdf. Accessed 18 Aug 2020.

  78. Lamb BW, Brown KF, Nagpal K, Vincent C, Green JSA, Sevdalis N. Quality of care management decisions by multidisciplinary cancer teams: a systematic review. Ann Surg Oncol. 2011;18(8):2116–2125. Available from: https://doi.org/10.1245/s10434-011-1675-6.

  79. Siddique O, Yoo ER, Perumpail RB, Perumpail BJ, Liu A, Cholankeril G, et al. The importance of a multidisciplinary approach to hepatocellular carcinoma. J Multidiscip Healthc. 2017;10:95–100.

    Google Scholar 

  80. Chang TA, Sawhney R, Monto A, Ben Davoren J, Kirkland JA, Stewart L, et al. Implementation of a multidisciplinary treatment team for hepatocellular cancer at a Veterans Affairs Medical Center improves survival. HPB. 2008;10(6):405–11.

    Google Scholar 

  81. Serper M, Kaplan DE, Serper M, Goldberg DS, Kaplan DE, Taddei TH, et al. Association of provider specialty and multidisciplinary care with hepatocellular carcinoma treatment and mortality. Gastroenterology 2017;152(8):1954–1964. Available from: https://doi.org/10.1053/j.gastro.2017.02.040

  82. Zhang J, Mavros MN, Cosgrove D, Hirose K, Herman JM, Smallwood-Massey S, et al. Impact of a single-day multidisciplinary clinic on the management of patients with liver tumours. Curr Oncol. 2013;20(2):123–31.

    Google Scholar 

  83. Tanabe M, Kanki A, Wolfson T, Costa EAC, Mamidipalli A, Ferreira MPFD, et al. Imaging outcomes of liver imaging reporting and data system version 2014 category 2, 3, and 4 observations detected at CT and MR imaging. Radiology. 2016;281(1):129–39.

    Google Scholar 

  84. Abd Alkhalik Basha M, Abd El Aziz El Sammak D, El Sammak AA. Diagnostic efficacy of the Liver Imaging-Reporting and Data System (LI-RADS) with CT imaging in categorising small nodules (10–20 mm) detected in the cirrhotic liver at screening ultrasound. Clin Radiol. 2017;72(10):901.e1–901.e11. Available from: https://doi.org/10.1016/j.crad.2017.05.019

Download references

Acknowledgments

We thank Shuchi K. Rodgers, MD from the Division of Radiology at Einstein Medical Center, for her contribution in providing radiologic images for this chapter, as depicted from Figs. 1, 2, 3, 4, 5 and 6.

Disclosures

No relevant disclosures for both authors.

Author information

Authors and Affiliations

  1. University Hospitals, Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA

    Naemat Sandhu

  2. Division of Digestive Disease and Transplantation, Einstein Medical Center, Philadelphia, PA, USA

    Simona Rossi

Authors
  1. Naemat Sandhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Simona Rossi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Simona Rossi .

Editor information

Editors and Affiliations

  1. Medical Director, Capital Health Cancer Center, Director, CH Pancreas Center of Excellence, Director, CH Liver Center of Excellence, Pennington, NJ, USA

    Cataldo Doria

  2. Director of Interventional Gastroenterology, Capital Health Medical Center, Pennington, NJ, USA

    Jason N. Rogart

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Sandhu, N., Rossi, S. (2022). Diagnosis and Evaluation of Hepatocellular Carcinoma. In: Doria, C., Rogart, J.N. (eds) Hepato-Pancreato-Biliary Malignancies. Springer, Cham. https://doi.org/10.1007/978-3-030-41683-6_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-41683-6_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-41682-9

  • Online ISBN: 978-3-030-41683-6

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation