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Understanding the role of radiologists in complex treatment decisions for patients with hepatocellular carcinoma

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Abstract

Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver and represents a significant global health burden. Management of HCC can be challenging due to multiple factors, including variable expectations for treatment outcomes. Several treatment options are available, each with specific eligibility and ineligibility criteria, and are provided by a multidisciplinary team of specialists. Radiologists should be aware of the types of treatment options available, as well as the criteria guiding the development of individualized treatment plans. This awareness enables radiologists to contribute effectively to patient-centered multidisciplinary tumor boards for HCC and play a central role in reassessing care plans when the treatment response is deemed inadequate. This comprehensive review aims to equip radiologists with an overview of HCC staging systems, treatment options, and eligibility criteria. The review also discusses the significance of imaging in HCC diagnosis, treatment planning, and monitoring treatment response. Furthermore, we highlight the crucial branch points in the treatment decision-making process that depend on radiological interpretation.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Oregon Health & Science University, Mail Code: L340, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA

    Omar Kamal, Manida Wungjramirun & Alice Fung

  2. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Natally Horvat

  3. Yale School of Medicine, New Haven, CT, USA

    Sandeep Arora

  4. Rutgers New Jersey Medical School, Newark, NJ, USA

    Humaira Chaudhry

  5. Baylor College of Medicine, Houston, TX, USA

    Mohab Elmohr

  6. UT Health San Antonio, San Antonio, TX, USA

    Lokesh Khanna

  7. Massachusetts General Hospital, Boston, MA, USA

    Pankaj Sharma Nepal & Anuradha S. Shenoy-Bhangle

  8. Emory University Hospital, Atlanta, GA, USA

    Sadhna B. Nandwana

  9. University of Kentucky, Lexington, KY, USA

    James Lee

  10. University of Toronto, Toronto, Canada

    Ania Kielar

  11. University of California, San Diego, CA, USA

    Robert Marks

  12. MD Anderson Cancer Center, Houston, TX, USA

    Khaled Elsayes

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Kamal, O., Horvat, N., Arora, S. et al. Understanding the role of radiologists in complex treatment decisions for patients with hepatocellular carcinoma. Abdom Radiol 48, 3677–3687 (2023). https://doi.org/10.1007/s00261-023-04033-6

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