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Hepatocellular carcinoma imaging systems: why they exist, how they have evolved, and how they differ

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Abstract

Over the past 16 years, several scientific organizations have proposed systems that incorporate imaging for surveillance, diagnosis, staging, treatment, and monitoring of treatment response of hepatocellular carcinoma (HCC). These systems are needed to standardize the acquisition, interpretation, and reporting of liver imaging examinations; help differentiate benign from malignant observations; improve consistency between radiologists; and provide guidance for management of HCC. This review article discusses the historical evolution of HCC imaging systems. We indicate the features differentiating these systems, including target population, screening and surveillance algorithm, diagnostic imaging modalities, diagnostic scope, expertise and technical requirements, terminology, major and ancillary imaging features, staging and transplant eligibility, and assessment of treatment response. We highlight the potential benefits of unifying the systems, which we anticipate will enable sharing, pooling, and meta-analysis of data; facilitate multi-center trials; and accelerate dissemination of knowledge.

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Abbreviations

AASLD:

American Association for the Study of Liver Diseases

AOS:

Asian Oncology Summit

APASL:

Asian Pacific Association for the Study of the Liver

BASL:

Belgian Association for the Study of the Liver

BCLC:

Barcelona Clinic Liver Cancer staging system

CEUS:

Contrast-enhanced ultrasound

CT:

Computed tomography

CTHA:

CT during hepatic arteriography

EASL:

European Association for the Study of the Liver

EORTC:

European Organization for Research and Treatment of Cancer

ESMO:

European Society for Medical Oncology

HCC:

Hepatocellular carcinoma

J-HCC:

Japanese HCC guidelines

JSH:

Japan Society of Hepatology

LI-RADS:

Liver Imaging Reporting and Data System

MRI:

Magnetic resonance imaging

NCCN:

National Comprehensive Cancer Network

mUICC:

Modified Union for International Cancer Control

SGA:

Saudi Gastroenterology Association

SPIO:

Superparamagnetic iron oxide

UNOS-OPTN:

United Network for Organ Sharing and Organ Procurement and Transplantation Network

WGO:

World Gastroenterology Organisation

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Acknowledgements

This work was supported by the Fonds de recherche du Québec—Santé (Career Award #26993).

Author information

Authors and Affiliations

  1. Department of Radiology, Radio-oncology and Nuclear Medicine, Saint-Luc Hospital, University of Montreal and CRCHUM, 1058 rue Saint-Denis, Montreal, QC, H2X 3J4, Canada

    An Tang

  2. Centre de recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), 900 rue Saint-Denis, Montreal, QC, H2X 0A9, Canada

    An Tang

  3. Inland Imaging, Spokane, 801South Stevens St, Spokane, WA, 99204, USA

    Irene Cruite

  4. Department of Radiology, Thomas Jefferson University, 132 S. 10th St, 1094 Main Bldg., Philadelphia, PA, 19107, USA

    Donald G. Mitchell

  5. Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA

    Claude B. Sirlin

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  1. An Tang
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  4. Claude B. Sirlin
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Corresponding author

Correspondence to An Tang.

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Funding

This study was funded by a clinical research scholarship by the Fonds de recherche du Québec—Santé and Fondation de l’association des radiologistes du Québec (Career Award #26993) to An Tang.

Conflict of interest

An Tang, Donald G. Mitchell and Claude B. Sirlin are members of the LI-RADS Steering Committee. Irene Cruite declares that she has no conflict of interest. Claude B. Sirlin has industry research grants from Bayer, Guerbet, Siemens, GE, Philips, Supersonic, and Arterys and consulting and service agreeements with Alexion, AstraZeneca, Bioclinica, BMS, Bracco, Celgene, Fibrogen, Galmed, Genentech, Genzyme, Gilead, Icon, Intercept, Isis, Janssen, NuSirt, Perspectum, Pfizer, Profil, Sanofi, Shire, Synageva, Tobira, Takeda, and Virtual Scopics.

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This article does not contain any studies with human participants performed by any of the authors.

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Tang, A., Cruite, I., Mitchell, D.G. et al. Hepatocellular carcinoma imaging systems: why they exist, how they have evolved, and how they differ. Abdom Radiol 43, 3–12 (2018). https://doi.org/10.1007/s00261-017-1292-3

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