MRI Screening for Hepatocellular Carcinoma

Moreno, Courtney C.; Hang, Thuy-Van P.; Wedd, Joel

doi:10.37549/ar2665

Cited by 1 publication

(1 citation statement)

References 18 publications

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“…( 60 ) However, the number of features required for diagnosis depends on the lesion size, non‐rim arterial phase hyperenhancement, and other ancillary features. ( 61 ) A meta‐analysis of 17 studies involving 2,760 patients confirmed the usefulness of the LI‐RADS classification; it showed that the percentage of HCCs was higher in lesions of higher LI‐RADS category. ( 55 )…”

Section: What Are the Current And Emerging Imaging Tools For Hcc Surv...mentioning

confidence: 90%

Current and Emerging Tools for Hepatocellular Carcinoma Surveillance

Adeniji

Dhanasekaran

2021

Hepatol Commun

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Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide. Early detection of HCC enables patients to avail curative therapies that can improve patient survival. Current international guidelines advocate for the enrollment of patients at high risk for HCC, like those with cirrhosis, in surveillance programs that perform ultrasound every 6 months. In recent years, many studies have further characterized the utility of established screening strategies and have introduced new promising tools for HCC surveillance. In this review, we provide an overview of the most promising new imaging modalities and biomarkers for the detection of HCC. We discuss the role of imaging tools like ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) in the early detection of HCC, and describe recent innovations which can potentially enhance their applicability, including contrast enhanced ultrasound, low-dose CT scans, and abbreviated MRI. Next, we outline the data supporting the use of three circulating biomarkers (i.e., alpha-fetoprotein [AFP], AFP lens culinaris agglutinin-reactive fraction, and des-gamma-carboxy prothrombin) in HCC surveillance, and expand on multiple emerging liquid biopsy biomarkers, including methylated cell-free DNA (cfDNA), cfDNA mutations, extracellular vesicles, and circulating tumor cells. These promising new imaging modalities and biomarkers have the potential to improve early detection, and thus improve survival, in patients with HCC. (Hepatology Communications 2021;5:1972-1986).L iver cancer is the sixth most common cancer worldwide and is now the third-leading cause of cancer-related death, behind lung cancer and colorectal cancer. (1) In 2020, more than 900,000 cases of liver cancer were diagnosed globally, with more than 830,000 liver cancer-related deaths, underscoring the high mortality index of this cancer. (1) Hepatocellular carcinoma (HCC) accounts for 75%-85% of primary liver cancers. The global incidence of HCC has increased by more than 75% in the last 30 years, especially in Western countries, (2)(3)(4) and is expected to continue to grow in the near future. Unfortunately, survival rates for patients with HCC in the United States remain dismally low and essentially unchanged over the past 30 years, (5) with only 3%-34% of patients with HCC surviving 5 years after diagnosis. (6) The high HCC mortality rates can be attributed to several factors, with delayed diagnosis of cancer at more advanced stages of disease being an important reason. (2,7,8) HCC typically arises in the background of the cirrhotic liver, where chronic inflammation and fibrosis induce genomic alterations that render the hepatocytes vulnerable to malignant transformation. (9)(10)(11) The presence of cirrhosis is the strongest risk factor for HCC, with 90% of HCCs arising in cirrhotic livers. The

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Section: What Are the Current And Emerging Imaging Tools For Hcc Surv...mentioning

confidence: 90%