Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

Kudo, Masatoshi; Matsui, Osamu; Izumi, Namiki; Iijima, Hiroko; Kadoya, Masumi; Imai, Yumiko

doi:10.1159/000368141

Cited by 78 publications

(62 citation statements)

References 109 publications

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“…Seven out of these 8 lesions were diagnosed by gadobenate dimeglumine-enhanced MRI (multihance) as HCC, showing hyperintensity in the arterial phase and hypointensity in the HBP (according to the latest guidelines for diagnosis of HCC including those of the Japan Society of Hepatology (JSH), [12] the Korean Liver Cancer Study Group (KLCSG), the National Cancer Center (NCC), [13] and the Liver Imaging Reporting and Data System (LI-RADS).…”

Section: Discussionmentioning

confidence: 99%

Use of gadobenate dimeglumine dynamic MRI for detection of early hepatocellular carcinoma in atypical hepatic focal lesions

El-Gazzar¹,

Kohla²,

Elsakhawy³

et al. 2017

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How to cite this article: El-Gazzar MF, Kohla MAS, El-Sakhaw MM, Husseiny MM, Yousef RRH, El-Shorbagy SH. Use of gadobenate dimeglumine dynamic MRI for detection of early hepatocellular carcinoma in atypical hepatic focal lesions. Hepatoma Res 2017;3:123-8. Aim:Gadobenate dimeglumine (multihance) is a contrast medium which can be used not only as an extracellular contrast agent for dynamic imaging of the liver, but also as a liver specific agent for the acquisition of hepatobiliary-phase images which are more helpful in evaluation of small atypical hepatic focal lesions equal or less than 3 cm. The authors tried to evaluate multihance dynamic magnetic resonance imaging (MRI) as a new modality in early detection of hepatocellular carcinoma (HCC). Methods: Thirty cirrhotic patients with small hepatic focal lesions (less than 3 cm in diameter), detected by imaging (ultrasound and triphasic computed tomography) were subjected to dynamic MRI with multihance contrast. All patients had a liver biopsy stained with heat shock protein 70, glypican 3, and glutamine synthetase to confirm the diagnosis of HCC. Results: Eight out of 30 patients (26.6%) with atypical focal lesions proved to have HCC by histology, whereas 7 out of 8 histologically proven HCC patients (87.5%) were shown to have typical criteria on Multihance imaging. Conclusion: Multihance dynamic MRI is a promising diagnostic modality for detection of early HCC, however, future studies on large numbers of patients are warranted to precisely detect the sensitivity and specificity of this new modality. Key words:Dynamic magnetic resonance imaging, multihance, gadobenate dimeglumine, early detection, hepatocellular carcinoma ABSTRACTArticle history:

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Section: Discussionmentioning

confidence: 99%

Use of gadobenate dimeglumine dynamic MRI for detection of early hepatocellular carcinoma in atypical hepatic focal lesions

El-Gazzar¹,

Kohla²,

Elsakhawy³

et al. 2017

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“…However, for optimal screening examination results, high-quality imaging studies are also crucial. US surveillance of HCC every six months in populations at an elevated risk has been proven to reduce HCC related deaths and is recommended as a standard protocol in many countries, including the United States, Europe, Japan, and Korea [6][7][8][9][10]. Recent guidelines for the management of HCC from the American Association for the Study of Liver Disease (AASLD) and the European Association for the Study of Liver (EASL) recommended maintaining high-quality US examinations for optimal surveillance [6,7].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of on-site education for quality assurance of screening ultrasonography for hepatocellular carcinoma

et al. 2016

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Objective: To evaluate the usefulness of on-site education for clinical imaging evaluation using quality assurance (QA) testing of surveillance ultrasonography (US) for hepatocellular carcinoma (HCC). Material and methods: Thirty-eight medical institutes underwent on-site education in 2012 for QA testing of clinical imaging evaluation of surveillance US for HCC. Failure rates and mean scores of clinical imaging evaluation for surveillance US of the 2011 survey, the 2012 survey after onsite education and the 2013 survey were compared. Results: Failure rates and mean scores of the 2011 survey, the 2012 survey after education and the 2013 survey were 81.6%, 18.4%, 21.1% and 61.7, 82.7 and 74.6, respectively. Pair-wise analyses demonstrated that the failure rate of the 2011 survey was significantly larger compared to that observed in the other surveys. Mean score of the 2013 survey was worse than that of the 2012 survey after on-site education. Conclusions: On-site education positively impacts the failure rate and scores of clinical imaging evaluation of screening US for HCC. However, the impact may be reduced over time, and repeated, annual education might be necessary to maintain US quality.

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“…If an unlimited supply of donor grafts existed, it is likely that every cirrhotic patient with HCC would be considered for LT, representing an optimal hepatologic as well as oncologic treatment option. Compared to all other treatment strategies, LT has the highest potential for cure [17,18,19], because it leads to the removal of the diseased liver tissue that harbors and propagates the cancer while at the same time eliminating all cancer tissue. The number of LT for HCC has increased worldwide.…”

Section: Treatment Options For Hccmentioning

confidence: 99%

HCC-Associated Liver Transplantation - Where Are the Limits and What Are the New Regulations?

Strassburg

2016

Visc Med

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Background: Hepatocellular carcinoma (HCC) represents an increasing health burden worldwide and a challenging disease both in terms of diagnosis and treatment. Methods: The literature available on PubMed for the period of 1990-2016 was reviewed with reference to liver allocation, HCC, liver transplantation (LT), and prediction, and the allocation rules of the German Transplant Act were reviewed. Results: Due to etiological and geographical diversity, HCC is not a homogeneous disease. In the vast majority of patients, HCC develops as a complication of chronic liver disease and cirrhosis. While most patients present with advanced HCC for which palliative strategies are the only available option, LT is the best treatment approach as it not only eliminates the diseased liver and the underlying hepatocarcinogenic mechanisms but also the cancer. The decision for LT is not an easy one to make, because outcome prediction, staging, bridging therapy, and recurrence prevention are difficult and are estimated against the background of the scarce resource of donor organs which are also competitively sought after by patients suffering from non-neoplastic terminal liver diseases, raising the issue of equality of chances in a rationed therapeutic modality. Currently, the Milan criteria are the best evaluated decision tool for LT, but many issues such as down-staging, favorable biological behavior during treatment, expansion of the morphological classification, molecular predictors, and individualized approaches are not yet satisfactorily addressed. Conclusion: In order to provide a fair and effective approach to LT in HCC, the employed allocation rules require continuous development and scientific evaluation. Recently, the allocation rules for standard exception priority according to the German Transplant Act have been revised to improve patient selection for LT in HCC.

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Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

Cited by 78 publications

References 109 publications

Use of gadobenate dimeglumine dynamic MRI for detection of early hepatocellular carcinoma in atypical hepatic focal lesions

Use of gadobenate dimeglumine dynamic MRI for detection of early hepatocellular carcinoma in atypical hepatic focal lesions

Effectiveness of on-site education for quality assurance of screening ultrasonography for hepatocellular carcinoma

HCC-Associated Liver Transplantation - Where Are the Limits and What Are the New Regulations?

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