Utility of endoscopic ultrasound and endoscopy in diagnosis and management of hepatocellular carcinoma and its complications: What does endoscopic ultrasonography offer above and beyond conventional cross-sectional imaging?

Abstract

Hepatocellular carcinoma constitutes over 90% of the primary liver tumors, the rest being cholangiocarcinoma. It has an insidious presentation, which is responsible for the delayed presentation. Hence, the management strategy relies on screening to diagnose it an early stage for curative resection and/or treatment with local ablative techniques or chemotherapy. However, even with different screening programs, more than 60% of tumors are still detected at an advanced stage, leading to an unchanged mortality rate, thereby implying a room for improvement in the screening and diagnostic process. In the last few years, there has been evolution of utility of endoscopy, specifically endoscopic ultrasonography along with Fine needle aspiration, for this purpose, which we comprehensively review in this article.

Evaluation of the response of breast cancer patients to neoadjuvant chemotherapy by combined contrast‑enhanced ultrasonography and ultrasound elastography

“…After NAC, the regression of tumor cells mainly manifests as necrosis and fibrosis of the lesions (32,33). Conventional ultrasound cannot accurately distinguish between necrosis, fibrous hyperplasia and residual cancer (34).…”

Novel serum microRNAs panel on the diagnostic and prognostic implications of hepatocellular carcinoma

“…Thus, liver cancer remains one of the worst malignant tumors[ 3 ]. Despite this, early detection, early diagnosis, and early surgical treatment are still the keys to improved clinical outcomes in liver cancer treatment[ 4 ]. In recent years, with the advancement of diagnosis and treatment techniques for liver cancer, many patients have been diagnosed with liver cancer at early stages, and the detected tumors have been surgically removed, yielding a timely and effective treatment.…”

Imaging Negative Hepatic Lesions: A Rare Case of Infiltrative Hepatocellular Carcinoma Diagnosed With Endoscopic Ultrasound

“…Having a spike in AFP of >20,000 with consistently negative imaging prompted us to probe further with EUS. EUS is superior to CT in detecting small hepatic lesions, with a sensitivity of 100% compared with 71% of CT. 14 Several studies have postulated the benefit of EUS with FNA in detecting HCC. A retrospective study by Awad et al 15 on preoperative evaluation of hepatic lesions using EUS showed that in all 14 patients who underwent EUS and CT, EUS detected additional hepatic lesions in 28% of the patients.…”