Hepatocellular carcinoma: illustrated guide to systematic radiologic diagnosis and staging according to guidelines of the American Association for the Study of Liver Diseases.

Hdl Handle:
http://hdl.handle.net/10147/323637
Title:
Hepatocellular carcinoma: illustrated guide to systematic radiologic diagnosis and staging according to guidelines of the American Association for the Study of Liver Diseases.
Authors:
McEvoy, Sinead H; McCarthy, Colin J; Lavelle, Lisa P; Moran, Deirdre E; Cantwell, Colin P; Skehan, Stephen J; Gibney, Robert G; Malone, Dermot E
Affiliation:
Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Citation:
McEvoy SH et al. Hepatocellular carcinoma: illustrated guide to systematic radiologic diagnosis and staging according to guidelines of the American Association for the Study of Liver Diseases. Radiographics 2013, 33 (6):1653-68
Journal:
Radiographics : a review publication of the Radiological Society of North America, Inc
Issue Date:
Oct-2013
URI:
http://hdl.handle.net/10147/323637
DOI:
10.1148/rg.336125104
PubMed ID:
24108556
Abstract:
Hepatocellular carcinoma is a malignancy that predominantly occurs in the setting of cirrhosis. Its incidence is rising worldwide. Hepatocellular carcinoma differs from most malignancies because it is commonly diagnosed on the basis of imaging features alone, without histologic confirmation. The guidelines from the American Association for the Study of Liver Diseases (AASLD) are a leading statement for the diagnosis and staging of hepatocellular carcinoma, and they have recently been updated, incorporating several important changes. AASLD advocates the use of the Barcelona Clinic Liver Cancer (BCLC) staging system, which combines validated imaging and clinical predictors of survival to determine stage and which links staging with treatment options. Each stage of the BCLC system is outlined clearly, with emphasis on case examples. Focal liver lesions identified at ultrasonographic surveillance in patients with cirrhosis require further investigation. Lesions larger than 1 cm should be assessed with multiphasic computed tomography or magnetic resonance imaging. Use of proper equipment and protocols is essential. Lesions larger than 1 cm can be diagnosed as hepatocellular carcinoma from a single study if the characteristic dynamic perfusion pattern of arterial hyperenhancement and venous or delayed phase washout is demonstrated. If the imaging characteristics of hepatocellular carcinoma are not met, the alternate modality should be performed. Biopsy should be used if neither modality is diagnostic of hepatocellular carcinoma. Once the diagnosis has been made, the cancer should be assigned a BCLC stage, which will help determine suitable treatment options. Radiologists require a systematic approach to diagnose and stage hepatocellular carcinoma with appropriate accuracy and precision.
Item Type:
Article
Language:
en
Keywords:
LIVER CANCER
Local subject classification:
CIRRHOSIS; RADIOLOGY
MeSH:
Algorithms; Carcinoma, Hepatocellular; Contrast Media; Diagnostic Imaging; Humans; Liver Cirrhosis; Liver Neoplasms; Neoplasm Staging; United States
ISSN:
1527-1323

Full metadata record

DC FieldValue Language
dc.contributor.authorMcEvoy, Sinead Hen_GB
dc.contributor.authorMcCarthy, Colin Jen_GB
dc.contributor.authorLavelle, Lisa Pen_GB
dc.contributor.authorMoran, Deirdre Een_GB
dc.contributor.authorCantwell, Colin Pen_GB
dc.contributor.authorSkehan, Stephen Jen_GB
dc.contributor.authorGibney, Robert Gen_GB
dc.contributor.authorMalone, Dermot Een_GB
dc.date.accessioned2014-07-23T08:45:17Z-
dc.date.available2014-07-23T08:45:17Z-
dc.date.issued2013-10-
dc.identifier.citationMcEvoy SH et al. Hepatocellular carcinoma: illustrated guide to systematic radiologic diagnosis and staging according to guidelines of the American Association for the Study of Liver Diseases. Radiographics 2013, 33 (6):1653-68en_GB
dc.identifier.issn1527-1323-
dc.identifier.pmid24108556-
dc.identifier.doi10.1148/rg.336125104-
dc.identifier.urihttp://hdl.handle.net/10147/323637-
dc.description.abstractHepatocellular carcinoma is a malignancy that predominantly occurs in the setting of cirrhosis. Its incidence is rising worldwide. Hepatocellular carcinoma differs from most malignancies because it is commonly diagnosed on the basis of imaging features alone, without histologic confirmation. The guidelines from the American Association for the Study of Liver Diseases (AASLD) are a leading statement for the diagnosis and staging of hepatocellular carcinoma, and they have recently been updated, incorporating several important changes. AASLD advocates the use of the Barcelona Clinic Liver Cancer (BCLC) staging system, which combines validated imaging and clinical predictors of survival to determine stage and which links staging with treatment options. Each stage of the BCLC system is outlined clearly, with emphasis on case examples. Focal liver lesions identified at ultrasonographic surveillance in patients with cirrhosis require further investigation. Lesions larger than 1 cm should be assessed with multiphasic computed tomography or magnetic resonance imaging. Use of proper equipment and protocols is essential. Lesions larger than 1 cm can be diagnosed as hepatocellular carcinoma from a single study if the characteristic dynamic perfusion pattern of arterial hyperenhancement and venous or delayed phase washout is demonstrated. If the imaging characteristics of hepatocellular carcinoma are not met, the alternate modality should be performed. Biopsy should be used if neither modality is diagnostic of hepatocellular carcinoma. Once the diagnosis has been made, the cancer should be assigned a BCLC stage, which will help determine suitable treatment options. Radiologists require a systematic approach to diagnose and stage hepatocellular carcinoma with appropriate accuracy and precision.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to Radiographics : a review publication of the Radiological Society of North America, Incen_GB
dc.subjectLIVER CANCERen_GB
dc.subject.meshAlgorithms-
dc.subject.meshCarcinoma, Hepatocellular-
dc.subject.meshContrast Media-
dc.subject.meshDiagnostic Imaging-
dc.subject.meshHumans-
dc.subject.meshLiver Cirrhosis-
dc.subject.meshLiver Neoplasms-
dc.subject.meshNeoplasm Staging-
dc.subject.meshUnited States-
dc.subject.otherCIRRHOSISen_GB
dc.subject.otherRADIOLOGYen_GB
dc.titleHepatocellular carcinoma: illustrated guide to systematic radiologic diagnosis and staging according to guidelines of the American Association for the Study of Liver Diseases.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.en_GB
dc.identifier.journalRadiographics : a review publication of the Radiological Society of North America, Incen_GB
dc.description.fundingOtheren
dc.description.provinceLeinsteren
dc.description.peer-reviewpeer-reviewen

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