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

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    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.
    Issue Date
    2013-10
    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
    
    Metadata
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    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
    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
    ISSN
    1527-1323
    ae974a485f413a2113503eed53cd6c53
    10.1148/rg.336125104
    Scopus Count
    Collections
    St. Vincent's University Hospital

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