Learning objectives
To analyze the evolution in the diagnosis of Hepatocellular Carcinoma (HCC) in the last five years in our center with the introduction of Liver Imaging Reporting And Data System (LI-RADS).
To review the evolution in the treatment in the last five years.
Background
The previous guidelines of the EASL-European Organization for Research and Treatment of Cancer (EORTC) required two imaging techniques for the diagnosis of HCC for lesions between 10-20mm.
Since 2012,
the EASL-EORTC has proposed a single conclusive image for the HCC diasgnosis in centers with high-end diagnostic equipment.
In cirrhotic patients,
dynamic contrast-enhanced MRI or multiphasic CT with extracellular contrast allows definitive diagnosis of HCC which indicates active treatment without the need of biopsy.
The Liver Imaging Reporting And Data System (LI-RADS) of the American College...
Findings and procedure details
EPIDEMIOLOGY
In our center,
during January 2014-December 2018,
237 patients (50 women; 187 men; average age of 79 years) were diagnosticated for HCC and registered in tumors registry of the Region of Madrid.
An average of 40 HCC is diagnosed per year.
In these five years 30% have died and 59% remain alive.
DIAGNOSIS
In cirrhotic patients,
the diagnosis was based on imaging criteria.
Multiphasic CT or MR with extracellular contrast (late arterial phase,
portal venous phase,
and delayed phase) was used.
HCC in a...
Conclusion
The use LI-RADS allows definitive diagnosis of HCC without biopsy.
The number of biopsies could have decreased by the use of LI-RADS in our center.
Tendency to decrease the surgical treatment and increase therapies such as RF,
SBRT,
TACE,
TARE.
Personal information
Ana Belen Alcolado Jaramillo.
Department of Radiology,
University Hospital Puerta de Hierro Majadahonda/ES.
[email protected]
References
-Clinical Practice Guidelines.
EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. European Association for the Study of the Liver
-CT/MRI LI-RADS® v2018 American College of Radology
-Hepatocellular carcinoma.
Lancet.
2018.
Mar 31; 391(10127):1301-1314. Forner A,
Reig M,
Bruix J.
-Hepatic resection vs.
radiofrequency ablation for very early stage hepatocellular carcinoma: a Markov model analysis.
Cho YK,
Kim JK,
Kim WT,
Chung JW.
Hepatology 2010; 51:1284–1290.
-Cost-effectiveness of hepatic resection vs.
percutaneous radiofre- quency ablation for early hepatocellular carcinoma.
Cucchetti A,
Piscaglia F,
Cescon M,
Colecchia...
