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Imaging of hepatocellular carcinoma: a pilot international survey

  • Hepatobiliary
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To perform an international survey on current practices in imaging-based surveillance, diagnosis, staging, and assessment of treatment response for HCC.

Materials and methods

Three themes were covered in this international survey: demographics of respondents and liver imaging expertise; imaging practices for screening, surveillance, diagnosis, staging, and assessment of treatment response for HCC; and diagnostic imaging systems used. Descriptive summaries were created.

Results

Of 151 respondents, 22.5% were from Asia, 6.0% from Europe, 19.9% from North America, 26.5% from South America, and 25.2% from Australasia; 57.0% respondents worked in academic and 34.4% in private or mixed settings. Non-contrast ultrasound was most commonly used for screening and surveillance of HCC (90.7%), and multiphase computed tomography was used for diagnosis (96.0%). Extracellular contrast agents (69.5%) were the most commonly used MRI contrast agents and Lumason/SonoVue (31.1%) is the most commonly used contrast-enhanced ultrasound contrast agent. A majority (94.0%) of respondents use ancillary imaging features for assessment of liver lesions in at-risk patients. Usage of diagnostic imaging systems for HCC varied by region. RECIST or mRECIST criteria were most commonly used for assessing HCC treatment response (48.3%). Most respondents agreed that a standardized classification for the diagnosis of HCC is needed (68.9%) and that an atlas and lexicon would help improve inter-reader agreement (71.5%).

Conclusion

Practices and recommendations for imaging of HCC vary between geographical regions. Future efforts to develop a unified system should address regional differences and potential barriers for adoption of a standardized diagnostic system for HCC.

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Data availability

The data displayed in this manuscript are available by request to the corresponding author.

Abbreviations

AASLD:

American Association for the Study of Liver Diseases

BCLC:

Barcelona Clinic Liver Cancer

CEUS:

Contrast-enhanced ultrasound

EASL:

European Association for the Study of the Liver

EORTC:

European Organization for Research and Treatment of Cancer

HCC:

Hepatocellular carcinoma

LI-RADS:

Liver Imaging Reporting And Data System

mRECIST:

Modified Response Evaluation Criteria in Solid Tumors

MRI:

Magnetic Resonance Imaging

OPTN:

Organ Procurement and Transplantation Network

RECIST:

Response Evaluation Criteria in Solid Tumors

SAR:

Society of Abdominal Radiology

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Acknowledgements

The authors acknowledge Lauren Hicks from the American College of Radiology for her assistance in the distribution of the survey.

Funding

An Tang was supported by a Chercheur-Boursier Junior 2 from the Fonds de Recherche du Québec en Santé and Fondation de l'association des radiologistes du Québec (FRQS-ARQ #34939).

Author information

Authors and Affiliations

  1. Department of Radiology, Radio-Oncology and Nuclear Medicine, Centre Hospitalier de L’Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, Québec, H2X 3J4, Canada

    An Tang & Karma Abukasm

  2. Centre de Recherche du Centre Hospitalier de L’Université de Montréal (CRCHUM), Montréal, Québec, Canada

    An Tang

  3. Clínica de Diagnóstico Por Imagem (CDPI) - DASA, Rio de Janeiro, Brazil

    Guilherme Moura Cunha

  4. Department of Radiology, Liver Imaging Group, University of California San Diego, San Diego, CA, USA

    Guilherme Moura Cunha & Claude B. Sirlin

  5. Department of Radiology, West China Hospital, Sichuan University, Chengdu, China

    Bin Song

  6. The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

    Jin Wang

  7. Department of Radiology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Universités, Paris, France

    Mathilde Wagner

  8. Caritas-Krankenhaus, Medizinische Klinik 2, Bad Mergentheim, Germany

    Christoph F. Dietrich

  9. Dipartimento Di Biomedicina, Neuroscienze E Diagnostica Avanzata (BIND), University Hospital of Palermo, Palermo, Italy

    Giuseppe Brancatelli

  10. Department of Diagnostic Radiology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

    Kazuhiko Ueda

  11. Yonsei University College of Medicine, Seoul, Korea

    Jin-Young Choi

  12. Fundacion Santa Fe de Bogota, Bogota, Colombia

    Diego Aguirre

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  1. An Tang
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  12. Claude B. Sirlin
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Corresponding author

Correspondence to An Tang.

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Conflicts of interest

The following co-authors are members of the LI-RADS Steering Commitee: An Tang, Guilherme Moura Cunha, and Claude B. Sirlin. All other co-authors are members of the LI-RADS International Working Group.

Ethics approval

The institutional review board at the University of Montreal and CRCHUM granted an exemption for this electronic survey.

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Tang, A., Abukasm, K., Moura Cunha, G. et al. Imaging of hepatocellular carcinoma: a pilot international survey. Abdom Radiol 46, 205–215 (2021). https://doi.org/10.1007/s00261-020-02598-0

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