Value of HCC surveillance in a landscape of emerging surveillance options: Perspectives of a multi-stakeholder modified Delphi panel.

HCC surveillance is recommended by liver professional societies but lacks broad acceptance by several primary care and cancer societies due to limitations in the existing data. We convened a diverse multidisciplinary group of cancer screening experts to evaluate current and future paradigms of HCC prevention and early detection using a rigorous Delphi panel approach. The experts had high agreement on 21 statements about primary prevention, HCC surveillance benefits, HCC surveillance harms, and the evaluation of emerging surveillance modalities.

Prognostic and predictive imaging markers of hepatocellular carcinoma: a pictorial essay.

Hepatocellular carcinoma (HCC) encompasses a wide array of histopathologic and genetic features that can be broadly categorized as proliferative or non-proliferative HCC to reflect tumor aggressiveness. However, accurately characterizing tumor behavior remains challenging due to the biologic heterogeneity of HCC and limited access to tissue samples. Currently, imaging is used for the diagnosis of HCC using the Liver Imaging Reporting and Data System (LI-RADS) without histologic confirmation in most cases.

CT and MRI features of Catenin Beta 1-mutated hepatocellular carcinoma in a Western cohort.

Objectives: Various mutations in hepatocellular carcinoma (HCC) carry prognostic implications. The objective of this study is to assess CT and MRI imaging features associated with Catenin Beta-1 (CTNNB1) mutation in HCC.

Methods: This retrospective, IRB- approved multi-reader, single-center study included treatment-naive, pathologic-proven HCC that underwent contrast-enhanced CT, MRI or both, with subsequent targeted tumor sequencing test.

Predictors of hepatocellular carcinoma in LR-M category lesions, a multi-institutional analysis.

Purpose: The Liver Imaging Reporting and Data System (LI-RADS, LR) provides a framework for diagnosing hepatocellular carcinoma (HCC, LR-5). However, not all HCCs meet LR-5 criteria and are instead categorized as LR-M, probably or definitely malignant but not specific for HCC, necessitating biopsy for diagnosis. The purpose is to identify factors associated with HCC in LR-M observations.

US Liver Imaging Reporting and Data System Version 2017: A Systematic Review and Meta-Analysis.

Background The US Liver Imaging Reporting and Data System (LI-RADS) includes an assessment category (US-1, negative; US-2, subthreshold; and US-3, positive) and a visualization score reflecting image quality (VIS-A, no or minimal limitations; VIS-B, moderate limitations; and VIS-C, severe limitations). The US-3 and VIS-C impact patient treatment. Purpose To establish the distributions of categories and visualization scores, estimate the proportions of hepatocellular carcinoma (HCC) and overall malignancy in the US-3 category, and identify variables associated with the VIS-C score by conducting a meta-analysis.

Do Risk Factors for HCC Impact the Association of CT/MRI LIRADS Major Features With HCC? An Individual Participant Data Meta-Analysis.

Guidelines suggest the Liver Imaging Reporting and Data System (LI-RADS) may not be applicable for some populations at risk for hepatocellular carcinoma (HCC). However, data assessing the association of HCC risk factors with LI-RADS major features are lacking. To evaluate whether the association between HCC risk factors and each CT/MRI LI-RADS major feature differs among individuals at-risk for HCC.

LI-RADS in 2024: recent updates, planned refinements, and future directions.

Initially released in 2011, liver imaging reporting and data (LI-RADS) CT/MRI diagnostic algorithm categorizes hepatic observations on an ordinal scale based on the probability of hepatocellular carcinoma, malignancy, or benignity, and guides reproducible interpretation, clear communication, and standardized terminology for liver imaging. LI-RADS has significantly expanded in scope in the past decade, with the inclusion of algorithms that address screening and surveillance, diagnosis with contrast enhanced ultrasound (CEUS), and treatment response assessment with both CEUS and CT/MRI. LI-RADS algorithms undergo periodic refinements based on accumulating scientific evidence, user feedback, and technological advancements.

Performing liver imaging at a high level: quality and adequacy in LI-RADS.

Imaging is critical to HCC management, including surveillance, diagnosis, staging, and treatment response assessment, which requires it be performed consistently at a high level. The Liver Imaging Reporting and Data System (LI-RADS) was developed to standardize the acquisition, interpretation, and reporting of liver imaging, but until now, has not addressed the essential component of exam quality and adequacy. In this manuscript, we discuss the concepts of quality and adequacy and their clinical significance in the setting of HCC diagnostic imaging and treatment response assessment.

LI-RADS: Current Status and Future Directions.

The Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system that uses standardized terminology, technique, interpretation, and reporting of imaging studies for hepatocellular carcinoma surveillance, diagnosis, and locoregional treatment response assessment. Since its initial release in 2011, LI-RADS has evolved and expanded in scope. In this article, we discuss recent updates intended to address clinical needs and mitigate current challenges.

CT/MRI LI-RADS 2024 Update: Treatment Response Assessment.

With the rising incidence of hepatocellular carcinoma, there has been increasing use of local-regional therapy (LRT) to downstage or bridge to transplant, for definitive treatment, and for palliation. The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) Treatment Response Assessment (TRA) algorithm provides guidance for step-by-step tumor assessment after LRT and standardized reporting. Current evidence suggests that the algorithm performs well in the assessment of tumor response to arterial embolic and loco-ablative therapies and fair when assessing response to radiation-based therapies, with limited data to validate the latter.

MASLD: What We Have Learned and Where We Need to Go-A Call to Action.

Since its introduction in 1980, fatty liver disease (now termed [MASLD]) has grown in prevalence significantly, paralleling the rise of obesity worldwide. While MASLD has been the subject of extensive research leading to significant progress in the understanding of its pathophysiology and progression factors, several gaps in knowledge remain. In this pictorial review, the authors present the latest insights into MASLD, covering its recent nomenclature change, spectrum of disease, epidemiology, morbidity, and mortality.

Biomechanical Assessment of Liver Integrity: Prospective Evaluation of Mechanical Versus Acoustic MR Elastography.

Background: Magnetic resonance elastography (MRE) can quantify tissue biomechanics noninvasively, including pathological hepatic states like metabolic dysfunction-associated steatohepatitis.

Purpose: To compare the performance of 2D/3D-MRE using the gravitational (GT) transducer concept with the current commercial acoustic (AC) solution utilizing a 2D-MRE approach. Additionally, quality index markers (QIs) were proposed to identify image pixels with sufficient quality for reliably estimating tissue biomechanics.

Utility of pelvic CT in patients undergoing surveillance for hepatocellular carcinoma: A retrospective multi-institutional study.

Objective: To determine the frequency, characteristics and clinical significance of incidental pelvic findings reported on abdominopelvic CT performed for hepatocellular carcinoma (HCC) surveillance in at-risk patients.

Material And Methods: This two-center retrospective study received institutional review board approval with a waiver of informed consent. The radiologic reports of the CT exams performed 1/1/2010-2/28/2023 for HCC surveillance were reviewed.

Performance of LI-RADS category 5 vs combined categories 4 and 5: a systemic review and meta-analysis.

Objective: Computed tomography (CT)/magnetic resonance imaging (MRI) Liver Imaging Reporting and Data System (LI-RADS, LR) category 5 has high specificity and modest sensitivity for diagnosis of hepatocellular carcinoma (HCC). The purpose of this study was to compare the diagnostic performance of LR-5 vs combined LR-4 and LR-5 (LR-4/5) for HCC diagnosis.

Methods: MEDLINE and EMBASE databases through January 03, 2023 were searched for studies reporting the performance of LR-5 and combined LR-4/5 for HCC diagnosis, using CT/MRI LI-RADS version 2014, 2017, or 2018.

MRI imaging features for predicting macrotrabecular-massive subtype hepatocellular carcinoma: a systematic review and meta-analysis.

Purpose: To identify significant MRI features associated with macrotrabecular-massive hepatocellular carcinoma (MTM-HCC), and to assess the distribution of Liver Imaging Radiology and Data System (LI-RADS, LR) category assignments.

Methods: PubMed and EMBASE were searched up to March 28, 2023. Random-effects model was constructed to calculate pooled diagnostic odds ratios (DORs) and 95% confidence intervals (CIs) for each MRI feature for differentiating MTM-HCC from NMTM-HCC.