ACR appropriateness criteria radiologic management of hepatic malignancy

Brian E. Kouri*, Brian S. Funaki, Charles E. Ray, Ghassan K. Abou-Alfa, Charles T. Burke, Michael D. Darcy, Nicholas Fidelman, Frederick L. Greene, Stephen A. Harrison, Thomas B. Kinney, Jon K. Kostelic, Jonathan M. Lorenz, Ajit V. Nair, Albert A. Nemcek, Charles A. Owens, Wael E.A. Saad, George Vatakencherry

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Management of hepatic malignancy is a challenging clinical problem involving several different medical and surgical disciplines. Because of the wide variety of potential therapies, treatment protocols for various malignancies continue to evolve. Consequently, development of appropriate therapeutic algorithms necessitates consideration of medical options, such as systemic chemotherapy; surgical options, such as resection or transplantation; and locoregional therapies, such as thermal ablation and transarterial embolization. The authors discuss treatment strategies for the 3 most common subtypes of hepatic malignancy treated with locoregional therapies: hepatocellular carcinoma, neuroendocrine metastases, and colorectal metastases. The ACR Appropriateness Criteria ® are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)919-925
Number of pages7
JournalJACR Journal of the American College of Radiology
Issue number12
StatePublished - Dec 2012


  • Appropriateness criteria
  • ablation
  • chemoembolization
  • hepatocellular carcinoma
  • liver metastases
  • radioembolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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