TY - JOUR
T1 - Hepatocellular carcinoma Liver Imaging Reporting and Data Systems treatment response assessment
T2 - Lessons learned and future directions
AU - Aslam, Anum
AU - Gian Do, Richard Kinh
AU - Kambadakone, Avinash
AU - Spieler, Bradley
AU - Miller, Frank H.
AU - Gabr, Ahmed M.
AU - Charalel, Resmi A.
AU - Kirr, Charles Y.
AU - Madoff, David C.
AU - Mendiratta-Lala, Mishal
N1 - Funding Information:
Mendiratta-Lala M is funded from National Institute of Health (NIH) PO1 CA59827. Kim CY serves as a consultant for Medical advisory board Boston Scientific, Genentech;
Publisher Copyright:
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
PY - 2020/10/27
Y1 - 2020/10/27
N2 - Hepatocellular carcinoma (HCC) is a leading cause of morbidity and mortality worldwide, with rising clinical and economic burden as incidence increases. There are a multitude of evolving treatment options, including locoregional therapies which can be used alone, in combination with each other, or in combination with systemic therapy. These treatment options have shown to be effective in achieving remission, controlling tumor progression, improving disease free and overall survival in patients who cannot undergo resection and providing a bridge to transplant by debulking tumor burden to downstage patients. Following locoregional therapy (LRT), it is crucial to provide treatment response assessment to guide management and liver transplant candidacy. Therefore, Liver Imaging Reporting and Data Systems (LI-RADS) Treatment Response Algorithm (TRA) was created to provide a standardized assessment of HCC following LRT. LI-RADS TRA provides a step by step approach to evaluate each lesion independently for accurate tumor assessment. In this review, we provide an overview of different locoregional therapies for HCC, describe the expected post treatment imaging appearance following treatment, and review the LI-RADS TRA with guidance for its application in clinical practice. Unique to other publications, we will also review emerging literature supporting the use of LI-RADS for assessment of HCC treatment response after LRT.
AB - Hepatocellular carcinoma (HCC) is a leading cause of morbidity and mortality worldwide, with rising clinical and economic burden as incidence increases. There are a multitude of evolving treatment options, including locoregional therapies which can be used alone, in combination with each other, or in combination with systemic therapy. These treatment options have shown to be effective in achieving remission, controlling tumor progression, improving disease free and overall survival in patients who cannot undergo resection and providing a bridge to transplant by debulking tumor burden to downstage patients. Following locoregional therapy (LRT), it is crucial to provide treatment response assessment to guide management and liver transplant candidacy. Therefore, Liver Imaging Reporting and Data Systems (LI-RADS) Treatment Response Algorithm (TRA) was created to provide a standardized assessment of HCC following LRT. LI-RADS TRA provides a step by step approach to evaluate each lesion independently for accurate tumor assessment. In this review, we provide an overview of different locoregional therapies for HCC, describe the expected post treatment imaging appearance following treatment, and review the LI-RADS TRA with guidance for its application in clinical practice. Unique to other publications, we will also review emerging literature supporting the use of LI-RADS for assessment of HCC treatment response after LRT.
KW - Arterial phase hyper enhancement
KW - Hepatocellular cercinoma
KW - Liver Imaging Reporting and Data Systems
KW - Liver Imaging Reporting and Data Systems Treatment Response equivocal
KW - Locoregional therapy
KW - Stereotactic body radiotherapy
KW - Treatment Response Algorithm
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U2 - 10.4254/wjh.vl2.il0.738
DO - 10.4254/wjh.vl2.il0.738
M3 - Article
AN - SCOPUS:85096116264
SN - 1948-5182
VL - 12
SP - 738
EP - 753
JO - World Journal of Hepatology
JF - World Journal of Hepatology
IS - 10
ER -