Hepatocellular carcinoma Liver Imaging Reporting and Data Systems treatment response assessment: Lessons learned and future directions

• 作者: Ahmed M Gabr Anum Aslam Avinash Kambadakone Bradley Spieler Charles Y Kim David C Madoff Frank H Miller Mishal Mendiratta-Lala Resmi A Charalel Richard Kinh Gian Do
• 来源期刊: 世界肝病学杂志:英文版(电子版)
• 学科: 医学
• 关键词: Hepatocellular carcinoma Liver Imaging Reporting and Data Systems Treatment Response Algorithm Locoregional therapy Liver Imaging Reporting and Data Systems Treatment Response equivocal Arterial phase hyper enhancement Stereotactic body radiotherapy
• 年，卷（期）: 2020,（10）
• 页码范围: 738-753
• 页数: 16页
• 分类号: R73

摘要

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.LIRADS 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.