Emerging Role of Hepatobiliary Magnetic Resonance Contrast Media and Contrast-Enhanced Ultrasound for Noninvasive Diagnosis of Hepatocellular Carcinoma: Emphasis on Recent Updates in Major Guidelines.

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Clinical Guidelines
Authored By
Kim TH, Yoon JH, Lee JM
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Gastroenterology
Oncology
Radiology
Speciality
Gastroenterology
Radiology
Oncology
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volume
20
ISSN
2005-8330
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ISSN
2005-8330
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["Kim TH, Yoon JH, Lee JM","Publisher: Korean Society of Radiology Country of Publication: Korea (South) NLM ID: 100956096 Publication Model: Print Cited Medium: Internet ISSN: 2005-8330 (Electronic) Linking ISSN: 12296929 NLM ISO Abbreviation: Korean J Radiol Subsets: MEDLINE","Journal Article; Review","2019-06-01","Korean journal of radiology [Korean J Radiol] 2019 Jun; Vol. 20 (6), pp. 863-879.","English","2005-8330","Carcinoma, Hepatocellular\/*diagnosis , Carcinoma, Hepatocellular\/*diagnostic imaging , Liver Neoplasms\/*diagnosis , Liver Neoplasms\/*diagnostic imaging , Magnetic Resonance Imaging\/*methods , Ultrasonography\/*methods, Carcinoma, Hepatocellular\/pathology ; Liver Neoplasms\/pathology ; Magnetic Resonance Spectroscopy\/methods ; Tomography, X-Ray Computed\/methods ; Aged ; Contrast Media ; Female ; Guidelines as Topic ; Humans ; Male ; Middle Aged ; Republic of Korea","Carcinoma, Hepatocellular pathology, Liver Neoplasms pathology, Magnetic Resonance Spectroscopy methods, Tomography, X-Ray Computed methods, Aged, Contrast Media, Female, Guidelines as Topic, Humans, Male, Middle Aged, Republic of Korea, Carcinoma, Hepatocellular diagnosis, Carcinoma, Hepatocellular diagnostic imaging, Liver Neoplasms diagnosis, Liver Neoplasms diagnostic imaging, Magnetic Resonance Imaging methods, Ultrasonography methods","Korean journal of radiology","20"]
Description
Hepatocellular carcinoma (HCC) can be noninvasively diagnosed on the basis of its characteristic imaging findings of arterial phase enhancement and portal/delayed "washout" on computed tomography (CT) and magnetic resonance imaging (MRI) in cirrhotic patients. However, different specific diagnostic criteria have been proposed by several countries and major academic societies. In 2018, major guideline updates were proposed by the Association for the Study of Liver Diseases, European Association for the Study of the Liver (EASL), Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) of Korea. In addition to dynamic CT and MRI using extracellular contrast media, these new guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as the first-line diagnostic test, while the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound (CEUS) as the second-line diagnostic test. Therefore, hepatobiliary MR contrast media and CEUS will be increasingly used for the noninvasive diagnosis and staging of HCC. In this review, we discuss the emerging role of hepatobiliary phase MRI and CEUS for the diagnosis of HCC and also review the changes in the HCC diagnostic criteria in major guidelines, including the KLCA-NCC practice guidelines version 2018. In addition, we aimed to pay particular attention to some remaining issues in the noninvasive diagnosis of HCC.<br /> (Copyright © 2019 The Korean Society of Radiology.)
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