Non-invasive diagnosis and follow-up of primary malignant liver tumours - 12/01/22
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Highlights |
• | Based on typical radiological patterns in patients with chronic liver disease, typical contrast-enhanced imaging enable non-invasive diagnosis of HCC. |
• | These features also allow staging and prognostication of this tumour. |
• | Non-invasive monitoring of patients following the implementation of curative or palliative procedures are also endorsed by clinical guidelines |
• | This field of practice is in constant evolution and closely follows advances in radiology and biology to guide physicians in routine management. |
Summary |
Among a wide range of malignant liver tumours, hepatocellular carcinoma (HCC) developed on a background of cirrhosis represents the most frequent clinical situation. In this setting, HCC is one of the rare solid tumours for which histological confirmation is not mandatory. The convergence of multiple arguments obtained by non-invasive parameters using radiological findings allows to avoid liver biopsy in a large proportion of patients when a diagnosis of underlying cirrhosis is ascertained. Conversely, in case of atypical presentation or in order to exclude other rare malignant tumours mostly developed in the absence of cirrhosis, liver biopsy will then be essential. Based on typical radiological patterns described by contrast-enhanced imaging, numerous clinical guidelines have endorsed non-invasive diagnosis, staging and monitoring of HCC patients under treatment since 20 years. These algorithms have evolved over the years, taking into account progress in radiological technology and advances in curative or palliative procedures. Large cohort studies have also helped to refine diagnostic criteria and prognostication in the setting of complex therapeutic strategy. Unsupervised multi-analysis approaches both at the biological and radiological levels will in the future enrich the panel of non-invasive markers useful in clinical practice to manage HCC and other malignant tumours.
Le texte complet de cet article est disponible en PDF.Keywords : Hepatocellular carcinoma, Cirrhosis, Imaging, Non-invasive, Screening
Abbreviations : HCC, MRI, CT, EC, HS, US, AFP, BCLC
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Vol 46 - N° 1
Article 101766- janvier 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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