Changes of guidelines diagnosing hepatocellular carcinoma during the last ten-year period

Abstract

Hepatocellular carcinoma (HCC) is the third most common cause of cancer deaths in the world. There have been many advances in the diagnosis of HCC during the last ten years, especially in the imaging techniques. The Korean Liver cancer study group (KLCSG), European Association for the Study of the Liver (EASL), American Association for the Study of Liver disease (AASLD), and Asian-Pacific Association for the Study of Liver (APASL) have made and changed the HCC guidelines with the advances in the imaging techniques and according to the results of the researches on HCC. We reviewed the changes of the imaging guidelines in HCC diagnosis according to the advances in the imaging techniques. Further studies will be necessary to resolve the controversies in the diagnosis of HCC smaller than 1 cm in size.

Keywords: Diagnosis; Guideline; Hepatocellular carcinoma.

Figure 1

Surveillance and diagnostic algorithm for liver nodule of European Association for the Study of the Liver (EASL) guideline on clinical management of hepatocellular carcinoma in 2000 (Adopated from Bruix J et al3).

Figure 2

Diagnostic algorithm for liver nodule of Korean Liver Cancer Study Group (KLCSG) guideline in 2003.

Figure 3

Diagnostic algorithm for hepatocellular carcinoma of American Association for the Study of Liver Diseases (AASLD) practice guidelines on the management of HCC in 2005 (Adopted from Bruix J et al11).

Figure 4

Diagnostic algorithm for liver nodule of Korean Liver Cancer Study Group (KLCSG) practice guidelines for the management of HCC in 2009.

Figure 5

Diagnostic algorithm for suspected hepatocellular carcinoma (HCC) of American Association for the Study of Liver Diseases (AASLD) practice guideline on the management of HCC in 2010 (Adopted Bruix J et al16).

Figure 6

Diagnostic algorithm for hepatocellular carcinoma (HCC) of Asian Pacific Association for the Study of the Liver (APASL) consensus recommendations on HCC (Adopted from Omata M et al17).

Figure 7

Diagnostic algorithm and recall policy of European Association for the Study of the Liver (EASL) guideline in 2012. ^*One imaging technique only recommended in centers of excellence with high-end radiological equipment. ^†Hepatocellular carcinoma (HCC) radiological hallmark: Arterial hypervascularity and venous/late phase washout (Adopted from European Association for the Study of the Liver18).