Hepatocellular carcinoma imaging systems: why they exist, how they have evolved, and how they differ

Area of Science:

• Radiology
• Hepatology
• Oncology

Background:

• Standardized imaging systems are crucial for hepatocellular carcinoma (HCC) management.
• Existing systems aim to improve surveillance, diagnosis, staging, treatment, and response monitoring.
• Current systems vary in target population, algorithms, modalities, and reporting.

Purpose of the Study:

• To review the historical evolution of imaging systems for HCC.
• To compare and contrast key features of different HCC imaging systems.
• To highlight the benefits of unifying these disparate systems.

Main Methods:

• Literature review of proposed HCC imaging systems over the past 16 years.
• Analysis of system features including algorithms, modalities, terminology, and response assessment.
• Discussion of the potential advantages of system unification.

Main Results:

• Multiple HCC imaging systems have been developed, each with distinct characteristics.
• Key differentiating features include target population, screening protocols, imaging modalities, and terminology.
• Significant variations exist in how treatment response is assessed across systems.

Conclusions:

• Unifying HCC imaging systems can standardize practice and improve consistency.
• A unified system would facilitate data sharing, multi-center research, and knowledge dissemination.
• Standardization is essential for advancing the diagnosis and management of hepatocellular carcinoma.