Microvascular Invasion in HCC: The Molecular Imaging Perspective

Area of Science:

• Hepatobiliary surgery
• Transplant oncology
• Diagnostic imaging

Background:

• Hepatocellular carcinoma (HCC) is the most common primary liver tumor.
• Liver transplantation is a curative option, but Milan Criteria for selection may be too conservative.
• Vascular invasion, particularly microvascular invasion, is a key prognostic factor impacting transplant success but is difficult to detect preoperatively.

Purpose of the Study:

• To investigate the potential of positron emission tomography (PET) as a preoperative imaging biomarker.
• To assess PET's ability to predict microvascular invasion in HCC patients.
• To identify optimal candidates for liver transplantation by improving preoperative assessment.

Main Methods:

• Review of diagnostic imaging techniques for HCC.
• Analysis of the role of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET).
• Focus on PET's capability in detecting microvascular invasion.

Main Results:

• Microvascular invasion is associated with poorer prognosis after liver transplantation.
• Current diagnostic methods have limitations in detecting microvascular invasion preoperatively.
• PET shows promise as a tool to identify this adverse prognostic factor.

Conclusions:

• PET imaging may serve as a valuable preoperative biomarker for microvascular invasion in HCC.
• Improved detection of microvascular invasion can lead to better patient selection for liver transplantation.
• Utilizing PET could optimize transplant outcomes by identifying patients most likely to benefit from the procedure.