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Biopsy for hepatocellular carcinoma: only occasionally
Javier Crespo1, Álvaro Díaz González2
1Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, 39002.
Revista Espanola De Enfermedades Digestivas
|July 21, 2020
Summary
Non-invasive imaging criteria for diagnosing hepatocellular carcinoma (HCC) are highly accurate in specific patient groups. These validated methods, using MRI or CT, show near 100% specificity and positive predictive value when applied correctly.
Area of Science:
- Hepatobiliary Medicine
- Diagnostic Imaging
- Oncology
Background:
- Hepatocellular carcinoma (HCC) diagnosis relies on imaging.
- Non-invasive criteria are crucial for timely HCC detection.
Purpose of the Study:
- To highlight the validated non-invasive criteria for HCC diagnosis.
- To emphasize the high diagnostic performance and consensus on these criteria.
Main Methods:
- Utilizing established non-invasive imaging criteria (arterial wash-in, venous wash-out) on MRI/CT.
- Application in patients with high pre-test probability (liver cirrhosis, chronic hepatitis B, lesions >1 cm).
- Exclusion of other neoplastic processes.
Main Results:
- Non-invasive criteria demonstrate diagnostic specificity and positive predictive value approaching 100%.
- These criteria are validated by multiple cohort studies and meta-analyses.
- High diagnostic accuracy is achieved when applied in appropriate clinical scenarios.
Conclusions:
- Non-invasive imaging criteria are reliable for HCC diagnosis in selected patients.
- Broad consensus exists among hepatology, oncology, and radiology societies.
- Accurate application requires ruling out other neoplasms and high pre-test probability.
