Current and Emerging Tools for Hepatocellular Carcinoma Surveillance

Area of Science:

• Hepatology and Oncology
• Diagnostic Imaging
• Biomarker Discovery

Background:

• Hepatocellular carcinoma (HCC) is a major global cause of cancer mortality.
• Early detection of HCC is vital for accessing curative treatments and improving survival rates.
• Current surveillance guidelines recommend ultrasound every six months for high-risk individuals, such as those with cirrhosis.

Purpose of the Study:

• To provide a comprehensive overview of emerging imaging modalities and biomarkers for HCC detection.
• To discuss the role and innovations of imaging tools like ultrasound, CT, and MRI in early HCC diagnosis.
• To review established and novel circulating biomarkers for HCC surveillance.

Main Methods:

• Review of current literature on imaging techniques for HCC surveillance.
• Analysis of established biomarkers such as alpha-fetoprotein (AFP).
• Exploration of emerging liquid biopsy biomarkers including cell-free DNA (cfDNA) and circulating tumor cells.

Main Results:

• Established imaging tools (ultrasound, CT, MRI) show promise with recent innovations like contrast-enhanced ultrasound and abbreviated MRI.
• Circulating biomarkers like AFP, AFP-Lectin, and PIVKA-II are valuable in HCC surveillance.
• Emerging liquid biopsy markers such as methylated cfDNA, cfDNA mutations, extracellular vesicles, and circulating tumor cells show significant potential.

Conclusions:

• New imaging modalities and biomarkers offer enhanced capabilities for early HCC detection.
• These advancements have the potential to significantly improve patient survival rates through timely intervention.
• Continued research and validation of these tools are essential for optimizing HCC surveillance strategies.