Multimodality imaging approach in identifying invasive hepatocellular carcinoma

Area of Science:

• Hepatobiliary oncology
• Diagnostic radiology
• Interventional radiology

Background:

• Hepatocellular carcinoma (HCC) is a major global cancer with high mortality.
• Early-stage HCC is curable via liver resection or transplant, but vascular invasion limits these options.
• Advanced HCC requires palliative treatments like chemoembolization or chemotherapy.

Purpose of the Study:

• To highlight the significance of regional invasion in HCC.
• To emphasize the role of imaging in detecting HCC invasion and differentiating tumor thrombi from bland thrombi.
• To underscore the importance of accurate radiologic interpretation for patient management.

Main Methods:

• Review of imaging findings in HCC with regional invasion.
• Discussion of multimodality imaging approaches for tumor invasion assessment.
• Emphasis on differentiating bland thrombi from tumor thrombi in vascular invasion.

Main Results:

• HCC frequently invades regional structures, including the portal vein, hepatic vein, and inferior vena cava.
• Distinguishing tumor thrombi from bland thrombi is critical for treatment planning.
• Multimodality imaging aids in identifying invasion patterns and thrombus types.

Conclusions:

• Accurate identification of HCC regional invasion and vascular thrombus type is essential for prognosis and management.
• Radiologists play a key role in evaluating invasion and thrombus characteristics.
• Improved imaging interpretation can lead to better therapeutic decisions for HCC patients.