以患者为中心的HCC监测 - - 超声波和CT/MRI的互补作用
Jason Heald1, David T Fetzer2, Shuchi Rodgers3
1Loma Linda University Medical Center, Loma Linda, USA.
Abdominal radiology (New York)
|November 11, 2024
概括
肝细胞癌 (HCC) 查指南现在强调以患者为中心的方法. 这包括更新的肝脏成像报告和数据系统 (LI-RADS) 超声协议以及当超声质量差时的替代成像选项.
科学领域:
- 肝病学和瘤学 肝病学和瘤学
- 医疗成像医学成像
- 癌症监测 癌症监测
背景情况:
- 肝细胞癌 (HCC) 是一个重要的全球健康问题,代表癌症死亡率的主要原因.
- 在美国,HCC是癌症死亡增长最快的原因,需要有效的查策略.
- 目前的指导方针建议在高风险人群中半年进行血清α-fetoprotein和超声波 (US) 查.
研究的目的:
- 探索在HCC监测中转向以患者为中心的方法.
- 详细说明新LI-RADS美国监控 v2024核心的含义.
- 讨论针对美国质量低于最佳的患者的替代成像方法.
主要方法:
- 审查当前的临床实践指南 (AASLD 2023) 和LI-RADS美国监测 v2024核心.
- 分析可视化得分在确定超声波质量的作用.
- 评估与美国图像质量差相关的风险因素.
- 评估替代监测选项:多相CT,MRI和缩短的MRI协议.
主要成果:
- 更新后的LI-RADS US Surveillance v2024核心引入了一个可视化得分来评估超声波质量.
- 鉴定的风险因素可以预测HCC监测中的超声图像质量差.
- 当US不是最佳时,CT和MRI等替代成像策略提供了可行的选择.
结论:
- 转向以患者为中心的HCC监测模式至关重要.
- LI-RADS v2024核心和可视化得分提高了超声波质量评估.
- 其他成像方法可确保对所有高风险患者的持续监测.
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