国际肝细胞癌无创诊断指南比较:2018 年更新。
Comparison of international guidelines for noninvasive diagnosis of hepatocellular carcinoma: 2018 update.
机构信息
Department of Radiology, Seoul National University Hospital, Seoul, Korea.
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
出版信息
Clin Mol Hepatol. 2019 Sep;25(3):245-263. doi: 10.3350/cmh.2018.0090. Epub 2019 Feb 14.
The goal of this review is to present the similarities and differences among the latest guidelines for noninvasive diagnosis of hepatocellular carcinoma (HCC) of American Association for the Study of Liver Disease (AASLD), European Association for the Study of the Liver (EASL), Liver Imaging Reporting and Data System (LI-RADS), Asian Pacific Association for the Study of the Liver (APASL), and Korean Liver Cancer Association- National Cancer Center (KLCA-NCC) of Korea. In 2018, major guideline updates have been proposed by the AASLD, EASL and KLCA-NCC; AASLD newly incorporated LI-RADS into their HCC diagnostic algorithm. The AASLD and EASL guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as a first-line diagnostic test in addition to dynamic computed tomography and MRI using extracellular contrast media and the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound as a second-line diagnostic test. We will comprehensively review the HCC surveillance and diagnostic algorithms and compare and highlight key features for each guideline. We also address limitations of current systems for the noninvasive diagnosis of HCC.
本综述旨在介绍美国肝病研究协会(AASLD)、欧洲肝脏研究协会(EASL)、肝脏影像报告和数据系统(LI-RADS)、亚太肝脏研究协会(APASL)和韩国国家癌症中心-韩国肝癌协会(KLCA-NCC)最新的肝细胞癌(HCC)非侵入性诊断指南之间的异同。2018 年,AASLD、EASL 和 KLCA-NCC 提出了主要的指南更新;AASLD 新将 LI-RADS 纳入其 HCC 诊断算法。AASLD 和 EASL 指南现在将肝胆对比剂磁共振成像(MRI)作为除细胞外对比剂动态 CT 和 MRI 之外的一线诊断检测方法,KLCA-NCC 和 EASL 指南也将对比增强超声作为二线诊断检测方法。我们将全面审查 HCC 监测和诊断算法,并比较和突出每个指南的关键特征。我们还讨论了当前 HCC 非侵入性诊断系统的局限性。