Year 2020 / Volume 112 / Number 8
Letter
Biopsy for hepatocellular carcinoma: only occasionally

666-667

DOI: 10.17235/reed.2020.6935/2020

Javier Crespo, Álvaro Díaz González,

Abstract
We would like to highlight that the non-invasive criteria for HCC diagnosis, defined by the presence of hyperenhancement in the arterial phase (wash-in) followed by hypoenhancement (wash-out) in venous phases on MRI and/or CT, have been validated by multiple cohort studies and meta-analysis. These criteria are only applicable when the pre-test probability is high (lesions > 1 cm in patients diagnosed of liver cirrhosis or chronic hepatitis B). In addition, for an adequate use of these criteria, other processes such as active (or past) neoplasms must be ruled out. In this scenario, non-invasive criteria have repeatedly demonstrated a diagnostic specificity and positive predictive value close to 100 %. Moreover, we would like to remark the transversality in the consensus of the non-invasive diagnosis of HCC, since not only the hepatology societies recommend its use, but also the oncology and radiology ones.
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References
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2. Crespo J, Andrade RJ. Shadows in the current management of hepatocellular carcinoma in Spain - An embarrassing truth. Rev Esp Enferm Dig. 2019 Oct 1;111(10):727–30.
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4. Lee YJ, Lee JM, Lee JS, et al. Hepatocellular carcinoma: Diagnostic performance of multidetector CT and MR imaging-a systematic review and meta-analysis. Radiology. 2015 Apr 1;275(1):97–109.
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7. Vogel A, Cervantes A, Chau I, et al. Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2018 Oct 1;29(Supplement_4):iv238–55.
8. Silva MA, Hegab B, Hyde C, et al. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut. 2008 Nov 1;57(11):1592–6.
9. Stattaus J, Kuehl H, Ladd S, S, et al. CT-guided biopsy of small liver lesions: Visibility, artifacts, and corresponding diagnostic accuracy. Cardiovasc Intervent Radiol. 2007 Sep;30(5):928–35.
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1. Illan Varela A, (falta referencia dentro de la misma publicación)
2. Crespo J, Andrade RJ. Shadows in the current management of hepatocellular carcinoma in Spain - An embarrassing truth. Rev Esp Enferm Dig. 2019 111(10):727–730.
3. Forner A, Vilana R, Ayuso C , et al. Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: Prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology. 2008 47(1):97–104.
4. Lee YJ, Lee JM, Lee JS, et al. Hepatocellular carcinoma: Diagnostic performance of multidetector CT and MR imaging-a systematic review and meta-analysis. Radiology. 2015.275(1):97–109.
5. Galle PR, Forner A, Llovet JM, et al. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018 69(1):182–236.
6. Heimbach J, Kulik LM, Finn R, et al. Aasld guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018; 67 (1):358-380
7. Vogel A, Cervantes A, Chau I, et al. Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2018 29(Supplement_4):iv238–55.
8. Silva MA, Hegab B, Hyde C, et al. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut. 2008 57(11):1592–6.
9. Stattaus J, Kuehl H, Ladd S, et al. CT-guided biopsy of small liver lesions: Visibility, artifacts, and corresponding diagnostic accuracy. Cardiovasc Intervent Radiol. 2007 30(5):928–35.
10. Pinyol R, Montal R, Bassaganyas L, et al. Molecular predictors of prevention of recurrence in HCC with sorafenib as adjuvant treatment and prognostic factors in the phase 3 STORM trial. Gut. 2018 gutjnl-2018-316408.
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Crespo J, Díaz González Á. Biopsy for hepatocellular carcinoma: only occasionally. 6935/2020


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Publication history

Received: 03/02/2020

Accepted: 14/02/2020

Online First: 20/07/2020

Published: 30/07/2020

Article revision time: 9 days

Article Online First time: 168 days

Article editing time: 178 days


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