THE CURRENT STATUS AND RESEARCH PROGRESSION ON IMAGING EVALUATION OF HCC

Hepatocellular carcinoma (HCC) is the most common primary liver cancer, which is a consequence of cirrhosis and develops mostly from patients with chronic liver disease. According to the EASL and EORTIC recommendations, diagnosis of HCC depends on the results of histopathological reports or imaging modalities. Diagnostic imaging of HCC plays an essential role in detecting, staging, prognosis, and treatment. The characteristic angiographic behavior of HCC nodules can be evaluated by using Doppler ultrasound, contrast-enhanced ultrasound (CEUS), contrast-enhanced computed tomography (CECT), and contrastenhanced magnetic resonance imaging (CEMRI). Liver Imaging Reporting and Data System (LI-RADS) was created to standardize reporting and data collection. However, the use of LI-RADS in clinical practice is often mired by the lack of uniform terminology in reporting and the interpretation of the examination performed in the different centers or at different times. The objective of diagnostic imaging is to achieve early identification of the hepatic neoplasia for the possibility of curative therapies including local ablative, surgery or liver transplantation, and increase patient survival. Palliative therapies including transarterial chemoembolization (TACE), transarterial radio-embolization (TARE), or systematic therapy (administration of antiangiogenic drugs, sorafenib) have been frequently used according to HCC stages. The interpretation of the therapeutic response of HCC nodules was evaluated by using Modified Response Evaluation Criteria in Solid Tumors (mRECIST). These criteria are currently the gold standard for radiological response assessment as confirmed in the latest version of the EASL Guidelines. In this review, we aim to review the current imaging evaluation of Hepatocellular Carcinoma (HCC).