Imaging, Biomarkers May Improve Hepatocellular Carcinoma Surveillance

A review article published in the American Journal of Gastroenterology suggests that the standard imaging technique for hepatocellular carcinoma surveillance, ultrasound, can be improved upon with other imaging technology and use of biomarkers.

“Abdominal ultrasound, with or without alpha-fetoprotein, is the recommended strategy for hepatocellular carcinoma surveillance but misses over one-third of hepatocellular carcinoma at an early stage,” wrote corresponding author Amit G. Singal, MD, of the University of Texas Southwestern Medical Center Department of Internal Medicine in Dallas, and coauthors.

The review centered on emerging methods for enhanced surveillance of liver malignancy. Computed tomography and magnetic resonance imaging have each demonstrated high sensitivity in detecting hepatocellular carcinoma at an early stage, the authors reported. However, radiologic capacity, cost-effectiveness, and patient acceptance have yet to be investigated. Validation of early data in Western nonhepatitis B virus populations is also necessary.

Meanwhile, blood-based biomarker panels, including the GALAD model and liquid biopsy techniques, also show potential. According to the review, phase 2 case-control studies have produced promising data, but the tools still require validation in phase 3 and 4 cohort studies.

“While awaiting prospective validation data for these emerging strategies, ultrasound with or without alpha-fetoprotein remains the current gold standard hepatocellular carcinoma surveillance strategy,” the authors advised.

—Jolynn Tumolo

Reference
Singal AG, Reig M, Villanueva A. Emerging tools for hepatocellular carcinoma surveillance. Am J Gastroenterol. 2022;117(12):1948-1951. doi:10.14309/ajg.0000000000002015