Clinical and Molecular Hepatology

"So Yeon Kim"

Original Articles

Non-contrast magnetic resonance imaging for detection of late recurrent hepatocellular carcinoma after curative treatment: a prospective multicenter comparison to contrast-enhanced computed tomography: Dong Wook Kim, Won Chang, So Yeon Kim, Young-Suk Lim, Jonggi Choi, Jungheum Cho, Jin-Wook Kim, Jai Young Cho, Sun Kyung Jeon, Yun Bin Lee, Eun Ju Cho, Su Jong Yu, Kyung-Suk Suh, Kwang-Woong Lee, Dong Ho Lee; Clin Mol Hepatol 2025;31(4):1285-1297.
Published online June 13, 2025; DOI: https://doi.org/10.3350/cmh.2025.0258

Background/Aims
Hepatocellular carcinoma (HCC) frequently recurs after curative treatment, posing challenges to long-term survival. Although contrast-enhanced multiphasic computed tomography (CECT) is commonly used for detecting recurrence, it is associated with risks such as radiation exposure and contrast agent reactions. This study aimed to compare the diagnostic performance of non-contrast magnetic resonance imaging (NC-MRI) with CECT for detecting recurrent HCC.
Methods
In this prospective multicenter intra-individual head-to-head comparison trial (study identifier: NCT05690451, KCT0006395), participants who had undergone curative treatment for HCC and remained recurrence-free for over two years were enrolled. Each participant underwent three follow-up imaging sessions at 2–6-month intervals using both CECT and NC-MRI. The primary outcome was the detection accuracy of each modality, analyzed using the generalized estimating equation analysis. Secondary outcomes included sensitivity and specificity.
Results
The study included 203 participants with a total of 528 paired imaging sessions, identifying recurrent HCC in 22 cases (10.8%). Among these, 21 cases involved intrahepatic recurrence with a median tumor size of 1.3 cm, and one case had aortocaval lymph node metastasis. NC-MRI achieved a detection accuracy of 96.6% (196/203), higher than CECT’s 91.6% (186/203) (P=0.006). NC-MRI also showed greater sensitivity (77.3% [17/22] vs. 36.4% [8/22]; P=0.012), while specificity was comparable between NC-MRI and CECT (98.9% [179/181] vs. 98.3% [178/181]; P=0.999).
Conclusions
NC-MRI demonstrated higher sensitivity and accuracy compared to CECT in detecting recurrent HCC in patients who had been disease-free for over two years following curative treatment, indicating its potential as a preferred imaging modality for this purpose.

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Hepatic neoplasm

Stereotactic body radiation therapy for small (≤5 cm) hepatocellular carcinoma not amenable to curative treatment: Results of a single-arm, phase II clinical trial: Sang Min Yoon, So Yeon Kim, Young-Suk Lim, Kang Mo Kim, Ju Hyun Shim, Danbi Lee, Jihyun An, Jinhong Jung, Jong Hoon Kim, Han Chu Lee; Clin Mol Hepatol 2020;26(4):506-515.
Published online July 10, 2020; DOI: https://doi.org/10.3350/cmh.2020.0038

Background/Aims
Stereotactic body radiation therapy (SBRT) is used as an alternative ablative treatment in patients with hepatocellular carcinoma (HCC) not suitable for curative treatments. The purpose of this prospective study was to evaluate the long-term efficacy of SBRT for small (≤5 cm) HCCs.
Methods
A phase II, single-arm clinical trial on SBRT for small HCCs was conducted at an academic tertiary care center. The planned SBRT dose was 45 Gy with a fraction size of 15-Gy over 3 consecutive days. The primary endpoint was 2-year local control rate. Radiologic responses were assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1) and the modified RECIST criteria.
Results
Between 2013 and 2016, 50 patients (53 lesions) were enrolled, with a median follow-up period of 47.8 months (range, 2.9–70.6). Patients’ age ranged from 41 to 74 years, and 80% were male. Median tumor size was 1.3 cm (range, 0.7–3.1). The 2- and 5-year local control rates were 100% and 97.1%, respectively. The 5-year overall survival rate was 77.6%. Six months after SBRT, radiologic responses were evident in 44 lesions (83%) according to the RECIST criteria and 49 (92.4%) according to the modified RECIST criteria. None of the patients showed grade ≥3 adverse events.
Conclusions
SBRT showed excellent results as an ablative treatment for patients with small HCCs while showing minimal toxicities. SBRT can be a good alternative for both curative and salvage intents in patients with HCCs that are unsuitable for curative treatments.

Citations

Citations to this article as recorded by

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Editorial

Hepatic neoplasm

Diagnosis of hepatocellular carcinoma: Which MRI contrast agent? Which diagnostic criteria?: So Yeon Kim; Clin Mol Hepatol 2020;26(3):309-311.
Published online June 15, 2020; DOI: https://doi.org/10.3350/cmh.2020.0061

Citations

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Cancers.2020; 12(11): 3347. CrossRef

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Review

Hepatic neoplasm

Comparison of international guidelines for noninvasive diagnosis of hepatocellular carcinoma: 2018 update: Tae-Hyung Kim, So Yeon Kim, An Tang, Jeong Min Lee; Clin Mol Hepatol 2019;25(3):245-263.
Published online February 14, 2019; DOI: https://doi.org/10.3350/cmh.2018.0090

Abstract
PDF

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.

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Predictive Performance of CAGE-B and SAGE-B Models in Asian Treatment-Naive Patients Who Started Entecavir for Chronic Hepatitis B
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Development and Validation of a Difficulty Scoring System for Laparoscopic Liver Resection to Treat Hepatolithiasis
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Original Article

Liver Transplantation

Resection plane-dependent error in computed tomography volumetry of the right hepatic lobe in living liver donors: Heon-Ju Kwon, Kyoung Won Kim, Bohyun Kim, So Yeon Kim, Chul Seung Lee, Jeongjin Lee, Gi Won Song, Sung Gyu Lee; Clin Mol Hepatol 2018;24(1):54-60.
Published online August 1, 2017; DOI: https://doi.org/10.3350/cmh.2017.0023

Abstract
PDF

Background/Aims
Computed tomography (CT) hepatic volumetry is currently accepted as the most reliable method for preoperative estimation of graft weight in living donor liver transplantation (LDLT). However, several factors can cause inaccuracies in CT volumetry compared to real graft weight. The purpose of this study was to determine the frequency and degree of resection plane-dependent error in CT volumetry of the right hepatic lobe in LDLT.
Methods
Forty-six living liver donors underwent CT before donor surgery and on postoperative day 7. Prospective CT volumetry (V_P) was measured via the assumptive hepatectomy plane. Retrospective liver volume (V_R) was measured using the actual plane by comparing preoperative and postoperative CT. Compared with intraoperatively measured weight (W), errors in percentage (%) V_P and V_R were evaluated. Plane-dependent error in V_P was defined as the absolute difference between V_P and V_R. % plane-dependent error was defined as follows: |V_P–V_R|/W∙100.
Results
Mean V_P, V_R, and W were 761.9 mL, 755.0 mL, and 696.9 g. Mean and % errors in V_P were 73.3 mL and 10.7%. Mean error and % error in V_R were 64.4 mL and 9.3%. Mean plane-dependent error in V_P was 32.4 mL. Mean % plane-dependent error was 4.7%. Plane-dependent error in V_P exceeded 10% of W in approximately 10% of the subjects in our study.
Conclusions
There was approximately 5% plane-dependent error in liver V_P on CT volumetry. Plane-dependent error in V_P exceeded 10% of W in approximately 10% of LDLT donors in our study. This error should be considered, especially when CT volumetry is performed by a less experienced operator who is not well acquainted with the donor hepatectomy plane.

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Liver Imagings

Liver fibrosis, cirrhosis, and portal hypertension

What we need to know when performing and interpreting US elastography: So Hyun Park, So Yeon Kim, Chong Hyun Suh, Seung Soo Lee, Kyoung Won Kim, So Jung Lee, Moon-Gyu Lee; Clin Mol Hepatol 2016;22(3):406-414.
Published online September 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0106

Abstract
PDF

According to the increasing need for accurate staging of hepatic fibrosis, the ultrasound (US) elastography techniques have evolved significantly over the past two decades. Currently, US elastography is increasingly used in clinical practice. Previously published studies have demonstrated the excellent diagnostic performance of US elastography for the detection and staging of liver fibrosis. Although US elastography may seem easy to perform and interpret, there are many technical and clinical factors which can affect the results of US elastography. Therefore, clinicians who are involved with US elastography should be aware of these factors. The purpose of this article is to present a brief overview of US techniques with the relevant technology, the clinical indications, diagnostic performance, and technical and biological factors which should be considered in order to avoid misinterpretation of US elastography results.

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Hepatic neoplasm

Recent advances in the imaging of hepatocellular carcinoma: Myung-Won You, So Yeon Kim, Kyoung Won Kim, So Jung Lee, Yong Moon Shin, Jin Hee Kim, Moon-Gyu Lee; Clin Mol Hepatol 2015;21(1):95-103.
Published online March 25, 2015; DOI: https://doi.org/10.3350/cmh.2015.21.1.95

Abstract
PDF

The role of imaging is crucial for the surveillance, diagnosis, staging and treatment monitoring of hepatocellular carcinoma (HCC). Over the past few years, considerable technical advances were made in imaging of HCCs. New imaging technology, however, has introduced new challenges in our clinical practice. In this article, the current status of clinical imaging techniques for HCC is addressed. The diagnostic performance of imaging techniques in the context of recent clinical guidelines is also presented.

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Benign liver tumors and cystic disease of liver

Sonography of hepatic hemangioma accompanied by arterioportal shunt: Sang Hyun Choi, Kyoung Won Kim, Gil Sun Hong, So Jung Lee, So Yeon Kim, Jong Seok Lee, Hyoung Jung Kim; Clin Mol Hepatol 2014;20(1):85-87.
Published online March 26, 2014; DOI: https://doi.org/10.3350/cmh.2014.20.1.85

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Benign liver tumors and cystic disease of liver

Hepatic angiomyolipoma with minimal fat, mimicking hepatocellular carcinoma: So Jung Lee, So Yeon Kim, Kyoung Won Kim, Yong Moon Shin, Hyoung Jung Kim, Jong Seok Lee, Sun A Kim; Korean J Hepatol 2012;18(3):330-335.
Published online September 25, 2012; DOI: https://doi.org/10.3350/cmh.2012.18.3.330

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American Journal of Roentgenology.2016; 207(3): 562. CrossRef
Epithelioid Angiomyolipoma in a Patient With Li-Fraumeni Syndrome: Rare Pathologic Diagnosis
Sina Jasim, Pheroze Tamboli, Soo-Chin Lee, Louise C. Strong, Khaled Elsayes, Montserrat Ayala-Ramirez, Mouhammed Amir Habra
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Imaging findings of mimickers of hepatocellular carcinoma
Tae Kyoung Kim, Eunchae Lee, Hyun-Jung Jang
Clinical and Molecular Hepatology.2015; 21(4): 326. CrossRef
Hepatic Angiomyolipoma Mimicking Hepatocellular Carcinoma
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Myomatous hepatic angiomyolipoma: imaging findings in 14 cases with radiological–pathological correlation and review of the literature
Z Zhu, L Yang, X-M Zhao, D-Q Luo, H-T Zhang, C-W Zhou
The British Journal of Radiology.2014; 87(1038): 20130712. CrossRef
MR Characterization of Focal Liver Lesions
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Magnetic Resonance Imaging Clinics of North America.2014; 22(3): 295. CrossRef
A case of multiple hepatic angiomyolipomas with high 18 F-fluorodeoxyglucose uptake
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BMC Medical Imaging.2014;[Epub] CrossRef
Epithelioid angiomyolipoma of the liver: a clinicopathologic study of 5 cases
Regina Cheuk-lam Lo
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