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"Liver neoplasm"

Editorial

A novel link between tumor cell metabolism and patient prognosis: Editorial on “Molecular classification of hepatocellular carcinoma based on zoned metabolic feature and oncogenic signaling pathway”
Eun Ji Jang, Pil Soo Sung
Clin Mol Hepatol 2026;32(1):420-422.
Published online April 16, 2025
DOI: https://doi.org/10.3350/cmh.2025.0395

Citations

Citations to this article as recorded by  Crossref logo
  • Correspondence to editorial on “Molecular classification of hepatocellular carcinoma based on zoned metabolic feature and oncogenic signaling pathway”
    Tomoko Aoki, Naoshi Nishida, Masatoshi Kudo
    Clinical and Molecular Hepatology.2026; 32(1): e79.     CrossRef
  • Reply to correspondence on “Molecular classification of hepatocellular carcinoma based on zoned metabolic feature and oncogenic signaling pathway”
    Eun Ji Jang, Pil Soo Sung
    Clinical and Molecular Hepatology.2026; 32(1): e115.     CrossRef
  • Clinical Prediction of Glycolysis-Driven Molecular Subclass of Hepatocellular Carcinoma without Transcriptomic Profiling
    Tomoko Aoki, Masatoshi Kudo, Satoshi Ogiso, Genki Okumura, Megumi Hoshino, Yuka Nakamura, Ryo Morisue, Shohei Koyama, Naoshi Nishida, Kohei Hanaoka, Kazuko Sakai, Yutaka Kurebayashi, Masakatsu Tsurusaki, Masahiro Morita, Atsushi Takebe, Takaaki Murase, Ke
    Liver Cancer.2026; : 1.     CrossRef
  • Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography: A Potential Imaging Biomarker for Predicting Response to Combination Immunotherapy in Hepatocellular Carcinoma
    Masatoshi Kudo
    Liver Cancer.2025; 14(5): 511.     CrossRef
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Review

Hepatic neoplasm

Hepatocellular carcinoma: updates on epidemiology, surveillance, diagnosis and treatment
Soo Young Hwang, Pojsakorn Danpanichkul, Vatche Agopian, Neil Mehta, Neehar D. Parikh, Ghassan K. Abou-Alfa, Amit G. Singal, Ju Dong Yang
Clin Mol Hepatol 2025;31(Suppl):S228-S254.
Published online December 26, 2024
DOI: https://doi.org/10.3350/cmh.2024.0824
Hepatocellular carcinoma (HCC) is a major global burden, ranking as the third leading cause of cancer-related mortality. HCC due to chronic hepatitis B virus (HBV) or C virus (HCV) infection has decreased due to universal vaccination for HBV and effective antiviral therapy for both HBV and HCV, but HCC related to metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease is increasing. Biannual liver ultrasonography and serum α-fetoprotein are the primary surveillance tools for early HCC detection among high-risk patients (e.g., cirrhosis, chronic HBV). Alternative surveillance tools such as blood-based biomarker panels and abbreviated magnetic resonance imaging (MRI) are being investigated. Multiphasic computed tomography or MRI is the standard for HCC diagnosis, but histological confirmation should be considered, especially when inconclusive findings are seen on cross-sectional imaging. Staging and treatment decisions are complex and should be made in multidisciplinary settings, incorporating multiple factors including tumor burden, degree of liver dysfunction, patient performance status, available expertise, and patient preferences. Early-stage HCC is best treated with curative options such as resection, ablation, or transplantation. For intermediate-stage disease, locoregional therapies are primarily recommended although systemic therapies may be preferred for patients with large intrahepatic tumor burden. In advanced-stage disease, immune checkpoint inhibitor-based therapy is the preferred treatment regimen. In this review article, we discuss the recent global epidemiology, risk factors, and HCC care continuum encompassing surveillance, diagnosis, staging, and treatments.

Citations

Citations to this article as recorded by  Crossref logo
  • Response Assessment in Hepatocellular Carcinoma: A Primer for Radiologists
    Nayla Mroueh, Jinjin Cao, Shravya Srinivas Rao, Soumyadeep Ghosh, Ok Kyu Song, Sasiprang Kongboonvijit, Anuradha Shenoy-Bhangle, Avinash Kambadakone
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  • Emerging evidence supports direct-acting antiviral therapy for HCC patients beyond the early stage: Correspondence to editorial on “Direct-acting antiviral therapy for patients with HCV-related hepatocellular carcinoma: A nationwide cohort study”
    Teng-Yu Lee, Pei-Chien Tsai, Shou-Wu Lee, Ming-Lung Yu
    Clinical and Molecular Hepatology.2026; 32(1): e68.     CrossRef
  • Advancing policy and practice in alcohol-associated liver disease and alcohol-attributable cancer: Correspondence to the editorial on “Sex disparities in alcohol-associated liver disease and subtype differences in alcohol-attributable cancers in the Unite
    Pojsakorn Danpanichkul, Donghee Kim, Karn Wijarnpreecha, Amit G. Singal, Ju Dong Yang
    Clinical and Molecular Hepatology.2026; 32(1): e96.     CrossRef
  • Transarterial radioembolization versus atezolizumab-bevacizumab for the treatment of hepatocellular carcinoma with portal vein tumor thrombosis
    Youngsu Park, Yuri Cho, Seung Up Kim, Aryoung Kim, Hyunjae Shin, Hyo-Cheol Kim, In Joon Lee, Gyoung Min Kim, Dongho Hyun, Yunmi Ko, Jeayeon Park, Jae Woong Yoon, Gyung Sun Lim, Moon Haeng Hur, Yun Bin Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jung-Hwan
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  • Gender, Age, Alpha-fetoprotein, and Des-gamma-carboxyprothrombin Score as a Novel Approach to Early Detection of Hepatocellular Carcinoma: A Narrative Review
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  • MRI-based Habitat Imaging Enhances the Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma
    Xiaogang Li, Anbin Hu
    Academic Radiology.2026; 33(1): 59.     CrossRef
  • Split biosensor based on nano-enzymatic ferrocene-tyramine deposition reaction for detection of SMP30 antibody
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    Cellular Signalling.2026; 138: 112212.     CrossRef
  • Integrated multi-Omics and network toxicology elucidate the multi-target mechanisms of environmental hormones in driving hepatocellular carcinoma
    Rong Huang, Jinyue Ma, Jiaxin Yao, Jiyu Pang, Min Zhang, Lu Wen, Liang Wang, Yanan Deng, Xiu He, Chunyan Zhao, Bo Mu
    Ecotoxicology and Environmental Safety.2026; 309: 119519.     CrossRef
  • The regulatory role of circGDI2 in hepatocellular carcinoma proliferation and glycolysis with the involvement of m6A modification
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    Non-coding RNA Research.2026; 17: 21.     CrossRef
  • CTTN overexpression on circulating tumor cells promotes hepatocellular carcinoma recurrence via enhancing the proliferation and clonality of circulating tumor cells
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    Cytotechnology.2026;[Epub]     CrossRef
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    Genes & Diseases.2026; 13(4): 101963.     CrossRef
  • Phenylalanine-Coated PLGA Nanoparticles for Targeted Delivery of Silibinin in Hepatocellular Carcinoma
    Claudia Mari, Federica Aliperta, Amadeo Sanz-Pérez, Mario Alonso, Elena González-Burgos, Juan Francisco González, Irene Lozza, Ana Fernández-Carballido, Ana Isabel Fraguas-Sánchez
    Molecular Pharmaceutics.2026; 23(1): 487.     CrossRef
  • Outcomes of Nivolumab Plus Ipilimumab After Atezolizumab Plus Bevacizumab in Advanced HCC: An International Multicentre Study
    Jung Sun Kim, Jeffrey Wong, San‐Chi Chen, David Tai, Hannah Yang, Youngun Kim, Beodeul Kang, Ilhwan Kim, Hyeyeong Kim, Chansik An, Su Jin Jang, Masatoshi Kudo, Ho Yeong Lim, Chan Kim, Thomas Yau, Hong Jae Chon
    Liver International.2026;[Epub]     CrossRef
  • Integrative analyses of network pharmacology and bioinformatics reveal the synergistic antitumor effects of cantharidin and ginsenosides Rg3 on hepatocellular carcinoma
    Xianggang Gou, Zhongzheng Zhou, Yuehua Wang, Henye Yuan, Ziyao Wang, Jie Chen, Wei Yan, Haisheng Wang, Jia Yan
    Biochemical Pharmacology.2026; 246: 117700.     CrossRef
  • Risk stratification for hepatocellular carcinoma in metabolic dysfunction-associated steatotic liver disease: Editorial on “High Steatosis-Associated Fibrosis Estimator scores predict hepatocellular carcinoma in viral and non-viral hepatitis and metabolic
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    Clinical and Molecular Hepatology.2026; 32(1): 368.     CrossRef
  • An Inflammation-Associated Prognostic Model for Hepatocellular Carcinoma Following Radical Resection
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    Journal of Hepatocellular Carcinoma.2026; Volume 13: 1.     CrossRef
  • Distinct tumor immune microenvironment modulation by anti-PD-1/PD-L1, VEGF, and CTLA-4 blockade provides a rationale for triplet therapy in hepatocellular carcinoma
    Hideki Iwamoto, Hironori Koga, Takumi Kawaguchi
    Clinical and Molecular Hepatology.2026; 32(1): e38.     CrossRef
  • Landscape of Somatic and Age‐Related Pathogenic Structural Variations in Hepatocellular Carcinoma Revealed by Long‐Read Sequencing
    Zhewen Wei, Yinghao Cao, Hongchao Liu, Mei Liu, Bolun Zhang, Jianming Ying, Jianqiang Cai, Xinyu Bi, Jianjun Zhao, Jianguo Zhou, Zhiyu Li, Zhen Huang, Jianmei Liu, Xueyan Lv, Zhiwen Luo, Zhicheng Wei, Xiaoshi Zhang, Yi Yang, Yiqiao Deng, Yanjiang Yin, Jin
    MedComm.2026;[Epub]     CrossRef
  • Gastrointestinal cancer statistics in 2022 and projection to 2050: GLOBOCAN estimates across 185 countries
    Pojsakorn Danpanichkul, Yanfang Pang, Primrose Tothanarungroj, Disatorn Dejvajara, Donghee Kim, Preenapun Saokhieo, Kanokphong Suparan, Mark D. Muthiah, Kwanjit Duangsonk, Diego Olavarria Bernal, Rashid N. Lui, Karn Wijarnpreecha, Ghassan K. Abou‐Alfa, Mi
    Cancer.2026;[Epub]     CrossRef
  • Integrating CyTOF with scRNA-seq reveals that Cyclovirobuxine D inhibits HCC progression through hepatic immune microenvironment remodeling
    Fuqiang Ma, Lele Zhang, Yitao Fan, Ziyi Xu, Yuhua He, Jiachun Sun, Juan Lu, Xinyu Gu
    Phytomedicine.2026; 150: 157751.     CrossRef
  • A Biomimetic Manganese Complex Synergistically Disables Antioxidant Defenses and Amplifies Oxidative Stress to Potentiate Ferroptosis in Hepatocellular Carcinoma
    Pengchen Ren, Yan Huang, Linhong Zhong, Ranran Luo, Chenxi Zhang, Zening Zhang, Rui Tang, Zhongsheng Xu, Yun Liu
    Advanced Healthcare Materials.2026;[Epub]     CrossRef
  • Effectiveness of Machine Learning in Detecting Vessels Encapsulating Tumor Clusters in Hepatocellular Carcinoma: Systematic Review and Meta-Analysis
    Huili Shui, Wenyu Wu, Zhenming Xie, Bing Yang, Jia Deng, Dongxin Tang
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    World Journal of Gastroenterology.2026;[Epub]     CrossRef
  • Effect of statin use on prognostic outcomes in hepatocellular carcinoma following liver surgery: a systematic review and meta-analysis
    Diski Saisa, Syifa Mustika, Mochamad Fachrureza, Stevanus Christian Surya, Derren Rampengan, Juan Alessandro Jeremis Maruli Nura Lele, Ammar Nojaid, Michael Owen Hogipranata
    European Journal of Gastroenterology & Hepatology.2026; 38(5): 527.     CrossRef
  • Identification of novel circulating protein biomarkers for hepatocellular carcinoma superior to alpha-fetoprotein through a stemness index and secretome analysis
    Cai Gao, Xuebing Li, Xinwei Liu, Sha Yan, Xiaodan Ran, Jingxian Han
    World Journal of Surgical Oncology.2026;[Epub]     CrossRef
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    Hongwei Chen, Xinggang Fan, Di Cui
    Frontiers in Oncology.2026;[Epub]     CrossRef
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  • AEG-1/MTDH Enhances Hepatocellular Carcinoma Radioresistance by Recruiting PTBP1 Via SND1 To Stabilize ATG5 mRNA and Promote Protective Autophagy
    Xiaochun Chen, Yu Wang, Qishuai Guo, Xing Lin, Zhiping Yuan, Wei Liu, Chuan Lin, Yongjun Li, Yongpeng He
    Cell Biochemistry and Biophysics.2026; 84(2): 2087.     CrossRef
  • A prognostic signature of ferroptosis and lipid metabolism related genes predicts survival and immunotherapy response in hepatocellular carcinoma
    Hu Chen, Yan Kong, Qian Dong
    Discover Oncology.2026;[Epub]     CrossRef
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    Biochemical Pharmacology.2026; 246: 117732.     CrossRef
  • Regulation of Keratin Chemical Modifications: Potential Molecular Mechanisms in Proliferative Diseases
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    International Journal of Molecular Sciences.2026; 27(2): 972.     CrossRef
  • Non-Transplantable Recurrence After Initial Liver Resection of Hepatocellular Carcinoma: A Narrative Review
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    Cancers.2026; 18(2): 317.     CrossRef
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    Ziyue Huang, Taifeng Zhu, Xiaokun Chen, Mingjian Piao, Yang Tan, Chengjie Li, Kai Liu, Shanshan Wang, Lei Zhang, Shunda Du, Chengpei Zhu, Kang Zhou, Xiaobo Yang, Daobing Zeng, Haitao Zhao
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    International Immunopharmacology.2026; 172: 116246.     CrossRef
  • RNA splicing dysregulation in hepatocellular carcinoma: Molecular mechanisms, therapeutic targets, and intervention strategies—A comprehensive review
    Shuai Xiong, Lei Hu, Yun-Yang Sun, Wei Huang, Xiao-Yu Hu
    Biomedicine & Pharmacotherapy.2026; 195: 119025.     CrossRef
  • Assessing predictive value of contrast-enhanced ultrasound combined with doppler ultrasound for post-transcatheter arterial chemoembolization prognosis in hepatocellular carcinoma
    Jia-Jiao Qian, Min Xu, Yan-Song Ji
    World Journal of Gastrointestinal Surgery.2026;[Epub]     CrossRef
  • Adjuvant cytokine-induced killer cell immunotherapy in hepatocellular carcinoma: real-world data and 9-year extended follow-up of a randomized controlled trial
    Hyunjae Shin, Youngsu Park, Byeong Geun Song, Won-Mook Choi, Hyung Joon Han, Youngwoo Lee, Tae-Jin Song, Jong-Eun Yeon, Young-Suk Lim, Moon Haeng Hur, Yun Bin Lee, Eun Ju Cho, Su Jong Yu, Yoon Jun Kim, Joon Hyeok Lee, Jung-Hwan Yoon, Jeong-Hoon Lee
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  • First-line systemic therapy for hepatocellular carcinoma: new options
    Rashida V. Orlova, Natalia V. Popova, Svetlana I. Kutukova, Viacheslav A. Chubenko, Rima S. Agbalyan, Michael V. Pugin
    Clinical Case in Oncology.2026; 3(3): 15.     CrossRef
  • Chronic inflammation and immune response in hepatocellular carcinoma: a comprehensive literature review
    Manaf Alsudaney, Mohammed N. Abdulhaleem, Abdelrahman M. Attia, Jessica Liu, Hasmik Adetyan, Osama Khattab, Andrew Hendifar, Alexander Kuo
    Journal of Cancer Metastasis and Treatment.2026;[Epub]     CrossRef
  • Preclinical Evaluation of Rationally Designed Peptide-NIRF Probe for c-Met Positive Liver Cancer Imaging-Guided Surgery
    Xiaohui Wang, Yongjia Tang, Mengmeng Xiao, Jia Huang, Yaxue Dai, Wenjing Huang, Zhihao Han, Yueqing Gu
    Analytical Chemistry.2026; 98(5): 4179.     CrossRef
  • Research Progress on the Biological Function, Disease-Driving Mechanism and Clinical Targeting Strategies of G3BP2
    Yao Chen, Qi Deng, Li-Ling Yang, Ai-Ling Jiang, Rong Zhang, Qi-Bing Yan, Yong-Kang Wu
    Molecules.2026; 31(4): 622.     CrossRef
  • Quality of Gadoxetate-enhanced MRI versus US during Hepatocellular Carcinoma Screening in Participants with Cirrhosis
    Sara Lewis, Benjamin Wildman-Tobriner, Jordan Cuevas, Sergio Calle, Ian Bolger, Katherine Wang, Himanshu Joshi, Lori Mankowski Gettle, Ju Dong Yang, Ji Hye Min, Claude B. Sirlin, Scott B. Reeder, Mustafa R. Bashir, Bachir Taouli
    Radiology.2026;[Epub]     CrossRef
  • KLF1 Exerts Pro‐Tumour Role in Liver Cancer via Inhibiting ACSL4/LPCAT3‐Regulated Ferroptosis
    Zhihui Chen, Changyan Zhang, Jialin Yang, Yong Peng
    Journal of Cellular and Molecular Medicine.2026;[Epub]     CrossRef
  • Pretransplant Systemic Therapies for Hepatocellular Carcinoma: A Systematic Review of Posttransplant Outcomes
    Joana Rodrigues Ribeiro, Célia Procter, Christian Toso
    Journal of Gastrointestinal Cancer.2026;[Epub]     CrossRef
  • Expert consensus on the selection of surgical treatment modalities for hepatocellular carcinoma (fourth revision)
    Xiaoping Chen
    Oncology and Translational Medicine.2026;[Epub]     CrossRef
  • Comparing Minimally Invasive Puncture Under Local Anesthesia to Open Laparotomy Under General Anesthesia for Establishing a Rabbit VX2 Liver Tumor Model
    Gang Yuan, Ran Cui, Yanneng Xu, Jianming Luo, Bo Zheng, Wei Hu, Xun Zhang, Guangyan Si
    Journal of Hepatocellular Carcinoma.2026; Volume 13: 1.     CrossRef
  • Structure–function paradigms of natural polysaccharides in hepatocellular carcinoma therapy
    Jingqian Guan, Kexin Liang, Hongbo Su, Xizi Jiang
    Carbohydrate Polymers.2026; 380: 125093.     CrossRef
  • Identification of Unrecognized Hepatitis B, C, and D Infections Through the Private Laboratory-Based RE-LINK Screening Project in Romania: A Micro-Elimination Initiative
    Liliana Gheorghe, Antoanela Curici, Speranta Iacob
    Livers.2026; 6(1): 13.     CrossRef
  • FAM216A Promotes Hepatocellular Carcinoma Proliferation and Invasion through the PLK1/ERK Signaling Pathway
    Peng Ma, Ying Hao, Yuefeng Zhang, Weiguo Tang, Wei Wang, Zuo Muo, Kaihuan Yu, Weixing Wang
    Genetic Testing and Molecular Biomarkers.2026; 30(3): 55.     CrossRef
  • Effect of compound kushen injection on immune function in patients with primary liver cancer: a systematic review and meta-analysis
    Yu Xiong, Yutong Cai, Chenxi Li, Qian Yan, Xiongwen Wang, Xiaoying Zhang
    Frontiers in Pharmacology.2026;[Epub]     CrossRef
  • Achieving free-breathing liver magnetic resonance imaging by combining compressed sensing with the number of excitations
    Ruirui Yang, Huicong Shen, Boyun Yan, Zhaoying Liu, Yanan Dong, Jiawei Zhang, Wenjia Wang, Liu Ya jie
    Abdominal Radiology.2026;[Epub]     CrossRef
  • GPC3 and CD133-targeted peptide dual modification enhances the therapeutic effect of doxorubicin carried by OMVs on hepatocellular carcinoma
    Zuo Mou, Yuefeng Zhang, Xiaodian He, Mingze Zhang, Xiaoqin He, Wei Wang, Zehao Liu, Xinxin Xiong, Peng Ma, Kaihuan Yu
    International Journal of Pharmaceutics: X.2026; 11: 100510.     CrossRef
  • Synchronous vs sequential combination of transarterial chemoembolization and microwave ablation for hepatocellular carcinoma: Efficacy and prognosis
    Yi Yu, Wei Yuan, Jin Lei, Chun-Bo Zhao, Cheng-Gang Tao, Sheng-Hui Liu, Bai-Lin Wang
    World Journal of Gastrointestinal Surgery.2026;[Epub]     CrossRef
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    Yoon Jun Kim
    Hepatology International.2026; 20(2): 257.     CrossRef
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    Wei Feng, Bo Qu, Shuo Han
    Journal of Medical Internet Research.2026; 28: e82000.     CrossRef
  • Liver transplantation for hepatocellular carcinoma: from patient selection and downstaging to risk stratification and post-transplant surveillance
    Mohammad Saeid Rezaee-Zavareh, Ju Dong Yang
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    Julie Y. An, Bari R. Dane, Robert M. Marks
    Radiologic Clinics of North America.2026; 64(3): 475.     CrossRef
  • Multi-omics biomarker detection in Diethylnitrosamine (DENA) induced hepatocellular carcinoma
    Obaid Afzal, Pavan Goud, Kavita Goyal, Ali Altharawi, Mubarak A. Alamri, Manal A. Alossaimi, Abdulmalik S.A. Altamimi, Surya Nath Pandey
    Clinica Chimica Acta.2026; 587: 120937.     CrossRef
  • Synthesis, characterization, antioxidant and anticancer potential of Kalanchoe pinnata green synthesized silver nanoparticles targeting p53/MDM2 nexus in hepatic cancer: integrated in vitro and in silico study
    Afrasim Moin, Talib Hussain, Ahmed Alafnan, Abdulwahab Alamri, Saeed Alghamdi, Syed Mohd.Danish Rizvi, Sirajudheen Anwar, Muskan Chadha, Mohammad Khalid, Rohit Kumar Tiwari, Afza Ahmad
    Scientific Reports.2026;[Epub]     CrossRef
  • Association of documented social deprivation with cardiovascular and liver outcomes in alcohol-associated liver disease
    Pojsakorn Danpanichkul, Yanfang Pang, Andrew F. Ibrahim, Supapitch Sirimangklanurak, Allan Bueso, Daniel M. Simadibrata, Shu-Yen Chan, Karn Wijarnpreecha, Mazen Noureddin, Donghee Kim, Suthat Liangpunsakul
    Alcohol.2026; 132: 24.     CrossRef
  • Efficacy and safety of bronchial arterial infusion chemotherapy combined with transarterial chemoembolization and systemic therapy in hepatocellular carcinoma patients with lung metastases
    Caihong Yu, Juncheng Wan, Chaoqiao Jin, Changyu Li, Yuqi Jiang, Yongjie Zhou, Xudong Qu
    International Journal of Cancer.2026; 159(2): 423.     CrossRef
  • ABT-737 efficiently inhibits hepatocellular carcinoma cell activity via regulating PANoptosis
    Bi Deng, Xuefeng Jin, Dongmei Ye, Hefang Liu, Yunyun Qin, Xiaoyu Chen
    Discover Oncology.2026;[Epub]     CrossRef
  • Selinexor enhances the sensitivity of hepatocellular carcinoma cells to sorafenib by regulating the BAX/Bcl-2/PUMA apoptotic pathway and the XPO1/p27 cell cycle pathway
    Shenghong Du, Ling Wang, Chen Chen, Yu Sun, Qian Liu, Jingfei Shi, Feng Zhang, Kai Wang, Chao Cui
    Frontiers in Oncology.2026;[Epub]     CrossRef
  • Juglans mandshurica-Eleutherococcus senticosus herb pair inhibits hepatocellular carcinoma growth by inducing immunogenic cell death via the HIF-1α/STAT3 pathway
    Yu Jiang, Lili Jiang, He Zhang, Huiming Lv, Lina Xu, Linlin Zheng, Shengjin Yu
    Fitoterapia.2026; 190: 107168.     CrossRef
  • Metabolic Concepts of Sodium-Glucose Cotransporter 2 Inhibitors-Based Therapies Against Hepatocarcinogenesis and Therapy Resistance in Hepatocellular Carcinoma
    Hsien-Hui Chung
    Life.2026; 16(3): 446.     CrossRef
  • Strategic drug sequencing in hepatocellular carcinoma in the era of chemo-diversity: maximizing the therapeutic benefit of lenvatinib
    Hideki Iwamoto, Shigeo Shimose, Hironori Koga, Takumi Kawaguchi
    Journal of Liver Cancer.2026; 26(1): 83.     CrossRef
  • Safety and feasibility of a layered embolization strategy with drug-eluting and uniform-caliber microspheres for advanced hepatocellular carcinoma and unresectable liver metastases: a prospective single-arm clinical trial
    Xiangrui Chen, Louzong Sun, Min Hu, Ju Zhou, Chengluo Hao, Yunwei Han
    Frontiers in Oncology.2026;[Epub]     CrossRef
  • Knockdown of CCT2 inhibits the malignant progression of hepatocellular carcinoma cells by impairing STAT3 activation
    Chao Li, Lei Yang, Yudong Zhang, Baocheng Zhao, Hao Qu
    Oncology Reports.2026; 55(5): 1.     CrossRef
  • FAT4 loss promotes tumor growth and ferroptosis resistance in hepatocellular carcinoma via PI3K/AKT pathway activation
    Jing Li, Jialing Sun, Rui Hu, Mengqing Ma, Kongli Fan, Minling Lv, Qi Huang, Wenmin Yang, Yuan Yang, Yan Wang, Xiaozhou Zhou, Xinfeng Sun
    Clinical and Translational Oncology.2026;[Epub]     CrossRef
  • Moving beyond Ultrasound for Hepatocellular Carcinoma Surveillance in High-Risk Patients with Chronic Hepatitis B
    Hae Lim Lee
    Gut and Liver.2026; 20(2): 174.     CrossRef
  • Effects of cirrhosis on 3.0 T MRI DWI features of hepatocellular carcinoma, peri-tumoral sub-zones, and background liver: clinical implications for surgical planning
    Jinjia Zhu, Yuankai Du, Yidi Hu, Jiachen Jiao
    European Journal of Radiology.2026; 199: 112791.     CrossRef
  • Case Report: Serum AKR1B10 as a complementary marker for the detection of AFP-negative hepatocellular carcinoma – a report of two cases
    Ye Gao, Lihua Xie, Yuting Ou, Xi Zeng, Deliang Cao, Jianping Yin
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Original Article

Steatotic liver disease

Evolutionary changes in metabolic dysfunction-associated steatotic liver disease and risk of hepatocellular carcinoma: A nationwide cohort study
Seogsong Jeong, Yun Hwan Oh, Joseph C Ahn, Seulggie Choi, Sun Jae Park, Hye Jun Kim, Gyeongsil Lee, Joung Sik Son, Heejoon Jang, Dong Hyeon Lee, Meng Sha, Lei Chen, Won Kim, Sang Min Park
Clin Mol Hepatol 2024;30(3):487-499.
Published online May 7, 2024
DOI: https://doi.org/10.3350/cmh.2024.0145
Background/Aims
To determine the association between evolutionary changes in metabolic dysfunction-associated steatotic liver disease (MASLD) status and the risk of hepatocellular carcinoma (HCC) in a nationwide population-based cohort.
Methods
Information on study participants was derived from the Korea National Health Insurance Service database. The study population consisted of 5,080,410 participants who underwent two consecutive biennial health screenings between 2009 and 2012. All participants were followed up until HCC, death, or 31 December 2020. The association of evolutionary changes in MASLD status, as assessed by the fatty liver index and cardiometabolic risk factors, including persistent non-MASLD, resolved MASLD, incident MASLD, and persistent MASLD, with HCC risk was evaluated using multivariable-adjusted Cox proportional hazards regression.
Results
Among the 5,080,410 participants with 39,910,331 person-years of follow-up, 4,801 participants developed HCC. The incidence of HCC in participants with resolved, incident, and persistent MASLD was approximately 2.2-, 2.3-, and 4.7-fold higher, respectively, than that in those with persistent non-MASLD among the Korean adult population. When stratifying the participants according to the evolutionary change in MASLD status, persistent (adjusted hazard ratio [aHR], 2.94; 95% confidence interval [CI], 2.68–3.21; P<0.001), incident (aHR, 1.85; 95% CI, 1.63–2.10; P<0.001), and resolved MASLD (aHR, 1.33; 95% CI, 1.18–1.50; P<0.001) had an increased risk of HCC compared to persistent non-MASLD.
Conclusions
The evolutionary changes in MASLD were associated with the differential risk of HCC independent of metabolic risk factors and concomitant medications, providing additional information on the risk of HCC stratification in patients with MASLD.

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Editorial

Hepatic neoplasm

The latest global burden of liver cancer: A past and present threat
Joo Hyun Oh, Dae Won Jun
Clin Mol Hepatol 2023;29(2):355-357.
Published online March 9, 2023
DOI: https://doi.org/10.3350/cmh.2023.0070

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Review

Hepatic neoplasm

Hepatocellular carcinoma surveillance in patients with non-alcoholic fatty liver disease
Karim Seif El Dahan, Darine Daher, Amit G. Singal
Clin Mol Hepatol 2023;29(Suppl):S207-S219.
Published online September 14, 2022
DOI: https://doi.org/10.3350/cmh.2022.0247
Non-alcoholic fatty liver disease (NAFLD) may progress to cirrhotic or non-cirrhotic hepatocellular carcinoma (HCC), and is currently recognized as the fastest growing cause of HCC worldwide. Accordingly, professional society guidelines recommend HCC surveillance in patients with cirrhosis from any etiology, and some may consider it beneficial in subgroups with non-cirrhotic NAFLD at higher risk for HCC. Notably, patients with NAFLD-related HCC are more likely to have HCC diagnosed at more advanced stages and have poorer outcomes when compared to other etiologies, and suboptimal effectiveness of HCC surveillance programs is a major culprit. In this review, we summarize the current guidelines for HCC surveillance and discuss its benefits versus potential harms for NAFLD patients. We also address the unique challenges of HCC surveillance in NAFLD, including higher proportion of NAFLD-related HCC without cirrhosis, poor recognition of at-risk patients, lack of consensus regarding the value of surveillance in non-cirrhotic NAFLD, subpar effectiveness of surveillance tools related to NAFLD phenotype, and preponderant surveillance underuse among NAFLD patients. Finally, we examine the effectiveness of currently used surveillance tools (i.e., ultrasound and alpha fetoprotein) and outline future perspectives including emerging risk stratification tools, imaging surveillance strategies (e.g., abbreviated magnetic resonance imaging protocols), blood-based biomarkers (e.g., GALAD and circulating tumor DNA panels), and interventions to improve surveillance adherence.

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Original Article

Hepatic neoplasm

Cause of death and cause-specific mortality for primary liver cancer in South Korea: A nationwide population-based study in hepatitis B virus-endemic area
Bo Hyun Kim, Dahhay Lee, Kyu-Won Jung, Young-Joo Won, Hyunsoon Cho
Clin Mol Hepatol 2022;28(2):242-253.
Published online February 7, 2022
DOI: https://doi.org/10.3350/cmh.2021.0355
Background/Aims
Primary liver cancer is one of the leading causes of cancer mortality worldwide. However, the causes of death have not been studied in detail in patients with liver cancer.
Methods
The causes of death and cause-specific mortality risks in patients with primary liver cancer, diagnosed during 2000–2016, were investigated using the nationwide population-based cancer registry data in South Korea (n=231,388). The cumulative incidence function and Fine-Gray models were used to estimate the cause-specific mortality under the competing risks. Risks of non-cancer deaths relative to the general population were compared by standardized mortality ratios (SMRs).
Results
Among 179,921 total deaths, 92.4%, 1.7%, and 6.0% of patients died of primary liver cancer, cancer from other sites, and non-cancer illnesses, respectively. Proportionate mortality from liver cancer remained high. The 5-year competing risks probability of death from liver cancer varied by tumor stage, from 42% to 94%, and it remained high 10 years after the diagnosis (61–95%). Competing mortality from other causes has continuously increased. The most common non-cancer causes of death were underlying liver diseases (SMR, 15.6; 95% confidence interval [CI], 15.1–16.1) and viral hepatitis (SMR, 46.5; 95% CI, 43.9–49.2), which demonstrated higher mortality risks compared to the Korean general population. Higher mortality risks of suicide (SMR, 2.6; 95% CI, 2.4–2.8) was also noted.
Conclusions
Patients with liver cancer are most likely to die from liver cancer and related liver disease, even 10 years after the diagnosis, highlighting a need for specialized long-term follow-up care.

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Editorial

Hepatic neoplasm

Biopsy or cytology for diagnosing hepatic focal lesions?
Haeryoung Kim
Clin Mol Hepatol 2021;27(2):278-280.
Published online March 4, 2021
DOI: https://doi.org/10.3350/cmh.2021.0031

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Original Article

Persistence of intrahepatic hepatitis B virus DNA integration in patients developing hepatocellular carcinoma after hepatitis B surface antigen seroclearance
Jeong Won Jang, Jin Seoub Kim, Hye Seon Kim, Kwon Yong Tak, Heechul Nam, Pil Soo Sung, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Lewis R. Roberts
Clin Mol Hepatol 2021;27(1):207-218.
Published online December 3, 2020
DOI: https://doi.org/10.3350/cmh.2020.0115
Background/Aims
The role of hepatitis B virus (HBV) integration into the host genome in hepatocarcinogenesis following hepatitis B surface antigen (HBsAg) seroclearance remains unknown. Our study aimed to investigate and characterize HBV integration events in chronic hepatitis B (CHB) patients who developed hepatocellular carcinoma (HCC) after HBsAg seroclearance.

Methods
Using probe-based HBV capturing followed by next-generation sequencing technology, HBV integration was examined in 10 samples (seven tumors and three non-tumor tissues) from seven chronic carriers who developed HCC after HBsAg loss. Genomic locations and patterns of HBV integration were investigated.

Results
HBV integration was observed in six patients (85.7%) and eight (80.0%) of 10 tested samples. HBV integration breakpoints were detected in all of the non-tumor (3/3, 100%) and five of the seven (71.4%) tumor samples, with an average number of breakpoints of 4.00 and 2.43, respectively. Despite the lower total number of tumoral integration breakpoints, HBV integration sites in the tumors were more enriched within the genic area. In contrast, non-tumor tissues more often showed intergenic integration. Regarding functions of the affected genes, tumoral genes with HBV integration were mostly associated with carcinogenesis. At enrollment, patients who did not remain under regular HCC surveillance after HBsAg seroclearance had a large HCC, while those on regular surveillance had a small HCC.

Conclusions
The biological functions of HBV integration are almost comparable between HBsAg-positive and HBsAgserocleared HCCs, with continuing pro-oncogenic effects of HBV integration. Thus, ongoing HCC surveillance and clinical management should continue even after HBsAg seroclearance in patients with CHB.

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Special topic: Alcoholic liver diseases
The 14th International Symposium on Alcoholic Liver and Pancreatic Diseases and Cirrhosis (ISALPDC)

Hepatic neoplasm

Alcohol and hepatocarcinogenesis
Makiko Taniai
Clin Mol Hepatol 2020;26(4):736-741.
Published online October 1, 2020
DOI: https://doi.org/10.3350/cmh.2020.0203
An excessive alcohol intake may result in fatty liver, acute/chronic hepatitis, cirrhosis, and lead to hepatocellular carcinoma (HCC). The aim of this review is to clarify the present condition and the mechanisms of alcohol-related hepatocarcinogenesis and clinical risk factors for alcohol-related HCC. There are several possible mechanisms through which alcohol may induce hepatocarcinogenesis, including the mutagenic effects of acetaldehyde toxicity through the formation of protein and DNA adducts and the production of reactive oxygen species due to the excessive hepatic deposition of iron, changes to lipid peroxidation and metabolism, inflammation and an impaired immune response and modifications to DNA methylation. Furthermore, it has been reported that alcohol accelerates liver carcinogenesis through several signaling pathways including gut-liver axis. From a clinical perspective, it is well known that alcohol interacts with other factors, such as age, gender, viral hepatitis, obesity, and diabetes leading to an increased risk of HCC.

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Review

Hepatic neoplasm

Switching to systemic therapy after locoregional treatment failure: Definition and best timing
Sadahisa Ogasawara, Yoshihiko Ooka, Keisuke Koroki, Susumu Maruta, Hiroaki Kanzaki, Kengo Kanayama, Kazufumi Kobayashi, Soichiro Kiyono, Masato Nakamura, Naoya Kanogawa, Tomoko Saito, Takayuki Kondo, Eiichiro Suzuki, Shingo Nakamoto, Akinobu Tawada, Tetsuhiro Chiba, Makoto Arai, Jun Kato, Naoya Kato
Clin Mol Hepatol 2020;26(2):155-162.
Published online January 15, 2020
DOI: https://doi.org/10.3350/cmh.2019.0021n
In patients with unresectable hepatocellular carcinoma (HCC) without both macrovascular invasion and extrahepatic metastasis, the initial treatment choice recommended is transarterial chemoembolization (TACE). Before sorafenib came into wide use, TACE had been pointlessly carried out repeatedly. It was in the early 2010s that the concept of TACE refractory was advocated. Two retrospective studies from Japan indicated that conversion from TACE to sorafenib the day after patients were deemed as TACE refractory improved overall survival compared with continued TACE, according to the definition by the Japan Society of Hepatology. Nowadays, phase 3 trials have shown clinical benefits of several novel molecular target agents. Compared with the era of sorafenib, sequential treatments with these molecular target agents have gradually prolonged patients’ survival and have become major strategies in patients with HCC. Taking these together, conversion from TACE to systemic therapies at the time of TACE refractory, compared with before, may have a greater impact on survival and may be considered deeper in the decisions-making process in patients with unresectable HCC who are candidate for TACE. Up-to-date information on the concept of TACE refractory is summarized in this review. We believe that the survival of patients with unresectable HCC without both macrovascular invasion and extrahepatic metastasis may be dramatically improved by optimal timing of TACE refractory and switching to systemic therapies.

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Original Articles

Hepatic neoplasm

Risk assessment of hepatocellular carcinoma development for indeterminate hepatic nodules in patients with chronic hepatitis B
Haneulsaem Shin, Yeon Woo Jung, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Yeun-Yoon Kim, Jin-Young Choi, Seung Up Kim
Clin Mol Hepatol 2019;25(4):390-399.
Published online May 31, 2019
DOI: https://doi.org/10.3350/cmh.2018.0103
Background/Aims
A risk prediction model for the development of hepatocellular carcinoma (HCC) from indeterminate nodules detected on computed tomography (CT) (RadCT score) in patients with chronic hepatitis B (CHB)-related cirrhosis was proposed. We validated this model for indeterminate nodules on magnetic resonance imaging (MRI).
Methods
Between 2013 and 2016, Liver Imaging Reporting and Data System (LI-RADS) 2/3 nodules on MRI were detected in 99 patients with CHB. The RadCT score was calculated.
Results
The median age of the 72 male and 27 female subjects was 58 years. HCC history and liver cirrhosis were found in 47 (47.5%) and 44 (44.4%) patients, respectively. The median RadCT score was 112. The patients with HCC (n=41, 41.4%) showed significantly higher RadCT scores than those without (median, 119 vs. 107; P=0.013); the Chinese university-HCC and risk estimation for HCC in CHB (REACH-B) scores were similar (both P>0.05). Arterial enhancement, T2 hyperintensity, and diffusion restriction on MRI were not significantly different in the univariate analysis (all P>0.05); only the RadCT score significantly predicted HCC (hazard ratio [HR]=1.018; P=0.007). Multivariate analysis showed HCC history was the only independent HCC predictor (HR=2.374; P=0.012). When the subjects were stratified into three risk groups based on the RadCT score (<60, 60–105, and >105), the cumulative HCC incidence was not significantly different among them (all P>0.05, log-rank test).
Conclusions
HCC history, but not RadCT score, predicted CHB-related HCC development from LI-RADS 2/3 nodules. New risk models optimized for MRI-defined indeterminate nodules are required.

Citations

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Hepatic neoplasm

A survey on transarterial chemoembolization refractoriness and a real-world treatment pattern for hepatocellular carcinoma in Korea
Jae Seung Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Jin Sil Seong, Kwang-Hyub Han, Do Young Kim
Clin Mol Hepatol 2020;26(1):24-32.
Published online May 20, 2019
DOI: https://doi.org/10.3350/cmh.2018.0065
Background/Aims
Transarterial chemoembolization (TACE) is a standard treatment for intermediate-stage hepatocellular carcinoma (HCC), but there is much controversy about TACE refractoriness. The aim of this study was to identify trends in the actual clinical application of TACE and recognition of TACE refractoriness by Korean experts.
Methods
In total, 17 questionnaires on TACE refractoriness were administered to 161 clinicians via an online survey. Multiple answers were allowed for some questions.
Results
Most clinicians agreed that there is a need for standardization of TACE application through specific scoring systems (n=124, 77.0%). TACE refractoriness was predominantly expected by participants when recurrences were detected within 1 month (n=70, 43.5%), there were 4 to 6 tumors (n=77, 47.8%), the maximal tumor size was 3–5 cm (n=49, 30.4%), and when there was insufficient tumor necrosis despite TACE being repeated more than three times (n=78, 48.4%). Overall, sorafenib therapy (n=137) and radiotherapy (n=114) were preferred when repeated TACE was considered ineffective.
Conclusions
Treatment of HCC is often based on the clinical judgment of clinicians because of the heterogeneity among individuals. Experts need to continue discussions on the standardization and sub-classification of HCC treatment guidelines in Korea.

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Reviews

Hepatic neoplasm

Gadoxetic acid-enhanced magnetic resonance imaging: Hepatocellular carcinoma and mimickers
Yeun-Yoon Kim, Mi-Suk Park, Khalid Suliman Aljoqiman, Jin-Young Choi, Myeong-Jin Kim
Clin Mol Hepatol 2019;25(3):223-233.
Published online January 21, 2019
DOI: https://doi.org/10.3350/cmh.2018.0107
Gadoxetic acid, a hepatocyte-specific magnetic resonance imaging (MRI) contrast agent, has emerged as an important tool for hepatocellular carcinoma (HCC) diagnosis. Gadoxetic acid-enhanced MRI is useful for the evaluation of earlystage HCC, diagnosis of HCC precursor lesions, and highly sensitive diagnosis of HCC. Furthermore, functional information provided by gadoxetic acid-enhanced MRI can aid in the characterization of focal liver lesions. For example, whereas lesions lack functioning hepatocytes appear hypointense in the hepatobiliary phase, preserved or enhanced expression of organic anion transporting polypeptides in some HCCs as well as focal nodular hyperplasia lead to hyperintensity in the hepatobiliary phase; and a targetoid appearance on transitional phase or hepatobiliary phase imaging can be helpful for identifying the histopathological composition of tumors. While gadoxetic acid-enhanced MRI may improve the sensitivity of HCC diagnosis and provide new insights into the characterization of focal liver lesions, there are many challenges associated with its use. This article reviews the pros and cons of HCC diagnosis with gadoxetic acid-enhanced MRI and discuss some clues in the radiological differentiation of HCC from HCC mimickers.

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Hepatic neoplasm

Pathologic differential diagnosis of metastatic carcinoma in the liver
Jeong Hwan Park, Jung Ho Kim
Clin Mol Hepatol 2019;25(1):12-20.
Published online October 5, 2018
DOI: https://doi.org/10.3350/cmh.2018.0067
The liver is one of the most common sites to which malignancies preferentially metastasize. Although a substantial number of liver malignancies are primary tumors, including hepatocellular carcinoma and intrahepatic cholangiocarcinoma, the metastasis of carcinomas to the liver is relatively common and frequently encountered in clinical settings. Representative carcinomas that frequently metastasize to the liver include colorectal carcinoma, breast carcinoma, neuroendocrine tumors, lung carcinoma, and gastric carcinoma. The diagnostic confirmation of suspected metastatic lesions in the liver is generally achieved through a histopathologic examination of biopsy tissues. Although morphology is the most important feature for a pathologic differential diagnosis of metastatic carcinomas, immunohistochemical studies facilitate the differentiation of metastatic carcinoma origins and subtypes. Useful immunohistochemical markers for the differential diagnosis of metastatic carcinomas in the liver include cytokeratins (CK7, CK19, and CK20), neuroendocrine markers (CD56, synaptophysin, and chromogranin A), and tissue-specific markers (CDX2, SATB2, TTF-1, GCDFP-15, mammaglobin, etc.). Here, we provide a brief review about the pathologic differential diagnosis of major metastatic carcinomas in the liver.

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Liver Imaging

Vascular disorders of liver

Focal type of peliosis hepatis
Gil-Sun Hong, Kyoung Won Kim, Jihyun An, Ju Hyun Shim, Jihun Kim, Eun Sil Yu
Clin Mol Hepatol 2015;21(4):398-401.
Published online December 24, 2015
DOI: https://doi.org/10.3350/cmh.2015.21.4.398

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Case Report

Hepatic neoplasm

Imaging findings for intravascular large B-cell lymphoma of the liver
Jungmin Bae, Hyo Keun Lim, Ha Young Park
Clin Mol Hepatol 2015;21(3):295-299.
Published online September 30, 2015
DOI: https://doi.org/10.3350/cmh.2015.21.3.295

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of extranodal diffuse large B-cell lymphoma that most commonly involves the central nervous system and skin. To our knowledge, no state-of-the art imaging findings have been reported for hepatic IVLBCL in the English literature. We report the first case of hepatic involvement of IVLBCL along with a literature review.

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Original Articles

Hepatic neoplasm

Growth rate of early-stage hepatocellular carcinoma in patients with chronic liver disease
Chansik An, Youn Ah Choi, Dongil Choi, Yong Han Paik, Sang Hoon Ahn, Myeong-Jin Kim, Seung Woon Paik, Kwang-Hyub Han, Mi-Suk Park
Clin Mol Hepatol 2015;21(3):279-286.
Published online September 30, 2015
DOI: https://doi.org/10.3350/cmh.2015.21.3.279
Background/Aims

The goal of this study was to estimate the growth rate of hepatocellular carcinoma (HCC) and identify the host factors that significantly affect this rate.

Methods

Patients with early-stage HCC (n=175) who underwent two or more serial dynamic imaging studies without any anticancer treatment at two tertiary care hospitals in Korea were identified. For each patient, the tumor volume doubling time (TVDT) of HCC was calculated by comparing tumor volumes between serial imaging studies. Clinical and laboratory data were obtained from the medical records of the patients.

Results

The median TVDT was 85.7 days, with a range of 11 to 851.2 days. Multiple linear regression revealed that the initial tumor diameter (a tumor factor) and the etiology of chronic liver disease (a host factor) were significantly associated with the TVDT. The TVDT was shorter when the initial tumor diameter was smaller, and was shorter in HCC related to hepatitis B virus (HBV) infection than in HCC related to hepatitis C virus (HCV) infection (median, 76.8 days vs. 137.2 days; P=0.0234).

Conclusions

The etiology of chronic liver disease is a host factor that may significantly affect the growth rate of early-stage HCC, since HBV-associated HCC grows faster than HCV-associated HCC.

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    Irene Cruite, An Tang, Adrija Mamidipalli, Amol Shah, Cynthia Santillan, Claude B. Sirlin
    Seminars in Roentgenology.2016; 51(4): 292.     CrossRef
  • Multiplication of Tumor Volume by Two Tumor Markers Is a Post-Resection Prognostic Predictor for Solitary Hepatocellular Carcinoma
    Shin Hwang, Gi-Won Song, Young-Joo Lee, Ki-Hun Kim, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Dong-Hwan Jung, Gil-Chun Park, Sung-Gyu Lee
    Journal of Gastrointestinal Surgery.2016; 20(11): 1807.     CrossRef
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Spiral CT of Hepatic Masses ; Usefulness of Additional Findings Except Enhancement Patterns
Keun Young Kong , Dong Ho Lee , Young Tae Ko , Ju Won Lim , Joung Il Lee , Byung Ho Kim
Korean J Hepatol 1998;4(1):23-32.
Backgound/Aims - We compared the accuracy in the diagnosis of hepatic masses such as hepatocellular carcinoma (HCC), metastasis and hemangioma using enhancing pattern alone with using additional findings, and determined whether the additional findings could improve the diagnostic accuracy. M ethods/Materials Triphasic spiral CT images were retro- spectively analyzed in 83 cases of hepatic lesions,' 40 HCC, 21 metastases, and 22 hemangiomas. Three observers made the diagnosis first by the enhancement pattern of the mass alone, and then, by the whole information. The diagnosis of a lesion was considered correct if the lesion was correctly categorized by at least two observers. Diagnostic accuracies of two sessions were compared with McNemar test. Results - Using enhancing patterns alone, 31/40 HCC (78%), 8/21 metastases (38%), 21/22 hemangiomas (95%) were correctly diagnosed. The frequency of correct diagnosis was significantly improved when all images with additional findings were used: 36/40 (90%) HCC, 20/21 (95%) metastases, 22/22 (100%) hemangiomas (P=0.00006). Metastasis showed most prominent and statistically significant improvement in the diagnostic accuracy (P=0.0004). The number of correct diagnoses for HCC increased without statistical significance (P=0.17). However, the images with additional findings did not significantly contribute to the diagnosis of hemangiomas. The additional finidngs those led to correct diagnosis of metastases were multiple mass (7 cases), coexistence of primary malignancy (6 cases), and metastasis to other organ (1 case). The findings of liver cirrhosis were helpful to diagnose HCC correctly in 5 cases. Conclusion- The enhancing pattems of tumors were important in the diagnosis of hepatic masses in spiral CT. However, the additional finidngs were also helpful for the diagnosis of hepatic masses especially for the masses with atypical enhancement pattern. In metastases, the additional findings such as multiple masses or detection of primary malignant focus were useful to diagnose correctly. (Korean J Hepatol 1998;8:23 - 32)
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Liver Imagings

Focal Nodular Hyperplasia of the Liver: Imaging Findings with Emphasis on the Findings of Superparamagnetic Iron Oxide-enhanced MR Imaging
Joon Koo Han , Se Hyung Kim
Korean J Hepatol 2006;12(1):116-119.
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Double-contrast MR Imaging for Hepatocellular Carcinoma
Joon Koo Han , Se Hyung Kim
Korean J Hepatol 2006;12(2):247-250.
  • 3,108 View
  • 14 Download

Case Report

A Case of Needle Tract Implantation of Hepatocellular Carcinoma after Percutaneous Biopsy with an 18G Tru-cut Needle
Samuel Chang , Hyo Keun Lim
Korean J Hepatol 2006;12(3):439-443.
Needle tract implantation of hepatocellular carcinoma (HCC) is a rare complication of percutaneous biopsy, and it is largely associated with end-cutting needles or aspiration biopsy. The CT findings that have been reported include oval or round soft tissue nodules with persistent contrast enhancement along the needle tract, mostly in the subcutaneous tissue or the intercostal muscle layers. In this report, we describe a case of needle tract implantation of HCC after US-guided percutaneous biopsy with an 18G tru-cut needle. (Korean J Hepatol 2006;12:439-443)
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Original Article
Diagnostic Accuracy of 18F-FDG Positron Emission Tomography for Evaluation of Hepatocellular Carcinoma
Jeong A Shin , Joong Won Park , Min An , Joon Il Choi , Seong Hoon Kim , Seok Ki Kim , Woo Jin Lee , Sang Jae Park , Eun Kyung Hong , Chang Min Kim
Korean J Hepatol 2006;12(4):546-552.
Background/Aims
Positron emission tomography (PET) is an imaging technique reflecting cellular metabolism. However, the feasibility of PET in the diagnosis of hepatocellular carcinoma (HCC) is limited because of vague accuracy and high cost. The aim of this study was to evaluate the diagnostic accuracy of 18F-FDG-PET in detection of HCC. Methods: We retrospectively studied HCC patients who underwent 18F- FDG-PET between June 2001 and February 2005 in Korea National Cancer Center. Thirty-two patients were enrolled and HCC status of these patients were verified by surgical pathology or clinical course using imaging studies (CT, MRI or angiography) within 3 months after PET. PET studies were read by 2 specialists for nuclear medicine and determined as malignant when its standardized uptake value (SUV) was over 2.5. Results: HCC was suspected in 21 out of 32 cases on 18F-FDG-PET. On follow-up, 2 of 21 cases were determined false-positive. In cases of 11 patients without evidence of HCC on 18F-FDG-PET, 10 patients were found to have HCC on follow-up. Thus, the sensitivity and specificity of 18F-FDG-PET were 65.5% and 33.3% respectively. The positive predictive value was 90.5%. The diagnostic accuracy was 62.5%. Conclusion: 18F- FDG-PET showed a low accuracy in diagnosis of HCC. Therefore, 18F-FDG-PET has a limited role in a staging and detection of occult HCC. (Korean J Hepatol 2006;12:546-552)
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