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Osho et al. Hepatoma Res 2020;6:55 I http://dx.doi.org/10.20517/2394-5079.2020.42 Page 11 of 15

SUMMARY
Imaging has played a significant role in the advancements of surveillance, diagnosis, and treatment of HCC.
Across all professional societies, ultrasound is the most recognized imaging modality for HCC screening
among at-risk patients. CT and MRI are currently not recommended for surveillance given similar
sensitivities as ultrasound and cost-effectiveness, but recent trials are studying abbreviated MRI protocols
for surveillance. Non-invasive diagnosis of HCC relies heavily on CT and MRI with application of the
LI-RADS in classifying suspicious lesions for HCC. PET imaging is best utilized to identify extrahepatic
metastases but has poor performance for diagnosis of primary HCC. CEUS has also been studied for its
role in HCC diagnosis and is currently accepted as a second line imaging modality in most professional
societies. Imaging with CT and MRI has also been shown to be effective in monitoring treatment response,
with most centers using RECIST or mRECIST for trial analysis.

DECLARATIONS
Authors’ contributions
Conception of manuscript: Singal AG
Drafting of manuscript: Osho A, Rich NE
Critical revisions of manuscript: Rich NE, Singal AG
Administrative support: Singal AG

Availability of data and materials
Not applicable.

Financial support and sponsorship
Dr. Singal’s research is supported in part by NIH (R01 CA212008, and R01 CA222900). The content is
solely the responsibility of the authors and does not necessarily represent the official views of the National
Institutes of Health.

Conflicts of interest
Dr. Singal AG has served on advisory boards or as consultant for Genentech, Bayer, Eisai, Exelixis, BMS,
Merck, Wako Diagnostics, Glycotest, Exact Sciences, Roche, and TARGET Pharmasolutions. Other authors
declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.

REFERENCE
1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and
mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424.
2. Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018
Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology 2018;68:723-50.
3. European Association for the Study of the Liver. European association for the study of the liver. EASL Clinical practice guidelines:
management of hepatocellular carcinoma. J Hepatol 2018;69:182-236.
4. Zhang BH, Yang BH, Tang ZY. Randomized controlled trial of screening for hepatocellular carcinoma. J Cancer Res Clin Oncol
2004;130:417-22.