Journal of Liver Cancer

Review Articles

Insights into hepatocellular adenomas in Asia: molecular subtypes, clinical characteristics, imaging features, and hepatocellular carcinoma risks: Subin Heo, In Hye Song, Edouard Reizine, Maxime Ronot, Jean-Charles Nault, Hae Young Kim, Sang Hyun Choi, So Yeon Kim; Received February 7, 2025 Accepted March 6, 2025 Published online March 7, 2025; DOI: https://doi.org/10.17998/jlc.2025.03.06 [Accepted]

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Abstract PDF: Hepatocellular adenomas (HCAs) are benign monoclonal liver tumors. Advances in molecular studies have led to the identification of distinct subtypes of HCA with unique pathways, clinical characteristics, and complication risks, underscoring the need for precise diagnosis and tailored management. Malignant transformation and bleeding remain significant concerns. Imaging plays a crucial role in the identification of these subtypes, offering a non-invasive method to guide clinical decision-making. Most studies involving patients with HCAs have been conducted in Western populations; however, the number of studies focused on Asian population has increased in recent years. HCAs exhibit distinct features in Asian population, such as a higher prevalence among male patients and specific subtypes (e.g., inflammatory HCAs). Current clinical guidelines are predominantly influenced by Western data, which may not fully capture these regional differences in epidemiology and subtype distribution. Therefore, this review presents the updated molecular classification of HCAs and their epidemiologic differences between Asian and Western populations, and discuss the role of imaging techniques, particularly magnetic resonance imaging using hepatobiliary contrast agents, in classifying the subtypes and predicting the risk of hepatocellular carcinoma.

Imaging Modalities for Hepatocellular Carcinoma Surveillance: Expanding Horizons beyond Ultrasound: Hyo Jung Park, So Yeon Kim; J Liver Cancer. 2020;20(2):99-105. Published online September 30, 2020; DOI: https://doi.org/10.17998/jlc.20.2.99

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In Asian countries favoring loco-regional treatment such as surgical resection or ablation, very early-stage hepatocellular carcinoma (HCC) should be the main target for surveillance. Even though ultrasound (US) has been accepted as a primary imaging modality for HCC surveillance, its performance in detecting very early-stage HCCs is insufficient. Moreover, in more than 20% of patients at high risk for HCC, visualization of the liver on US may be limited owing to the advanced distortion and heterogeneity of the liver parenchyma. Recently revised HCC clinical guidelines allow the use of alternative surveillance tools including computed tomography or magnetic resonance imaging in patients with inadequate US exams. This paper summarizes the findings of recent studies using imaging modalities other than US as surveillance tools for HCC as well as strengths and limitations of these modalities.

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Long‐Term Outcome of Chronic Hepatitis B—Histological Score and Viral Genotype Are Important Predictors of Hepatocellular Carcinoma
Anders Eilard, Johan Ringlander, Maria E. Andersson, Staffan Nilsson, Gunnar Norkrans, Magnus Lindh
Journal of Viral Hepatitis.2025;[Epub] CrossRef
Advanced Imaging of Hepatocellular Carcinoma: A Review of Current and Novel Techniques
Trinh Nguyen, Jaijo Vennatt, Lincoln Downs, Venkateswar Surabhi, Nir Stanietzky
Journal of Gastrointestinal Cancer.2024; 55(4): 1469. CrossRef
Imaging features of hepatobiliary MRI and the risk of hepatocellular carcinoma development
Jong-In Chang, Dong Hyun Sinn, Woo Kyoung Jeong, Jeong Ah Hwang, Ho Young Won, Kyunga Kim, Wonseok Kang, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung-Woon Paik
Scandinavian Journal of Gastroenterology.2022; 57(12): 1470. CrossRef

Response Evaluation Assessment in HCC: Modified RECIST: So Yeon Kim; Journal of the Korean Liver Cancer Study Group. 2011;11(2):111-115. Published online September 30, 2011

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Abstract PDF: The accurate evaluation of response to treatment is a key aspect in cancer therapy, because an objective response may become a surrogate marker of improver survival. For cytotoxic drugs, tumor response evaluation according to the World Health Organization (WHO) criteria or the Response Evaluation Criteria in Solid Tumors (RECIST) guideline offers simple approaches based on the size of the lesions. However, considering the nature of locoregional therapy or new cytostatic agent for hepatocellular carcinoma (HCC), which do not decrease the size of the tumor but induce tumor necrosis, original WHO or RECIST criteria will not reflect clinical benefit exactly. Recently, modified RECIST assessment is proposed by AASLD-JNCI guidelines. Given that complete necrosis was well correlated with better survival, modified RECIST criteria consider changes in tumor viability, which can be measured as the area of arterial enhancement, with maintaining overall response assessment similar to RECIST. The proposed modified RECIST assessment is expected to provide a reliable method for assessing tumor response in HCC clinical trials.

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