title: ACR Appropriateness Criteria radiologic management of hepatic malignancy.
abstract: Management of hepatic malignancy is a challenging clinical problem involving several different medical and surgical disciplines. Because of the wide variety of potential therapies, treatment protocols for various malignancies continue to evolve. Consequently, development of appropriate therapeutic algorithms necessitates consideration of medical options, such as systemic chemotherapy; surgical options, such as resection or transplantation; and locoregional therapies, such as thermal ablation and transarterial embolization. The authors discuss treatment strategies for the 3 most common subtypes of hepatic malignancy treated with locoregional therapies: hepatocellular carcinoma, neuroendocrine metastases, and colorectal metastases. The ACR Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
authors.affiliation: Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, USA. bkouri@wakehealth.edu
authors.forename: Brian E
authors.initials: BE
authors.lastname: Kouri
authors.forename: Brian S
authors.initials: BS
authors.lastname: Funaki
authors.forename: Charles E
authors.initials: CE
authors.lastname: Ray
authors.forename: Ghassan K
authors.initials: GK
authors.lastname: Abou-Alfa
authors.forename: Charles T
authors.initials: CT
authors.lastname: Burke
authors.forename: Michael D
authors.initials: MD
authors.lastname: Darcy
authors.forename: Nicholas
authors.initials: N
authors.lastname: Fidelman
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Greene
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Harrison
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Kinney
authors.forename: Jon K
authors.initials: JK
authors.lastname: Kostelic
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Lorenz
authors.forename: Ajit V
authors.initials: AV
authors.lastname: Nair
authors.forename: Albert A
authors.initials: AA
authors.lastname: Nemcek
authors.forename: Charles A
authors.initials: CA
authors.lastname: Owens
authors.forename: Wael E A
authors.initials: WE
authors.lastname: Saad
authors.forename: George
authors.initials: G
authors.lastname: Vatakencherry
mesh_terms: D003952:Diagnostic Imaging / Q000592:standards*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D008495:Medical Oncology / Q000592:standards*; D017410:Practice Guidelines as Topic; D011871:Radiology / Q000592:standards*; D014481:United States