title: Hepatocellular carcinoma: modern image-guided therapies.
abstract: The most common primary malignancy of the liver and the third leading cause of cancer mortality worldwide is hepatocellular carcinoma (HCC), which presents a major global health problem due to its increasing incidence. Most cases of HCC are secondary to either infection (hepatitis B or C) or cirrhosis (alcohol being the most common cause). Clinical presentation is variable and the tumour can be an incidental finding. Treatment options for HCC and prognosis are dependent on many factors but most importantly tumour size and staging. The last two decades have revolutionised the treatment of HCC using image-guided techniques. The concepts of imaging and image-guided techniques are still young and not well described in standard textbooks and hence an up to date review article is essential. The clinical subspecialities may lack familiarity with image-guided techniques but are responsible for management of these patients before and after the treatment by interventional radiologists. This article reviews current image-guided techniques, evidence and outcomes and provides educational highlights and question and answers. The article provides an overview in a simple understandable manner to enable readers from various levels of practice and training to benefit from and apply in their practice.
authors.affiliation: Department of Radiology, Leeds Teaching Hospitals, Leeds, UK.
authors.forename: Sapna
authors.initials: S
authors.lastname: Puppala
authors.affiliation: Department of Radiology, Leeds Teaching Hospitals, Leeds, UK.
authors.forename: Rafiuddin
authors.initials: R
authors.lastname: Patel
authors.affiliation: Department of Radiology, Leeds Teaching Hospitals, Leeds, UK.
authors.forename: Ki Sing
authors.initials: KS
authors.lastname: Yap
authors.affiliation: Department of Radiology, Leeds Teaching Hospitals, Leeds, UK.
authors.forename: Jai
authors.initials: J
authors.lastname: Patel
authors.affiliation: Department of Radiology, Leeds Teaching Hospitals, Leeds, UK.
authors.forename: Tze
authors.initials: T
authors.lastname: Wah
authors.affiliation: Department of Radiology, Leeds Teaching Hospitals, Leeds, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Snoddon
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000401:mortality; D003952:Diagnostic Imaging / Q000295:instrumentation; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000401:mortality; D016031:Liver Transplantation; D009367:Neoplasm Staging / Q000295:instrumentation; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology