TY  - JOUR
A1  - Herden, Uta
A1  - Schöning, Wenzel
A1  - Pratschke, Johann
A1  - Manekeller, Steffen
A1  - Paul, Andreas
A1  - Linke, Richard
A1  - Lorf, Thomas
A1  - Lehner, Frank
A1  - Braun, Felix
A1  - Stippel, Dirk
A1  - Sucher, Robert
A1  - Schmidt, Hartmut
A1  - Straßburg, Christian P.
A1  - Guba, Markus
A1  - Rosmalen, Marieke van
A1  - Rogiers, Xavier
A1  - Samuel, Undine
A1  - Schön, Gerhard
A1  - Nashan, Björn
T1  - Accuracy of pretransplant imaging diagnostic for hepatocellular carcinoma : a retrospective German multicenter study
T2  - Canadian journal of gastroenterology and hepatology
N2  - Selection and prioritization of patients with HCC for LT are based on pretransplant imaging diagnostic, taking the risk of incorrect diagnosis. According to the German waitlist guidelines, imaging has to be reported to the allocation organization (Eurotransplant) and pathology reports have to be submitted thereafter. In order to assess current procedures we performed a retrospective multicenter analysis in all German transplant centers with focus on accuracy of imaging diagnostic and tumor classification. 1168 primary LT for HCC were conducted between 2007 and 2013 in Germany. Patients inside the Milan, UCSF, and up-to-seven criteria were misclassified with definitive histologic results in 18%, 15%, and 11%, respectively. Patients pretransplant outside the Milan, UCSF, and up-to-seven criteria were otherwise misclassified in 34%, 43%, and 41%. Recurrence-free survival correlated with classification by posttransplant histological report, but not pretransplant imaging diagnostic. Univariate analysis revealed tumor size, vascular invasion, and grading as significant parameters for outcome, while tumor grading was the only parameter persisting by multivariate testing. Conclusion. There was a relevant percentage (15-40%) of patients misclassified by imaging diagnosis at a time prior to LI-RADS and guidelines to improve imaging of HCC. Outcome analysis showed a good correlation to histological, in contrast poor correlation to imaging diagnosis, suggesting an adjustment of the LT selection and prioritization criteria.
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/50160
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-501603
SN  - 2291-2789
SN  - 1916-7237
N1  - Copyright © 2019 Uta Herden et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
VL  - 2019
IS  - Art. 8747438
SP  - 1
EP  - 9
PB  - Hindawi Publishing Corporation
CY  - [Cairo]
ER  -