Accuracy of pretransplant imaging diagnostic for hepatocellular carcinoma : a retrospective German multicenter study

  • 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.

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Author:Uta HerdenORCiDGND, Wenzel Schöning, Johann PratschkeGND, Steffen ManekellerORCiDGND, Andreas Paul, Richard LinkeGND, Thomas Lorf, Frank LehnerORCiDGND, Felix Braun, Dirk StippelORCiDGND, Robert Sucher, Hartmut Schmidt, Christian P. StraßburgGND, Markus Guba, Marieke van Rosmalen, Xavier Rogiers, Undine Samuel, Gerhard SchönORCiDGND, Björn Nashan
Pubmed Id:
Parent Title (English):Canadian journal of gastroenterology and hepatology
Publisher:Hindawi Publishing Corporation
Place of publication:[Cairo]
Contributor(s):Kevork M. Peltekian
Document Type:Article
Year of Completion:2019
Date of first Publication:2019/03/05
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2019/04/18
Issue:Art. 8747438
Page Number:10
First Page:1
Last Page:9
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.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0