Hepatocellular Carcinoma Clinical Trial
Official title:
Evaluation of Liver Stiffness by Ultrasound Elastography for Predicting Early Hepatocellular Carcinoma Recurrence After Treatment
We aim to evaluate liver stiffness as a marker of severity and duration of the underlying liver disease to predict for early HCC recurrence after treatment.
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide and contributes to
enormous cancer-related deaths annually . Hepatocellular carcinoma is a frequent complication
of liver disease. Early recurrence is mainly tumour or treatment-related .
Liver fibrosis stagging is essential to evaluate the expected prognosis against the
concomitant therapies. Liver biopsy remain the gold standard for diagnosing liver fibrosis,
however, it is limited due to the associated costs, invasiveness, and intra and inter
observer variability. Patient discomfort, refusal and risk of complications. Ultrasound
Elastography is a non-invasive imaging method liver fibrosis staging . Ultrasound
Elastography is an imaging technology sensitive to tissue stiffness that was developed in the
1990s. It has been further developed and refined in recent years to enable quantitative
assessment of tissue stiffness. Elastography methods take advantage of the changed elasticity
of soft tissues resulting from specific pathological or physiological processes .
Elastography is an application, which produces the force coupled with a measurement system
for the deformities caused by the force. There are several types of forces: 1. static
compression induced externally by manual compression or internally by organ motion (heart,
vessel, and breathing) 2. Dynamic compression induced with a continuous vibration at a given
frequency 3. Impulse compression (transient vibration) induced externally by a transient
mechanical impulse ( Fibroscan) or internally by an ultrasound impulse (ARFI, SWE), both
compression types producing shear waves. While contrast-enhanced imaging is the first-line
approach in the diagnosis of HCC, recent report show that the non-invasively measured
stiffness of hepatic nodule could help to distinguish between malignant and benign liver
lesions.
The treatment of HCC depends on the stage of liver disease and in many cases, curative
resection is not possible. Therefore local ablative therapies, such as transarterial
chemoembolization (TACE) and radiofrequency ablation (RFA), are considered viable therapeutic
options . However, HCC might behave very differently and could show more or less of a
response to local ablative treatment
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