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Dr.ssa Cristina Angonese
Imaging del fegato L’HCC nelle linee guida internazionali:
è possibile una classificazione unificante ad indirizzo prognostico-terapeutico?
Camposampiero
11.10.2013
=
Bruix et al., Hepatol 2005
2005
Linee guida in PubMed
Linee guida
Screening e sorveglianza
0
10
20
30
40
50
<20 ng 20-200 201-400 >401
<20 ng 20-200 201-400 >401
1099 patients subgrouped for
AFP classses (ITA.Li.CA)
0
20
40
60
1 nodulo 2-3 noduli >3 noduli diffuso massivo
AFP >400 ng/ml
0
20
40
60
< 2 cm 2-3 cm 3-5 cm >5 cm
AFP >400 ng/ml
Diagnosiss
Staging
Resection/LT
2 cm 3 cm >3 cm
SURGERY RFTA
TACE
TACE
Riassumendo…. > EASL-EORTC AASLD JSH AISF
Screening/ surveillance
US/4-6 Months US/6 months US/3-6 months + tumor markers
US/6Months
Diagnosis RMN/TAC RMN/TAC RMN/TAC Sonazoid Ceus Gd-EOB-MRI
CEUS/RMN/TAC
Staging BCLC BCLC NO BCLC – JHS/TNM
+/- BCLC
Treatment BCLC with adjustment for
LT
BCLC Complex Algorithm
MODIFIED BCLC
LT Milan criteria Milan criteria Milan criteria Milan (expansion)
Comments Biobanks/ Biomarkers
Multidisciplinarity Expertise
GRAZIE !
