Response Assessment in Hepatocellular Carcinoma: A Primer for Radiologists.

Journal: Journal of computer assisted tomography
Published Date: Aug 7, 2025

Abstract

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide, necessitating accurate and early diagnosis to guide therapy, along with assessment of treatment response. Response assessment criteria have evolved from traditional morphologic approaches, such as WHO criteria and Response Evaluation Criteria in Solid Tumors (RECIST), to more recent methods focused on evaluating viable tumor burden, including European Association for Study of Liver (EASL) criteria, modified RECIST (mRECIST) and Liver Imaging Reporting and Data System (LI-RADS) Treatment Response (LI-TR) algorithm. This shift reflects the complex and evolving landscape of HCC treatment in the context of emerging systemic and locoregional therapies. Each of these criteria have their own nuanced strengths and limitations in capturing the detailed characteristics of HCC treatment and response assessment. The emergence of functional imaging techniques, including dual-energy CT, perfusion imaging, and rising use of radiomics, are enhancing the capabilities of response assessment. Growth in the realm of artificial intelligence and machine learning models provides an opportunity to refine the precision of response assessment by facilitating analysis of complex imaging data patterns. This review article provides a comprehensive overview of existing criteria, discusses functional and emerging imaging techniques, and outlines future directions for advancing HCC tumor response assessment.

Authors

  • Nayla Mroueh
    Abdominal Radiology Division, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114-2696, USA.
  • Jinjin Cao
    Department of Radiology, Massachusetts General Hospital, White 270, 55 Fruit Street, Boston, MA, 02114, USA.
  • Shravya Srinivas Rao
    Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114-2696, USA.
  • Soumyadeep Ghosh
    Department of Radiology, Massachusetts General Hospital, Boston, MA, United States. Electronic address: sghosh18@mgh.harvard.edu.
  • Ok Kyu Song
    Kakao, Seoul, South Korea.
  • Sasiprang Kongboonvijit
    Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114-2696, USA.
  • Anuradha Shenoy-Bhangle
    Department of Radiology, UPMC, Pittsburgh, PA Massachusetts General Hospital, Harvard Medical School, Boston, MA.
  • Avinash Kambadakone
    Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: akambadakone@mgh.harvard.edu.

Keywords

No keywords available for this article.

External Resources

Popular Topics
Recent Journals