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 sub...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2019/8747438 |
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| author | Uta Herden Wenzel Schoening Johann Pratschke Steffen Manekeller Andreas Paul Richard Linke Thomas Lorf Frank Lehner Felix Braun Dirk L. Stippel Robert Sucher Hartmut Schmidt Christian P. Strassburg Markus Guba Marieke van Rosmalen Xavier Rogiers Undine Samuel Gerhard MSc Schön Bjoern Nashan |
| author_facet | Uta Herden Wenzel Schoening Johann Pratschke Steffen Manekeller Andreas Paul Richard Linke Thomas Lorf Frank Lehner Felix Braun Dirk L. Stippel Robert Sucher Hartmut Schmidt Christian P. Strassburg Markus Guba Marieke van Rosmalen Xavier Rogiers Undine Samuel Gerhard MSc Schön Bjoern Nashan |
| author_sort | Uta Herden |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-0cdb02886ef145d89a2739ac0f241eb0 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-0cdb02886ef145d89a2739ac0f241eb02025-02-03T05:59:51ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972019-01-01201910.1155/2019/87474388747438Accuracy of Pretransplant Imaging Diagnostic for Hepatocellular Carcinoma: A Retrospective German Multicenter StudyUta Herden0Wenzel Schoening1Johann Pratschke2Steffen Manekeller3Andreas Paul4Richard Linke5Thomas Lorf6Frank Lehner7Felix Braun8Dirk L. Stippel9Robert Sucher10Hartmut Schmidt11Christian P. Strassburg12Markus Guba13Marieke van Rosmalen14Xavier Rogiers15Undine Samuel16Gerhard MSc Schön17Bjoern Nashan18Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of General, Visceral, and Transplantation Surgery, University Hospital of RWTH, Aachen, GermanyDepartment of Surgery, Campus Charité-Mitte and Campus Virchow-Klinikum, Charité, Berlin, GermanyDepartment of General, Visceral, Thoracic, and Vascular Surgery, University Hospital of Bonn, Bonn, GermanyDepartment of General, Visceral, and Transplantation Surgery, University of Duisburg-Essen, University Hospital Essen, Essen, GermanyDepartment of General and Visceral Surgery, Frankfurt University Hospital, Goethe-University Frankfurt/Main, Frankfurt/Main, GermanyDepartment of General, Visceral, and Transplant Surgery, University Medical Center Göttingen, Göttingen, GermanyDepartment of General, Visceral, and Transplantation Surgery, Hannover Medical School, Hannover, GermanyDepartment of General, Visceral, Thoracic, Transplantation, and Pediatric Surgery, University Medical Center Schleswig-Holstein, Kiel, GermanyDepartment of General, Visceral, and Cancer Surgery, University of Cologne, Köln, GermanyDepartment of Visceral, Transplantation, Vascular, and Thoracic Surgery, University Hospital of Leipzig, Leipzig, GermanyDepartment of Transplantation Medicine, University Hospital Münster, Münster, GermanyEurotransplant Liver Intestine Advisory Committee, Eurotransplant International Foundation, Leiden, NetherlandsEurotransplant Liver Intestine Advisory Committee, Eurotransplant International Foundation, Leiden, NetherlandsEurotransplant Liver Intestine Advisory Committee, Eurotransplant International Foundation, Leiden, NetherlandsEurotransplant Liver Intestine Advisory Committee, Eurotransplant International Foundation, Leiden, NetherlandsEurotransplant International Foundation, Leiden, NetherlandsDepartment of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanySelection 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.http://dx.doi.org/10.1155/2019/8747438 |
| spellingShingle | Uta Herden Wenzel Schoening Johann Pratschke Steffen Manekeller Andreas Paul Richard Linke Thomas Lorf Frank Lehner Felix Braun Dirk L. Stippel Robert Sucher Hartmut Schmidt Christian P. Strassburg Markus Guba Marieke van Rosmalen Xavier Rogiers Undine Samuel Gerhard MSc Schön Bjoern Nashan Accuracy of Pretransplant Imaging Diagnostic for Hepatocellular Carcinoma: A Retrospective German Multicenter Study Canadian Journal of Gastroenterology and Hepatology |
| title | Accuracy of Pretransplant Imaging Diagnostic for Hepatocellular Carcinoma: A Retrospective German Multicenter Study |
| title_full | Accuracy of Pretransplant Imaging Diagnostic for Hepatocellular Carcinoma: A Retrospective German Multicenter Study |
| title_fullStr | Accuracy of Pretransplant Imaging Diagnostic for Hepatocellular Carcinoma: A Retrospective German Multicenter Study |
| title_full_unstemmed | Accuracy of Pretransplant Imaging Diagnostic for Hepatocellular Carcinoma: A Retrospective German Multicenter Study |
| title_short | Accuracy of Pretransplant Imaging Diagnostic for Hepatocellular Carcinoma: A Retrospective German Multicenter Study |
| title_sort | accuracy of pretransplant imaging diagnostic for hepatocellular carcinoma a retrospective german multicenter study |
| url | http://dx.doi.org/10.1155/2019/8747438 |
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