Journal highlights

Malignant liver cancers such as hepatocellular carcinoma (HCC) are a major global health challenge. In 2020, approximately 830,200 people worldwide died from HCC alone; by 2040, deaths could increase by 55%. The first-line curative treatment for small (≤3–5 cm) hepatic tumors is percutaneous ablation (PTA), which includes microwave and radiofrequency ablation.

Compared with surgical resection, PTA has a superior safety profile. However, most existing safety data are outdated. Ablation technology and procedural complexity have evolved and contemporary benchmarks for procedure-related mortality and major adverse events are needed.

To address this gap, Gary Doppelt, MD, St-Éloi University Hospital, Montpellier, and Caremeau University Hospital, Nîmes, France, and colleagues published a meta-analysis in Radiology of 4,149 patients who underwent PTA of malignant liver tumors across 49 studies. They found that 90-day procedure-related mortality was near zero and the major complication rate was only 3%.

“These results support PTA as a lowrisk treatment with consistent safety outcomes, reinforcing its central role as a cornerstone technique within the multidisciplinary management of liver malignant neoplasms,” the authors said.

Read the full article, “The Safety Standards for Liver Percutaneous Thermal Ablation: A Meta-Analysis of Adverse Events over 15 Years.”

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Using PRECISE Version 2 for Prostate Cancer Monitoring

Although prostate cancer is the second leading cause of cancer-related death in men, most patients do not experience aggressive disease. To help determine who needs treatment and who can be safely monitored, active surveillance (AS) with MRI has emerged as a strategy for managing low-risk disease. The Prostate Cancer Radiologic Estimation of Change in Sequential Evaluation (PRECISE) criteria were introduced in 2016 to standardize MRI reporting during AS, but the system had several limitations. PRECISE version 2 is now available.

In a recent article in RadioGraphics, authors led by Arthur Ogata, MD, University of São Paulo, and Giorgio Brembilla, MD, Università Vita-Salute San Raffaele, Italy, discuss the foundations, key updates and practical applications of PRECISE version 2. They also review prostate anatomy, histologic classification and disease staging.

“Although it requires further validation, the PRECISE version 2 scoring system provides the only available structured and reproducible framework for reporting serial MRI findings, promoting consistency across follow-up examinations and enhancing communication between health care practitioners,” the authors conclude.

Read the full article, “PRECISE Version 2: Essential Tips for Prostate Cancer Monitoring Using MRI.” This article is also available for CME on EdCentral.

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Prognostic Value of CT and MR LI-RADS Discordance

Differences in Liver Imaging Reporting and Data System (LI-RADS) categorization between CT and MRI may provide important prognostic information for patients with hepatocellular carcinoma (HCC), according to a new study published in Radiology: Imaging Cancer.

In this dual-center retrospective study, Yong Jun Jung, MD, University of Ulsan College of Medicine, Seoul, South Korea, and colleagues evaluated intraindividual agreement and discordance in LI-RADS categorizations between preoperative CT and MRI in 319 patients who underwent curative resection for HCC.

LI-RADS category M (LRM), indicating malignancy not specific for HCC, was significantly more common on MRI than CT (21.6% vs 6.0%). LRM categorization on either modality was independently associated with worse two-year recurrence-free survival (RFS). When CT and MRI findings were combined, outcomes declined in stages, with those classified as LRM on both CT and MRI having the poorest outcomes.

“Future studies are warranted to validate these results in more diverse populations and to determine how combined CT- and MRI-based LI-RADS assessment can be optimally integrated into postoperative risk stratification and management of HCC,” the authors concluded.

Read the full article, “Prognostic Significance of Intraindividual CT and MRI LI-RADS Agreement and Discordance in Hepatocellular Carcinoma.” 

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