第十届全球肝脏磁共振成像(MRI)论坛于2021年10月举行了为期2天的虚拟会议,来自北美和南美的代表参加了会议。亚洲,澳大利亚,和欧洲。大多数代表是有肝脏磁共振成像经验的放射科医生,肝脏外科专家也有代表,肿瘤学,和肝病学。介绍,讨论,和工作组在论坛集中关注以下主题:•临床实践中的甲氧乙酸:东西方对肝细胞癌(HCC)筛查/监测的当前用途和挑战的看法,诊断,和管理•HCC成像的经济学和成果•影像组学,磁共振成像在肝癌中的人工智能(AI)和深度学习(DL)应用。这些主题是当前手稿的主题。第二篇手稿讨论了多学科肿瘤委员会的观点:如何尽早接近,mid-,从肝脏外科医生的角度来看,晚期肝癌的管理,介入放射科医生,和肿瘤学家(Taouli等人,2023年)。代表们对工作组就这些会议主题发表的协商一致声明进行了表决。如果至少有80%的投票代表同意这些发言,则认为达成了共识。临床意义陈述:本文综述了gadoxetic酸增强MRI在肝癌筛查和诊断中的临床应用。以及其成本效益和影像组学和人工智能在肝癌患者中的应用。重点:•东西方指南对gadoxetic酸增强MRI的解释略有不同,反映不同地区对敏感性和特异性的要求。•新兴的数据是令人鼓舞的成本效益的gadoxetic酸增强MRI在肝癌筛查和诊断,但需要更多的研究。•影像组学和人工智能很可能,在未来,为检测做出贡献,分期,评估治疗反应和预测HCC的预后-减轻放射科医生和其他专家的负担,并支持对患者进行及时和有针对性的治疗。
The 10th Global Forum for Liver Magnetic Resonance Imaging (MRI) was held as a virtual 2-day meeting in October 2021, attended by delegates from North and South America, Asia, Australia, and Europe. Most delegates were radiologists with experience in liver MRI, with representation also from specialists in liver surgery, oncology, and hepatology. Presentations, discussions, and working groups at the Forum focused on the following themes: • Gadoxetic acid in clinical practice: Eastern and Western perspectives on current uses and challenges in hepatocellular carcinoma (HCC) screening/surveillance, diagnosis, and management • Economics and outcomes of HCC imaging • Radiomics, artificial intelligence (AI) and deep learning (DL) applications of MRI in HCC. These themes are the subject of the current manuscript. A second manuscript discusses multidisciplinary tumor board perspectives: how to approach early-, mid-, and late-stage HCC management from the perspectives of a liver surgeon, interventional radiologist, and oncologist (Taouli et al, 2023). Delegates voted on
consensus statements that were developed by working groups on these meeting themes. A
consensus was considered to be reached if at least 80% of the voting delegates agreed on the statements. CLINICAL RELEVANCE STATEMENT: This review highlights the clinical applications of gadoxetic acid-enhanced MRI for liver cancer screening and diagnosis, as well as its cost-effectiveness and the applications of radiomics and AI in patients with liver cancer. KEY POINTS: • Interpretation of gadoxetic acid-enhanced MRI differs slightly between Eastern and Western
guidelines, reflecting different regional requirements for sensitivity vs specificity. • Emerging data are encouraging for the cost-effectiveness of gadoxetic acid-enhanced MRI in HCC screening and diagnosis, but more studies are required. • Radiomics and artificial intelligence are likely, in the future, to contribute to the detection, staging, assessment of treatment response and prediction of prognosis of HCC-reducing the burden on radiologists and other specialists and supporting timely and targeted treatment for patients.