Dr. Jordi Bruix leads a document that establishes radiological diagnostic criteria for hepatocellular carcinoma in the US

The American Society of Radiology publishes in its journal Radiology an updated article summarizing the new recommendations to diagnose and follow patients with hepatocellular carcinoma considered for liver transplantation in the United States. The document is the result of a task force created in 2008 in the heart of an expert conference organized by UNOS (the american organ distribution agency). Dr. Jordi Bruix, head of the Hepatic Oncology IDIBAPS - Hospital Clínic research team, participated as an international expert in the field of diagnosis and treatment of liver cancer. He is the last author of this document that defines the strategy in the US, which includes other internationally renowned experts from institutions such as Tufts University Medical School, Carolinas Medical Center, Mayo Clinic and University of Michigan Hospital.

The document establishes the more suitable technologies for diagnosis, the criteria that should be applied to reach a 100% specificity, and how to define the tumor stage. It is crucial to decide patient prioritization or when a tumor has progressed beyond what is accepted to proceed with a transplant. Regarding priority policies it should be noted that in the United States they are based in tumor burden defined by radiology and the transplant is not indicated when it exceeds a determined threshold.

The group led by Dr. Jordi Bruix has become a world leader in developing and validating radiology based diagnostic criteria. Ultimately, these criteria have resulted in recommendations included in Spanish, European and American diagnosis and treatment guidelines for liver cancer.

All these aspects are critical to ensure an accurate indication of transplantation in patients with liver cancer, so that the few available livers are correctly used. Standardizing the technological requirements and criteria to be used is essential to prevent heterogeneity among different groups of transplant candidates that could result in a lack of equity in the organ distribution. This was the fundamental motivation of UNOS when the process started, and certainly similar processes will be started elsewhere.

Article reference: Wald C, Russo MW, Heimbach JK, Hussain HK, Pomfret EA, Bruix J. New OPTN/UNOS Policy for LiverTransplantAllocation: Standardization of LiverImaging, Diagnosis, Classification, and Reporting of Hepatocellular Carcinoma. Radiology. 2013 Feb;266(2):376-82. doi: 10.1148/radiol.12121698