A group of experienced and trainee radiologists, Spencer Behr, Michael Ohliger, Omar Hassan, and Hailey Choi, led an engaging discussion on research opportunities related to Hepatocellular Carcinoma (HCC) Imaging. This is a significant opportunity, as UCSF sees a high volume of HCC patients including for liver transplant, and there are ample opportunities to leverage our collective broad imaging expertise.

Dr. Hassan shared his work in rad-path correlations where he has built up an approximately 200 patient database (~75%/25% CT/MRI), who have gone onto transplant and so pathology is available. He is investigating the LI-RADS standardized reporting system, which primarily relies on contrast-enhanced images for assessment, and focusing on the challenging case of recurrant disease after local-regional therapy.

This work particularly highlighted the challenges for doing research given the heterogeneity in image protocols, image quality, radiology reporting, and pathology reporting. Improving standardization in reporting, creating common frameworks, databases, and/or registries as well as other tools such as NLP could open up a lot more data-driven research for HCC imaging.

The group highlighted ther areas of potential related to patient management as the screening and surviellance population (SFGH), and monitoring of Y90 segmentectomy by imaging.

0.55T MRI is also a new research area led by Dr. William Hong, aiming to develop fast screening protocols ideally using free-breathing that could be more accessible with this low-cost, low-footprint system.

There was debate about the role of molecular imaging for HCC. Prof. Youngho Seo shared his experience with PET in this area, which currently focuses on treatment strategies in animal models, but there was not a lot of optimism or clear PET agents to develop further. Dr. Ohliger shared plans to try hyperpolarized 13C MRI in HCC patients for metabolic imaging.

The consensus of the group that we should expand our discussions and opportunities in this area. I liked the idea proposed of a Body Imaging subgroup focused on Liver Imaging that could take the lead in this area. Given the breadth of the Body Imaging Research Group, doing activities with focused subgroups I think would support more meaningful detailed discussions (like this), while full Group activities I think will be better for sharing broader inspirational ideas as well as supporting common activities. I plan to experiment with mixing subgroup and fullgroup activities.