Monitoring
Patients with lesions <1 cm on initial screening ultrasound are typically monitored with a further ultrasound and alpha fetoprotein (AFP) every 3-6 months.[3] If the lesion demonstrates no growth after two or more follow-up ultrasound exams, these patients may revert to routine surveillance (ultrasound and AFP every 6 months).[3]
Patients with treated HCC should be followed up with dynamic contrast imaging (multidetector computed tomography [MDCT] or magnetic resonance imaging [MRI]) every 3-4 months for the first 2 years. Imaging interval may be increased after 2 years in recurrence-free patients. In patients with elevated serum AFP at diagnosis, serial monitoring every 3-4 months posttreatment may allow for earlier detection of recurrence.
For patients who receive liver transplantation for HCC, 6- to 12-monthly surveillance with serum AFP and dynamic contrast MDCT or MRI is recommended.[147] In selected high-risk patients who are found to have lymphovascular invasion or out-of-criteria tumor burden on explant pathology, enhanced surveillance at 3- to 4-monthly intervals may be considered.
Use of this content is subject to our disclaimer