Liver Cancer

Liver Cancer Management

Enabling better outcomes​ for patients with liver diseases​

Liver cancer - in particular, hepatocellular carcinoma (HCC) - is a complex disease, often detected in later stages, which leads to poorer patient outcomes. It is the third deadliest cancer in the world, killing 840,000 people each year1. Most patients with HCC have signs of advanced fibrosis, which is caused by chronic liver diseases, such as nonalcoholic fatty liver disease, alcoholic liver disease or viral hepatitis. 

Although viral hepatitis is still the leading risk factor for HCC, it is expected that soon non-alcoholic fat liver disease (NAFLD) will become the leading cause for HCC2. Due to insufficient awareness within the general population, healthcare providers need to seek ways to detect disease earlier and ultimately improve outcomes.   

With solutions along the entire patient pathway – from risk stratification, to diagnosis, treatment and survivorship – Siemens Healthineers sees as its mission to take up the fight against the world’s most deadly diseases. 

As your partner in liver cancer management, Siemens Healthineers helps you accelerate the path from risk stratification, diagnosis, therapy and survivorship. In addition to driving speed and precision, our solutions seek to streamline workflows and empower cancer care teams to improve performance and meet unique and evolving patient needs.

At the ECR 2023, Valérie Vilgrain, Chair of the Radiology Department at Beaujon Hospital in Paris, sat down with André Hartung, President of Diagnostic Imaging at Siemens Healthineers. In the video interview, they discuss how imaging can address the challenges in liver cancer diagnosis and treatment today.

Risk stratification & Early detection

Liver disease is a silent killer

Often called a silent killer, liver disease has become more prevalent in recent years. Non-alcoholic fatty liver disease (NAFLD) is a spectrum of conditions that range from simple fatty liver (steatosis) to non-alcoholic steatohepatitis (NASH), which can progress to cirrhosis, and hepatocellular carcinoma (HCC). The incidence of NAFLD-related HCC is projected to increase dramatically by 2030, with increases of 82%, 117% and 122% from 2016 in China, France and the USA, respectively4
To identify and monitor steatosis, all major guidelines recommended ultrasound and after the diagnosis, monitor those patients for developing fibrosis is highly indicated using FIB-4, ELF test and Ultrasound elastography5. Professional societies recommend HCC surveillance in high-risk individuals using ultrasound, including those with cirrhosis and patients with chronic HBV infection.6,7 
Given the under-implementation of screening, incidental diagnosis has been estimated to occur in 50% of cases globally, many of them in advanced-stage7. Early detection of HCC enables patients to access curative therapies that can improve patient survival8. With Siemens Healthineers you can improve value, efficiency and excellent patient care.

Diagnosis & Therapy decision

Accurate diagnosis is key for treatment decision

Diagnosis of HCC can be confirmed with imaging tools and in many cases doesn’t even require biopsy7. Multidisciplinary management of HCC with comprehensive review of radiological and pathological findings helps to tackle the complexity of liver disease9
Major guidelines worldwide recommend using multiphasic computed tomography (CT) or magnetic resonance imaging (MRI) to diagnose HCC10. Contrast-enhanced Ultrasound (CEUS) is recommended for incidental findings of focal liver lesions in non-cirrhotic patients, in patients with renal insufficiency or as subsequent modality before biopsy in case of inconclusive findings at CT or MR11
Siemens Healthineers provides imaging technology and the smart imaging value chain that enable reliable therapy decision.

Treatment planning & Delivery

Provide the right treatment at the right time for every patient.

Management of HCC has substantially improved over the past decade. Many institutions assign the treatment according to tumor stages following the Barcelona Clinic Liver Cancer (BCLC) staging system12. Early- stage HCC tumors are the preferred candidates for resection, transplantation and loco-regional ablation. Some studies have demonstrated similar recurrence rates between patients undergoing surgical resection and ablation13. Intermediate stages are first candidates for Transcatheter arterial chemoembolization (TACE) and those with advanced disease will first receive systemic therapies12. Several new molecular targeted agents have demonstrated benefits in survival of HCC as adjuvant therapy to resection or ablation14, calling for Oncology Information Systems which help to streamline departmental workflows. 

Siemens Healthineers and Varian provide solutions for precision therapy. Our portfolio includes tools and devices for planning, guidance and verification of procedures and empower consistent outcomes.

Follow-up & Survivorship

Evidence-based care and patient experience

Post-treatment recurrence is as high as 50% within the first two-years of follow-up, even in patients with curative intend (BCLC stage 0 and A)13. Early recurrence is associated with low overall survival and the prediction of recurrence with digital pathology after resection could be used as predictor15. Periodic follow-ups are key to monitor therapy response and detect recurrence of cancer early. 
Siemens Healthineers’ advanced imaging portfolio has full potential to support evidence-based care. Longitudinal side-by-side comparison of images provides confidence for care teams.


Step into the future
Doctor using decision support software that suggests different treatment options.

Imagine an avatar,

a digital “you” so accurately mapped to your physical self that it could be used to personalize your healthcare, to predict and even prevent disease. It’s called a Digital Twin. And in the near future it’s going to become reality. Step into the future and read about how Anna’s Digital Twin saved her life. 

Watch Tony's story

"Early detection is invaluable," Villiotti says. "That's the single biggest thing a patient can do. If you're aware of it early, you can take action early and hopefully stop the progression."

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