Diagnosis of Hepatocellular Carcinoma with Non-Invasive Imaging: a Plea for Worldwide Adoption of Standard and Precise Terminology for Describing Enhancement Criteria

Hepatocellular carcinoma in cirrhosis is unique in oncology since a definitive diagnosis based on non-invasive imaging can be used without biopsy confirmation to determine even the most radical therapies such as liver transplantation. Given the enormous responsbility assigned to non-invasive imaging in guiding HCC management one would expect that there would be standardized terminology in use throughout the world for describing the diagnostic imaging criteria. Surprisingly, this is not the case. Different guidelines have adopted different terminology for assessing the temporal enhancement characteristics of HCC. The adoption of different terminology by different guidelines, even if intended to have similar meaning, contributes to inconsistency in clinical care, causes confusion in research, and is a barrier to progress in the field.