Guidelines updated for diagnosis, management of focal liver lesions

In a clinical guideline issued by the American College of Gastroenterology and published online in the July issue of The American Journal of Gastroenterology, updated recommendations are presented for the diagnosis and management of the most common focal liver lesions (FLL).

Catherine Frenette, M.D., from the Family Health Centers of San Diego, and colleagues used the best evidence available to make diagnosis and management recommendations for the most common FLLs.

The authors recommended multiphasic contrast-enhanced imaging, preferably magnetic resonance imaging (MRI) or computed tomography performed with late arterial, portal venous, and delayed phases in patients with FLL of uncertain etiology. In patients with hepatic adenomas, discontinuation of oral contraceptives or intrauterine devices that are hormone-impregnated is recommended.

Weight loss is suggested for overweight or obese patients with hepatic adenomas. To accurately distinguish hepatic adenomas from other benign or malignant liver lesions, multiphasic liver imaging (preferably MRI) is suggested over standard cross-sectional imaging modalities.

Discontinuation of exogenous hormones is suggested and weight loss advised, if applicable, in women with hepatic adenomas <5 cm. Continued imaging surveillance is recommended every three to six months for at least one year in patients with cirrhosis or chronic hepatitis B who meet criteria for hepatocellular carcinoma surveillance and have a suspected hemangioma.

"Despite the radiographic results, patients will continue to rely on their providers to make the best recommendations for ongoing care, which in the ideal scenario is the reassurance that no further follow-up is required, especially in patients without underlying comorbidities," the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

© 2024 HealthDay. All rights reserved.