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ACR Appropriateness Criteria® Chronic Liver Disease.

Publication ,  Journal Article
Expert Panel on Gastrointestinal Imaging, ; Bashir, MR; Horowitz, JM; Kamel, IR; Arif-Tiwari, H; Asrani, SK; Chernyak, V; Goldstein, A; Grajo, JR ...
Published in: J Am Coll Radiol
May 2020

The liver fibrosis stage is the most important clinical determinate of morbidity and mortality in patients with chronic liver diseases. With newer therapies, liver fibrosis can be stabilized and possibly reversed, thus accurate diagnosis and staging of liver fibrosis are clinically important. Ultrasound, CT, and conventional MRI can be used to establish the diagnosis of advanced fibrosis/cirrhosis but have limited utility for assessing earlier stages of fibrosis. Elastography-based ultrasound and MRI techniques are more useful for assessment of precirrhotic hepatic fibrosis. In patients with advanced fibrosis at risk for hepatocellular carcinoma (HCC), ultrasound is the surveillance modality recommended by international guidelines in nearly all circumstances. However, in patients in whom ultrasound does not assess the liver well, including those with severe steatosis or obesity, multiphase CT or MRI may have a role in surveillance for HCC. Both multiphase CT and MRI can be used for continued surveillance in patients with a history of HCC, and contrast-enhanced ultrasound may have an emerging role in this setting. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Duke Scholars

Published In

J Am Coll Radiol

DOI

EISSN

1558-349X

Publication Date

May 2020

Volume

17

Issue

5S

Start / End Page

S70 / S80

Location

United States

Related Subject Headings

  • United States
  • Societies, Medical
  • Nuclear Medicine & Medical Imaging
  • Liver Neoplasms
  • Liver Cirrhosis
  • Humans
  • Evidence-Based Medicine
  • Carcinoma, Hepatocellular
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Expert Panel on Gastrointestinal Imaging, ., Bashir, M. R., Horowitz, J. M., Kamel, I. R., Arif-Tiwari, H., Asrani, S. K., … Carucci, L. R. (2020). ACR Appropriateness Criteria® Chronic Liver Disease. J Am Coll Radiol, 17(5S), S70–S80. https://doi.org/10.1016/j.jacr.2020.01.023
Expert Panel on Gastrointestinal Imaging, Laura R., Mustafa R. Bashir, Jeanne M. Horowitz, Ihab R. Kamel, Hina Arif-Tiwari, Sumeet K. Asrani, Victoria Chernyak, et al. “ACR Appropriateness Criteria® Chronic Liver Disease.J Am Coll Radiol 17, no. 5S (May 2020): S70–80. https://doi.org/10.1016/j.jacr.2020.01.023.
Expert Panel on Gastrointestinal Imaging, Bashir MR, Horowitz JM, Kamel IR, Arif-Tiwari H, Asrani SK, et al. ACR Appropriateness Criteria® Chronic Liver Disease. J Am Coll Radiol. 2020 May;17(5S):S70–80.
Expert Panel on Gastrointestinal Imaging, Laura R., et al. “ACR Appropriateness Criteria® Chronic Liver Disease.J Am Coll Radiol, vol. 17, no. 5S, May 2020, pp. S70–80. Pubmed, doi:10.1016/j.jacr.2020.01.023.
Expert Panel on Gastrointestinal Imaging, Bashir MR, Horowitz JM, Kamel IR, Arif-Tiwari H, Asrani SK, Chernyak V, Goldstein A, Grajo JR, Hindman NM, Kamaya A, McNamara MM, Porter KK, Solnes LB, Srivastava PK, Zaheer A, Carucci LR. ACR Appropriateness Criteria® Chronic Liver Disease. J Am Coll Radiol. 2020 May;17(5S):S70–S80.
Journal cover image

Published In

J Am Coll Radiol

DOI

EISSN

1558-349X

Publication Date

May 2020

Volume

17

Issue

5S

Start / End Page

S70 / S80

Location

United States

Related Subject Headings

  • United States
  • Societies, Medical
  • Nuclear Medicine & Medical Imaging
  • Liver Neoplasms
  • Liver Cirrhosis
  • Humans
  • Evidence-Based Medicine
  • Carcinoma, Hepatocellular
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services