Diagnosing liver fibrosis and hepatocellular carcinoma in high risk

Diagnosing liver fibrosis and hepatocellular carcinoma in high risk
populations: the need for screening, diagnostic methods and effective
Ph.D. studerende: Maja Thiele, 1. reservelæge. Forskningsenhed for Gastroenterologi og
Hepatologi, afdeling for medicinske mavetarmsygdomme, Odense Universitetshospital,
Sdr. Boulevard 29, 5000 Odense C
Hovedvejleder: Aleksander Krag, PhD, professor i hepatologi, afdeling for medicinske
mavetarmsygdomme, Odense Universitetshospital.
Background: Chronic liver disease is the cause of 1.8 million deaths each year. Patients
die from hepatocellular carcinoma (HCC) and/or cirrhosis of the liver. Since early stages of
HCC and cirrhosis are asymptomatic and since there are large differences in incidence
according to risk factors, most patients are diagnosed at an advanced stage, where
curative treatment is no longer an option. Major advances in diagnostic techniques
potentially allows for timely diagnosis by screening patients at risk of HCC and cirrhosis.
Aims: To evaluate a new technology for improved screening for HCC and liver cirrhosis:
non-invasive tissue stiffness measurements using real-time shear-wave elastography with
the equipment Aixplorer. To assess HCC incidence rates in relation to individual risk
factors and preventive treatment.
Methods: Four studies are performed: 1) Real-time shear-wave elastography and
transient elastography for the non-invasive diagnosis of liver fibrosis and cirrhosis in
patients with alcohol abuse. A cohort study of 400 patients with prior or current alcohol
abuse using liver biopsy as gold standard. 2) Real-time shear-wave elastography for the
characterisation of hepatocellular carcinoma, colo-rectal cancer metastases and benign
nodules. A cohort study of 60 patients with cirrhosis and HCC or benign liver nodules and
40 patients with CRC and liver metastases or benign liver nodules. 3) Incidence of
hepatocellular carcinoma according to risk factors and effect of antiviral treatment in HBV:
Two systematic reviews of randomised trials and observational studies. 4) Effect of betablockers on HCC incidence in cirrhosis: Systematic review with meta-analyses of
randomised trials.
Ph.D. præsentation, Maja Thiele