RESUMO
Introduction: Hepatocellular carcinoma constitutes for approximately 75% of primary cancers of liver. Around 80- 90% of patients with HCC have cirrhosis at the time of diagnosis. Use of AI has recently gained significance in the field of hepatology, especially for the detection of HCC, owing to its increasing incidence and specific radiological features which have been established for its diagnostic criteria. Objectives: A systematic review was performed to evaluate the current literature for early diagnosis of hepatocellular carcinoma in cirrhotic patients. METHODS: Systematic review was conducted using PRISMA guidelines and the relevant studies were narrated in detail with assessment of quality for each paper. RESULTS: This systematic review displays the significance of AI in early detection and prognosis of HCC with the pressing need for further exploration in this field. CONCLUSIONS: AI can have a significant role in early diagnosis of HCC in cirrhotic patients.
Assuntos
Carcinoma Hepatocelular , Detecção Precoce de Câncer , Cirrose Hepática , Neoplasias Hepáticas , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/complicações , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/diagnóstico por imagem , Detecção Precoce de Câncer/métodos , Inteligência ArtificialRESUMO
Background and study aims Adenoma detection rate (ADR) is validated for measuring quality of colonoscopy, however there is lack of colorectal cancer (CRC) screening program in South Asia. The purpose of this study is to analyze and review the polyp detection rate (PDR) and ADR and provide insight into the factors that influence them in Pakistan. Patients and methods This retrospective, cross-sectional study was performed at the Aga Khan University Hospital, Karachi, Pakistan, on patients ≥â18 years, who underwent colonoscopy between January 1, 2017 and June 30, 2018. Results Of 1985 patients, 59â% were male and 41â% female, with mean age of 47.8â±â16.2 years. The most common indication for colonoscopy was bleeding-per-rectum (28.0â%) and overall PDR and ADR were 17.9â% and 9.9â%, respectively. There was no significant difference between genders for either PDR ( P â=â0.378) or ADR ( P â=â0.574). Significantly higher PDR and ADR were found for patientsâ≥â50 years ( P â<â0.001), as well as for suboptimal bowel preparation [PDR (25.7â%; P â=â0.007) and ADR (18.6â%; P â=â0.014)]. Interestingly, endoscopists withâ<â500 colonoscopy-procedural-experience reported a higher PDR (21.6â%; P â=â0.020) and ADR (14.4â%; Pâ=â0.049), corresponding to a significantly higher PDR (20.6â%; P â=â0.005) and ADR (11.7â%; P â=â0.02) for endoscopists in practice forâ≤â10 years. Conclusions We have noticed low PDR and ADR, which require further investigation and research. In addition, we believe there should be a different baseline ADR and PDR as a quality indicator for colonoscopy in our region, where no internationally recommended colonoscopic screening programs have been implemented.