What’s on the web for family physicians – focal liver lesions

Alfred KY Tang 鄧權恩，Chun-fai Lau 劉俊輝

National Cancer Institute: primary liver cancer
http://www.cancer.gov/types/liver/hp

The National Cancer Institute is the United States government's principal agency for cancer research and training. In their website, a wide range of up-to-date and evidence-based information organised for the patients and health professionals, including the PDQ database with treatment information, are available. In the section of primary liver and bile duct cancer, comprehensive materials ranging from cellular classification, staging, screening, prevention to treatment of liver cancer can be found.

National Institute for Health and Care Excellence (NICE)
https://www.nice.org.uk/guidance/conditions-and-diseases/cancer/liver-cancers

NICE was originally established to reduce variation in the availability and quality of treatments and care in the United Kingdom. It publishes technology appraisal guidelines and clinical guidelines for physicians and healthcare professionals. In the section on liver cancer, there are various guidance and advice from NICE on diagnostics, technology appraisal and interventional procedures for the diagnosis and treatment of liver cancers. Some of the topics includes laparoscopic liver resection, and the use of ablative and selective internal radiation therapies.

American College of Gastroenterology
http://gi.org/wp-content/uploads/2014/08/ACG_ Guideline_Focal_Liver_Lesions_September_2014.pdf

The American College of Gastroenterology(ACG) is a professional organisation that addresses the evolving needs of clinicians in the delivery of quality health care to gastroenterology patients. The website of the College harbours many clinical guidelines on various topics on gastrointestinal diseases. With advancing imaging techniques, there have been more and more incidental discoveries of focal liver lesions. ACG decided to publish a guideline on an evidencebased approach on the diagnosis and management of focal liver lesions. The guideline was published in the American Journal of Gastroenterology in Aug 2014.

Radiology Assistant
http://www.radiologyassistant.nl

This is a website with comprehensive educational materials in radiology. It is intended for helping radiologists and physicians interpret radiological images on different common disease entities, so as to make better use of radiological advances in improving quality of patient care. There are sections on images of different liver tumours, comparing and highlighting the characteristics of the various conditions. This is available at http://www.radiologyassistant.nl/en/p448eef3083354/liver-masses-ii-common-tumors.html. Another section on liver incidentalomas is available at http://www.radiologyassistant.nl/en/p45a5e818c709d/ liver-incidentalomas.html

Management of Benign liver lesions
http://anwresidency.com/conferences/CaseConf/14livermasses.pdf

This is a set of Powerpoint slides presented at a conference presentation in Abbott Northwestern Hospital. The lecture provides an overview of different liver lesions covering symptomatology, diagnostic challenges, and management strategies of the differential diagnoses. It outlines a systematic approach to diagnosis and management of different benign liver lesions. The presentation was well illustrated with radiological images of the differential condition highlighting the characteristics of different benign liver lesions.

American Association for the Study of Liver Diseases (AASLD)
http://www.aasld.org/publications/practice-guidelines-0

The AASLD is a professional organisation of healthcare scientists and physicians with emphasis on prevention and treatment of liver diseases. Evidencebased guidelines are developed and updated regularly by AASLD , together with recommendations of preferred approaches to the diagnostic, therapeutic, and preventative aspects of different liver diseases. For focal liver lesions, guidelines on management of hepatocellular carcinoma are available at http://www.aasld.org/sites/default/files/guideline_documents/ HCCUpdate2010.pdf and there is another guideline on liver biopsy at: http://www.aasld.org/sites/default/ files/guideline_documents/LiverBiopsy2009.pdf

Centre for Continuing Education, Cleveland Clinic
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement

The Center for Continuing Education of Cleveland Clinic is a highly accredited center committed to sharing knowledge with medical professionals worldwide. It provides quality, innovative CME programs for physicians. Its website provides evidencebased treatment guidelines and information on various disease entities, including details on the management of hepatocellular carcinoma. Another useful article found in the website is on screening for liver cancer at http:// www.clevelandclinicmeded.com/online/monograph/ hepc/page18.htm