{
  "abstract": "Objective Hepatocellular carcinoma (HCC) is the fastest rising cause of cancer-related deaths in the UK. The British Society of Gastroenterology and the European Association for the Study of the Liver recommend ultrasound scans (USS) biannually to survey high-risk patients. Implementing this can be labour-intensive and introduces significant clinical risk. We developed a radiology-led HCC surveillance (HCC-S) pathway—the ‘Traffic Light System’ (TLS)—allowing for protocolised booking of scans based on a colour coding system and associated protocols. We evaluated our service to assess safety, efficacy and provide practical implementation guidance.Methods A single-site, retrospective cohort study of patients undergoing HCC-S as part of the TLS was undertaken. Patients receiving USS surveillance between March 2021 and February 2022 were included and reviewed over an up to a 3-year follow-up period until March 2024. If 6 monthly follow-up did not occur or if new pathology was identified, notes were reviewed to determine outcomes.Results In total, 909 USS were completed under the TLS for 220 patients. Eight patients (3.6%) were diagnosed with HCC. Apparent non-adherence with HCC-S protocol was identified in 38 patients (17.3%). On further review, 10 patients (4.5%) were truly non-adherent to HCC-S. Administrative errors were identified in three patients (1.3%).Conclusion We have established a radiology-led HCC-S programme that we believe to be robust, effective and reliable with an adherence rate of 95.5% over up to 3 years. Therefore, this may be a template for other services to follow when establishing HCC-S programmes.",
  "authors": [
    {
      "affiliations": [
        "Gastroenterology Department, Somerset NHS Foundation Trust, Taunton, UK"
      ],
      "name": "Robert Miller"
    },
    {
      "affiliations": [
        "Gastroenterology Department, Somerset NHS Foundation Trust, Taunton, UK"
      ],
      "name": "Lusyan Dayalan"
    },
    {
      "affiliations": [
        "Gastroenterology Department, Somerset NHS Foundation Trust, Taunton, UK"
      ],
      "name": "Christina Owen"
    },
    {
      "affiliations": [
        "Radiology Department, Somerset NHS Foundation Trust, Taunton, UK"
      ],
      "name": "Caragh Mathew"
    },
    {
      "affiliations": [
        "Gastroenterology Department, Somerset NHS Foundation Trust, Taunton, UK"
      ],
      "name": "Tom Johnston"
    },
    {
      "affiliations": [
        "Gastroenterology Department, Somerset NHS Foundation Trust, Taunton, UK"
      ],
      "name": "Tim Jobson"
    },
    {
      "affiliations": [
        "Radiology Department, Somerset NHS Foundation Trust, Taunton, UK"
      ],
      "name": "Andrew Lowe"
    },
    {
      "affiliations": [
        "Radiology Department, Somerset NHS Foundation Trust, Taunton, UK"
      ],
      "name": "Paul Carruthers"
    },
    {
      "affiliations": [
        "Gastroenterology Department, Somerset NHS Foundation Trust, Taunton, UK"
      ],
      "name": "Wolf-Rudiger Matull"
    }
  ],
  "title": "The ‘Traffic Light System’: a radiology-led pathway for hepatocellular carcinoma surveillance in patients with liver cirrhosis",
  "uid": "3359ed5d-0fec-5bf4-b1e7-bf3808229f94"
}