Hepatitis B Surveillance and Treatment in the UCSF Department of Radiology and Biomedical Imaging

Hepatitis B virus infection is a worldwide health problem and is particularly prevalent in the San Francisco Bay Area. Infection with the hepatitis B virus occurs through both the sharing of body fluids such as blood, as well as through vertical transmission from mother to child. Left untreated, infection with hepatitis B over many years can lead to liver damage as well as cancers such as hepatocellular carcinoma.

When people with hepatitis B develop liver tumors, they often have no symptoms. Therefore, imaging is crucial for monitoring infected patients for early signs of liver cancer. In the UCSF Department of Radiology and Biomedical Imaging, patients with hepatitis B are initially screened for liver tumors using ultrasound, followed by CT and MRI if anything suspicious is found. UCSF radiologists perform screening both at the main UCSF Health Hospitals as well as at the Zuckerberg San Francisco General Hospital and San Francisco Veterans Affairs Medical Center.

In addition to causing liver tumors, hepatitis B also damages the liver and over time can lead to liver fibrosis and liver failure. This chronic liver damage also generally has no symptoms until it is very advanced. Classically, liver fibrosis has been diagnosed by a liver biopsy, where a specialized needle is used to remove a piece of liver tissue. This procedure is prone to complications such as pain and bleeding. At UCSF, we have adopted new MRI technology (MR Elastography) in which the stiffness of the liver can be measured non-invasively, allowing patients to avoid needle biopsies.

UCSF radiologists are actively involved in research programs to develop new imaging methods to detect inflammation in the liver. This inflammation is thought to be the underlying cause of liver injury caused by hepatitis B virus infection.

For patients with hepatitis B who develop liver tumors, scientists in the UCSF Department of Radiology play a central role in treating those tumors. Interventional radiologists at UCSF can use small catheters to either cut off the blood flow feeding the liver tumors or else, to selectively inject chemotherapy into the tumor while sparing much of the rest of the body. Additionally, interventional radiologists can treat tumors by heating them, having patients avoid surgery.

Besides offering localized therapies to treat hepatitis B and liver tumors, UCSF has a robust liver transplant program. Diagnostic and interventional radiologists work closely with transplant doctors and hepatobiliary surgeons to assess and monitor patients being considered for liver transplant. These specialized teams work together to provide every transplant patient the best care possible.

Radiologists at UCSF are actively involved in every facet of hepatitis B care, from screening to treatment of complications.

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