Standardization of diagnostic imaging scans in patients at risk for liver cancer in the Greater Toronto Area


Hepatocellular carcinoma (HCC) is overwhelmingly diagnosed through CT and MRI scans. At the regional HCC treatment center, there was a perception of gaps in quality and heterogeneity in image acquisition protocols of the diagnostic scans performed in community hospitals across the region and in Ontario. The aim of this project was to validate the perception, pinpoint the gaps, and determine a validated plan to homogenize the image acquisition protocols and correct the quality deficiencies. A stakeholder analysis revealed community hospital radiologists and technologists as the primary targets for intervention, with Cancer Care Ontario as a guiding partner in the process. Qualitative and quantitative measures of imaging quality and acquisition across the province were performed identifying several common, specific and correctable deficiencies. A scorecard of HCC imaging quality and guideline compliance was created for all the regions hospitals. Applicable international guidelines were identified for regional/provincial adoption. Focus group sessions at two GTA community hospitals were led to pinpoint specific areas of system failure along the steps of HCC imaging and determine means of correcting the failures. Consultation with Cancer Care Ontario was performed. A plan to the identified gap with intrinsic effectiveness measures was devised and will be presented to Cancer care Ontario’s Cancer imaging program for feedback and potential adoption.

Capstone Team: 

Korosh Khalili


Capstone Advisory Committee:

Dr. Jordan Feld
Dr. Martin O’Malley
Dr. Alice Wei


TRP Faculty Lead:

Dr. Joseph Ferenbok