In an OncoDaily “Voices” piece, Achyut Saroj, founder and consultant at AwareOnc and a medical affairs liaison at Tatva Health, explores how liver cancer surveillance is changing. He uses the Johari Window framework to show how a blood-based, multi-analyte test like HelioLiver is shrinking the blind spot in hepatocellular carcinoma (HCC) detection. As rates of MASLD, MASH and obesity climb, he argues, traditional imaging such as ultrasound is reaching its limits.
The heart of the piece is what ultrasound misses. Saroj points to the fully prospective CLiMB trial, where ultrasound showed 0 percent sensitivity for HCC lesions smaller than 2 cm, particularly in patients with high BMI or liver scarring. HelioLiver, by contrast, proved roughly four times more sensitive to very early stage (T1) lesions and identified more actionable cases than ultrasound alone, with an overall sensitivity of 47.8 percent. In effect, the blood test can reveal cancers that physical imaging simply cannot see.
Beyond catching what imaging misses, Saroj describes how HelioLiver looks for cancer before a tumor is even visible on a scan. Because DNA methylation is an early step in liver cancer development, the test analyzes roughly 500,000 base pairs of cell-free DNA to detect these molecular signals. That can give clinicians a lead time advantage, allowing them to act before a mass appears. Its AI-generated methylation score also serves as a molecular barometer of tumor aggressiveness, with an AUC of 0.897, helping to resolve uncertain findings that might otherwise leave patients in a cycle of watchful waiting.
Saroj concludes that surveillance is ultimately about understanding the molecular environment, not just the picture on a scan. By shifting from morphological imaging to proactive, multi-analyte detection, clinicians can catch liver cancer earlier, when treatment is most likely to be curative. It is a clinician’s perspective on why blood-based tools like HelioLiver are becoming central to the future of HCC surveillance.
Read more: View the full article on OncoDaily →