Achyut Saroj: Seeing the Invisible – Closing the Liver Cancer Blind Spot

As patient populations change — with rising rates of MASLD/MASH and obesity — traditional morphological imaging like ultrasound is increasingly hitting a diagnostic wall. Saroj maps HelioLiver’s role across the four quadrants of the Johari Window.

The Open Area: Actionable Detection

Where the tumor is present and visible to both a multi-analyte test and standard imaging. In the CLiMB trial, HelioLiver identified more cases in this actionable area than ultrasound alone, with an overall sensitivity of 47.8%.

The Blind Spot: Where Ultrasound Falls Short

High BMI and liver scarring increasingly compromise abdominal ultrasound. In the fully prospective CLiMB trial, ultrasound showed 0% sensitivity for HCC lesions smaller than 2 cm, while HelioLiver was roughly 4× more sensitive to very early-stage (T1) lesions — helping to illuminate the blind spot created by physical imaging barriers.

The Hidden Area: Proactive Molecular Signals

Before a tumor is large enough to be seen on a scan, it leaves a biological footprint. DNA methylation is an early step in hepatocarcinogenesis, and by analyzing roughly 500,000 base pairs of cell-free DNA, HelioLiver can surface these hidden molecular signals — offering a potential lead-time advantage before a mass appears on imaging.

The Unknown: Resolving Indeterminacy

For the indeterminate LI-RADS 3 or 4 findings that often lead to watchful waiting, HelioLiver’s AI-generated methylation score (with a 0.75 threshold and an AUC of 0.897) acts as a molecular barometer for tumor aggressiveness — helping move patients from uncertainty toward timely intervention or prioritized transplant listing.

Saroj originally shared the analysis on LinkedIn, and it was featured by OncoDaily.

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