LiverMultiScan Analysis of MRI Scans in HCC

Inclusion criteria:

Common Inclusion Criteria (Surgical Resection, Y90 Treatment and Systemic Therapy):

* Male and female patients, 21 to 90 years of age at the time of signing of the informed consent form.
* For HCC patients: Diagnosis of HCC confirmed by either 1 of the following 3 criteria:

  * AASLD imaging criteria
  * Histology/cytology of biopsy or surgically resected tumor tissue samples
  * Space occupying lesion in the liver and serum alpha-fetoprotein (AFP) of more than 400 in patients with chronic viral hepatitis or cirrhosis of any cause
* For CM patients: Diagnosis of colorectal cancer with metastasis to the liver confirmed by histology/cytology.
* Has ECOG performance status 0-1 before treatment intervention.

Inclusion Criteria Specific to Treatment Arm:

* Surgical Resection

  * Has received no anti-cancer specific treatment for HCC i.e. previous liver resection, loco-regional therapy (e.g. RFA, TACE, SIRT), radiotherapy, immunotherapy, chemotherapy or neo-adjuvant chemotherapy within 4 weeks prior to the date of the planned surgery.
  * Has adequate bone-marrow reserve, renal function and hepatic function as assessed by standard laboratory criteria:

    * Absolute neutrophil count ≥ 1.0 x 10\^9/L
    * Platelet count ≥ 50 x 10\^9/L
    * Haemoglobin ≥ 9.0 g/dL
    * INR ≤ 2.0
    * Serum creatinine ≤ 1.5 times the Upper Limit of Normal (ULN)
    * Albumin ≥ 2.5 g/dL
    * Total bilirubin ≤ 1.5 times the ULN
    * Alanine transaminase (ALT) ≤ 2.5 times the ULN
    * Aspartate Transaminase (AST) ≤ 2.5 times the ULN
  * Has Child-Pugh score ≤ 7.
* Y90 treatment

  * Y-90 therapy as the main treatment.
  * Has Child-Pugh score ≤ 7.
* Systemic therapy

  * Systemic therapy as the only treatment.
  * Has Child-Pugh score ≤ 8

Exclusion criteria:

Common Exclusion Criteria (Surgical Resection, Y90 Treatment and Systemic Therapy):

* Has low creatinine clearance (estimated glomerular filtration rates \< 60)
* Is unable to return for follow-up visits to monitor for disease response/progression
* Is unable to have a MRI scan, including but not limited to claustrophobia, implanted metallic devices and metal foreign bodies
* Non-provision of informed consent
* For female patients: pregnant or lactating

Exclusion Criteria Specific to Treatment Arm:

* Surgical resection

  * Has encephalopathy.
  * Has received a major organ allograft.
  * Has an uncontrolled bleeding disorder.
  * Has uncontrolled congestive heart failure or hypertension, unstable heart disease (coronary artery disease or myocardial infarction) or uncontrolled arrhythmia at the time of enrolment.
  * Has psychiatric or addictive disorders that may compromise his/her ability to give informed consent, or to comply with the study procedures.
  * Has other concurrent severe medical problems, unrelated to the malignancy, that would significantly limit full compliance with the study or expose the patient to unacceptable risk.
* Y90 treatment

  o Nil
* Systemic therapy

  * Receiving concurrent therapy alongside systemic therapy.
  * Has no anti-cancer specific treatment within 4 weeks prior to the initiation of systemic therapy.
  * Has encephalopathy.
  * Has history of allergic disease or reactions likely to be exacerbated by any component of treatment.
  * Has had a solid organ or hematologic transplant. Has clinically apparent ascites on physical examination. Note: Ascites detectable on imaging studies only are allowed.
  * Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
  * Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Note: Replacement therapy (e.g. thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
  * Has current pneumonitis or known history of, or any evidence of active, non-infectious pneumonitis that requires steroids.
  * Has uncontrolled congestive heart failure or hypertension, unstable heart disease (coronary artery disease or myocardial infarction) or any uncontrolled arrhythmia at the time of enrolment into study.
  * Has known psychiatric or addictive disorders that may compromise the patient's ability to give informed consent, or to comply with trial procedures.
  * Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial.
  * Has had a minor surgery ≤7 days prior to the first dose of systemic therapy.