Diagnosis and staging of hepatocellular carcinoma (HCC): current guidelines

Publication date: Available online 31 January 2018 Source:European Journal of Radiology Author(s): Carmen Ayuso, Jordi Rimola, Ramón Vilana, Marta Burrel, Anna Darnell, Ángeles García-Criado, Luis Bianchi, Ernest Belmonte, Carla Caparroz, Marta Barrufet, Jordi Bruix, Concepción Brú One of the key strategies to improve the prognosis of HCC, beside prevention, is to diagnose the tumor in early stages, when the patient is asymptomatic and the liver function is preserved, because in this clinical situation effective therapies with survival benefit can be applied. Imaging techniques are a key tool in the surveillance and diagnosis of HCC. Screening should be based in US every 6 months and non-invasive diagnostic criteria of HCC based on imaging findings on dynamic-MR and/or dynamic-CT have been validated and thus, accepted in clinical guidelines. The typical vascular pattern depicted by HCC on CT and or MRI consists on arterial enhancement, stronger than the surrounding liver (wash-in), and hypodensity or hyposignal intensity compared to the surrounding liver (wash-out) in the venous phase. This has a sensitivity of around 60% with a 96–100% specificity. Major improvements on liver imaging have been introduced in the latest years, adding functional information that can be quantified: the use of hepatobiliary contrast media for liver MRI, the inclusion of diffusion-weighted sequences in the standard protocols for liver MRI studies and new radiotracers for posit...
Source: European Journal of Radiology - Category: Radiology Source Type: research