Title:Diagnostic Imaging of Hepatocellular Carcinoma - A Pictorial Essay
VOLUME: 13 ISSUE: 2
Author(s):Tomasz K. Nowicki*, Karolina Markiet and Edyta Szurowska
Affiliation:Department of Radiology, Medical University of Gdansk, Smoluchowskiego 17, 80-214 Gdansk, Department of Radiology, Medical University of Gdansk, Smoluchowskiego 17, 80-214 Gdansk, Department of Radiology, Medical University of Gdansk, Smoluchowskiego 17, 80-214 Gdansk
Keywords:Cirrhosis, diagnostic algorithm, hepatocellular carcinoma, magnetic resonance imaging, multidetector computed
tomography, ultrasound.
Abstract:Hepatocellular carcinoma (HCC) is the most common primary liver cancer, which develops
mostly in the setting of chronic liver disease. European Association for the Study of the Liver
(EASL) and European Organization for Research and Treatment of Cancer (EORTC) prepared
guidelines for screening, follow-up and diagnosis of HCC to facilitate decision making and optimize
both diagnostic and therapeutic protocols.
The review briefly describes etiology, epidemiology and histopathology of HCC and presents
EASL-EORTC guidelines for surveillance and diagnosis of HCC. Target population and screening
algorithm is presented in the surveillance section. Ultrasound imaging of HCC and the role of contrast
enhanced ultrasound are described as well as the value of laboratory tests in screening. Further,
radiological features of HCC in multiphase CT and dynamic contrast enhanced MRI and diagnostic
criteria are presented. Additionally, the advantages of advanced techniques in MRI such as diffusion
weighed imaging and the use of hepatocyte-specific contrast agents are discussed.
Lastly, the EASL-EORTC guidelines are compared with the guidelines of the American Association
for the Study of Liver Diseases and the Japan Society of Hepatology. Also LI-RADS and the Barcelona
Clinic Liver Cancer classification are mentioned.
In the near future, due to the ongoing advances in imaging a revision of the guidelines may be expected.
