How do you diagnose hepatocellular carcinoma?


Can HCC be diagnosed without a biopsy?

If the nodule is larger than 2 cm at initial diagnosis and has the typical features of HCC on one dynamic imaging technique, biopsy is not necessary for the diagnosis of HCC. Alternatively, if the AFP is >200 ng/mL, biopsy is also not required.

What is the modality of choice in the diagnosis of hepatocellular carcinoma?

Ultrasound and Contrast-Enhanced Ultrasound

It is the modality of choice for HCC screening and surveillance because of its advantages and its high specificity that reaches over 90% for detecting HCC [16].

Can an MRI detect hepatocellular carcinoma?

Preferred examination. Cross-sectional imaging with computed tomography (CT) scanning and magnetic resonance imaging (MRI) is most commonly used to detect hepatocellular carcinoma (HCC).

What are the clinical features for diagnosis of early hepatocellular carcinomas?

Patients with hepatocellular carcinoma (HCC) generally present with signs and symptoms of advancing cirrhosis, as follows:

  • Pruritus.
  • Jaundice.
  • Splenomegaly.
  • Variceal bleeding.
  • Cachexia.
  • Increasing abdominal girth (portal vein occlusion by thrombus with rapid development of ascites)
  • Hepatic encephalopathy.
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What is the life expectancy of a person with hepatocellular carcinoma?

Average follow-up for all HCC patients in this study was 20.4 months. Overall median survival of all 389 patients was 11 months from the date of diagnosis.

When should you suspect HCC?

Suspicion for HCC is raised when any lesion is recognized in US, particularly if it is more than 1 cm in size in the background of liver cirrhosis[47] (Figure ​ 1). Several studies assessed the diagnostic accuracy of US as a screening tool for early detection of HCC[48-51].

What does hepatocellular carcinoma look like on ultrasound?

Hepatocellular carcinoma does not have a characteristic appearance at US. The lesions are typically hypoechoic, but they can be hyperechoic or have mixed echogenicity. The majority of nodules that measure less than 1 cm are not hepatocellular carcinoma (8).

What are the complications of hepatocellular carcinoma?

Complications from HCC are those of hepatic failure; death occurs from cachexia, variceal bleeding, or (rarely) tumor rupture and bleeding into the peritoneum. Signs and symptoms of hepatic failure may signify tumor recurrence and/or progression.

Who should be screened for hepatocellular carcinoma?

In its 2018 guidelines for the management of HCC, the AASLD recommends surveillance for HCC in adults with cirrhosis, because it improves overall survival. Surveillance should be conducted with ultrasonography (US), with or without alpha-fetoprotein (AFP) testing, every 6 months.

What imaging tests are used to diagnose HCC?

Dynamic and multiphase contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) are the standard diagnostic tests for HCC.

Can ultrasound detect HCC?

Ultrasonography (US) is a major, sustainable hepatocellular carcinoma (HCC) surveillance method as it provides inexpensive, real-time, and noninvasive detection. Since US findings are based on pathological features, knowledge of pathological features is essential for delivering a correct US diagnosis.

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What is metastasis of the liver?

Liver metastases are cancerous tumors that have spread (metastasized) to the liver from another part of the body. These tumors can appear shortly after the original tumor develops, or even months or years later. This information is about cancer that has spread to the liver.

What is HCC diagnosis?

Hepatocellular carcinoma (HCC) is a primary tumor of the liver that usually develops in the setting of chronic liver disease, particularly in patients with cirrhosis due to alcohol use, chronic hepatitis B or C virus infections, or nonalcohol-associated steatohepatitis (NASH) [1,2].

What does hepatocellular disease mean?

Hepatocellular carcinoma is a cancer that starts in your liver. It’s different from “secondary” liver cancers, which have spread to the liver from other organs. If caught early, it can sometimes be cured with surgery or transplant.

What is an HCC screening?

Screening for HCC is important to identify tumors that are amenable to hepatic resection or liver transplantation. Early detection improves 5-year survival rates to > 60% with tumor resection or liver transplantation, compared with only 32% when advanced tumors are detected.