Preoperative Imaging of Liver Cancers: Hepatocellular Carcinoma

Abstract

Hepatocellular carcinoma (HCC) is a tumor of increasing incidence that usually arises in cirrhotic liver. Worldwide, HCC is the sixth most common cancer with 626,000 new cases in 2002, and is also the third most common cause of cancer death. Both surgical resection and transplantation are highly effective in the treatment of patients with localized HCC. Typically, these surgical modalities complement each other, as patients with preserved liver function are candidates for resection and those with poor underlying liver function would be directed toward liver transplantation. Liver resection for HCC requires rigorous patient selection, including evaluation of the stage of the tumor and of the functional reserve of the liver. Cross-sectional imaging modalities such as ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) play a crucial role in the diagnosis and tumor staging of HCC and thus enhance the safety and efficacy of hepatic resection. These modalities, along with biologic scanning techniques such as positron emission tomography (PET), are also invaluable for staging malignancies so as to improve patient selection and thereby optimize long-term surgical outcome.