European Radiology

, Volume 24, Issue 7, pp 1446–1454 | Cite as

Hepatocellular carcinoma (HCC) in non-cirrhotic liver: clinical, radiological and pathological findings

  • Michele Di MartinoEmail author
  • Luca Saba
  • Sandro Bosco
  • Massimo Rossi
  • Kirchin A. Miles
  • Rossella Di Miscio
  • Concetta Valentina Lombardo
  • Elisabetta Tamponi
  • Mario Piga
  • Carlo Catalano



Our aim was to evaluate the clinical and pathological findings, mutidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI) appearances, treatment and 1-year survival of patients with HCC in non-cirrhotic liver.


Histopathological and laboratory findings of 30 non-cirrhotic patients with 32 HCCs were reviewed retrospectively. MDCT and gadobenate dimeglumine-enhanced MR images were evaluated in consensus by two radiologists in terms of HCC size, presence of tumour capsule, necrosis, haemorrhage, fat and calcification, and vascular involvement. Imaging patterns were compared directly with HCC findings in a matched group of cirrhotic patients.


No differences between non-cirrhotic and cirrhotic patients were noted in terms of serum α-fetoprotein levels (elevated in 11 [36.7 %] and 21 [35 %] patients, respectively). The imaging appearance at CT and contrast-enhanced MRI was typical in 27 (84.3 %) and 28 (87.5 %) cases respectively. Most lesions presented as a well-differentiated large solitary mass, with well-defined margins, areas of necrosis and peripheral capsule. No significant differences in HCC pattern were observed between cirrhotic and non-cirrhotic liver.


In non-cirrhotic patients, HCC is more likely to manifest as an asymptomatic mass with elevation of serum tumour markers similar to that seen in cirrhotic patients. HCC in cirrhotic and non-cirrhotic livers show similar enhancement patterns.

Key Points

  • HCC shows similar CT/MRI pattern in cirrhotic and non-cirrhotic livers.

  • Non-invasive diagnostic criteria for HCC should also be extended to non-cirrhotic livers.

  • No differences were found between α-fetoprotein levels in non-cirrhotic and cirrhotic patients.


Hepatocellular carcinoma (HCC) Non-cirrhotic liver Magnetic resonance imaging Multislice computed tomography Non-invasive diagnostic criteria 



The scientific guarantor of this publication is Michele Di Martino, MD. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Luca Saba, one of the authors, has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was not required for this study because it was a retrospective study. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, multicentre study.


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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Michele Di Martino
    • 1
    Email author
  • Luca Saba
    • 2
  • Sandro Bosco
    • 3
  • Massimo Rossi
    • 4
  • Kirchin A. Miles
    • 5
  • Rossella Di Miscio
    • 1
  • Concetta Valentina Lombardo
    • 1
  • Elisabetta Tamponi
    • 6
  • Mario Piga
    • 2
  • Carlo Catalano
    • 1
  1. 1.Department of Radiological Sciences, Oncology and Anatomical PathologyUniversity of Rome “Sapienza”RomeItaly
  2. 2.Department of Radiology Azienda Ospedaliera Universitaria (A.O.U.)MonserratoItaly
  3. 3.Department of Molecular MedicineUniversity of Rome “Sapienza”RomeItaly
  4. 4.Department of General Surgery, Division of Organ TransplantationUniversity of Rome “Sapienza”RomeItaly
  5. 5.Worldwide Medical and Regulatory AffairsMilanItaly
  6. 6.Department of Anatomical PathologyAzienda Ospedaliera Universitaria (A.O.U.)MonserratoItaly

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