Radiological Evaluation of Hepatocellular Carcinoma

  • Michael P. Federle
  • Michael J. Payne
Part of the Current Clinical Oncology book series (CCO)


Chapter 5 discusses the rationale and techniques for screening an at-risk population for the presence of hepatocellular carcinoma (HCC). The typical appearance of small HCC on ultrasound CT, and MRI and the challenges inherent in diagnosing early HCC and distinguishing it from regenerating and dysplastic nodules, arterioportal shunts, fibrosis, and other lesions have been noted. When proper computed tomography (CT) and magnetic resonance imaging (MRI) techniques are used with expert interpretation in a well-run screening program, many HCCs should be diagnosed when they are amenable to curative treatments, including resection, ablation, and liver transplantation.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Okuda K. Hepatocellular carcinoma. J Hepatol 2000;32:225–237.PubMedCrossRefGoogle Scholar
  2. 2.
    Nzeako UC, Goodman ZD, Ihsak KG. Hepatocellular carcinoma in cirrhotic and noncirrhotic livers: a clinico-histopathologic study of 804 North American patients. Anat Path 1996;105:67–75.Google Scholar
  3. 3.
    Yamashita Y, Takahashi M, Baba Y, et al. Hepatocellular carcinoma with or without cirrhosis: a comparison of CT and angiographic presentation in the United States and Japan. Abdom Imaging 1995;18:168–175.Google Scholar
  4. 4.
    Brancatelli G, Federle MP, Grazioli L. Hepatocellular carcinoma in noncirrhotic liver: CT, clinical and pathologic findings in 39 US residents. Radiology 2002;222:89–94.PubMedCrossRefGoogle Scholar
  5. 5.
    Winston CB, Schwartz LH, Fong Y, Blumgart LH, Panicek DM. Hepatocellular carcinoma: MR imaging findings in cirrhotic and noncirrhotic livers. Radiology 1999;210:75–79.PubMedGoogle Scholar
  6. 6.
    Ichikawa T, Federle MP, Grazioli L, et al. Fibrolamellar hepatocellular carcinoma: imaging and pathologic findings in 31 recent cases. Radiology 1999;213:352–361.PubMedGoogle Scholar
  7. 7.
    Brandt D, Johnson CD, Stephens DH, Weiland LH. Imaging of fibrolamellar carcinoma. AJR Am J Roentgenol 1988;151:295–298.PubMedGoogle Scholar
  8. 8.
    Brancatelli G, Federle MP, Grazioli L, et al. Focal nodular hyperplasia: CT findings with emphasis on multiphasic helical CT in 78 patients. Radiology 2001;219:61–68.PubMedGoogle Scholar
  9. 9.
    Ichikawa T, Federle MP, Grazioli L, Nalesnick M. Hepatocellular adenoma: multiphasic CT and histopathologic findings in 25 patients. Radiology 2000;214:861–868.PubMedGoogle Scholar
  10. 10.
    Laghi A, Iannacone R, Rossi P, et al. Hepatocellular carcinoma: detection with triple-phase multi-detector row helical CT in patients with chronic hepatitis. Radiology 2003;226:543–549.PubMedCrossRefGoogle Scholar
  11. 11.
    Ichikawa T, Kitamura T, Nakajima H, et al. Hypervascular hepatocellular carcinoma: can double arterial phase imaging with multidetector CT improve tumor depiction in the cirrhotic liver. Am J Roentgenol 2002;179:751–758.Google Scholar
  12. 12.
    Kim T, Murakami T, Hori M, et al. Small hypervascular hepatocellular carcinoma revealed by double arterial phase CT performed with single breath-hold scanning and automatic bolus tracking. Am J Roentgenol 2002;178:899–904.Google Scholar
  13. 13.
    Kim T, Federle MP, Baron RL, Peterson MS, Kawamori Y. Discrimination of small hepatic hemangiomas from hypervascular malignant tumors smaller than 3 cm with three-phase helical CT. Radiology 2001;219:699–706.PubMedGoogle Scholar
  14. 14.
    Baron RL, Oliver JH, Dodd GD, et al. Hepatocellular carcinoma: evaluation with biphasic, contrast-enhanced, helical CT. Radiology 1996;199:505–511.PubMedGoogle Scholar
  15. 15.
    Kanematsu M, Semelka RC, Matsuo M, et al. Gadolinium-enhanced MR imaging of the liver: optimizing imaging delay for hepatic arterial and portal venous phases: a prospective randomized study in patients with chronic liver disease. Radiology 2002;225:407–415.PubMedCrossRefGoogle Scholar
  16. 16.
    Kang BK, Lim JH, Kim SH, et al. Preoperative depiction of hepatocellular carcinoma: ferumoxides-enhanced MR imaging versus triple-phase helical CT. Radiology 2003;226:79–85.PubMedCrossRefGoogle Scholar
  17. 17.
    Shimizu A, Ito K, Koike S, et al. Cirrhosis or chronic hepatitis: evaluation of small (<2 cm) early-enhancing hepatic lesions with serial contrast-enhanced dynamic MR imaging. Radiology 2003;226:550–555.PubMedCrossRefGoogle Scholar
  18. 18.
    Ebara M, Fukuda H, Kojima Y, et al. Small hepatocellular carcinoma: relationship of signal intensity to histopathologic findings and metal content of the tumor and surrounding hepatic parenchyma. Radiology 1999;210:81–88.PubMedGoogle Scholar
  19. 19.
    Stevens WR, Gulino SP, Batts KP, Stephens DH, Johnson CD. Mosaic pattern of hepatocellular carcinoma: histologic basis for a characteristic CT appearance. J Comput Assist Tomogr 1996;20:337–342.PubMedCrossRefGoogle Scholar
  20. 20.
    Oliver JH, Baron RL, Federle MP, Rochette HE Jr. Detecting hepatocellular carcinoma: value of unenhanced or arterial phase CT imaging or both used in conjunction with conventional portal venous phase contrast-enhanced CT imaging. Am J Roentgenol 1996;167:71–77.Google Scholar
  21. 21.
    Tublin ME, Dodd GD, Baron RL. Benign and malignant portal vein thrombosis: differentiation by CT characteristics. AJR Am J Roentgenol 1997;168:719–723.PubMedGoogle Scholar

Copyright information

© Humana Press Inc., Totowa, NJ 2005

Authors and Affiliations

  • Michael P. Federle
    • 1
  • Michael J. Payne
    • 1
  1. 1.Department of RadiologyUniversity of Pittsburgh School of MedicinePittsburgh

Personalised recommendations