Imaging diagnosis

Riccardo Lencioni, Dania Cioni, Clotilde Della Pina, Laura Crocetti, Carlo Bartolozzi

Research output: Contribution to journalReview article

63 Scopus citations

Abstract

The diagnosis of hepatocellular carcinoma (HCC) is based on imaging examinations in combination with clinical and laboratory findings. Despite technological advances, imaging cirrhotic patients remains a challenging issue because nonmalignant hepatocellular lesions, such as dysplastic nodules, mimic a small HCC. One of the key pathologic factors for differential diagnosis that is reflected in imaging appearances is the vascular supply to the lesion. It is accepted that imaging techniques may establish the diagnosis of HCC in nodules larger than 2 cm showing characteristic arterial hypervascularization. In lesions ranging from 1 to 2 cm, biopsy is still recommended, although a negative response can never be used to rule out malignancy completely. Although ultrasonography is widely accepted for HCC surveillance, spiral computed tomography (CT) or dynamic magnetic resonance imaging is required for diagnostic confirmation and intrahepatic tumor staging. These examinations have replaced invasive procedures, such as lipiodol CT, but remain relatively insensitive for the detection of tiny HCC lesions and tumor vascular invasion into peripheral portal vein branches.

Original languageEnglish (US)
Pages (from-to)162-170
Number of pages9
JournalSeminars in liver disease
Volume25
Issue number2
DOIs
StatePublished - May 1 2005

Keywords

  • Computed tomography
  • Magnetic resonance imaging
  • Percutaneous biopsy
  • Ultrasonography

ASJC Scopus subject areas

  • Hepatology

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    Lencioni, R., Cioni, D., Della Pina, C., Crocetti, L., & Bartolozzi, C. (2005). Imaging diagnosis. Seminars in liver disease, 25(2), 162-170. https://doi.org/10.1055/s-2005-871196