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Hepatocellular Carcinoma
David Burrowes, MD; Aya Kamaya, MD, FSRU, FSAR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Hepatocellular carcinoma (HCC)
              • Synonyms

                • Hepatoma, primary liver cancer
              • Definitions

                • Malignant neoplasm originating from hepatocytes

              IMAGING

              • General Features

                • Ultrasonographic Findings

                  • CT Findings

                    • MR Findings

                      • Angiographic Findings

                        • Nuclear Medicine Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Burrowes DP et al: Characterization of focal liver masses: a multicenter comparison of contrast-enhanced ultrasound, computed tomography, and magnetic resonance imaging. J Ultrasound Med. ePub, 2021
                                              2. Kamaya A et al: HCC screening: is ultrasound still needed at transplant centers?-point: yes, ultrasound remains first line. AJR Am J Roentgenol. 216(3):579-80, 2021
                                              3. Burrowes DP et al: RadioGraphics update: contrast-enhanced US approach to the diagnosis of focal liver masses. Radiographics. 40(4):E16-20, 2020
                                              4. Rodgers SK et al: Role of US LI-RADS in the LI-RADS algorithm. Radiographics. 39(3):690-708, 2019
                                              5. ACR Committee on LI-RADS (Liver): Liver Imaging & Reporting Data System (LI-RADS) v2018. http://www.acr.org/quality-safety/resources/LIRADS
                                              6. Chernyak V et al: Liver Imaging Reporting and Data System (LI-RADS) version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology. 289(3):816-30, 2018
                                              7. Tang A et al: Epidemiology of hepatocellular carcinoma: target population for surveillance and diagnosis. Abdom Radiol (NY). 43(1):13-25, 2018
                                              8. ACR Committee on Ultrasound LI-RADS: Ultrasound LI-RADS v2017. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS/Ultrasound-LI-RADS-v2017
                                              9. OPTN: Adult MELD Exceptions for Hepatocellular Carcinoma (HCC). https://optn.transplant.hrsa.gov/media/2846/liver_guidance_hcc_201706.pdf
                                              10. Davarpanah AH et al: The role of imaging in hepatocellular carcinoma: the present and future. J Clin Gastroenterol. 47 Suppl:S7-10, 2013
                                              11. Liu YI et al: Quantitatively defining washout in hepatocellular carcinoma. AJR Am J Roentgenol. 200(1):84-9, 2013
                                              12. Niu Y et al: Contrast-enhanced ultrasonography for the diagnosis of small hepatocellular carcinoma: a meta-analysis and meta-regression analysis. Tumour Biol. 34(6):3667-74, 2013
                                              13. McEvoy SH et al: Hepatocellular carcinoma: illustrated guide to systematic radiologic diagnosis and staging according to guidelines of the American Association for the Study of Liver Diseases. Radiographics. 33(6):1653-68, 2013
                                              14. Patel M et al: Hepatocellular carcinoma: diagnostics and screening. J Eval Clin Pract. 18(2):335-42, 2012
                                              15. Maturen KE et al: Posterior acoustic enhancement in hepatocellular carcinoma. J Ultrasound Med. 30(4):495-9, 2011
                                              16. Murakami T et al: Ultrasonography, computed tomography and magnetic resonance imaging of hepatocellular carcinoma: toward improved treatment decisions. Oncology. 81 Suppl 1:86-99, 2011
                                              17. Lencioni R: Surveillance and early diagnosis of hepatocellular carcinoma. Dig Liver Dis. 42 Suppl 3:S223-7, 2010
                                              18. Kamaya A et al: Hypervascular liver lesions. Semin Ultrasound CT MR. 30(5):387-407, 2009
                                              19. Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases 
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Hepatocellular carcinoma (HCC)
                                                          • Synonyms

                                                            • Hepatoma, primary liver cancer
                                                          • Definitions

                                                            • Malignant neoplasm originating from hepatocytes

                                                          IMAGING

                                                          • General Features

                                                            • Ultrasonographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Angiographic Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Burrowes DP et al: Characterization of focal liver masses: a multicenter comparison of contrast-enhanced ultrasound, computed tomography, and magnetic resonance imaging. J Ultrasound Med. ePub, 2021
                                                                                          2. Kamaya A et al: HCC screening: is ultrasound still needed at transplant centers?-point: yes, ultrasound remains first line. AJR Am J Roentgenol. 216(3):579-80, 2021
                                                                                          3. Burrowes DP et al: RadioGraphics update: contrast-enhanced US approach to the diagnosis of focal liver masses. Radiographics. 40(4):E16-20, 2020
                                                                                          4. Rodgers SK et al: Role of US LI-RADS in the LI-RADS algorithm. Radiographics. 39(3):690-708, 2019
                                                                                          5. ACR Committee on LI-RADS (Liver): Liver Imaging & Reporting Data System (LI-RADS) v2018. http://www.acr.org/quality-safety/resources/LIRADS
                                                                                          6. Chernyak V et al: Liver Imaging Reporting and Data System (LI-RADS) version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology. 289(3):816-30, 2018
                                                                                          7. Tang A et al: Epidemiology of hepatocellular carcinoma: target population for surveillance and diagnosis. Abdom Radiol (NY). 43(1):13-25, 2018
                                                                                          8. ACR Committee on Ultrasound LI-RADS: Ultrasound LI-RADS v2017. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS/Ultrasound-LI-RADS-v2017
                                                                                          9. OPTN: Adult MELD Exceptions for Hepatocellular Carcinoma (HCC). https://optn.transplant.hrsa.gov/media/2846/liver_guidance_hcc_201706.pdf
                                                                                          10. Davarpanah AH et al: The role of imaging in hepatocellular carcinoma: the present and future. J Clin Gastroenterol. 47 Suppl:S7-10, 2013
                                                                                          11. Liu YI et al: Quantitatively defining washout in hepatocellular carcinoma. AJR Am J Roentgenol. 200(1):84-9, 2013
                                                                                          12. Niu Y et al: Contrast-enhanced ultrasonography for the diagnosis of small hepatocellular carcinoma: a meta-analysis and meta-regression analysis. Tumour Biol. 34(6):3667-74, 2013
                                                                                          13. McEvoy SH et al: Hepatocellular carcinoma: illustrated guide to systematic radiologic diagnosis and staging according to guidelines of the American Association for the Study of Liver Diseases. Radiographics. 33(6):1653-68, 2013
                                                                                          14. Patel M et al: Hepatocellular carcinoma: diagnostics and screening. J Eval Clin Pract. 18(2):335-42, 2012
                                                                                          15. Maturen KE et al: Posterior acoustic enhancement in hepatocellular carcinoma. J Ultrasound Med. 30(4):495-9, 2011
                                                                                          16. Murakami T et al: Ultrasonography, computed tomography and magnetic resonance imaging of hepatocellular carcinoma: toward improved treatment decisions. Oncology. 81 Suppl 1:86-99, 2011
                                                                                          17. Lencioni R: Surveillance and early diagnosis of hepatocellular carcinoma. Dig Liver Dis. 42 Suppl 3:S223-7, 2010
                                                                                          18. Kamaya A et al: Hypervascular liver lesions. Semin Ultrasound CT MR. 30(5):387-407, 2009
                                                                                          19. Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases