Imaging of HCC |
| |
Authors: | Carmen Ayuso Jordi Rimola Ángeles García-Criado |
| |
Institution: | 1.Barcelona Clinic Liver Cancer (BCLC) Group, Radiology Department, Hospital Clínic,University of Barcelona, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS),Barcelona,Spain;2.Barcelona Clinic Liver Cancer (BCLC) Group, Radiology Department, Hospital Clínic,University of Barcelona,Barcelona,Spain |
| |
Abstract: | Imaging techniques play a crucial role in the management of patients with liver cirrhosis in whom a nodular hepatic lesion
is detected. The most severe complication of patients with liver cirrhosis is the development of a hepatocellular carcinoma
(HCC), and the prognosis of the disease depends on the tumoral stage. Surveillance programs based on ultrasonography (US)
are recommended in cirrhotic patients with possibility to be treated if an HCC is detected, in order to improve the patient’s
survival. Nevertheless, early detection and diagnostic confirmation of HCC remains a challenge despite technological advances.
The non-invasive criteria to characterize small HCCs in patients with cirrhosis are based on the evaluation of the vascular
profile of the lesion. Dynamic multidetector computed tomography (MDCT) and dynamic magnetic resonance imaging (MRI) are the
suitable techniques for this purpose. When diagnosis is not achieved, fine US-guided fine needle biopsy (FNB) is indicated.
Cellular-MRI contrast agents may have a role in lesions with atypical vascular pattern in which FNB is not feasible. The assessment
of the disease extent is another important goal for imaging techniques. Again, dynamic MDCT and dynamic MRI may be used for
staging purposes. Although MRI is more accurate in the detection of additional nodules ranging 1–2 cm, both remain relatively
insensitive for the detection of tiny satellite nodules below 1 cm. The therapeutic decision can be made in any particular
patient on the basis of the tumoral extension, the liver function, and the general status. After curative and palliative therapeutic
procedures, the monitoring of the response is mandatory to decide the next approach: to follow-up, to repeat the treatment,
to modify the treatment indication, or to suspend the treatment. In this review, we discuss the most recent information on
the imaging of HCC. |
| |
Keywords: | |
本文献已被 PubMed SpringerLink 等数据库收录! |
|