To analyze the imaging oh HCC lesions in chronic liver disease with histological findings.
To correlate false positive HCC lesions in chronic liver disease and histological findings.
Hepatocellular carcinoma (HCC) is the 6th most common cancer worldwide,
in particular fifth in men and seventh in women.
Cirrhosis is the most important clinical risk factor for HCC; 80% of cases of HCC develop in patient with a cirrhotic liver.
Imaging plays a critical role in HCC screening and diagnosis in high risk patients.
CT and MRI are performed to confirm the suspected lesions,
relegating histology to the most controversial cases (3).
The new EASL guidelines indicate that multiphasic contrast-enhanced CT or multiphasic contrast-enhanced...
Findings and procedure details
1: Typical HCC nodule in the cirrhotic liver in CT/MRI and histopathology.
Male; 56 y; follow up in HCV cirrhosis.
CT contrast medium: lesion > 2 cm; global contrast enhancement in arterial phases (wash in); wash out in following phases; capsule enhancement (Fig.1).
MRI is more sensitive and is performed to exclude other lesion.
The sequence after contrast medium confirms the contrast enhancement behavior of the lesion as CT image (Fig 2).
The lesion appears mild hyperintense in T2w fat-sat and in DWI (high density...
Cirrhosis is the most important clinical risk factor for HCC; patients should be followed in dedicated centers with expert radiologists and pathologists.
Despite MRI and CT show a high sensitivity on HCC assessment,
diagnosis is available only when every imaging feature correlates with the clinical status.
Otherwise histological examination becomes mandatory.
On the other hand,
histology can also have important limits such as sampling type and size,
so the optimal collaboration between radiologist and pathologist is essential to correct diagnosis.
Epidemiology of hepatocellular carcinoma : target population for surveillance and diagnosis.
Epidemiology and natural history of hepatocellular carcinoma.
Best Pract Res Clin Gastroenterol.
When and how should we perform a biopsy for HCC in patients with liver cirrhosis in 2018? A review.
Dig Liver Dis.
EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma....