HCC
----Hepatocellular
carcinoma is increasing in frequency.
----It is a malignancy encountered mainly in
the setting of cirrhosis; therefore, US surveillance and monitoring of AFP
levels are recommended for patients with cirrhosis.
---- The detection of focal liver lesions
larger than 1 cm at routine US surveillance requires immediate further
investigation with multiphasic CT or MR imaging.
-----The characteristic imaging appearance
of hepatocellular carcinoma is its enhancement pattern: arterial phase
hyperenhancement and venous or delayed phase washout.
-----The diagnosis of
hepatocellular carcinoma can be made from a single imaging study when the
characteristic enhancement pattern is demonstrated.
----The BCLC system is the
staging system of choice because it combines validated predictors of survival
and links staging with treatment options. Stages are not determined on the
basis of radiologic findings alone; imaging information is combined with
clinical and biochemical parameters.
---- In the future, as classification systems
evolve further, the diagnostic roles of diffusion-weighted imaging and
hepatocyte-specific MR imaging contrast media and the therapeutic role of newer
interventional techniques will become better defined.
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