Imaging of dysplastic nodules and small hepatocellular carcinomas: experience with explanted livers

Differentiation of benign from malignant nodules in the end-stage cirrhotic liver can be challenging, due to the presence of fibrosis, necrosis and altered blood supply. Whole liver explant pathologic correlation provides a unique opportunity to evaluate the sensitivity and specificity of current imaging modalities for the diagnosis of HCC and dysplastic nodules in the cirrhotic liver. This chapter will explore and critique the imaging literature with an emphasis on studies performed with timely explanted liver correlation.