[Diagnostic imaging for the screening of hepatocellular carcinoma]

The application of diagnostic imaging is of fundamental importance in the screening, diagnosis and therapy of hepatocellular carcinoma. Among the diagnostic imaging options, ultrasonography has leading role, as it is simple, non-invasive and enables real-time imaging. Screening and active follow up of patients at high risk of primary liver tumors is essential in their early detection. Screening/active follow up of patients at high risk of primary liver tumors means six monthly ultrasound examination. The diagnosis of hepatocellular carcinoma is based on the detection of its characteristic contrast enhancing dynamics, which is possible through dynamic diagnostic imaging procedures (contrast agent enhanced ultrasonography, triphasic CT, MRI). The diagnostic imaging procedure applied depends on the size of the lesions. Examination of the cirrhotic liver remains particularly difficult even with the modern diagnostic imaging procedures, especially concerning the recognition of small early stage hepatocellular carcinoma, and premalignant lesions.