Hepatocellular carcinoma with macrovascular invasion: multimodality imaging features for the diagnosis

Area of Science:

• Radiology
• Oncology
• Hepatology

Background:

• Hepatocellular carcinoma (HCC) frequently involves macrovascular invasion in advanced stages.
• Distinguishing tumor thrombus from bland thrombus is critical for treatment planning, impacting eligibility for liver resection or transplantation.

Purpose of the Study:

• To review current guidelines and characteristic imaging findings of HCC with macrovascular invasion.
• To enhance diagnostic confidence in identifying tumor thrombus versus bland thrombus.

Main Methods:

• Review of current clinical guidelines.
• Analysis of radiologic imaging features suggestive of tumor thrombus in HCC.
• Discussion of subtle imaging findings, particularly in infiltrative HCC lesions.

Main Results:

• Macrovascular invasion in HCC presents diagnostic challenges due to subtle imaging features.
• Various imaging modalities offer clues to differentiate tumor thrombus from bland thrombus.
• Understanding common imaging patterns improves diagnostic accuracy.

Conclusions:

• Accurate imaging diagnosis of macrovascular invasion in HCC is essential for patient management.
• Familiarity with imaging features aids in differentiating tumor thrombus, guiding therapeutic options.
• Improved diagnostic confidence can lead to better patient outcomes in HCC.