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[Small hepatocellular carcinoma : Diagnostics according to guidelines and established in the clinical setting]
Thomas J Vogl1, Christoph Mader2, Sabine Michalik2
1Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Frankfurt, Johann Wolfgang Goethe Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland. t.vogl@em.uni-frankfurt.de.
Clinical/Methodical Issue:
The diagnosis of hepatocellular carcinoma (HCC)-especially the characterization of small lesions <2 cm-continues to be a radiological challenge.
Standard Radiological Methods:
In the current S3 guideline on diagnosis and therapy of HCC, contrast-enhanced imaging examinations, such as contrast-enhanced ultrasonography (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI), are still the diagnostic standard.
Methodological Innovations:
HCC in the cirrhotic liver should be diagnosed by its typical contrast-enhanced pattern in the MRI. In addition, the use of quality assurance instruments such as LI-RADS (Liver Imaging Reporting and Data System) contributes to the desired consistency of findings, even with small ambiguous findings.
Performance:
Many studies have shown that the LI-RADS classification reflects the likelihood of HCC and other malignant liver lesions.
Achievements:
Guidelines and quality assurance instruments contribute to a more precise diagnosis in patients with suspected HCC.
Practical Recommendations:
A guideline-compliant diagnostic algorithm and the LI-RADS should be used across the board for accurate HCC diagnostics.
