Radiologic diagnosis of hepatocellular carcinoma

Recent developments in medical imaging technology and their clinical application for the diagnosis and management of hepatocellular carcinoma (HCC) are reviewed. Real-time ultrasound is effective for the screening of HCC in high-risk patients with liver cirrhosis. Information on blood flow is available by color Doppler or power Doppler technique. Dynamic computed tomography (CT) using a fast scanner and the modified contrast administration technique is useful for detection, differential diagnosis, and staging of HCC. Application of magnetic resonance (MR) imaging is increasing with rapid improvements in speed of image acquisition and resolution. Dynamic MR imaging and MR angiography have also been available. Diagnostic and interventional hepatic angiography are now performed less invasively, more safely, and more quickly with modern technologies of digital subtraction angiography (DSA) and catheters. CT during hepatic arteriography (CT arteriography) and arterial portography (CTAP) are used for evaluation of small focal nodules in the cirrhotic liver.