Diagnostic imaging of hepatocellular carcinoma in patients with cirrhosis before liver transplantation.
1. The lack of whole-liver explant correlation has led to an overestimation of the sensitivity of imaging tests for the diagnosis of HCC in the radiological literature. 2. Ultrasound is insensitive for the diagnosis of HCC in the cirrhotic liver and should not be used for the detection of focal liver lesions in this setting. 3. Although magnetic resonance (MR) imaging is more sensitive than multidetector 3-phase computed tomography (CT) for the diagnosis of regenerative and dysplastic nodules it is probably no better than CT for detection of HCC and has a lower false-positive rate. 4. Approximately 10-30% of nodules measuring <2 cm seen only on the hepatic arterial phase at CT or MR imaging represent small HCC and vigilant surveillance imaging is required as interval growth is the best indicator of malignancy.
Taouli
Bachir
B
New York University, Department of Radiology, New York, NY 10016, USA. bachir.taouli@med.nyu.edu
Krinsky
Glenn A
GA
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D003287:Contrast Media; D006526:Hepatitis C / Q000473:pathology / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000601:surgery; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed
D003287:Contrast Media