title: Ongoing challenges in the diagnosis of hepatocellular carcinoma.
abstract: In 2001, the European Association for the Study of the Liver (EASL) endorsed the possibility of achieving a non-invasive diagnosis of Hepatocellular Carcinoma (HCC) for the first time. Since then, various refinements of the criteria and techniques capable of achieving this diagnosis and the role of plasma and tissue oncomarkers have been reported in the literature and have been accepted to different extents in various geographical areas. Such tools can also potentially imply prognostic significance. The present article critically discusses some of the most relevant and debated challenges which have emerged in this field, including the role of contrast-enhanced ultrasound, and of hepatocyte-specific magnetic resonance contrast agents, the pitfall of transient hepatic attenuation differences, the reliability of biopsy and the status of biomarkers.
authors.affiliation: a Division of Internal Medicine, Department of Digestive Disease and Internal Medicine, Sant'Orsola-Malpighi Hospital , University of Bologna , Bologna , Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Terzi
authors.affiliation: a Division of Internal Medicine, Department of Digestive Disease and Internal Medicine, Sant'Orsola-Malpighi Hospital , University of Bologna , Bologna , Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Salvatore
authors.affiliation: a Division of Internal Medicine, Department of Digestive Disease and Internal Medicine, Sant'Orsola-Malpighi Hospital , University of Bologna , Bologna , Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Negrini
authors.affiliation: a Division of Internal Medicine, Department of Digestive Disease and Internal Medicine, Sant'Orsola-Malpighi Hospital , University of Bologna , Bologna , Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Piscaglia
mesh_terms: D000465:Algorithms; D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003287:Contrast Media / Q000008:administration & dosage; D019091:Critical Pathways; D003937:Diagnosis, Differential; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000592:standards; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000592:standards; D047368:Tumor Burden; D014463:Ultrasonography / Q000592:standards
chemical_list: D014408:Biomarkers, Tumor; D003287:Contrast Media
keywords: Contrast-enhanced ultrasound; Primovist; Sonovue; alphafetoprotein; dysplastic nodule; glypican 3; hepatocellular carcinoma; hepatocyte-specific magnetic resonance contrast agents; transient hepatic attenuation difference (THAD)