Hepatocellular carcinoma CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]

Hepatocellular carcinoma Microchapters
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Overview

Abdominal CT scan with intravenous contrast agent is the best method to diagnose hepatocellular carcinoma. Three-phase scanning (before contrast administration, immediately after contrast administration, and again after a delay) to increase the ability of the radiologist to detect small or subtle tumors. It is important to optimize the parameters of the CT examination, because the underlying liver disease (e.g. hepatitis B) that most hepatocellular carcinoma patients have can make the findings more difficult to appreciate.

Key CT Findings in Hepatocellular Carcinoma

On CT, hepatocellular carcinoma (HCC) is characterized by:

• Focal HCC

• large usually hypoattenuating mass
• May have necrosis/fat/calcification

• Multifocal HCC

• Multiple masses of variable attenuation lesions
• May also have central hypoattenuating necrotic portions

• Diffuse HCC

• May be difficult to distinguish from associated cirrhosis

Abdominal CT showing massive hepatocellular carcinoma. Case courtesy of Dr Natalie Yang, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/6871">rID: 6871</a>

Abdominal CT showing diffuse hepatocellular carcinoma. Case courtesy of Dr Ahmed Abd Rabou, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/37397">rID: 37397</a>

References

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