Evaluation of Liver Cancer

Ultrasound of the liver and conventional CT scan are regularly obtained in the diagnostic evaluation of HCC (hepatocellular cancer or primary liver cancer), but they are often too insensitive to detect multi-focal small lesions and for treatment planning.

Thorough assessment with a biphasic spiral CT scan of the abdomen is essential. The fast spiral scanner allows scanning of the liver at the arterial phase shortly after the patient is given an intravenous bolus of contrast.

Percutaneous fine needle biopsy may be indicated in cases when the diagnosis of primary versus metastatic liver tumor is uncertain, providing that it can be safely performed. Post biopsy bleeding can be life threatening in cirrhotic patients with low platelet count, prolonged clotting time, and enlarged blood vessels that are under high pressure (portal hypertension). In general, metastatic liver lesions are rare in patients with cirrhosis. Screening for liver cancer is the only effective way of improving the outcome of treatment.