Skip to main content
SpringerLink
Log in

Diagnosis and Staging of Hepatocellular Carcinoma (HCC)

  • Chapter
  • First Online:
Liver Cancers

Abstract

The diagnostic criteria for HCC involve the use of contrast-enhanced radiology in the presence of cirrhosis whilst understanding the behaviour of different nodules to contrast injection and diffusion weighting. In those with indeterminate nodules on imaging criteria or with non-cirrhotic livers, a tissue diagnosis (biopsy) is needed to establish the diagnosis. Once diagnosed there are several staging systems, for both the cancer and underlying liver disease, with the BCLC system being recommended in international guidelines. Only once staged can a management plan be determined.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. EASL Clinical Practice Guidelines. Management of hepatocellular carcinoma. J Hepatol. 2018; https://doi.org/10.1016/j.jhep.2018.03.019.

    Article  Google Scholar 

  2. Bota S, Piscaglia F, Marinelli S, Pecorelli A, Terzi E, Bolondi L. Comparison of international guidelines for noninvasive diagnosis of hepatocellular carcinoma. Liver Cancer. 2012;1(3–4):190–200.

    Article  Google Scholar 

  3. Rimola J, Forner A, Reig M, Vilana R, de Lope CR, Ayuso C, et al. Cholangiocarcinoma in cirrhosis: absence of contrast washout in delayed phases by magnetic resonance imaging avoids misdiagnosis of hepatocellular carcinoma. Hepatology. 2009;50(3):791–8.

    Article  Google Scholar 

  4. Jang HJ, Kim TK, Burns PN, Wilson SR. Enhancement patterns of hepatocellular carcinoma at contrast-enhanced US: comparison with histologic differentiation. Radiology. 2007;244(3):898–906.

    Article  Google Scholar 

  5. Lencioni R, Mascalchi M, Caramella D, Bartolozzi C. Small hepatocellular carcinoma: differentiation from adenomatous hyperplasia with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging. Abdom Imaging. 1996;21(1):41–8.

    Article  CAS  Google Scholar 

  6. Lencioni R, Pinto F, Armillotta N, Bartolozzi C. Assessment of tumor vascularity in hepatocellular carcinoma: comparison of power Doppler US and color Doppler US. Radiology. 1996;201(2):353–8.

    Article  CAS  Google Scholar 

  7. Lee JM, Trevisani F, Vilgrain V, Wald C. Imaging diagnosis and staging of hepatocellular carcinoma. Liver Transpl. 2011;17(Suppl 2):S34–43.

    Article  Google Scholar 

  8. Choi JY, Lee JM, Sirlin CB. CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part I. Development, growth, and spread: key pathologic and imaging aspects. Radiology. 2014;272(3):635–54.

    Article  Google Scholar 

  9. Silva AC, Evans JM, McCullough AE, Jatoi MA, Vargas HE, Hara AK. MR imaging of hypervascular liver masses: a review of current techniques. Radiographics. 2009;29(2):385–402.

    Article  Google Scholar 

  10. Khosa F, Khan AN, Eisenberg RL. Hypervascular liver lesions on MRI. AJR Am J Roentgenol. 2011;197(2):W204–20.

    Article  Google Scholar 

  11. Silva MA, Hegab B, Hyde C, Guo B, Buckels JA, Mirza DF. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut. 2008;57(11):1592–6.

    Article  CAS  Google Scholar 

  12. Di Tommaso L, Franchi G, Park YN, Fiamengo B, Destro A, Morenghi E, et al. Diagnostic value of HSP70, glypican 3, and glutamine synthetase in hepatocellular nodules in cirrhosis. Hepatology. 2007;45(3):725–34.

    Article  Google Scholar 

  13. Bruix J, Sherman M. Management of hepatocellular carcinoma: An update. Hepatology. 2011;53(3):1020–2.

    Article  Google Scholar 

  14. Botta F, Giannini E, Romagnoli P, Fasoli A, Malfatti F, Chiarbonello B, et al. MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study. Gut. 2003;52(1):134–9.

    Article  CAS  Google Scholar 

  15. Neuberger J, Gimson A, Davies M, Akyol M, O'Grady J, Burroughs A, et al. Selection of patients for liver transplantation and allocation of donated livers in the UK. Gut. 2008;57(2):252–7.

    Article  CAS  Google Scholar 

  16. Marrero JA, Fontana RJ, Barrat A, Askari F, Conjeevaram HS, Su GL, et al. Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort. Hepatology. 2005;41(4):707–16.

    Article  Google Scholar 

  17. Kadalayil L, Benini R, Pallan L, O'Beirne J, Marelli L, Yu D, et al. A simple prognostic scoring system for patients receiving transarterial embolisation for hepatocellular cancer. Ann Oncol. 2013;24(10):2565–70.

    Article  CAS  Google Scholar 

  18. Sieghart W, Hucke F, Pinter M, Graziadei I, Vogel W, Muller C, et al. The ART of decision making: retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma. Hepatology. 2013;57(6):2261–73.

    Article  CAS  Google Scholar 

  19. Subramaniam S, Kelley RK, Venook AP. A review of hepatocellular carcinoma (HCC) staging systems. Chin Clin Oncol. 2013;2(4):33.

    PubMed  Google Scholar 

  20. Villanueva A, Hoshida Y, Battiston C, Tovar V, Sia D, Alsinet C, et al. Combining clinical, pathology, and gene expression data to predict recurrence of hepatocellular carcinoma. Gastroenterology. 2011;140(5):1501–12.e2.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Liverpool, Liverpool, UK

    Vinay Kumar Balachandrakumar

  2. Aintree University Hospital, Liverpool, UK

    Nadya Fatima Jabbar, David White & Nicholas Stern

Authors
  1. Vinay Kumar Balachandrakumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nadya Fatima Jabbar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David White
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nicholas Stern
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Royal Liverpool University Hospital, Liverpool, Merseyside, UK

    Tim Cross

  2. University of Liverpool, Liverpool Early Drug Development Unit, Liverpool, UK

    Daniel H. Palmer

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Balachandrakumar, V.K., Jabbar, N.F., White, D., Stern, N. (2019). Diagnosis and Staging of Hepatocellular Carcinoma (HCC). In: Cross, T., Palmer, D. (eds) Liver Cancers. Springer, Cham. https://doi.org/10.1007/978-3-319-92216-4_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-92216-4_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92215-7

  • Online ISBN: 978-3-319-92216-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation