Screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis: A cost-utility analysis

https://sites.ualberta.ca/~loewen/Medicine/GIM%20Residents%20Core%20Reading/LIVER%20MASSES/screeningHCC.pdf

Screening for hepatocellular carcinoma in cirrhosis

Improvements in imaging technology allow exploitation of the dual blood supply of the liver to aid in the identification and characterisation of both malignant and benign liver lesions. Imaging techniques available include contrast enhanced ultrasound, computed tomography and magnetic resonance imaging. This review discusses the application of several imaging techniques in the diagnosis and staging of both hepatocellular carcinoma and cholangiocarcinoma and outlines certain characteristics of benign liver lesions. The advantages of each imaging technique are highlighted, while underscoring the potential pitfalls and limitations of each imaging modality.

Imaging of liver cancer

Computed tomographic imaging of hepatocellular carcinoma.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1053/jlts.2003.50120

Hepatocellular carcinoma screening in patients waiting for liver transplantation: A decision analytic model

PURPOSE: To assess computed tomography (CT) with iodized oil for depiction of small hepatocellular carcinoma (HCC) before liver transplantation. MATERIALS AND METHODS: Thirty-five consecutive cirrhotic patients underwent CT with iodized oil to determine the presence, number, size, and location of possible nodules. All patients underwent liver transplantation within 4 months after CT. Explanted livers were cut in 8-mm slices that corresponded to axial CT scan planes. Comparison between CT staging and pathologic findings was made. RESULTS: Pathologic studies showed 17 HCC nodules (diameter, 0.9-4.0 cm) in nine of the 35 livers. CT depicted nine of these 17 nodules. Lesion-by-lesion analysis revealed a sensitivity of 53%; CT falsely depicted three additional nodules not confirmed with pathologic findings. Patient-by-patient analysis revealed an 89% sensitivity and an 88% specificity. CONCLUSION: CT with iodized oil, when assessed lesion by lesion, has a low sensitivity. These results must be considered when ...

Small hepatocellular carcinoma in patients undergoing liver transplantation: detection with CT after injection of iodized oil.

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Small hepatocellular carcinoma in patients undergoing liver transplantation: detection with CT after injection of iodized oil.