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Hepatocellular carcinoma (HCC) frequently occurs in association with liver
cirrhosis, as chronic liver disease is one of the most important factors in
carcinogenesis. In addition to HCCs, recent reports of pathologic studies of
resected specimens from cirrhotic liver describe associated small nodular
lesions such as regenerative nodule, dysplastic nodule (adenomatous
hyperplasia), and dysplastic nodule with subfocus of HCC (early HCC). In
hepatocarcinogenesis of the cirrhotic liver, a regenerative nodule might be the
first step in the development of HCC, going through phases of dysplastic nodule,
early HCC and early advanced HCC in a multistep fashion. Fortunately, recent
advances in various imaging techniques have facilitated the verification of
these nodules. In this review, new nomenclature of small hepatocellular nodules,
and detection and characterization of hepatic nodules in carcinogenesis with
various imaging techniques are described with focus on the premalignant lesions
and early stage of HCC. In addition, the efficacy of various imaging techniques
for diagnosing them is discussed. Although the terms and definitions of these
nodules are still variable and controversial, familiarity with the concept of
these borderline lesions is important.