J Korean Med Assoc.  2013 Nov;56(11):948-955. 10.5124/jkma.2013.56.11.948.

Recent development of diagnostic imaging of hepatocellular carcinoma

• Kim MJ

• KMID: 2193466
• DOI: http://doi.org/10.5124/jkma.2013.56.11.948

Abstract

Various imaging examinations, such as ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) have played important roles in the evaluation of hepatocellular carcinoma (HCC). Recent advances in US include contrast-enhanced examinations, fusion imaging, and elastography. For CT, various radiation reduction techniques as well as perfusion imaging and dual-energy examination techniques have been developed. For MRI, hepatocyte-specific contrast-enhanced imaging improved the accuracy of examinations by detection of smaller tumors and better characterization of equivocal lesions. Recent MRI developments also include diffusion-weighted imaging, perfusion imaging, and MR elastography. Newer imaging techniques will increase the roles of imaging examinations in the evaluation of HCC.

Keyword

Hepatocellular carcinoma; Diagnostic imaging; Ultrasonography; Computed tomography; Magnetic resonance imaging

MeSH Terms

Carcinoma, Hepatocellular*
Diagnostic Imaging*
Elasticity Imaging Techniques
Magnetic Resonance Imaging
Perfusion Imaging
Ultrasonography

Figure

• 

  Figure 1 Contrast-enhanced sonography of hepatocellular carcinoma. (A) Arterial phase image obtained 16 seconds after the injection of contrast material shows increased enhancement of the tumor. (B) Delayed phase image obtained at 2 minutes 21 seconds after the injection of the contrast material showed decreased enhancement (washout) of the tumor than surrounding the parenchyma.

• 

  Figure 2 Detection of an additional hepatocellular carcinoma by magnetic resonance imaging (MRI) in a preoperative examination of 60-year-old man. (A-D) Preoperative computed tomography (CT) and MRI show a small hepatocellular carcinoma (arrows). (F-J) At a different level, no lesion was seen on a CT exam (F). However, a small hepatocellular carcinoma is well visible. The both lesions were confirmed on surgery (E,J).

• 

  Figure 3 Fusion imaging of magnetic resonance imaging (MRI) and positron emission tomography (PET)-computed tomography. (A) T1-weighted MRI shows an infiltrative tumor (long white arrow) with portal venous thrombosis (short black arrow). (B) Portal venous phase image shows washout of contrast enhancement indicating a tumor thrombosis (arrows) filled in the right portal trunk. (C) T2-weighted images show hyperintense tumor thrombosis and the infiltrative tumor (arrows). (D) Fusion image of transverse T1-weighted magnetic resonance and fluorodeoxyglucose (FDG)-PET exams show increased uptake in the tumor (long white arrow) and in the tumor thrombosis (short black arrow). (E) Fusion image of coronal T2-weighted MRI and FDG-PET exams show increased uptake in the primary tumor (arrow) and absence of extrahepatic metastasis.

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