"Hepatocellular carcinoma receives most of its blood supply from branches of the hepatic artery, accounting for its characteristic enhancement pattern: early arterial enhancement with early "washout." Hence, small foci of hepatocellular carcinoma may be seen within a regenerative liver nodule as foci of arterial enhancement (nodule-in-nodule appearance) 11."
"T1 C+ (hepatobiliary agents: Eovist, Primovist)"
"T2: variable, typically moderately hyperintense"
"C+ post-SPIO (iron oxide): increases sensitivity in diagnosing small hepatocellular carcinomas"
"DWI: intratumoural high signal; increases sensitivity and specificity 33"
"C+ post-SPIO (iron oxide): increases sensitivity in diagnosing small hepatocellular carcinomas"
"FDG PET is a valuable tool in assessing extrahepatic disease, but its assessment in identifying HCC from normal liver tissue is less promising. Well-differentiated hepatocellular carcinoma is the most common histopathological pattern and thus resembles normal hepatocytes and shows similar metabolism. Therefore, FDG PET is less sensitive for these lesions. Poorly differentiated HCCs or HCCs with high proliferation index show increased metabolic activity and thus are easily detectable 35. 68Ga labelled PSMA has also shown promising results, as PSMA is expressed in vascular channels of HCC 36."
"hepatitis B (HBV) infection: 10% 5-year cumulative risk 3"
"hepatitis C (HCV) infection: 30% 5-year cumulative risk"
"The origin of hepatocellular carcinomas is believed to be related to repeated cycles of necrosis and regeneration, irrespective of the cause. Additionally, the genomes of HBV and HCV contain genetic material that may predispose cells to accumulate mutations or disrupt growth control, thus allowing for a second mechanism by which infection with these agents predisposes to hepatocellular carcinoma 1."
"The origin of hepatocellular carcinomas is believed to be related to repeated cycles of necrosis and regeneration, irrespective of the cause. Additionally, the genomes of HBV and HCV contain genetic material that may predispose cells to accumulate mutations or disrupt growth control, thus allowing for a second mechanism by which infection with these agents predisposes to hepatocellular carcinoma 1."
"C+ post-SPIO (iron oxide): increases sensitivity in diagnosing small hepatocellular carcinomas"
"FDG PET is a valuable tool in assessing extrahepatic disease, but its assessment in identifying HCC from normal liver tissue is less promising. Well-differentiated hepatocellular carcinoma is the most common histopathological pattern and thus resembles normal hepatocytes and shows similar metabolism. Therefore, FDG PET is less sensitive for these lesions. Poorly differentiated HCCs or HCCs with high proliferation index show increased metabolic activity and thus are easily detectable 35. 68Ga labelled PSMA has also shown promising results, as PSMA is expressed in vascular channels of HCC 36."
"FDG PET is a valuable tool in assessing extrahepatic disease, but its assessment in identifying HCC from normal liver tissue is less promising. Well-differentiated hepatocellular carcinoma is the most common histopathological pattern and thus resembles normal hepatocytes and shows similar metabolism. Therefore, FDG PET is less sensitive for these lesions. Poorly differentiated HCCs or HCCs with high proliferation index show increased metabolic activity and thus are easily detectable 35. 68Ga labelled PSMA has also shown promising results, as PSMA is expressed in vascular channels of HCC 36."
"The typical TNM staging system seen in most other epithelial cancers is not as prognostically useful for the stratification of patients with hepatic cancers. Early recurrence within 2 years implies an aggressive initial tumour type, whereas late recurrence after 2 years suggests de novo tumour and a better prognosis 37."
"If neither of these options are possible, then a variety of options exist including chemotherapy, transarterial chemoembolisation (TACE), transarterial radioembolisation (TARE) / selective internal radiation therapy (SIRT), thermal ablation (RFA, cryoablation, or microwave ablation), and chemical ablation 20-22."
"T1 C+ (hepatobiliary agents: Eovist, Primovist)"
"T1 C+ (hepatobiliary agents: Eovist, Primovist)"
"Treatment options are improving; minimally invasive surgical techniques reduce the complication rate and the combination of newer radiofrequency ablation techniques with transarterial chemoembolisation (TACE) can be comparable or safer 37. TACE enhances thermocoagulation by reducing intra-tumoural blood circulation and cooling. It can also treat micrometastases."
"On gross pathology, hepatocellular carcinomas typically appear as pale masses within the liver and may be unifocal, multifocal or diffusely infiltrative at the time of presentation."
"The macroscopic growth of hepatocellular carcinoma is usually categorised into three subtypes: nodular, massive and infiltrative. Each has different radiological features, which are detailed below 9. The infiltrative subtype is characterised by the growth of multiple tiny nodules throughout the entire liver or an entire liver segment."
"larger lesions are heterogeneous due to fibrosis, fatty change, necrosis and calcification 12"
"DWI: intratumoural high signal; increases sensitivity and specificity 33"
"Treatment options are improving; minimally invasive surgical techniques reduce the complication rate and the combination of newer radiofrequency ablation techniques with transarterial chemoembolisation (TACE) can be comparable or safer 37. TACE enhances thermocoagulation by reducing intra-tumoural blood circulation and cooling. It can also treat micrometastases."
"There are several substitute staging systems used in guiding therapy for hepatocellular carcinoma (see hepatocellular carcinoma staging) 18. The LI-RADS imaging classification system is also used to stratify lesions in an at-risk liver."
"If neither of these options are possible, then a variety of options exist including chemotherapy, transarterial chemoembolisation (TACE), transarterial radioembolisation (TARE) / selective internal radiation therapy (SIRT), thermal ablation (RFA, cryoablation, or microwave ablation), and chemical ablation 20-22."
"If neither of these options are possible, then a variety of options exist including chemotherapy, transarterial chemoembolisation (TACE), transarterial radioembolisation (TARE) / selective internal radiation therapy (SIRT), thermal ablation (RFA, cryoablation, or microwave ablation), and chemical ablation 20-22."