Liver Imaging Techniques for Hepatocellular Carcinoma Diagnosis
Summary
Hepatocellular carcinoma (HCC) ranks among the most prevalent and lethal malignancies worldwide, and timely, accurate detection is essential for guiding therapeutic decisions. Imaging plays a central role in noninvasive diagnosis, surveillance and treatment monitoring. Conventional ultrasonography remains the cornerstone for surveillance in at‐risk populations, yet its sensitivity diminishes for lesions below 2 cm. Contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) provide multiphase vascular assessment, exploiting arterial-phase hyperenhancement, washout appearance in venous or delayed phases and capsule appearance to characterise nodules. Hepatocyte-specific MRI agents enable additional hepatobiliary-phase information, revealing functional uptake and focal defects. Diffusion-weighted imaging and perfusion sequences further interrogate cellular density and microvascular perfusion. Contrast-enhanced ultrasound (CEUS) offers real-time assessment of vascular dynamics without ionising radiation. Emerging methodologies such as radiomics and artificial intelligence aim to extract high-dimensional quantitative features from routine imaging, fostering predictive models for lesion classification, risk stratification and treatment response. Integration of standardised reporting systems—most notably the Liver Imaging Reporting and Data System (LI-RADS)—ensures consistency across modalities and centres, facilitating early detection, appropriate triage and prognostic evaluation.
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Liver Imaging Techniques for Hepatocellular Carcinoma Diagnosis publication trend
The graph below shows the total number of articles in liver imaging techniques for hepatocellular carcinoma diagnosis across all publications each year (not limited to Nature Index journals).
Technical terms
Arterial-phase hyperenhancement: Early contrast uptake by a lesion during the arterial phase relative to adjacent liver parenchyma, indicating neovascularity.
Washout appearance: Contrast washout of a lesion becoming hypointense relative to the liver during portal venous or delayed phases, a hallmark of HCC.
Capsule appearance: Peripheral rim of delayed enhancement surrounding a lesion, reflecting fibrous pseudocapsule formation.
Diffusion-weighted imaging (DWI): MRI technique measuring the Brownian motion of water molecules; restricted diffusion suggests increased cellular density common in malignancy.
Gadoxetate disodium: A hepatocyte-specific MRI contrast agent taken up by functioning hepatocytes and excreted via bile ducts, facilitating hepatobiliary-phase imaging.
Radiomics: Extraction of high-throughput quantitative features (texture, shape, intensity) from medical images to build predictive models.
LI-RADS: Standardised reporting framework developed by the American College of Radiology to categorise liver observations in patients at risk for HCC, based on major and ancillary imaging features.
References
- Utilization of a Machine Learning Algorithm for the Application of Ancillary Features to LI-RADS Categories LR3 and LR4 on Gadoxetate Disodium-Enhanced MRI. Cancers (2023).
- Man or machine? Prospective comparison of the version 2018 EASL, LI-RADS criteria and a radiomics model to diagnose hepatocellular carcinoma. Cancer Imaging (2019).
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