Digestive Diseases and Sciences

, Volume 64, Issue 4, pp 934–950 | Cite as

Hepatocellular Carcinoma: Current Imaging Modalities for Diagnosis and Prognosis

  • Maxime RonotEmail author
  • Yvonne Purcell
  • Valérie Vilgrain


As opposed to most solid cancers, hepatocellular carcinoma (HCC) does not necessarily require histological confirmation. Noninvasive diagnosis is possible and relies on imaging. In cirrhotic patients, the diagnosis can be obtained in tumors displaying typical features that include non-rim arterial phase hyperenhancement followed by washout during the portal venous and/or delayed phases on CT or MR imaging. This pattern is very specific and, as such, has been endorsed by both Western and Asian diagnostic guidelines and systems. However, its sensitivity is not very high, especially for small lesions. Numerous ancillary features favoring the diagnosis of HCC may be depicted, including appearance after injection of hepatobiliary MR imaging contrast agents. These features increase confidence in diagnosis, but cannot be used as substitutes to liver biopsy. Aside from its diagnostic purpose, imaging also helps to assess tumor biology and patient outcome, by identifying features of local invasiveness. The purpose of this review article is to offer an overview of the role of imaging for the diagnosis and prognostication of HCC.


Hepatocellular carcinoma Computed tomography Magnetic resonance imaging Contrast-enhanced ultrasound Hypervascularity Washout Hepatobiliary 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Maxime Ronot
    • 1
    • 2
    • 3
    Email author
  • Yvonne Purcell
    • 1
  • Valérie Vilgrain
    • 1
    • 2
    • 3
  1. 1.Department of RadiologyAPHP, University Hospitals Paris Nord Val de Seine, BeaujonClichyFrance
  2. 2.University Paris Diderot, Sorbonne Paris CitéParisFrance
  3. 3.INSERM U1149centre de recherche biomédicale Bichat-Beaujon, CRB3ParisFrance

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