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Hepatocellular Carcinoma

  • Chapter
Spiral CT of the Abdomen

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world, with an estimated incidence of about 1,000,000 cases per year throughout the world (Lencioni and Bartolozzi 1997). This tumor is the seventh most common cancer in men and the ninth most common cancer in women. HCC varies considerably among the various geographic areas in incidence, etiology, and clinicopathologic features. While this neoplasm is very common in the South-East of Asia and in sub-Saharan Africa, it is relatively rare in the United States and in the North of Europe. The South of Europe is characterized by a medium to high incidence of HCC. In Western countries and in Japan, HCC emerges in cirrhotic livers in more than 90% of cases. In fact, patients with liver cirrhosis have long been identified as a high-risk group for the development of HCC. The yearly incidence of HCC in cirrhotic patients may reach 3–5%, and HCC is recognized as the principal cause of death in these patients (Colombo et al. 1991; Lencioni et al. 1995a).

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References

  • Bartolozzi C, Lencioni R (1996) Ethanol injection for the treatment of hepatic tumours. Eur Radiol 6:682–696

    PubMed  CAS  Google Scholar 

  • Bartolozzi C, Lencioni R, Caramella D, et al (1994a) Treatment of hepatocellular carcinoma with percutaneous ethanol injection: evaluation with contrast-enhanced MR imaging. AJR Am J Roentgenol 162:827–831

    PubMed  CAS  Google Scholar 

  • Bartolozzi C, Lencioni R, Caramella D, et al (1994b) Hepatocellular carcinoma: CT and MR features after transcatheter arterial embolization and percutaneous ethanol injection. Radiology 191:123–128

    PubMed  CAS  Google Scholar 

  • Bartolozzi C, Lencioni R, Caramella D, et al (1995) Treatment of large hepatocellular carcinoma: transcatheter arterial chemoembolization combined with percutaneous ethanol injection versus repeated transcatheter arterial chemoembolization. Radiology 197:812–818

    PubMed  CAS  Google Scholar 

  • Bartolozzi C, Lencioni R, Caramelia D, Palla A, Bassi AM, Di Candio G (1996) Small hepatocellular carcinoma. Detection with US, CT, MR imaging, DSA, and Lipiodol-CT. Acta Radiol 37:69–74

    PubMed  CAS  Google Scholar 

  • Bartolozzi C, Lencioni R, Ricci P, Paolicchi A, Rossi P, Passariello R (1998) Hepatocellular carcinoma treatment with percutaneous ethanol injection: evaluation with contrast-enhanced color Doppler US. Radiology 209:387–393

    PubMed  CAS  Google Scholar 

  • Becker CD, Grossholz M, Mentha G, et al (1997) Ablation of hepatocellular carcinoma by percutaneous ethanol injection: imaging findings. Cardiovasc Intervent Radiol 20:204–210

    Article  PubMed  CAS  Google Scholar 

  • Bisollon T, Rode A, Baricel B, et al (1998) Diagnostic value and tolerance of Lipiodol computed tomography for the detection of small hepatocellular carcinoma: correlation with pathologic examination of explanted livers. J Hepatol 28:491–496

    Article  Google Scholar 

  • Bluemke DA, Soyer P, Chan B, et al (1995) Spiral CT during arterial portography: techniques and application. RadioGraphics 15:633–637

    Google Scholar 

  • Bonaldi VM, Bret PM, Reinhold C, Atri M (1995) Helical CT of the liver: value of an early hepatic arterial phase. Radiology 197:357–363

    PubMed  CAS  Google Scholar 

  • Choi BI (1995) Vascular invasion by hepatocellular carcinoma. Abdom Imaging 20:277–278

    Article  PubMed  CAS  Google Scholar 

  • Choi BI, Takayasu K, Han MC, et al (1993) Small hepatocellular carcinomas and associated nodular lesions of the liver: pathology, pathogenesis and imaging findings. AJR Am J Roentgenol 160:1177–1187

    PubMed  CAS  Google Scholar 

  • Choi BI, Cho GM, Han JK, et al (1996) Spiral CT for the detection of hepatocellular carcinoma: relative value of arterial and late phase scanning. Abdom Imaging 21:440–444

    Article  PubMed  CAS  Google Scholar 

  • Choi BI, Lee HJ, Han JK, Choi DS, Seo JB, Han MC (1997) Detection of hypervascular nodular hepatocellular carcinomas: value of triphasic helical CT compared with iodized-oil CT. AJR Am J Roentgenol 168:219–224

    PubMed  CAS  Google Scholar 

  • Colombo M, De Franchis R, Del Ninno, et al (1991) Hepatocellular carcinoma in Italian patients with cirrhosis. N Engl J Med 325:675–680

    Article  PubMed  CAS  Google Scholar 

  • Dodd GD, Miller WJ, Baron RL et al (1992) Detection of malignant tumors in end-stage cirrhotic livers: efficacy of sonography as a screening technique. AJR Am J Roentgenol 159:727–733

    PubMed  Google Scholar 

  • Fasel JH, Gailloud P, Terrier F, Mentha G, Sprumont P (1996) Segmental anatomy of the liver: a review and a proposal for an international working nomenclature. Eur Radiol 6:834–837

    Article  PubMed  CAS  Google Scholar 

  • Fasel JH, Selle D, Evertsz CJ, Terrier F, Peitgen HO, Gailloud P (1998) Segmental anatomy of the liver: poor correlation with CT. Radiology 206:151–156

    PubMed  CAS  Google Scholar 

  • Fernandez MP, Redvanly RD (1998) Primary hepatic malignant neoplasms. Radiol Clin North Am 36:333–348

    Article  PubMed  CAS  Google Scholar 

  • Freeny PC, Baron RL, Teefey SA (1992) Hepatocellular carcinoma: reduced frequency of typical findings with dynamic contrast enhanced CT in a non Asian population. Radiology 185:143–148

    Google Scholar 

  • Grangier C, Tourniaire J, Mentha G, et al (1994) Enhancement of liver hemangiomas on T1-weighted MR SE images by superparamagnetic iron oxide particles. J Comput Assist Tomogr 18:888–896

    Article  PubMed  CAS  Google Scholar 

  • Grossholz M, Terrier F, Rubbia L, et al (1998) Focal sparing in the fatty liver as a sign of an adjacent space-occupying lesion. AJR Am J Roentgenol 171:1391–1395

    PubMed  CAS  Google Scholar 

  • Hanafusa K, Ohashi I, Gomi N, Himeno Y, Wakita T, Shibuya H (1997) Differential diagnosis of early homogeneously enhancing hepatocellular carcinoma and hemangioma by two-phase CT. J Comput Assist Tomogr 21:361–368

    Article  PubMed  CAS  Google Scholar 

  • Hollett MD, Jeffry RB Jr, Nino-Murcia M, et al (1995) Dualphase helical CT of the liver: value of arterial phase scans in the detection of small <1.5 cm) malignant hepatic neoplasms. AJR Am J Roentgenol 164:879–884

    PubMed  CAS  Google Scholar 

  • Hori M, Murakami T, Kim T, et al (1998) Sensitivity of doublephase helical CT during arterial portography for detection of hypervascular hepatocellular carcinoma. J Comput Assist Tomogr 22:861–867

    Article  PubMed  CAS  Google Scholar 

  • Jang HJ, Choi BI, Kim TK, et al (1998) Atypical small hemangiomas of the liver: “bright dot” sign at two-phase spiral CT. Radiology 208:543–548

    PubMed  CAS  Google Scholar 

  • Kanai T, Hirohashi S, Upton M, et al (1987) Pathology of small hepatocellular carcinoma: a proposal for a new gross classification. Cancer 60:810–819

    Article  PubMed  CAS  Google Scholar 

  • Kanematsu M, Oliver JH III, Carr B, Baron RL (1997) Hepatocellular carcinoma: the role of helical biphasic contrastenhanced CT versus CT during arterial portography. Radiology 205:75–80

    PubMed  CAS  Google Scholar 

  • Kanematsu M, Kondo H, Enya M, Yokoyama R, Hoshi H (1998) Nondiseased portal perfusion defects adjacent to the right ribs shown on helical CT during arterial portography. AJR Am J Roentgenol 171:445–448

    PubMed  CAS  Google Scholar 

  • Kanematsu M, Hoshi H, Yamawaki Y, et al (1999) Angiographically assisted helical CT of the liver. AJR Am J Roentgenol 172:97–105

    PubMed  CAS  Google Scholar 

  • Kim SR, Hayashi Y, Matsuoka T, et al (1998a) A case of well-differentiated minute hepatocellular carcinoma with extrahepatic metastasis. J Gastroenterol Hepatol 13:892–896

    Article  PubMed  CAS  Google Scholar 

  • Kim TK, Choi BI, Han JK, Chung JW, Park JH, Han MC (1998b) Nontumorous arterioportal shunt mimicking hypervascular tumor in cirrhotic liver: two-phase spiral CT findings. Radiology 208:597–603

    PubMed  CAS  Google Scholar 

  • Kitagaua K, Matsui O, Kadoya M, et al (1991) Hepatocellular carcinomas with excessive copper accumulation: CT and MR findings. Radiology 180:623–628

    Google Scholar 

  • Krinsky GA, Theise ND, Rofsky NM, Mizrachi H, Tepperman LW, Weinreb JC (1998) Dysplastic nodules in cirrhotic liver: arterial phase enhancement at CT and MR imaging-a case report. Radiology 209:461–464

    PubMed  CAS  Google Scholar 

  • Lee HM, Lu DS, Krasny RM, Busuttil R, Kadell B, Lucas J (1997) Hepatic lesion characterization in cirrhosis: significance of arterial hypervascularity on dual-phase helical CT. AJR Am J Roentgenol 169:125–130

    PubMed  CAS  Google Scholar 

  • Lencioni R, Bartolozzi C (1997) Nonsurgical treatment of hepatocellular carcinoma. Cancer J 10:17–23

    CAS  Google Scholar 

  • Lencioni R, Vignali C, Caramella D, et al (1994) Transcatheter arterial embolization followed by percutaneous ethanol injection in the treatment of hepatocellular carcinoma. Cardiovasc Intervent Radiol 17:70–75

    Article  PubMed  CAS  Google Scholar 

  • Lencioni R, Bartolozzi C, Caramella D, et al (1995a) Treatment of small hepatocellular carcinoma with percutaneous ethanol injection: analysis of prognostic factors in 105 Western patients. Cancer 76:1737–1746

    Article  PubMed  CAS  Google Scholar 

  • Lencioni R, Caramella D, Bartolozzi C (1995b) Hepatocellular carcinoma: use of color Doppler US to evaluate response to treatment with percutaneous ethanol injection. Radiology 194:113–118

    PubMed  CAS  Google Scholar 

  • Lencioni R, Caramella D, Sanguinetti F, Battolla L, Falaschi F, Bartolozzi C (1995c) Portal vein thrombosis after percutaneous ethanol injection for hepatocellular carcinoma: value of color Doppler sonography in distinguishing chemical and tumor thrombi. AJR Am J Roentgenol 164:1125–1130

    PubMed  CAS  Google Scholar 

  • Lencioni R, Mascalchi M, Caramella D, Bartolozzi C (1996a) Small hepatocellular carcinoma: differentiation from adenomatous hyperplasia with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging. Abdom Imaging 21:41–48

    Article  PubMed  CAS  Google Scholar 

  • Lencioni R, Pinto F, Armillotta N, Bartolozzi C (1996b) Assessment of tumor vascularity in hepatocellular carcinoma: comparison of power Doppler US and color Doppler US. Radiology 201:353–358

    PubMed  CAS  Google Scholar 

  • Lencioni R, Pinto F, Armillotta N, et al (1997a) Long-term results of percutaneous ethanol injection therapy for hepatocellular carcinoma in cirrhosis: a European experience. Eur Radiol 7:514–519

    Article  PubMed  CAS  Google Scholar 

  • Lencioni R, Pinto F, Armillotta N, et al (1997b) Intrahepatic metastatic nodules of hepatocellular carcinoma detected at Lipiodol-CT: imaging-pathologic correlation. Abdom Imaging 22:253–258

    Article  PubMed  CAS  Google Scholar 

  • Lencioni R, Paolicchi A, Moretti M, et al (1998) Combined transcatheter arterial chemoembolization and percutaneous ethanol injection for the treatment oflarge hepatocellular carcinoma: local therapeutic effect and long-term survival rate. Eur Radiol 8:439–444

    Article  PubMed  CAS  Google Scholar 

  • Matsui O, Kadoya M, Kameyama T, et al (1991) Benign and malignant nodules in cirrhotic livers: distinction based on blood supply. Radiology 178:493–497

    PubMed  CAS  Google Scholar 

  • Matsui O, Takahashi S, Kadoya M, et al (1994) Pseudolesion in segment IV of the liver at CT during arterial portography: correlation with aberrant gastric venous drainage. Radiology 193:31–35

    PubMed  CAS  Google Scholar 

  • Merine D, Takayasu K, Wakao F (1990) Detection of hepatocellular carcinoma: comparison of CT during arterial portography with CT after intraarterial injection of iodized oil. Radiology 175:707–710

    PubMed  CAS  Google Scholar 

  • Mitsukaki K, Yamashita Y, Ogata I et al (1996) Multiple phase helical-CT of the liver for detecting small hepatomas in patients with liver cirrhosis: contrast-injection protocol and optimal timing. AJR Am J Roentgenol 167:753–757

    Google Scholar 

  • Nakakuma Y, Terada T, Ueda K, et al (1993) Adenomatous hyperplasia of the liver as a precancerous lesion. Liver 13:1–9

    Article  Google Scholar 

  • Nelson RC, Chezmar JL, Sugarbaker TH, et al (1990) Preoperative localization of focal liver lesions to specific liver segments: utility of CT during arterial portography. Radiology 176:89–94

    PubMed  CAS  Google Scholar 

  • Novick SL, Fishman EK (1998) Portal vein thrombosis: spectrum of helical CT and CT angiographic findings. Abdom Imaging 23:505–510

    Article  PubMed  CAS  Google Scholar 

  • Oi H, Murakami T, Kim T, et al (1996) Dynamic MR imaging and early-phase helical CT for detecting small intrahepatic metastases of hepatocellular carcinoma. AJR Am J Roentgenol 166:369–374

    PubMed  CAS  Google Scholar 

  • Oka H, Kurioka M, Kim K, et al (1990) Prospective study of early detection of hepatocellular carcinoma in patients with cirrhosis. Hepatology 12:680–687

    Article  PubMed  CAS  Google Scholar 

  • Oliver JH III, Baron RL (1996) Helical biphasic contrast-enhanced CT of the liver: technique, indications, interpretation and pitfalls. Radiology 201:1–14

    PubMed  Google Scholar 

  • Oliver JH III, Baron RL, Federle MP, et al (1996) Detecting hepatocellular carcinoma: value of unenhanced or arterial phase CT imaging or both, used in conjunction with conventional portal venous phase contrast-enhanced CT imaging. AJR Am J Roentgenol 167:71–77

    PubMed  Google Scholar 

  • Oliver JH III, Baron RL, Federle MP, Jones BC, Sheng R (1997) Hypervascular liver metastases: do unenhanced and hepatic arterial phase CT images affect tumor detection? Radiology 205:709–715

    PubMed  Google Scholar 

  • Ohtomo K, Baron RJ, Dodd GD, et al (1993) Confluent hepatic fibrosis in advanced cirrhosis: appearance at CT. Radiology 188:31–35

    PubMed  CAS  Google Scholar 

  • Pateron D, Ganne N, Trinchet J, et al (1994) Prospectiv study of screening of hepatocellular carcinoma in Caucasian patients with cirrhosis. J Hepatol 20:65–71

    Article  PubMed  CAS  Google Scholar 

  • Rofflett MD, Jeffrey RB, Nino Murcia M, et al (1995) Dual phase helical CT of the liver: value of arterial phase scans in the detection of small < 1.5 cm) malignant hepatic neoplasms. AJR Am J Roentgenol 164:879–884

    Google Scholar 

  • Ros PR, Buck JL, Goodman ID, et al (1988) Intrahepatic cholangiocarcinoma: radiologic-pathologic correlation. Radiology 167:689–693

    PubMed  CAS  Google Scholar 

  • Ros PR, Murphy BJ, Back JL, et al (1990) Encapsulated hepatocellular carcinoma: radiologic findings and pathological correlation. Gastrointest Radiol 15:233–237

    Article  PubMed  CAS  Google Scholar 

  • Rubin GD, Dake MD, Napel SA, et al (1993) Three dimensional spiral CT angiography of the abdomen: initial clinical experience. Radiology 186:147–152

    PubMed  CAS  Google Scholar 

  • Rummeny EJ, Marchal G (1997) Liver imaging. Clinical applications and future perspectives. Acta Radiol 38:626–630

    PubMed  CAS  Google Scholar 

  • Small WC, Mehard WB, Langmo LS, et al (1993) Preoperative determination of the resectability of hepatic tumors; efficacy of CT during arterial portography. AJR Am J Roentgenol 161:319–322

    PubMed  CAS  Google Scholar 

  • Soyer P, Bluemke DA, Bliss DF, et al (1994) Surgical segmental anatomy of the liver: demonstration with spiral CT during arterial portography and multiplanar reconstruction. AJR Am J Roentgenol 163:99–103

    PubMed  CAS  Google Scholar 

  • Takayama T, Makuuchi M, Hirahashi S, et al (1990) Malignant transformation of adenomatous hyperplasia to hepatocellular carcinoma. Lancet 336:1150–1153

    Article  PubMed  CAS  Google Scholar 

  • Takayasu K, Moriyama N, Muramatsu Y, et al (1990) The diagnosis of small hepatocellular carcinomas: efficacy of various imaging procedures in 100 patients. AJR Am J Roentgenol 155:49–54

    PubMed  CAS  Google Scholar 

  • Takayasu K, Muramatsu Y, Furukawa H, et al (1995a) Early hepatocellular carcinoma: appearance at CT during arterial portography and CT arteriography with pathologic correlation. Radiology 194:101–105

    PubMed  CAS  Google Scholar 

  • Takayasu K, Furukawa H, Wakao F, et al (1995b) CT diagnosis of early hepatocellular carcinoma: sensitivity, findings, and CT pathologic correlation. AJR Am J Roentgenol 164:885–890

    PubMed  CAS  Google Scholar 

  • Tillich M, Mischinger HJ, Preisegger KH, Rabl H, Szolar DH (1998) Multiphasic helical CT in diagnosis and staging of hilar cholangiocarcinoma. AJR Am J Roentgenol 171:651–658

    PubMed  CAS  Google Scholar 

  • Tourel PG, Pageaux GP, Coste V, et al (1995) Small hepatocellular carcinoma in patients undergoing liver transplantation: detection with CT after injection of iodized oil. Radiology 197:377–380

    Google Scholar 

  • Tublin ME, Tessler FN, Cheng SL, Peters TL, McGovern PC (1999) Effect of injection rate of contrast medium on pancreatic and hepatic helical CT. Radiology 210:97–101

    PubMed  CAS  Google Scholar 

  • Ueda K, Kitigawa K, Kadoya M, et al (1995) Detection of hypervascular hepatocellular carcinoma by using spiral volumetric CT: comparison of US and MR imaging. Abdom Imaging 20:547–554

    Article  PubMed  CAS  Google Scholar 

  • Ueda K, Matsui O, Kawamori Y, et al (1998) Differentiation of hypervascular hepatic pseudolesions from hepatocellular carcinoma: value of single-level dynamic CT during hepatic arteriography. J Comput Assist Tomogr 22:703–708

    Article  PubMed  CAS  Google Scholar 

  • van Hoe L, Baert AL, Gryspeerdt S, et al (1997) Dual-phase helical-CT of the liver: value of an early phase acquisition in the differential diagnosis of non-cystic focal lesions. AJR Am J Roentgenol 169:1185–1192

    Google Scholar 

  • Yamashita Y, Fan ZM, Yamamoto H, et al (1993) Sclerosing hepatocellular carcinoma: radiologic findings. Abdom Imaging 18:347–351

    Article  PubMed  CAS  Google Scholar 

  • Yoshikawa J, Matsui O, Takashima T, et al (1988) Fatty metamorphosis in hepatocellular carcinoma: radiologic features in 10 cases. AJR Am J Roentgenol 151:717–720

    PubMed  CAS  Google Scholar 

  • Yoshikawa J, Matsui O, Kadoya M, et al (1992) Delayed enhancement of fibrotic areas in hepatic masses: CT-pathologic correlation. J Comput Assist Tomogr 16:206–211

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Diagnostic and Interventional Radiology, Department of Oncology, University of Pisa, Via Roma 67, 1-56125, Pisa, Italy

    R. Lencioni MD, D. Cioni MD & C. Bartolozzi MD (Professor and Chairman)

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  1. R. Lencioni MD
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  2. D. Cioni MD
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  3. C. Bartolozzi MD
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Editors and Affiliations

  1. Department of Radiology Division of Diagnostic and Interventional Radiology, Geneva University Hospital, 24, Rue Micheli-du-Crest, CH-1211, Genève 14, Switzerland

    François Terrier MD (Professor) & Christoph D. Becker MD (Professor) & 

  2. Hôpital de la Tour, CH-1217, Meyrin, Switzerland

    Marianne Grossholz MD

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© 2000 Springer-Verlag Berlin Heidelberg

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Lencioni, R., Cioni, D., Bartolozzi, C. (2000). Hepatocellular Carcinoma. In: Terrier, F., Grossholz, M., Becker, C.D. (eds) Spiral CT of the Abdomen. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56976-0_9

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  • DOI: https://doi.org/10.1007/978-3-642-56976-0_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-42291-4

  • Online ISBN: 978-3-642-56976-0

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