Skip to main content
SpringerLink
Log in
Book cover

Liver Malignancies pp 71–94Cite as

Computed Tomography of Hepatocellular Carcinoma

  • Chapter

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

Abstract

Computed tomography (CT) currently plays a fundamental role in the screening, differential diagnosis, staging, and evaluation of response to treatment of hepatocellular carcinoma (HCC) (Oliver et al. 1996). HCC is a hypervascular tumor which is best depicted by CT images obtained during the predominantly arterial phase of contrast enhancement. Hence, the use of a spiral scanner is mandatory when studying this kind of malignancy to perform an accurate examination of the entire liver parenchyma (Rummeny and Marchal 1997). This article will focus on spiral CT features of HCC lesions and on the role of CT for screening, differential diagnosis, and staging of HCC. The usefulness of spiral CT for the assessment of tumor response will be discussed in the relevant chapter.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Bartolozzi C, Lencioni R, Caramella 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

    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 Hepalol 28:491–496

    Article  Google Scholar 

  • Bluemke DA, Soyer P, Chan B, et al (1995) Spiral CT during arterial portography: techniques and afplication. 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 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 168:219–224

    PubMed  CAS  Google Scholar 

  • Dodd GD, Miller WJ, Baron RL, et al (1992) Detection of nalignant tumors in end-stage cirrhotic livers: eificacy of sonography as a screening technique. AIR 159:717–733

    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, Gs illoud 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 

  • Grossholz M, Terrier F, Rubbia L, et al (1998) Focal sparing in the fatty liver as a sign of an adjacent space-occupying Computed Tomography of Hepatocellular Carcinoma 93 lesion. AJR 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. AIR 164:879–884

    CAS  Google Scholar 

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

    Article  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 T, Baron RL (1997) Hepatocellular carcinoma: the role of helical biphasic contrast-enhanced 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. AIR 171:445–448

    CAS  Google Scholar 

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

    CAS  Google Scholar 

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

    CAS  Google Scholar 

  • Kim TK, Choi BI, Han JK, Chung JW, Park JH, Han MC (1998) 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 IC (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 T, Lucas J (1997) Hepatic lesion characterization in cirrhosis: significance of arterial hypervascularity on dual-phase helical CT. AIR 169:125–30

    CAS  Google Scholar 

  • Lencioni R, Mascalchi M, Caramella D, Bartolozzi C (1996) 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, et al (1997) Intrahepatic metastatic nodules of hepatocellular carcinoma detected at Lipiodol-CT: imaging-pathologic correlation. Abdom Imaging 22:253–258

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  • Matsui O, Takahshi 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. AIR 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 IL, Sugarbaker TH, et a1 (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 

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

    PubMed  CAS  Google Scholar 

  • Oi H, Murakami T, Kim I, et al (1996) Dynamic MR imaging and early-phase helical CT for detecting small intrahepatic metastases of hepatocellular carcinoma. AIR 166:369–3 74

    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 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 

  • 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. AIR 164:879–884

    Google Scholar 

  • Ros PR, Buck IL, Goodman ID, et al (1988) Intrahepatic cholangiocarcinoma: radiologie-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 appli- cations 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 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 inultiplanar reconstruction. AJR 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 155:49–54

    PubMed  CAS  Google Scholar 

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

    CAS  Google Scholar 

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

    CAS  Google Scholar 

  • Tillich M, Mischinger HJ, Preisegger KH, Rai H, Szolar DH (1998) Multiphasic helical CT in diagnosis and staging of hilar cholangiocarcinoma. AJR 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. AIR 169:1185–1192

    Google Scholar 

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

    CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

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

    C. Bartolozzi MD, F. Donati MD, D. Cioni MD, L. Crocetti MD & R. Lencioni MD

Authors
  1. C. Bartolozzi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Donati MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Cioni MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. Crocetti MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R. Lencioni MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

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

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

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Bartolozzi, C., Donati, F., Cioni, D., Crocetti, L., Lencioni, R. (1999). Computed Tomography of Hepatocellular Carcinoma. In: Bartolozzi, C., Lencioni, R. (eds) Liver Malignancies. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58641-5_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-58641-5_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63679-0

  • Online ISBN: 978-3-642-58641-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation