Diagnosis of primary liver cancer by computed tomography

  • Osamu Matsui
  • Yuji Itai


For the early detection of hepatocellular carcinoma (HCC), the effectiveness of ultrasonography (US) has been widely accepted in Japan. However, US examination of the entire liver is occasionally impossible because of intervening bones, air in the gut or lung, or dense fatty tissue, especially in patients with a small cirrhotic liver. In such patients, computed tomography (CT) has begun to play an increasingly important role in detecting HCC as a complementary imaging method for US. CT is also very useful in differentiating various space-occupying lesions of the liver [1,2], evaluating the location and extension of these lesions, and determining the viability of neoplasms treated by transcatheter arterial embolization (TAE), percutaneous ethanol injection therapy, or chemotherapy. Another advantage of CT is its objectiveness in visualizing the relation between the lesions and the surrounding tissues. For these reasons and because of widespread availability of CT machines in Japan, CT is now performed in almost all patients with HCC and is making a major contribution to the treatment of HCC.


Tumor Thrombus Focal Nodular Hyperplasia Cavernous Hemangioma Fibrous Capsule Adenomatous Hyperplasia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Itai Y, Nishikawa J, Tasaka A (1979) Computed tomography in the evaluation of hepatocellular carcinoma. Radiology 131: 165–170PubMedGoogle Scholar
  2. 2.
    Itai Y, Araki T, Furui S, Tasaka A (1981) Differential diagnosis of hepatic masses on computed tomography, with particular reference to hepatocellular carcinoma. J Comput Assist Tomogr 5: 834–842PubMedCrossRefGoogle Scholar
  3. 3.
    Itai Y (1987) Imaging diagnosis with computed tomography. In: Okuda K, Ishak KG (eds) Neoplasms of the Liver. Springer-Verlag, Tokyo, pp 289–300Google Scholar
  4. 4.
    Itai Y, Ohtomo K, Yamauchi T, Minami M, Yashiro N, Araki T (1986) CT of hepatic masses: Significance of prolonged enhancement and delayed enhancement. AJR 146: 792–733Google Scholar
  5. 5.
    Prando A, Wallace S, Bernardino ME, Lindell MM Jr (1979) Computed tomographic arteriography of the liver. Radiology 130: 697–701PubMedGoogle Scholar
  6. 6.
    Matsui O, Kadoya M, Suzuki M, Inoue K, Itoh H, Ida M, Takashima T (1983) Dynamic sequential computed tomography during arterial portography in the detection of hepatic neoplasms. Radiology 146: 721–727PubMedGoogle Scholar
  7. 7.
    Ohishi H, Uchida H, Yoshimura H, Ohue S, Ueda J, Katsuragi M, Matsuo N, Hosogi Y (1985) Hepatocellular carcinoma detected by iodized oil: Use of anticancer agents. Radiology 154: 25–30PubMedGoogle Scholar
  8. 8.
    Matsui O, Takashima T, Kadoya M, Suzuki M, Hirose J, Kameyama T, Choto S, Konishi H, Ida M, Yamaguchi A, Izumi R (1987) Liver metastases from colorectal cancers: Detection with CT during arterial portography. Radiology 165: 65–69PubMedGoogle Scholar
  9. 9.
    Matsui O, Takashima T, Kadoya M, Kitagawa K, Hirose J, Kameyama T, Choto S, Miyata S (1987) Mechanism of Lipiodol accumulation and retention in hepatic tumors: Analysis in cases with simple Lipiodol injection. Nippon Acta Radiol. 47: 1395–1404 [Japanese]PubMedGoogle Scholar
  10. 10.
    Takayasu K, Shima Y, Muramatu Y, Goto H, Moriyama N, Yamada T, Makuuchi M, Yamasaki S, Hasegawa H, Okazaki N, Hirohashi S, Kishi K (1986) Angiography of small hepatocellular carcinoma: analysis of 105 resected tumors. AJR 147: 525–529PubMedGoogle Scholar
  11. 11.
    Matsui O, Takashima T, Kadoya M, Ida M, Suzuki M, Kitagawa K, Kamimura R, Inoue K, Konishi H, Itoh H (1985) Dynamic computed tomography during arterial portography: the most sensitive examination for small hepatocellular carcinomas. J Comput Assist Tomogr 9: 19–24PubMedCrossRefGoogle Scholar
  12. 12.
    Kojiro M, Nakashima T (1987) Pathology of hepatocellular carcinoma. In: Okuda K, Ishak KG (eds) Neoplasms of the Liver. Springer-Verlag, Tokyo pp 81–104Google Scholar
  13. 13.
    Araki T, Itai Y, Furui S, Tasaka A (1980) Dynamic CT densitometry of hepatic tumors. AJR 135: 1037–1043PubMedGoogle Scholar
  14. 14.
    Suzuki M, Itoh H, Konishi H, Ida M, Matsui O, Takashima T (1982) Hepatocellular carcinoma involving the portal vein. J Comput Assist Tomogr 6: 831–832PubMedCrossRefGoogle Scholar
  15. 15.
    Itai Y, Furui S, Ohtomo K, Kokubo T, Yamauchi T, Minami M, Yashiro N (1986) Dynamic CT features of arterioportal shunt in hepatocellular carcinoma. AJR 146: 723–727PubMedGoogle Scholar
  16. 16.
    Matsui O, Takashima T, Kadoya M, Kitagawa K, Kamimura R, Itoh H, Suzuki M, Ida M (1984) Segmental staining on hepatic arteriography as a sign of intrahepatic portal vein obstruction. Radiology 152: 601–606PubMedGoogle Scholar
  17. 17.
    Itai Y, Moss AA, Goldberg HI (1982) Transient hepatic attenuation difference of lobar or segmental distribution detected by dynamic computed tomography. Radiology 144: 835–839PubMedGoogle Scholar
  18. 18.
    Kerlin P, Davis GL, McGill DB, Weiland LH, Adson MA, Sheedy PF (1983) Hepatic adenoma and focal nodular hyperplasia: Clinical, pathological and radiologic features. Gastroenterology 84: 994–1002PubMedGoogle Scholar
  19. 19.
    Itai Y, Furui S, Araki T, Yashiro N, Tasaka A (1980) Computed tomography of cavernous hemangioma of the liver. Radiology 137: 149–155PubMedGoogle Scholar
  20. 20.
    Yoshikawa J, Matsui O, Takashima T, Ida M, Takanaka T, Kawamura I, Kakuda K, Miyata S (1988) Fatty metamorphosis in hepatocellular carcinoma: Radiologic features in 10 cases. AJR 151: 717–720PubMedGoogle Scholar
  21. 21.
    Yoshikawa J, Matsui O, Takashima T, Sugiura H, Katayama K, Nishida Y, Tsuji M (1987) Focal fatty change of the liver adjacent to the falciform ligament: CT and sonographic findings in five surgically confirmed cases. AJR 149: 491–494PubMedGoogle Scholar
  22. 22.
    Kadoya M, Matsui O, Nakanuma Y, Yoshikawa J, Arai K, Takashima T, Amano M, Kimura M (1990) Ciliated hepatic foregut cyst: Radiologic features. Radiology 175: 475–477PubMedGoogle Scholar
  23. 23.
    Muramatsu Y, Takayasu K, Moriyama N, Shima Y, Goto H, Ushio K, Yamada T, Hasegawa H, Koyama Y, Hirohashi S (1986) Peripheral lowdensity area of hepatic tumors: CT-pathologic correlation. Radiology 160: 49–52PubMedGoogle Scholar
  24. 24.
    Nakanuma Y, Terada T, Terasaki S, Ueda K, Nonomura A, Kawahara E, Matsui O (1990) “Atypical adenomatous hyperplasia” in liver cirrhosis: Low-grade hepatocellular carcinoma or borderline lesion? Histopathology 17:27–35PubMedCrossRefGoogle Scholar
  25. 25.
    Matsui O, Kadoya M, Kameyama T, Yoshikawa J, Takashima T, Nakanuma Y, Unoura M, Kobayashi K, Izumi R, Ida M, Kitagawa K (1991) Benign and malignant nodules in the cirrhotic livers: Distinction based on blood supply. Radiology 178: 493–497PubMedGoogle Scholar
  26. 26.
    Nelson RC, Chezmar JL, Sugarbaker PH, Murray DR, Bernardino ME (1990) Preoperative localization of focal liver lesions to specific liver segments: Utility of CT during arterial portography. Radiology 176: 89–94PubMedGoogle Scholar
  27. 27.
    Matsui O (1986) Basic and clinical studies of dynamic sequential computed tomography during arterial portography in the diagnosis of hepatic cancers (in Japanese). Nippon Acta Radiol. 46: 335–359PubMedGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1992

Authors and Affiliations

  • Osamu Matsui
    • 1
  • Yuji Itai
    • 2
  1. 1.Kanazawa University School of MedicineKanazawa, IshikawaJapan
  2. 2.Department of RadiologyInstitute of Clinical Medicine, Tsukuba UniversityIbarakiJapan

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