OMICS Journal of Radiology
Open Access

The most common imaging modalities used in the evaluation of Hepatocellular Carcinoma include ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). Due to the low uptake of the commonly used radiotracer, 2-[18 F]-2-deoxy-D-glucose (FDG), which results in a high false positive rate, positron emission tomography (PET) has played a minor role in HCC imaging thus far. Moreover, the expense related with a PET output kept it from becoming reconnaissance or screening device. A few existing little particle PET tracers, which were at first produced for different examinations, have shown take-up in HCC. [11 C]-acetate, [11 C]-methionine, [11 C]- choline, and [18 F]-labeled fluorinated choline analogs are among these [1,2].

An animal model of hepatitis viral infection-induced HCC and preliminary clinical PET scans of HCC using the same tracer were used to investigate the uptake mechanisms of each of these tracers in detail. In any case, the full clinical utility of every tracer should be additionally researched through persistent examinations to decide whether any of them is valuable for early recognition, arranging, or potentially treatment assessment. Due to their degradation in the liver, the promising PET tracers 3-deoxy-3-fluorothymidine (FLT) and 2-18 F fluoro-5-methyl-l-P-Darabinofuranosyluracil (FMAU) both of which are intended for imaging tumor proliferation, may not be suitable for imaging HCC [3-5].

The most common imaging modalities used in the evaluation of HCC include:

Ultrasound, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI).

Ultrasound is usually the first-line imaging modality in the evaluation of HCC due to its low cost, wide availability, lack of ionizing radiation, and ability to provide real-time images. On ultrasound, HCC typically appears as a hyperechoic (brighter than normal liver tissue) or hypoechoic (darker than normal liver tissue) mass. Doppler ultrasound can also evaluate blood flow to and from the tumor, which is important in the diagnosis and staging of HCC [1,5].

Computed Tomography is another commonly used imaging modality in the evaluation of HCC. CT scans can provide detailed images of the liver and surrounding structures, and can help differentiate between HCC and other liver lesions. On CT scans, HCC typically appears as a hyper vascular (having increased blood flow) or hypodense (having decreased density) mass in the liver. CT scans can also evaluate the extent of the tumor and help guide treatment decisions.

MRI is another useful imaging modality for the evaluation of HCC. MRI can provide detailed images of the liver and surrounding structures, and can help differentiate between HCC and other liver lesions. On MRI scans, HCC typically appears as a hyperintense (brighter than normal liver tissue) or hypo intense (darker than normal liver tissue) mass. MRI can also evaluate the extent of the tumor and help guide treatment decisions.

Conclusion

Ultrasound, CT and MRI are the most common imaging modalities used in the evaluation of HCC. The choice of imaging modality depends on various factors, including the patient’s clinical presentation, availability of the imaging modality, and the expertise of the interpreting physician.

Acknowledgement

None

Conflict of Interest

None

1. El-Serag HB, Rudolph KL (2007) Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 132: 2557-2576.

Indexed at, Google Scholar, Crossref

2. Forner A, Llovet JM, Bruix J (2012) Hepatocellular carcinoma. Lancet 379: 1245-1255.

Indexed at, Crossref

3. Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, et al. (2018) Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American Association for the Study of Liver Diseases. Hepatology 68: 723-750.

Indexed at, Google Scholar, Crossref

4. Finn RS, Qin S, Ikeda M, Galle PR, Ducreux M, et al. (2020) Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma. N Engl J Med 382: 1894-1905.

Indexed at, Google Scholar, Crossref

5. Bruix J, Takayama T, Mazzaferro V, Chau GY, Yang J, et al. (2015) Adjuvant Sorafenib for Hepatocellular Carcinoma after Resection or Ablation (STORM): a phase 3, randomised, double-blind, placebo-controlled trial. Lancet Oncol 16: 1344-1354.

Indexed at, Google Scholar, Crossref