Hepatocellular carcinoma CT

Abdominal CT scan with intravenous contrast agent is used to diagnose hepatocellular carcinoma. Three-phase scanning (before contrast administration, immediately after contrast administration, and again after a delay) is employed to increase the ability of the radiologist to detect small tumors. It is important to optimize the parameters of the CT examination, because the underlying liver disease (e.g. hepatitis B) that most hepatocellular carcinoma patients have can make the findings more difficult to appreciate.

• Abdominal CT scan may be helpful in the diagnosis of hepatocellular carcinoma (HCC).
• Findings on CT scan suggestive of hepatocellular carcinoma include the following:^[1][2][3][4]
  • Enhanced mass during the arterial phase
  • Wedge shaped perfusion abnormality because of the arterioportal shunts (APS)
  • Focal fatty change in the normal liver
  • Focal fatty sparing in the diffusely fatty liver
  • Halo of focal fatty sparing around the hepatocellular carcinoma

• 
  Abdominal CT showing massive hepatocellular carcinoma. Case courtesy of Dr Natalie Yang,^[5]
• 
  Abdominal CT showing diffuse hepatocellular carcinoma. Case courtesy of Dr Ahmed Abd Rabou,^[6]

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