Diagnosis and Staging of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the fifth most common tumor in the world, and its incidence is increasing. It is second most common cause of cancer related death worldwide and fastest growing cause of cancer death in the United States. Cirrhosis is the most important clinical risk factor for HCC, with approximately 80% of cases of HCC developing in patients with a cirrhotic liver. HCC differs from most malignancies because it is commonly diagnosed on the basis of imaging features alone, without histologic confirmation. The prognosis of HCC depends largely on the stage at which the tumor is detected. The detection of HCC early in its development, therefore, is critical to improve the survival of affected patients. In this talk, we discuss surveillance strategies with ultrasonography (US) as the primary screening imaging test as well as current state of the art for the imaging-based diagnosis and staging of HCC.