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Table of Contents
1, No. 2, 2012
Issue release date: September 2012
Section title: Review
Free Access
Liver Cancer 2012;1:94–109
(DOI:10.1159/000342404)

New Paradigm for Management of Hepatocellular Carcinoma by Imaging

Joo I. · Choi B.I.
Department of Radiology, Seoul National University Hospital, Seoul, Korea

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Abstract

Based on recent clinical practice guidelines, imaging is largely replacing pathology as the preferred diagnostic method for determination of hepatocellular carcinoma (HCC). A variety of imaging modalities, including ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, and angiography, are currently used to examine patients with chronic liver disease and suspected HCC. Advancements in imaging techniques such as perfusion imaging, diffusion imaging, and elastography along with the development of new contrast media will further improve the ability to detect and characterize HCC. Early diagnosis of HCC is essential for prompt treatment, which may in turn improve prognosis. Considering the process of hepatocarcinogenesis, it is important to evaluate sequential changes via imaging which would help to differentiate HCC from premalignant or benign lesions. Recent innovations including multiphasic examinations, high-resolution imaging, and the increased functional capabilities available with contrast-enhanced US, multidetector row CT, and MRI have raised the standards for HCC diagnosis. Although hemodynamic features of nodules in the cirrhotic liver remain the main diagnostic criterion, newly developed cell-specific contrast agents have shown great possibilities for improved HCC diagnosis and may overcome the diagnostic dilemma associated with small or borderline hepatocellular lesions. In the 20th century paradigm of medical imaging, radiological diagnosis was based on morphological characteristics, but in the 21st century, a paradigm shift to include biomedical, physiological, functional, and genetic imaging is needed. A multidisciplinary team approach is necessary to foster an integrated approach to HCC imaging. By developing and combining new imaging modalities, all phases of HCC patient care, including screening, diagnosis, treatment, and therapy, can be dramatically improved.


  

Author Contacts

Byung Ihn Choi, MD
Department of Radiology, Seoul National University Hospital
101 Daehakro, Jongno-gu, Seoul 110-744 (Korea)
Tel. +82 2 2072 2515, E-Mail bichoi@snu.ac.kr

  

Article Information

Published online: September 28, 2012
Number of Print Pages : 16

  

Publication Details

Liver Cancer

Vol. 1, No. 2, Year 2012 (Cover Date: September 2012)

Journal Editor: Kudo M. (Osaka)
ISSN: 2235-1795 (Print), eISSN: 1664-5553 (Online)

For additional information: http://www.karger.com/LIC


Article / Publication Details

First-Page Preview
Abstract of Review

Published online: 9/28/2012

Number of Print Pages: 0
Number of Figures: 0
Number of Tables: 0

ISSN: 2235-1795 (Print)
eISSN: 1664-5553 (Online)

For additional information: http://www.karger.com/LIC


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