Hepatocellular carcinoma CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

On CT, HCC can have three distinct patterns of growth:

  • A single large tumor
  • Multiple tumors
  • Poorly defined tumor with an infiltrative growth pattern

Once imaged, diagnosis is confirmed by percutaneous biopsy and histopathologic analysis.

The key characteristics on CT are hypervascularity in the arterial phase scans, washout or de-enhancement in the portal and delayed phase studies, a pseudocapsule and a mosaic pattern. Both calcifications and intralesional fat may be appreciated.

CT scans use contrast agents, which are typically iodine or barium based. Some patients are allergic to one or both of these contrast agents, most often iodine. Usually the allergic reaction is manageable and not life threating.

An alternative to a CT imaging study would be the MRI.

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