Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Mar 28, 2023; 15(3): 56-68
Published online Mar 28, 2023. doi: 10.4329/wjr.v15.i3.56
Hepatocellular carcinoma: State of the art diagnostic imaging
Cody Criss, Arpit M Nagar, Mina S Makary
Cody Criss, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, United States
Arpit M Nagar, Mina S Makary, Department of Radiology, The Ohio State University Medical Center, Columbus, OH 43210, United States
Author contributions: Cody C designed and wrote the review; Nagar AM reviewed and critically advised the paper; Makary MS supervised and critically revised the paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mina S Makary, MD, Assistant Professor, Attending Doctor, Director, Department of Radiology, The Ohio State University Medical Center, 395 W. 12th Ave., Columbus, OH 43210, United States. mina.makary@osumc.edu
Received: December 18, 2022
Peer-review started: December 18, 2022
First decision: January 31, 2023
Revised: February 12, 2023
Accepted: March 22, 2023
Article in press: March 22, 2023
Published online: March 28, 2023
Processing time: 99 Days and 5.1 Hours
Abstract

Primary liver cancer is the fourth most common malignancy worldwide, with hepatocellular carcinoma (HCC) comprising up to 90% of cases. Imaging is a staple for surveillance and diagnostic criteria for HCC in current guidelines. Because early diagnosis can impact treatment approaches, utilizing new imaging methods and protocols to aid in differentiation and tumor grading provides a unique opportunity to drastically impact patient prognosis. Within this review manuscript, we provide an overview of imaging modalities used to screen and evaluate HCC. We also briefly discuss emerging uses of new imaging techniques that offer the potential for improving current paradigms for HCC characterization, management, and treatment monitoring.

Keywords: Hepatocellular carcinoma; Imaging; Diagnostic; Magnetic resonance imaging; Computed tomography; Ultrasound; Radiogenomics

Core Tip: Successful tumor assessment can be a critical component to patient management and prognosis. The expansion of imaging techniques beyond conventional modalities (e.g. ultrasound, computed tomography, magnetic resonance imaging) provides an opportunity to improve the identification of small or well-differentiated hepatocellular carcinoma tumors, along with the capability to monitor treatment responses to surgery or locoregional therapy.