• Benign Lesions
• Malignant lesions
  • Hepatucellolar carcinoma (HCC)
  • Metastatic liver tumor
  • Cholangiocellular carcinoma
  • Clinical utility

Hepatucellolar carcinoma (HCC)

Hepatocellular carcinoma (HCC) is the most common primary malignant neoplasm of the liver worldwide. Recent estimations revealed between 250,000 and 1,000,000 deaths per year. Its etiological factors include cirrhosis, chronic hepatitis B and C virus infection, extensive alcohol use, hemochromatosis, and carcinogens. The most common underlying pathology is cirrhosis. HCC is usually either diffuse or nodular and some HCCs have a capsule. The prognosis of HCC is poor, therefore diagnosis and treatment decision are essential.

MRI appearance of a HCC without (pre-contrast) and with Primovist^®

HCCs show various signal intensity patterns. The most frequent appearance is of hypointensity (dark areas) on T1-weighted images and a moderately hyperintensity (bright areas) of T2-weighted images (left-hand-side). A hypointense rim and a mosaic interior constitute characteristic features of HCC.

In the liver-specific phase after injection of Primovist^®, HCCs usually show no relevant liver-specific uptake (right-hand-side) and appear dark in relation to the surrounding bright tissue with high liver-to-lesion contrast (see arrow).

Hepatocellular carcinoma (HCC)

Therapy

There are several surgical and non-surgical therapies available. Surgical resection and/or liver transplantation are, however, the only curative treatments. Most patients with HCC have cirrhosis of the liver, which makes liver resection surgery less tolerable. Even if resection is performed successfully, underlying cirrhosis allows for the possibility of recurrence. Orthotopic liver transplantation (OLT) is the best treatment for non-resectable hepatocellular carcinoma (HCC). Tumor recurrence, however, reduces medium-term and long-term survival. Non-surgical treatments include chemoembolization, radiofrequency ablation, and according to recent scientific publications, intravenous chemotherapy with e.g. long acting octreotide (LAR) or tamoxifen (Nolvadex^®) and Nexavar^® which offers a treatment option with proven clinical benefit for HCC.