The cross-sectional imaging findings play a crucial role in the diagnosis of hepatocellular carcinoma (HCC). Recent studies have shown that imaging findings of HCC are not only relevant for the diagnosis of HCC, but also for identifying genetic and pathologic characteristics and determining prognosis. Imaging findings such as rim arterial phase hyperenhancement, arterial phase peritumoral hyperenhancement, hepatobiliary phase peritumoral hypointensity, non-smooth tumor margin, low apparent diffusion coefficient, and the LR-M category of the Liver Imaging-Reporting and Data System have been reported to be associated with poor prognosis. In contrast, imaging findings such as enhancing capsule appearance, hepatobiliary phase hyperintensity, and fat in mass have been reported to be associated with a favorable prognosis. Most of these imaging findings were examined in retrospective, single-center studies that were not adequately validated. However, the imaging findings can be applied for deciding the treatment strategy for HCC, if their significance can be confirmed by a large multicenter study. In this literature, we would like to review imaging findings related to the prognosis of HCC as well as their associated clinicopathological characteristics.
Citations
Citations to this article as recorded by
A Nomogram Based on MRI Visual Decision Tree to Evaluate Vascular Endothelial Growth Factor in Hepatocellular Carcinoma Hanting Dai, Chuan Yan, Wanrong Huang, Yifan Pan, Feng Pan, Yamei Liu, Shunli Wang, Huifang Wang, Rongping Ye, Yueming Li Journal of Magnetic Resonance Imaging.2025; 61(2): 970. CrossRef
Radiomics and machine learning based on preoperative MRI for predicting extrahepatic metastasis in hepatocellular carcinoma patients treated with transarterial chemoembolization Gang Peng, Xiaojing Cao, Xiaoyu Huang, Xiang Zhou European Journal of Radiology Open.2024; 12: 100551. CrossRef
Clinical Parameters Work Well as Predictive Factors for Atezolizumab and Bevacizumab Treatment in Hepatocellular Carcinoma Ji Yeon Lee, Pil Soo Sung Gut and Liver.2024; 18(4): 558. CrossRef
Advances in Understanding Hepatocellular Carcinoma Vasculature: Implications for Diagnosis, Prognostication, and Treatment Hyungjin Rhee, Young Nyun Park, Jin-Young Choi Korean Journal of Radiology.2024; 25(10): 887. CrossRef
Inter-reader agreement for CT/MRI LI-RADS category M imaging features: a systematic review and meta-analysis Dong Hwan Kim, Sang Hyun Choi Journal of Liver Cancer.2024; 24(2): 192. CrossRef
Gd-EOB-DTPA-enhanced MR imaging features of hepatocellular carcinoma in non-cirrhotic liver Mingyue Song, Yuhao Tao, Hanjun Zhang, Mingzhan Du, Lingchuan Guo, Chunhong Hu, Weiguo Zhang Magnetic Resonance Imaging.2024; 114: 110241. CrossRef
Prediction of PD-L1 expression in unresectable hepatocellular carcinoma with gadoxetic acid-enhanced MRI Jun Gu Kang, Kyunghwa Han, Taek Chung, Hyungjin Rhee European Journal of Radiology.2024; 181: 111772. CrossRef
The histopathological and molecular heterogeneity of hepatocellular
carcinoma: a narrative review Wonju Chung, Haeryoung Kim The Ewha Medical Journal.2024;[Epub] CrossRef
Gadoxetic Acid-Enhanced Magnetic Resonance Imaging Features Can Predict Immune-Excluded Phenotype of Hepatocellular Carcinoma Eisuke Ueshima, Keitaro Sofue, Takahiro Kodama, Shuhei Yamamoto, Masato Komatsu, Shohei Komatsu, Nobuaki Ishihara, Akihiro Umeno, Takeru Yamaguchi, Masatoshi Hori, Takumi Fukumoto, Tetsuo Takehara, Takamichi Murakami Liver Cancer.2024; : 1. CrossRef
Imaging prognostication and tumor biology in hepatocellular carcinoma Diana Kadi, Marilyn F. Yamamoto, Emily C. Lerner, Hanyu Jiang, Kathryn J. Fowler, Mustafa R. Bashir Journal of Liver Cancer.2023; 23(2): 284. CrossRef
Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a malignant primary liver carcinoma characterized by the unequivocal presence of both hepatocytic and cholangiocytic differentiation within the same tumor. Recent research has highlighted that cHCC-CCAs are more heterogeneous than previously expected. In the updated consensus terminology and WHO 2019 classification, “classical type” and “subtypes with stem-cell features” of the WHO 2010 classification are no longer recommended. Instead, it is recommended that the presence and percentages of various histopathologic components and stem-cell features be mentioned in the pathologic report. The new terminology and classification enable the exchange of clearer and more objective information about cHCC-CCAs, facilitating multi-center and multinational research. However, there are limitations to the diagnosis of cHCC-CCA by imaging and biopsy. cHCC-CCAs showing typical imaging findings of HCC could be misdiagnosed as HCC and subjected to inappropriate treatment, if other clinical findings are not sufficiently considered. cHCC-CCAs showing at least one of the CCA-like imaging features or unusual clinical features should be subjected to biopsy. There may be a sampling error for the biopsy diagnosis of cHCC-CCA. An optimized diagnostic algorithm integrating clinical, radiological, and histopathologic information of biopsy is required to resolve these diagnostic pitfalls.
Citations
Citations to this article as recorded by
Enhancing liver cirrhosis varices and CSPH risk prediction with spleen stiffness measurement using 100-Hz probe Jeong-Ju Yoo, Sun Ah Maeng, Young Chang, Sae Hwan Lee, Soung Won Jeong, Jae Young Jang, Gab Jin Cheon, Young Seok Kim, Hong Soo Kim, Sang Gyune Kim Scientific Reports.2024;[Epub] CrossRef
MRI features of combined hepatocellular-cholangiocarcinoma Noor Fatima Majeed, Mathew Macey, Marta Braschi Amirfarzan, Sheida Sharifi, Jeremy R Wortman Abdominal Radiology.2024; 50(1): 169. CrossRef
Imaging findings of intrahepatic cholangiocarcinoma for prognosis
prediction and treatment decision-making: a narrative review Jun Gu Kang, Taek Chung, Dong Kyu Kim, Hyungjin Rhee The Ewha Medical Journal.2024;[Epub] CrossRef
Differentiation between hepatic angiomyolipoma and hepatocellular carcinoma in individuals who are not at-risk for hepatocellular carcinoma Sungtae Park, Myeong-Jin Kim, Kyunghwa Han, Jae Hyon Park, Dai Hoon Han, Young Nyun Park, Jaehyo Kim, Hyungjin Rhee European Journal of Radiology.2023; 166: 110957. CrossRef
The Human TOR Signaling Regulator Is the Key Indicator of Liver Cancer Patients’ Overall Survival: TIPRL/LC3/CD133/CD44 as Potential Biomarkers for Early Liver Cancers Soo Young Jun, Hyang Ran Yoon, Ji-Yong Yoon, Su-Jin Jeon, Jeong-Ju Lee, Debasish Halder, Jin-Man Kim, Nam-Soon Kim Cancers.2021; 13(12): 2925. CrossRef