Considerations regarding current diagnosis and prognosis of hepatocellular carcinoma

Hepatocellular carcinoma is a major health issue, ranked the fifth most common tumor and currently being responsible for a third of the cancer-related deaths globally, with an ever-increasing number of fatalities. Current advances in contrast-enhanced imaging techniques such as contrast-enhanced ultrasonography, multi-detector computed tomography and diffusion-weighted magnetic resonance imaging are improving the rate of hepatocellular carcinoma diagnosis. Contrast-enhanced ultrasonography has widely become the first choice in liver tumor assessment, as it is faster, simpler and safer than other forms of diagnostic imaging. On the other hand, cross sectional computed tomography is frequently employed when a hepatic formation is suspected of malignancy and allows a more accurate characterization of lesions through multiphasic multi-detector computed tomography technology. Diffusion weighted magnetic resonance imaging represents another addition to the wide range of diagnostic and prognostic techniques available for patients with hepatocellular carcinoma and is currently regarded as one of the best tools for the characterization of these lesions. Furthermore, groundbreaking biomarkers for hepatocellular carcinoma are being discovered, although alpha-fetoprotein remains one of the most frequently used serum test in the early stages. Nonetheless, further advances are required for the detection of small liver carcinomas. Abbreviations : AASLD = American Association for the Study of Liver Diseases, AFP = Alpha-fetoprotein, AFP-L3 = Alpha-fetoprotein isoform 3, CEUS = Contrast-enhanced ultrasonography, DCP = Des-gamma-carboxy-prothrombin, DW-MRI = Diffusion weighted magnetic resonance imaging, FNA = Fine neddle aspiration, Gd-EOB-DTPA = Gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid, GGT-II = Gamma-glutamyl transpeptidase II, GP73 = Golgi protein 73, HCC = Hepatocellular carcinoma, HCCR-1 = Human cervical cancer proto-oncogene 1, IL-18 = Interleukin 18, MDCT = Multi-detector computed tomography, PET-CT = Positron emission tomography – computed tomography, SUV = Standardized Uptake Value