Imaging Techniques for the Diagnosis and Staging of Hepatocellular Carcinoma [Retrospectively Entered]

Project Summary Title and Description

Title
Imaging Techniques for the Diagnosis and Staging of Hepatocellular Carcinoma [Retrospectively Entered]
Description
Hepatocellular carcinoma (HCC) is the most common primary malignant neoplasm of the liver, and accurate diagnosis and staging of HCC are important for guiding treatment and other clinical decisions. A number of imaging modalities are available for detection of HCC in surveillance and non-surveillance settings, evaluation of focal liver lesions to identify HCC, and staging of HCC. The purpose of this review is to compare the effectiveness of imaging techniques for HCC on test performance, clinical decisionmaking, clinical outcomes, and harms.
Attribution
N/A
Authors of Report
N/A
Methodology description
We used predefined criteria to determine study eligibility. We selected studies of ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) that evaluated test performance for detection of HCC lesions, evaluation of focal liver lesions, or staging of HCC. We also included randomized trials and comparative observational studies on effects of imaging on clinical decisionmaking, clinical outcomes, and harms. The risk of bias (quality) of included studies was assessed, data were extracted, and results were summarized quantitatively (through meta-analysis) and qualitatively. Analyses were stratified by imaging type and unit of analysis (patient or HCC lesion). Additional analyses were conducted to evaluate the effects of the reference standard used and study, patient, tumor, and technical characteristics on estimates of test performance.
PROSPERO
CRD42013005246
DOI
10.7301/Z05D8PSC
Notes
The full report of this project is AHRQ Publication No. 14(15)-EHC048-EF, available at www.effectivehealthcare.ahrq.gov/reports/final.cfm.
Funding Source
This report is based on research conducted by the Pacific Northwest Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2012-00014-I).

Key Questions

1. Key Question 1 - Appendix C1 - Diagnostic Studies Risk of Bias
2. Key Question 2 - Appendix C2 - Randomized Controlled Trials Risk of Bias
3. Key Question 3 - Appendix C3 - Cohort Study Risk of Bias
4. Key Question 4 - Appendix D - Diagnostic Accuracy Studies of Ultrasound Imaging
5. Key Question 5 - Appendix E - Diagnostic Accuracy Studies of Computed Tomography Imaging
6. Key Question 6 - Appendix F - Diagnostic Accuracy Studies of Magnetic Resonance Imaging
7. Key Question 7 - Appendix G - Diagnostic Accuracy Studies of Positron Emission Tomography Imaging
8. Key Question 8 - Appendix H - Patient Outcomes for Staging (Randomized Controlled Trials)
9. Key Question 9 - Appendix I - Patient Outcomes for Staging (Cohort Study)

Associated Extraction Forms

Associated Studies (each link opens a new tab)

TitleAuthorsYear
Accuracy of hepatocellular carcinoma detection on multidetector CT in a transplant liver population with explant liver correlation.2011
Added value of gadoxetic acid-enhanced hepatobiliary phase MR imaging in the diagnosis of hepatocellular carcinoma.2010
Detection of hepatocellular carcinoma by Gd-EOB-DTPA-enhanced liver MRI: comparison with triple phase 64 detector row helical CT.
Usefulness of combination of imaging modalities in the diagnosis of hepatocellular carcinoma using Sonazoid®-enhanced ultrasound, gadolinium diethylene-triamine-pentaacetic acid-enhanced magnetic resonance imaging, and contrast-enhanced computed tomography.2011
Prediction of the histopathological grade of hepatocellular carcinoma using qualitative diffusion-weighted, dynamic, and hepatobiliary phase MRI.2012
Added value of subtraction imaging in detecting arterial enhancement in small (<3 cm) hepatic nodules on dynamic contrast-enhanced MRI in patients at high risk of hepatocellular carcinoma.
Comparison of clinical and pathological staging and long-term results of liver transplantation for hepatocellular carcinoma in a single transplant center.2006
Hepatocellular carcinoma in patients with chronic liver disease: a comparison of gadoxetic acid-enhanced MRI and multiphasic MDCT.2012
Retrospective audit to determine the diagnostic accuracy of Primovist-enhanced MRI in the detection of hepatocellular carcinoma in cirrhosis with explant histopathology correlation.2013
MnDPDP-enhanced MRI vs dual-phase spiral CT in the detection of hepatocellular carcinoma in cirrhosis.2000
Sonographic detection of hepatocellular carcinoma and dysplastic nodules in cirrhosis: correlation of pretransplantation sonography and liver explant pathology in 200 patients.
Liver transplantation in cirrhotic patients with small hepatocellular carcinoma: an analysis of pre-operative imaging, explant histology and prognostic histologic indicators.2004
MRI angiography is superior to helical CT for detection of HCC prior to liver transplantation: an explant correlation.2003
Characterization of focal liver lesions: comparative study of contrast-enhanced ultrasound versus spiral computed tomography.2007
Comparison of portal venous and delayed phases of gadolinium-enhanced magnetic resonance imaging study of cirrhotic liver for the detection of contrast washout of hypervascular hepatocellular carcinoma.-- Not Found --
Screening for hepatocellular carcinoma in patients with advanced cirrhosis.1999
Utility of FDG-PET for investigating unexplained serum AFP elevation in patients with suspected hepatocellular carcinoma recurrence.-- Not Found --
Can positron emission tomography with the dual tracers 11 Cacetate and 18 Ffludeoxyglucose predict microvascular invasion in hepatocellular carcinoma?2011
11C-acetate and 18F-FDG PET/CT for clinical staging and selection of patients with hepatocellular carcinoma for liver transplantation on the basis of Milan criteria: surgeon's perspective.2013
Hepatocellular carcinoma in liver transplantation candidates: detection with gadobenate dimeglumine-enhanced MRI.2008
Detection of hepatocellular carcinoma: combined T2-weighted and dynamic gadolinium-enhanced MRI versus combined CT during arterial portography and CT hepatic arteriography.-- Not Found --
Characterization of hyperintense nodules on T1-weighted liver magnetic resonance imaging: comparison of Ferucarbotran-enhanced MRI with accumulation-phase FS-T1WI and gadolinium-enhanced MRI.2011
Hypervascular hepatocellular carcinoma in the cirrhotic liver: diffusion-weighted imaging versus superparamagnetic iron oxide-enhanced MRI.2011
Comparison of two different injection rates of gadoxetic acid for arterial phase MRI of the liver.2010
Value of hepatic arterial phase CT versus lipiodol ultrafluid CT in the detection of hepatocellular carcinoma.-- Not Found --
Diagnosis of small hepatic nodules detected by surveillance ultrasound in patients with cirrhosis: Comparison between contrast-enhanced ultrasound and contrast-enhanced helical computed tomography.2008
Detection of nodules in liver cirrhosis: spiral computed tomography or magnetic resonance imaging? A prospective study of 88 nodules in 34 patients.2002
Evaluation of benign vs malignant hepatic lesions with positron emission tomography.1998
Multislice computed tomography using a triple-phase contrast protocol for preoperative assessment of hepatic tumor load in patients with hepatocellular carcinoma before liver transplantation.2009
Hepatocellular carcinoma in cirrhotic patients: prospective comparison of US, CT and MR imaging.2013
Intraindividual comparison of gadoxetate disodium-enhanced MR imaging and 64-section multidetector CT in the Detection of hepatocellular carcinoma in patients with cirrhosis.2010
Hypoechoic focal liver lesions: characterization with contrast enhanced ultrasonography.2005
Value of the unenhanced phase for detection of hepatocellular carcinomas 3 cm or less when performing multiphase computed tomography in patients with cirrhosis.-- Not Found --
Imaging of proliferation in hepatocellular carcinoma with the in vivo marker 18F-fluorothymidine.2009
Dynamic contrast-enhanced ultrasound (DCE-US) for easy and rapid evaluation of hepatocellular carcinoma compared to dynamic contrast-enhanced computed tomography (DCE-CT)--a pilot study.2012
Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: Prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma.2008
Validation of organ procurement and transplant network (OPTN)/united network for organ sharing (UNOS) criteria for imaging diagnosis of hepatocellular carcinoma.2013
Contrast-enhanced Doppler ultrasonography in the diagnosis of hepatocellular carcinoma and premalignant lesions in patients with cirrhosis.2001
Optimizing staging for hepatocellular carcinoma before liver transplantation: A retrospective analysis of the UNOS/OPTN database.2006
Significance of hyperattenuating and contrast-enhancing hepatic nodules detected in the cirrhotic liver during arterial phase helical CT in pre-liver transplant patients: radiologic-histopathologic correlation of explanted livers.-- Not Found --
Assessment of arterial tumor vascularity in small hepatocellular carcinoma. Comparison between color doppler ultrasonography and radiographic imagings with contrast medium: dynamic CT, angiography, and CT hepatic arteriography.2000
Usefulness of contrast-enhanced perfusional sonography in the assessment of hepatocellular carcinoma hypervascular at spiral computed tomography.2004
Sensitivity of commonly available screening tests in detecting hepatocellular carcinoma in cirrhotic patients undergoing liver transplantation.2000
Differentiating hepatocellular carcinoma from dysplastic nodules at gadobenate dimeglumine-enhanced hepatobiliary-phase magnetic resonance imaging.2013
Contrast-enhanced sonography in the characterization of small hepatocellular carcinomas in cirrhotic patients: comparison with contrast-enhanced ultrafast magnetic resonance imaging.-- Not Found --
Contrast-enhanced sonographic appearance of hepatocellular carcinoma in patients with cirrhosis: comparison with contrast-enhanced helical CT appearance.2004
Small (<or=3 cm) hepatocellular carcinoma in cirrhosis: the role of double contrast agents in MR imaging vs. multidetector-row CT.2009
Nodule-in-nodule appearance of hepatocellular carcinomas: comparison of gadolinium-enhanced and ferumoxides-enhanced magnetic resonance imaging.2004
Value of post-vascular phase (Kupffer imaging) by contrast-enhanced ultrasonography using Sonazoid in the detection of hepatocellular carcinoma.
3 T MRI of hepatocellular carcinomas in patients with cirrhosis: does T2-weighted imaging provide added value?2012
Additional value of gadoxetic acid-DTPA-enhanced hepatobiliary phase MR imaging in the diagnosis of early-stage hepatocellular carcinoma: comparison with dynamic triple-phase multidetector CT imaging.2011
Diagnostic accuracy of diffusion-weighted MRI for identifying hepatocellular carcinoma with liver explant correlation.2011
Can the patient with cirrhosis be imaged for hepatocellular carcinoma without gadolinium?: Comparison of combined T2-weighted, T2*-weighted, and diffusion-weighted MRI with gadolinium-enhanced MRI using liver explantation standard.-- Not Found --
Assessment of the diagnostic accuracy of T2*-weighted MR imaging for identifying hepatocellular carcinoma with liver explant correlation.
Differential diagnosis of hepatic tumors: value of contrast-enhanced harmonic sonography using the newly developed contrast agent, Sonazoid.
Hepatocellular carcinoma in the cirrhotic liver: gadolinium-enhanced 3D T1-weighted MR imaging as a stand-alone sequence for diagnosis.2006
Diagnostic accuracy of C-arm CT during selective transcatheter angiography for hepatocellular carcinoma: comparison with intravenous contrast-enhanced, biphasic, dynamic MDCT.
Performance of radiological methods in diagnosing hepatocellular carcinoma preoperatively in a recipient of living related liver transplantation: comparison with step section histopathology.2011
11C-acetate PET imaging in hepatocellular carcinoma and other liver masses.2003
Dual-tracer PET/CT imaging in evaluation of metastatic hepatocellular carcinoma.2007
Detection of hypervascular hepatocellular carcinoma: comparison of SPIO-enhanced MRI with dynamic helical CT.
Sensitivity in detection of hypervascular hepatocellular carcinoma by helical CT with intra-arterial injection of contrast medium, and by helical CT and MR imaging with intravenous injection of contrast medium.1998
Small (≤ 2 cm) hepatocellular carcinoma in patients with chronic liver disease: comparison of gadoxetic acid-enhanced 3.0 T MRI and multiphasic 64-multirow detector CT.2012
Evaluation of patients with hepatocellular carcinomas using (11)Cacetate and (18)FFDG PET/CT: A preliminary study.-- Not Found --
Hepatocellular carcinoma: role of unenhanced and delayed phase multi-detector row helical CT in patients with cirrhosis.2005
Diagnosis of hepatocellular carcinoma in cirrhosis by dynamic contrast imaging: the importance of tumor cell differentiation.2010
Detection and characterization of focal liver lesions: a Japanese phase III, multicenter comparison between gadoxetic acid disodium-enhanced magnetic resonance imaging and contrast-enhanced computed tomography predominantly in patients with hepatocellular carcinoma and chronic liver disease.2010
Hypervascular hepatocellular carcinoma: can double arterial phase imaging with multidetector CT improve tumor depiction in the cirrhotic liver?2002
Clinical usefulness of (18) F-fluorodeoxyglucose positron emission tomography/computed tomography for patients with primary liver cancer with special reference to rare histological types, hepatocellular carcinoma with sarcomatous change and combined hepatocellular and cholangiocarcinoma.2013
Power Doppler sonography for hepatocellular carcinoma: factors affecting the power Doppler signals of the tumors.1998
Assessment of Gd-EOB-DTPA-enhanced MRI for HCC and dysplastic nodules and comparison of detection sensitivity versus MDCT.2012
Value of liver parenchymal phase contrast-enhanced sonography to diagnose premalignant and borderline lesions and overt hepatocellular carcinoma.2009
Imaging of hepatocellular carcinoma: qualitative and quantitative analysis of postvascular phase contrast-enhanced ultrasonography with sonazoid. Comparison with superparamagnetic iron oxide magnetic resonance images.2008
Multiarterial phase dynamic MRI of small early enhancing hepatic lesions in cirrhosis or chronic hepatitis: differentiating between hypervascular hepatocellular carcinomas and pseudolesions.2004
Detection of hepatocellular carcinoma: comparison of angiographic C-arm CT and MDCT.2010
Hepatocellular carcinoma: are combined CT during arterial portography and CT hepatic arteriography in addition to triple-phase helical CT all necessary for preoperative evaluation?2000
Small nodules (1-2 cm) in liver cirrhosis: characterization with contrast-enhanced ultrasound.2009
Characterization of 1-to 2-cm liver nodules detected on hcc surveillance ultrasound according to the criteria of the American Association for the Study of Liver Disease: is quadriphasic CT necessary?2013
Limited value of 18F-2-deoxyglucose positron emission tomography to detect hepatocellular carcinoma in hepatitis B virus carriers.-- Not Found --
Spiral biphasic contrast-enhanced computerized tomography in the diagnosis of hepatocellular carcinoma.2002
Gadobenate dimeglumine-enhanced liver MR imaging in cirrhotic patients: quantitative and qualitative comparison of 1-hour and 3-hour delayed images.2011
Early homogeneously enhancing hemangioma versus hepatocellular carcinoma: differentiation using quantitative analysis of multiphasic dynamic magnetic resonance imaging.1999
Utility of adding Primovist magnetic resonance imaging to analysis of hepatocellular carcinoma by liver dynamic computed tomography.2013
Performance of gadoxetic acid-enhanced MRI for detecting hepatocellular carcinoma in recipients of living-related-liver-transplantation: Comparison with dynamic multidetector row computed tomography and angiography-assisted computed tomography.2013
Small hypervascular hepatocellular carcinoma versus hypervascular pseudolesions: differential diagnosis on MRI.-- Not Found --
Preoperative depiction of hepatocellular carcinoma: ferumoxides-enhanced MR imaging versus triple-phase helical CT.2003
Improved diagnosis of well-differentiated hepatocellular carcinoma with gadolinium ethoxybenzyl diethylene triamine pentaacetic acid-enhanced magnetic resonance imaging and Sonazoid contrast-enhanced ultrasonography.2010
FDG positron emission tomography/computed tomography for the detection of extrahepatic metastases from hepatocellular carcinoma.2009
Multidetector CT: diagnostic impact of slice thickness on detection of hypervascular hepatocellular carcinoma.
Optimization of imaging diagnosis of 1-2 cm hepatocellular carcinoma: an analysis of diagnostic performance and resource utilization.2011
Positron emission tomography scanning in the evaluation of hepatocellular carcinoma.2000
Detection of hepatocellular carcinoma in gadoxetic acid-enhanced MRI and diffusion-weighted MRI with respect to the severity of liver cirrhosis.2012
Detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic liver: accuracy of ultrasonography in transplant patients.2001
Small hypervascular hepatocellular carcinomas: value of diffusion-weighted imaging compared with "washout" appearance on dynamic MRI.
Quantitative CT color mapping of the arterial enhancement fraction of the liver to detect hepatocellular carcinoma.2009
Imaging features of small hepatocellular carcinomas with microvascular invasion on gadoxetic acid-enhanced MR imaging.2012
Planning ultrasound for percutaneous radiofrequency ablation to treat small (≤ 3 cm) hepatocellular carcinomas detected on computed tomography or magnetic resonance imaging: a multicenter prospective study to assess factors affecting ultrasound visibility.2012
Noninvasive diagnostic criteria for hepatocellular carcinoma in hepatic masses >2 cm in a hepatitis B virus-endemic area.2011
Gadoxetic acid-enhanced MRI versus triple-phase MDCT for the preoperative detection of hepatocellular carcinoma.2009
Ferucarbotran-enhanced MRI versus triple-phase MDCT for the preoperative detection of hepatocellular carcinoma.2005
Ferucarbotran-enhanced 3.0-T magnetic resonance imaging using parallel imaging technique compared with triple-phase multidetector row computed tomography for the preoperative detection of hepatocellular carcinoma.-- Not Found --
Detection of hepatocellular carcinoma: comparison of dynamic three-phase computed tomography images and four-phase computed tomography images using multidetector row helical computed tomography.-- Not Found --
Small hypervascular hepatocellular carcinoma revealed by double arterial phase CT performed with single breath-hold scanning and automatic bolus tracking.2002
Analysis of gadobenate dimeglumine-enhanced MR findings for characterizing small (1-2-cm) hepatic nodules in patients at high risk for hepatocellular carcinoma.
Detection of small hepatocellular carcinoma: intraindividual comparison of gadoxetic acid-enhanced MRI at 3.0 and 1.5 T.2011
Detection of liver malignancy with gadoxetic acid-enhanced MRI: is addition of diffusion-weighted MRI beneficial?2011
Detection of small hepatocellular carcinoma: can gadoxetic acid-enhanced magnetic resonance imaging replace combining gadopentetate dimeglumine-enhanced and superparamagnetic iron oxide-enhanced magnetic resonance imaging?2010
Comparison of gadoxetic acid-enhanced MRI and superparamagnetic iron oxide-enhanced MRI for the detection of hepatocellular carcinoma.2010
Usefulness 18F-FDG positron emission tomography/computed tomography for detecting recurrence of hepatocellular carcinoma in posttransplant patients.2010
Detection of hepatocellular carcinoma: gadoxetic acid-enhanced 3-dimensional magnetic resonance imaging versus multi-detector row computed tomography.-- Not Found --
Added diagnostic value of T2-weighted MR imaging to gadolinium-enhanced three-dimensional dynamic MR imaging for the detection of small hepatocellular carcinomas.2008
Double-dose 1.0-M gadobutrol versus standard-dose 0.5-M gadopentetate dimeglumine in revealing small hypervascular hepatocellular carcinomas.2008
Usefulness of combining sequentially acquired gadobenate dimeglumine-enhanced magnetic resonance imaging and resovist-enhanced magnetic resonance imaging for the detection of hepatocellular carcinoma: comparison with computed tomography hepatic arteriography and computed tomography arterioportography using 16-slice multidetector computed tomography.-- Not Found --
Comparison of gadobenate dimeglumine-enhanced dynamic MRI and 16-MDCT for the detection of hepatocellular carcinoma.2006
Hepatocellular carcinoma in patients with chronic liver disease: comparison of SPIO-enhanced MR imaging and 16-detector row CT.
Three-dimensional dynamic liver MR imaging using sensitivity encoding for detection of hepatocellular carcinomas: comparison with superparamagnetic iron oxide-enhanced mr imaging.2004
Comparison of superparamagnetic iron oxide-enhanced and gadobenate dimeglumine-enhanced dynamic MRI for detection of small hepatocellular carcinomas.2004
Detection of hypervascular hepatocellular carcinoma with multidetector-row CT: single arterial-phase imaging with computer-assisted automatic bolus-tracking technique compared with double arterial-phase imaging.-- Not Found --
Does T2-weighted MR imaging improve preoperative detection of malignant hepatic tumors? Observer performance study in 49 surgically proven cases.2005
Usefulness of Sonazoid contrast-enhanced ultrasonography for hepatocellular carcinoma: comparison with pathological diagnosis and superparamagnetic iron oxide magnetic resonance images.2009
Small hepatocellular carcinoma: assessment with T1-weighted spin-echo magnetic resonance imaging with and without fat suppression.2002
Transplantation for hepatocellular carcinoma and cirrhosis: sensitivity of magnetic resonance imaging.2002
Hepatocellular carcinoma and dysplastic nodules in patients with cirrhosis: prospective diagnosis with MR imaging and explantation correlation.2001
Efficacy of double arterial phase dynamic magnetic resonance imaging with the sensitivity encoding technique versus dynamic multidetector-row helical computed tomography for detecting hypervascular hepatocellular carcinoma.2009
Efficacy of fusion imaging combining sonography and hepatobiliary phase MRI with Gd-EOB-DTPA to detect small hepatocellular carcinoma.2012
Detection of hepatocellular carcinoma: comparison of ferumoxides-enhanced and gadolinium-enhanced dynamic three-dimensional volume interpolated breath-hold MR imaging.2005
Preoperative detection of hepatocellular carcinoma: comparison of combined contrast-enhanced MR imaging and combined CT during arterial portography and CT hepatic arteriography.2004
Hepatocellular carcinoma: detection with triple-phase multi-detector row helical CT in patients with chronic hepatitis.
Gadolinium-enhanced MRI for tumor surveillance before liver transplantation: center-based experience.2007
Using low tube voltage (80kVp) quadruple phase liver CT for the detection of hepatocellular carcinoma: two-year experience and comparison with Gd-EOB-DTPA enhanced liver MRI.2012
Diagnostic performance of multidetector row computed tomography, superparamagnetic iron oxide-enhanced magnetic resonance imaging, and dual-contrast magnetic resonance imaging in predicting the appropriateness of a transplant recipient based on milan criteria: correlation with histopathological findings.2009
Early hepatocellular carcinoma: three-phase helical CT features of 16 patients.2008
Diagnostic value for extrahepatic metastases of hepatocellular carcinoma in positron emission tomography/computed tomography scan.2012
Detection of small hypervascular hepatocellular carcinomas in cirrhotic patients: comparison of superparamagnetic iron oxide-enhanced MR imaging with dual-phase spiral CT.-- Not Found --
Ferucarbotran-enhanced magnetic resonance imaging versus gadoxetic acid-enhanced magnetic resonance imaging for the preoperative detection of hepatocellular carcinoma: initial experience.2010
Gadoxetic acid-enhanced hepatobiliary phase MRI and high-b-value diffusion-weighted imaging to distinguish well-differentiated hepatocellular carcinomas from benign nodules in patients with chronic liver disease.2011
Targeted sonography for small hepatocellular carcinoma discovered by CT or MRI: factors affecting sonographic detection.2010
Characterization of focal liver lesions: comparison of pulse-inversion harmonic contrast-enhanced sonography with contrast-enhanced CT.-- Not Found --
Imaging well-differentiated hepatocellular carcinoma with dynamic triple-phase helical computed tomography.2006
Comparison of (11)C-acetate positron emission tomography and (67)Gallium citrate scintigraphy in patients with hepatocellular carcinoma.
Positron emission tomography for detecting occult hepatocellular carcinoma in hepatitis C cirrhotics awaiting for liver transplantation.2003
Focal lesions in cirrhotic explant livers: pathological evaluation and accuracy of pretransplantation imaging examinations.2002
Ultrasonographic detection of hepatocellular carcinoma: correlation of preoperative ultrasonography and resected liver pathology.2006
Detection of hepatocellular carcinoma: value of adding delayed phase imaging to dual-phase helical CT.2002
Detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic livers: accuracy of helical CT in transplant patients.2000
Diagnostic sensitivity of hepatocellular carcinoma imaging and its application to non-cirrhotic patients.2011
Value of delayed 18F-FDG-PET imaging in the detection of hepatocellular carcinoma.2005
Quantitatively defining washout in hepatocellular carcinoma.2013
Multidetector computed tomography triphasic evaluation of the liver before transplantation: importance of equilibrium phase washout and morphology for characterizing hypervascular lesions.-- Not Found --
Poor sensitivity of sonography in detection of hepatocellular carcinoma in advanced liver cirrhosis: accuracy of pretransplantation sonography in 118 patients.2003
Correlation between imaging and pathologic findings in explanted livers of hepatocellular carcinoma cases.2010
Multidetector-row computed tomography (MDCT) for the diagnosis of hepatocellular carcinoma in cirrhotic candidates for liver transplantation: prevalence of radiological vascular patterns and histological correlation with liver explants.2010
Differentiation between malignant and benign nodules in the liver: use of contrast C3-MODE technology.2005
Sonazoid-enhanced ultrasonography for evaluation of the enhancement patterns of focal liver tumors in the late phase by intermittent imaging with a high mechanical index.2009
Focal liver tumors: characterization with 3D perflubutane microbubble contrast agent-enhanced US versus 3D contrast-enhanced multidetector CT.
Three-dimensional contrast-enhanced sonography of vascular patterns of focal liver tumors: pilot study of visualization methods.
Spectral CT in patients with small HCC: investigation of image quality and diagnostic accuracy.2012
Differentiation of small hepatic hemangioma from small hepatocellular carcinoma: recently introduced spectral CT method.2011
Hepatocellular carcinoma in patients undergoing living-donor liver transplantation. Accuracy of multidetector computed tomography by viewing images on digital monitors.2008
Detection of hepatocellular carcinoma in patients with cirrhosis: added value of coronal reformations from isotropic voxels with 64-MDCT.2009
Hepatocellular carcinoma in patients with cirrhosis: qualitative comparison of gadobenate dimeglumine-enhanced MR imaging and multiphasic 64-section CT.2009
Improving the prediction of hepatocellular carcinoma in cirrhotic patients with an arterially-enhancing liver mass.2005
Detection of malignant hepatic tumors: comparison of gadolinium-and ferumoxide-enhanced MR imaging.2001
Diagnostic sensitivity of imaging modalities for hepatocellular carcinoma smaller than 2 cm.2010
False-negative rate of abdominal sonography for detecting hepatocellular carcinoma in patients with hepatitis B and elevated serum alpha-fetoprotein levels.2004
Dynamic CT for detecting small hepatocellular carcinoma: usefulness of delayed phase imaging.2007
Triple arterial phase dynamic MRI with sensitivity encoding for hypervascular hepatocellular carcinoma: comparison of the diagnostic accuracy among the early, middle, late, and whole triple arterial phase imaging.2005
Efficacy of perflubutane microbubble-enhanced ultrasound in the characterization and detection of focal liver lesions: phase 3 multicenter clinical trial.2009
Malignant focal hepatic lesions complicating underlying liver disease: dual-phase contrast-enhanced spiral CT sensitivity and specificity in orthotopic liver transplant patients.2001
Distinguishing hypervascular pseudolesions of the liver from hypervascular hepatocellular carcinomas with gadoxetic acid-enhanced MR imaging.2010
Evaluation of optimal timing of arterial phase imaging for the detection of hypervascular hepatocellular carcinoma by using triple arterial phase imaging with multidetector-row helical computed tomography.2003
Hypervascular hepatocellular carcinoma: detection with double arterial phase multi-detector row helical CT.2001
Value of fusing PET plus CT images in hepatocellular carcinoma and combined hepatocellular and cholangiocarcinoma patients with extrahepatic metastases: preliminary findings.2006
Detectability of hepatocellular carcinoma by gadoxetate disodium-enhanced hepatic MRI: tumor-by-tumor analysis in explant livers.2013
Tumor-detecting capacity and clinical usefulness of SPIO-MRI in patients with hepatocellular carcinoma.2000
Value of lipiodol computed tomography and digital subtraction angiography in the era of helical biphasic computed tomography as preoperative assessment of hepatocellular carcinoma.2001
Detection of hepatocellular carcinoma: comparison of dynamic MR imaging with dynamic double arterial phase helical CT.2003
Detection of hypervascular hepatocellular carcinoma by dynamic magnetic resonance imaging with double-echo chemical shift in-phase and opposed-phase gradient echo technique: comparison with dynamic helical computed tomography imaging with double arterial phase.-- Not Found --
Contrast-enhanced ultrasonography findings using a perflubutane-based contrast agent in patients with early hepatocellular carcinoma.2014
Hypervascular hepatocellular carcinomas: detection with gadoxetate disodium-enhanced MR imaging and multiphasic multidetector CT.2012
Diagnostic accuracy of contrast-enhanced ultrasound in differentiating benign and malignant focal liver lesions: a retrospective study.2010
Gadoxetic acid-enhanced MRI compared with CT during angiography in the diagnosis of hepatocellular carcinoma.2013
Validation of diagnostic criteria using gadoxetic acid-enhanced and diffusion-weighted MR imaging for small hepatocellular carcinoma (<= 2.0 cm) in patients with hepatitis-induced liver cirrhosis.2013
Hepatocellular carcinoma: detection with diffusion-weighted versus contrast-enhanced magnetic resonance imaging in pretransplant patients.2012
Added value of 80 kVp images to averaged 120 kVp images in the detection of hepatocellular carcinomas in liver transplantation candidates using dual-source dual-energy MDCT: results of JAFROC analysis.2011
Gadoxetic acid (Gd-EOB-DTPA)-enhanced MRI versus gadobenate dimeglumine (Gd-BOPTA)-enhanced MRI for preoperatively detecting hepatocellular carcinoma: an initial experience.-- Not Found --
Diagnostic efficacy of gadoxetic acid-enhanced MRI in the detection of hepatocellular carcinomas: comparison with gadopentetate dimeglumine.2010
A prospective evaluation of 18F-FDG and 11C-acetate PET/CT for detection of primary and metastatic hepatocellular carcinoma.2008
Evaluating patients with cirrhosis for hepatocellular carcinoma: value of clinical symptomatology, imaging and alpha-fetoprotein.
Hepatocellular carcinoma: detection with gadolinium- and ferumoxides-enhanced MR imaging of the liver.2002
Quantitative analysis of contrast-enhanced ultrasonography: differentiating focal nodular hyperplasia from hepatocellular carcinoma.2013
Pretransplantation surveillance for possible hepatocellular carcinoma in patients with cirrhosis: epidemiology and CT-based tumor detection rate in 430 cases with surgical pathologic correlation.2000
Hepatocellular carcinoma likelihood on MRI exams: evaluation of a standardized categorization system.2013
New MR imaging criteria with a diffusion-weighted sequence for the diagnosis of hepatocellular carcinoma in chronic liver diseases.2011
MRI versus 64-row MDCT for diagnosis of hepatocellular carcinoma.2009
Multidetector CT with double arterial phase and high-iodine-concentration contrast agent in the detection of hepatocellular carcinoma.2006
Detection of small hypervascular hepatocellular carcinomas by EASL criteria: comparison with double-phase CT during hepatic arteriography.
The added diagnostic value of 64-row multidetector CT combined with contrast-enhanced US in the evaluation of hepatocellular nodule vascularity: implications in the diagnosis of malignancy in patients with liver cirrhosis.2009
US characterization of focal hepatic lesions with intermittent high-acoustic-power mode and contrast material.2003
Differentiation of early hepatocellular carcinoma from benign hepatocellular nodules on gadoxetic acid-enhanced MRI.
Improved diagnosing of small hepatocellular carcinomas by echo-enhanced power Doppler sonography in patients with cirrhosis.2003
Non-invasive diagnosis of hepatocellular carcinoma ≤ 2 cm in cirrhosis. Diagnostic accuracy assessing fat, capsule and signal intensity at dynamic MRI.2012
Is post-Lipiodol CT better than i.v. contrast CT scan for early detection of HCC? A single liver transplant center experience.2006
Small nodule detection in cirrhotic livers: evaluation with US, spiral CT, and MRI and correlation with pathologic examination of explanted liver.-- Not Found --
Role of MDCT in the diagnosis of hepatocellular carcinoma in patients with cirrhosis undergoing orthotopic liver transplantation.2007
The diagnostic and economic impact of contrast imaging techniques in the diagnosis of small hepatocellular carcinoma in cirrhosis.2010
Imaging study of early hepatocellular carcinoma: usefulness of gadoxetic acid-enhanced MR imaging.2011
Quadruple-phase MDCT of the liver in patients with suspected hepatocellular carcinoma: effect of contrast material flow rate.2006
The role of dynamic subtraction MRI in detection of hepatocellular carcinoma.2008
Contrast-Enhanced Ultrasound (CEUS) for the characterization of focal liver lesions - prospective comparison in clinical practice: CEUS vs. CT (DEGUM multicenter trial). Parts of this manuscript were presented at the Ultrasound Dreiländertreffen 2008, Davos.2009
Contrast-enhanced ultrasound (CEUS) for the characterization of focal liver lesions in clinical practice (DEGUM Multicenter Trial): CEUS vs. MRI--a prospective comparison in 269 patients.2010
Accuracy and disagreement of computed tomography and magnetic resonance imaging for the diagnosis of small hepatocellular carcinoma and dysplastic nodules: role of biopsy.2012
Accuracy of staging as a predictor for recurrence after liver transplantation for hepatocellular carcinoma.2006
Detection of hepatocellular carcinoma: comparison of Gd-DTPA- and ferumoxides-enhanced MR imaging.2005
EUS for detection of the hepatocellular carcinoma: results of a prospective study.2007
Evaluation of hypervascular hepatocellular carcinoma in cirrhotic liver: comparison of different concentrations of contrast material with multi-detector row helical CT--a prospective randomized study.2011
The potential use of 2-¹⁸Ffluoro-2-deoxy-D-galactose as a PET/CT tracer for detection of hepatocellular carcinoma.2011
Phase inversion harmonic imaging versus contrast-enhanced power Doppler sonography for the characterization of focal liver lesions.2003
Comparison of Kupffer-phase Sonazoid-enhanced sonography and hepatobiliary-phase gadoxetic acid-enhanced magnetic resonance imaging of hepatocellular carcinoma and correlation with histologic grading.2012
Assessment of arterial hypervascularity of hepatocellular carcinoma: comparison of contrast-enhanced US and gadoxetate disodium-enhanced MR imaging.2012
18F-FDG PET in the detection of extrahepatic metastases from hepatocellular carcinoma.2004
Differentiation of hepatic hyperintense lesions seen on gadoxetic acid-enhanced hepatobiliary phase MRI.2011
Gadoxetic acid-enhanced magnetic resonance imaging for differentiating small hepatocellular carcinomas (< or =2 cm in diameter) from arterial enhancing pseudolesions: special emphasis on hepatobiliary phase imaging.2010
Metabolic restaging of hepatocellular carcinoma using whole-body F-FDG PET/CT.2009
Differential diagnosis of hepatic nodules using delayed parenchymal phase imaging of levovist contrast ultrasound: comparative study with SPIO-MRI.2004
Characterization of hepatic lesions (≤ 30 mm) with liver-specific contrast agents: a comparison between ultrasound and magnetic resonance imaging.2013
Detection of hepatocellular carcinoma with PET/CT: a prospective comparison of 18F-fluorocholine and 18F-FDG in patients with cirrhosis or chronic liver disease.2010
PET/CT in patients with hepatocellular carcinoma using (18)Ffluorocholine: preliminary comparison with (18)FFDG PET/CT.2006
Higher lesion conspicuity for SENSE dynamic MRI in detecting hypervascular hepatocellular carcinoma: analysis through the measurements of liver SNR and lesion-liver CNR comparison with conventional dynamic MRI.2005
Dynamic sonography of hepatic tumors.2001
Detection of hepatocellular carcinoma arising in cirrhotic livers: comparison of gadolinium- and ferumoxides-enhanced MR imaging.1999
Routine MR imaging protocol with breath-hold fast scans: diagnostic efficacy for focal liver lesions.-- Not Found --
Detection of primary hepatic malignancy in liver transplant candidates: prospective comparison of CT, MR imaging, US, and PET.
Diagnostic capability of gadoxetate disodium-enhanced liver MRI for diagnosis of hepatocellular carcinoma: comparison with multi-detector CT.2013
Fluorine-18 FDG positron emission tomography for imaging of hepatocellular carcinoma.
Prospective comparison of high- and low-spatial-resolution dynamic MR imaging with sensitivity encoding (SENSE) for hypervascular hepatocellular carcinoma.2008
Pretransplantation diagnosis and staging of hepatocellular carcinoma in patients with cirrhosis: value of dual-phase helical CT.2004
The development of de novo hepatocellular carcinoma in patients on a liver transplant list: frequency, size, and assessment of current screening methods.2004
Diffusion-weighted MRI provides additional value to conventional dynamic contrast-enhanced MRI for detection of hepatocellular carcinoma.2009
Fluorine-18 FDG imaging in hepatocellular carcinoma using positron coincidence detection and single photon emission computed tomography.2002
Intraoperative ultrasound of the liver in primary and secondary hepatic malignancies: comparison with preoperative 1.5-T MRI and 64-MDCT.2011
Undetermined focal liver lesions on gray-scale ultrasound in patients with fatty liver: characterization with contrast-enhanced ultrasound.2008
Small hepatic nodules (< or =2 cm) in cirrhosis patients: characterization with contrast-enhanced ultrasonography.2006
Role of FDG-PET in the evaluation and staging of hepatocellular carcinoma with comparison of tumor size, AFP level, and histologic grade.-- Not Found --
F-18 FDG in conjunction with 11C-choline PET/CT in the diagnosis of hepatocellular carcinoma.2011
The role of 18Ffluorodeoxyglucose positron emission tomography imaging in the evaluation of hepatocellular carcinoma.2003
Multi-slice CT angiography by triple-phase enhancement in preoperative evaluation of hepatocellular carcinoma.2005
Discrimination between neoplastic and non-neoplastic lesions in cirrhotic liver using contrast-enhanced ultrasound.2012
Contribution of diffusion-weighted magnetic resonance imaging in the characterization of hepatocellular carcinomas and dysplastic nodules in cirrhotic liver.2010
Added value of breathhold diffusion-weighted MRI in detection of small hepatocellular carcinoma lesions compared with dynamic contrast-enhanced MRI alone using receiver operating characteristic curve analysis.2009
Contrast-enhanced sonography in the diagnosis of small hepatocellular carcinoma < or =2 cm.2008
Detection of hepatocellular carcinoma using 11C-choline PET: comparison with 18F-FDG PET.2008
Diagnosis of hepatocellular carcinoma using digital subtraction imaging with the contrast agent, Levovist: comparison with helical CT, digital subtraction angiography, and US angiography.-- Not Found --
Enhancement patterns of small hepatocellular carcinoma shown by dynamic MRI and CT.2002
Gd-EOB-DTPA-enhanced MRI is better than MDCT in decision making of curative treatment for hepatocellular carcinoma.2013
Additional value of SPIO-enhanced MR imaging for the noninvasive imaging diagnosis of hepatocellular carcinoma in cirrhotic liver.2009
Role of 18F-fluorodeoxyglucose positron emission tomography in detecting extrahepatic metastasis in pretreatment staging of hepatocellular carcinoma.2007
Double arterial phase dynamic MRI with sensitivity encoding (SENSE) for hypervascular hepatocellular carcinomas.2002
MRI for detection of hepatocellular carcinoma: comparison of mangafodipir trisodium and gadopentetate dimeglumine contrast agents.2004
Hepatocellular carcinoma and focal nodular hyperplasia of the liver: differentiation with CT spectral imaging.2013
Differentiating hepatocellular carcinoma from angiomyolipoma of the liver with CT spectral imaging: a preliminary study.2013
Role of C-arm CT for transcatheter arterial chemoembolization of hepatocellular carcinoma: diagnostic performance and predictive value for therapeutic response compared with gadoxetic acid-enhanced MRI.2013
CT and MRI improve detection of hepatocellular carcinoma, compared with ultrasound alone, in patients with cirrhosis.2011
Small hypervascular hepatocellular carcinomas: value of "washout" on gadolinium-enhanced dynamic MR imaging compared to superparamagnetic iron oxide-enhanced imaging.2009
Small hypervascular hepatocellular carcinoma: limited value of portal and delayed phases on dynamic magnetic resonance imaging.2008
Transient peritumoral enhancement during dynamic MRI of the liver: cavernous hemangioma versus hepatocellular carcinoma.-- Not Found --
Multidetector helical CT plus superparamagnetic iron oxide-enhanced MR imaging for focal hepatic lesions in cirrhotic liver: a comparison with multi-phase CT during hepatic arteriography.2007
Accuracy of multiphasic helical computed tomography and intraoperative sonography in patients undergoing orthotopic liver transplantation for hepatoma: what is the truth?2002
Detection of small hepatocellular carcinoma: comparison of dynamic enhancement magnetic resonance imaging and multiphase multirow-detector helical CT scanning.2007
Multiphase hepatic scans with multirow-detector helical CT in detection of hypervascular hepatocellular carcinoma.2004
Role of multiphase scans by multirow-detector helical CT in detecting small hepatocellular carcinoma.2003
Detection of hypervascular hepatocellular carcinoma: Comparison of multi-detector CT with digital subtraction angiography and Lipiodol CT.2005
Arterial phase of biphase enhancement spiral CT in diagnosis of small hepatocellular carcinoma.2002
Does chloroquine treatment influence the distribution of pyrimethamine-resistant P. falciparum parasites in the field?1996
Randomized controlled trial of screening for hepatocellular carcinoma.2004
Ultrasonographic surveillance of hepatocellular carcinoma in cirrhosis: a randomized trial comparing 3- and 6-month periodicities.2011
Hepatocellular carcinoma surveillance at 4- vs. 12-month intervals for patients with chronic viral hepatitis: a randomized study in community.
Surveillance for hepatocellular cancer with ultrasonography vs. computed tomography -- a randomised study.2013
The role of contrast-enhanced ultrasound in planning treatment protocols for hepatocellular carcinoma before radiofrequency ablation.2007
The use of contrast-enhanced ultrasonography in the selection of patients with hepatocellular carcinoma for radio frequency ablation therapy.2007

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