Blood tests, diagnostic imaging, biopsy, or a combination of these may be used to diagnose and determine the extent (stage) of liver cancer.
Diagnosing liver cancer may begin with a blood test to measure the level of alpha fetoprotein (AFP), a protein produced by the liver. An elevated AFP level may be an indication of hepatocellular carcinoma, the most common type of primary liver cancer. If liver cancer is suspected, the doctor may order additional blood tests to measure liver function and determine whether surgery or other treatments are appropriate.
Our physicians use the latest imaging techniques to pinpoint the exact location of liver tumors and determine the condition of the liver and surrounding organs and blood vessels. Diagnostic imaging techniques are capable of revealing precise details, such as the exact size and density of a newly diagnosed tumor, which can aid in predicting a tumor's response to treatment. Imaging technology also helps guide surgeons and interventional radiologists during a variety of therapeutic procedures.
Here are some of the imaging techniques commonly used in liver cancer:
- Triphasic CT
Doctors first determine the extent of the disease through CT scanning, an accurate method of diagnosing and staging liver cancer. Triphasic CT provides images of the liver, gallbladder, bile ducts, and nearby lymph nodes during three different phases of blood flow through the liver.
This technique, which may reveal the extent of tumor growth within the liver and surrounding organs and blood vessels, can help determine whether a tumor can be surgically removed.
A small probe uses sound waves to identify the location and number of tumors, as well as tumor involvement with blood vessels (tumors located near blood vessels may be more difficult to remove). Ultrasound also can be used to distinguish a cancerous mass from a benign tumor.
Additional Diagnostic Techniques
The following diagnostic tests may be required to gain more information about the extent of the tumor and the types of cells involved.
A small tissue sample may be obtained for microscopic examination through a technique called fine-needle aspiration (the removal of tissue or fluid for examination under a microscope).
A laparoscope — a thin, lighted tube with a camera on its tip — is passed through a small incision in the abdominal wall to view the liver and surrounding organs, and remove tissue samples for biopsy. Laparoscopy can be used to avoid the need for exploratory surgery in some patients.
Researchers at Memorial Sloan-Kettering are evaluating novel methods of diagnosing and staging primary liver tumors. Studies are underway to determine the potential value of diagnostic techniques such as volumetric CT, dynamic contrast-enhanced MRI and ultrasound, and nuclear imaging to identify new markers for the disease.