What is the role of CT scans in the workup of fibrolamellar hepatocellular carcinoma?

Updated: Sep 05, 2019
  • Author: W Ross Stevens, MD; Chief Editor: John Karani, MBBS, FRCR  more...
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Answer

Abdominal computed tomography (CT) scanning is the preferred examination for the detection, diagnosis, staging, and postoperative follow-up evaluation of fibrolamellar carcinoma. For the best evaluation of the liver and liver tumors with CT scanning, the intravenous administration of iodinated contrast material is necessary. Therefore, the use of CT scanning is limited in patients who cannot have iodinated contrast material because of an allergy or renal insufficiency. In these patients, MRI is preferred. In addition, CT scanning uses ionizing radiation; therefore, it can be relatively contraindicated in children or in women of childbearing age, in whom radiation doses should be limited as much as possible. [10, 12, 13]  On contrast-enhanced CT, fibrolamellar HCC typically presents as a large (7-20 cm), heterogeneous, well-defined mass with a lobulated outline. On unenhanced CT, fibrolamellar HCC is most often hypoattenuating with calcifications (40–68%) and a central stellate scar (65–75%). [8, 14, 15, 16]


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