Diagnosis of Liver Cancer

  • Garin Tomaszewski, MD, Director of Interventional Radiology

Liver cancer may be detected based on symptoms of discomfort in the right upper part of the abdomen or abnormal liver function blood tests. Some are found incidentally during an ultrasound, CT scan or MRI for other reasons. Patients at high risk, such as those with hepatitis or cirrhosis, often will have routine screenings such as blood tests to measure alpha fetoprotein (AFP) or liver ultrasounds.

In addition to diagnosing your exact cancer type, the stage of the cancer (how far it has spread) is key to determining your treatment options. When liver cancer does spread, the most common sites include lymph nodes near the liver, the bones and the lungs. Proper diagnosis and staging of liver cancer is contingent on state-of-the-art imaging.

At Roswell Park, we use the following diagnostic procedures:

  • Ultrasound: Uses sound waves to produce pictures of internal body structures.
  • High resolution CT: Determines whether cancer has spread to lymph nodes or other organs of the chest, abdomen and pelvis.
  • Multiphasic high definition “liver protocol” CT: Highly technical scan, specifically of the liver, which produces higher resolution than spiral CT.
  • Magnetic resonance cholangiopancreatography (MRCP): An MRI scan which uses powerful magnets and radio waves to take clear pictures of the pancreas and bile ducts. No contrast dye is needed with MRCP.
  • Image-guided biopsy: This procedure obtains a small piece of the cancer under the guidance of imaging scans, such as CT, MRI and ultrasound. This is needed to determine the diagnosis of cancer.
  • Diagnostic laparoscopy with intraoperative ultrasound: Small incisions are made in the abdomen and a laparoscope (a thin, lighted tube) and ultrasound devices is inserted to produce internal pictures.
  • Bone scan: Determines whether cancer has spread to the bones.
  • Blood tests: Measures liver function andmarkers such as alphafetoprotein (AFP).