How is liver cancer diagnosed?

Jill Onesti, MD
Surgical Oncology
Liver cancer is diagnosed through a variety of imaging studies as well as blood tests and potentially a biopsy. Screening studies are often done using an ultrasound of the abdomen as well as a blood test for alpha-fetoprotein (AFP) level. Follow-up studies include computed tomography (CT) scan or magnetic resonance imaging (MRI). Often the findings on the scans are diagnostic of the cancer, however occasionally a needle biopsy is performed. The tissue from this biopsy is then looked at under a microscope, which can lead to a formal diagnosis.
 
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Penn Medicine
Administration

Liver cancer can be diagnosed with diagnostic tests including CT scan, MRI, ultrasound, PET scan, angiography, biopsy, laparoscopy and lab tests.

Blood tests may lead a physician to suspect liver cancer, which can then be diagnosed by CT, MRI, or ultrasound with contrast. Cholangiocarcinoma must be diagnosed with special endoscopic and contrast imaging techniques to explore the bile ducts.

If liver cancer is suspected, physicians will perform a physical examination to check for lumps on the liver or hardening, and will take a medical history. To image the liver, a computed tomography (CT or CAT) scan and magnetic resonance imaging (MRI) will be performed.

In addition, blood tests are done to measure amounts of certain substances, called tumor markers, which are linked to liver cancer. The presence of one marker, alpha-fetoprotein (AFP) may indicate liver cancer, cirrhosis, or hepatitis if levels are elevated. Levels of red and white cells and platelets are also tested.

Physicians may also want to perform a liver biopsy to examine for cancer cells and damage from cirrhosis. During a liver biopsy, a physician removes a small amount of liver tissue using a thin needle inserted into the liver, which is guided by ultrasound or x-ray. Patients having a biopsy are given local anesthetic for the procedure and pain medication following it.

Johns Hopkins Medicine
Administration

During a routine examination, your doctor will ask about your general health and lifestyle habits, specifically whether you drink and smoke. Other questions may address your family history of cancer and liver disease. To determine for sure if you have liver cancer, your doctor may order one or more of the following tests: :

  • Blood work
  • Abdominal ultrasound
  • MRI
  • CT scan
  • Liver Biopsy
Ajay K. Sahajpal, MD
Transplant Surgery

There are several methods for diagnosing liver cancer. These include a thorough history and physical along with imaging, biopsy, and blood tests. Imaging tests include CT scans and MRIs. Blood work includes looking at tumor markers such as Alpha fetaprotein. A biopsy is only done if imaging is considered if the diagnosis can't be made with the imaging and blood work. It involves removing a small tissue sample from the liver and examining it for cancer. A liver biopsy may be risky and cause infection and bleeding.

Continue Learning about Liver Cancer

Liver Cancer

One of the most common cancers worldwide, liver cancer affects the largest organ inside our bodies.Cancer cells crowd out healthy ones in our liver, which filters and removes waste from our bodys blood. Four types of cancer begin ...

in the liver, although the most common called hepatocellular carcinoma or HCC accounts for 75% of all liver cancer. Still, it is more common for cancer to begin in other parts of the body, such as the pancreas, stomach, breast or lung and then spread to the liver as a secondary cancer. You are more likely to develop liver cancer if you have hepatitis or cirrhosis, which is the scarring of the liver cells. Symptoms typically do not appear until after the cancer has progressed, but see your doctor if you have unexplained weight or appetite loss, abdominal pain or swelling, or jaundice, which turns your skin and eyes yellow.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.