ARRS 2022 Abstracts


E1849. Imaging of Typical and Atypical Hepatocellular Carcinoma
  1. Mohammed Azfar Siddiqui; MU Health Care
  2. Sara Sartaj; SSM Health St. Mary's Hospital
Most management guidelines for hepatocellular carcinoma (HCC) accept typical imaging findings alone as method of diagnosis, without need for tissue sampling. Early detection is important, as small tumors are amenable to various potentially curative treatments.

Educational Goals / Teaching Points
The goals of this exhibit are to review the imaging findings of typical and atypical HCC.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Typical imaging features (LI-RADS version 2018) include major ancillary features favoring HCC in particular or malignancy in general). Atypical imaging features include: multifocal, infiltrating, central scar, fat, calcification, sarcomatoid, necrotic, nodule-in-nodule appearance, hemorrhagic/bleeding, rim enhancing, well differentiated, retaining contrast (Eovist), mimicking cholangiocarcinoma, and unusual local invasion, dissemination.

It is crucial to recognize the atypical imaging appearance of HCC to avoid false-positive and false-negative diagnosis. Multimodality imaging along with clinical and laboratory findings can be helpful to reach the accurate diagnosis.