for Health Care Providers

Table 11. Diagnostic workup of a liver mass in a patient with chronic liver disease


CAT, computerized axial tomography; HCC, hepatocellular carcinoma; MRI, magnetic resonance imaging; US, ultrasound.
Mass <1 cm	Diagnosis	Low likelihood of being HCC, therefore no specific diagnostic tests
Mass <1 cm	Follow-up	Repeat imaging study every 3 months If no growth in 1-2 years, no HCC; continue screening every 6 months If growth, treat as HCC
Mass 1-2 cm	Diagnosis	Two dynamic imaging studies (US, CAT scan, or MRI) Both with typical vascular pattern Treat as HCC One typical and the other atypical Consider biopsy of mass Both atypical Consider biopsy of mass vs. close follow-up
	Follow-up after biopsy	Biopsy confirms HCC Treat as HCC
	Follow-up after biopsy	Non-diagnostic Repeat imaging study every 3 months: If no growth in 1-2 years --> no HCC If growth, treat as HCC
Mass >2 cm	Diagnosis	One dynamic imaging study (US, CAT scan, or MRI) Typical vascular pattern Treat as HCC Atypical vascular pattern Biopsy of mass
	Follow-up after biopsy	Biopsy confirms HCC Treat as HCC
	Follow-up after biopsy	Non-diagnostic Repeat imaging study every 3 months: If no growth in 1-2 years --> no HCC If growth, treat as HCC