Liver Cancer Diagnosis

This is especially true because people who have liver cancer may experience few to no symptoms until the disease is in its later stages. Properly diagnosing and staging liver cancer means we can figure out how best to stop it.

At Winship Cancer Institute of Emory University, we use leading-edge technology to acquire the highest quality ultrasound and MRI scans and have dedicated radiologists and pathologists who specialize in analyzing liver cancer. This ensures your diagnosis is as accurate as possible.

There are two main types of liver cancer: primary liver cancer and metastatic cancer. Primary liver cancers, include hepatocellular carcinomas (HCC) and intrahepatic cholangiocarcinomas, arise directly in the liver. HCC is the sixth most common form of cancer worldwide, and the third leading cause of death from cancer. That’s because HCC predominantly occurs in people who have had liver disease for many years. Metastatic liver cancers are those that spread to the liver from other places in the body.

The stage of liver cancer indicates how much it has grown in the liver, and whether or not it has moved to other organs and lymph nodes. Early-stage cancer is a disease limited to the liver. Late-stage cancer indicates that it’s spread to other organs.

Understanding what type of liver cancer you have, its stage and where it is in your body, helps us tailor treatment to your cancer. And that relies on a proper diagnosis.

Your medical team will order a diagnostic test for liver cancer if I your primary care doctor notices signs such as abnormal swelling or lumps in your abdomen during a routine check-up, if a blood test indicates high levels of alpha-fetoprotein (AFP) or if you’re at risk for the disease and have received abnormal results from a liver cancer screening.

• Imaging. A CT or MRI scan can reveal a mass or masses in the liver, as well as tumor-induced angiogenesis, which is a likely indicator of cancerous tissue. An interventional radiologist can use radiological imaging to assist with minimally invasive local therapies such as biopsy, laparoscopic resection and radiofrequency ablation to diagnose the tissue as benign or cancerous, and even treat the tumor on site. It’s important to note that not all imaging centers produce images of equal quality. At Winship in Atlanta, we employ the latest advanced imaging protocols to ensure we are analyzing the highest quality scans. We can spot extremely small masses, or multiple masses, whereas other imaging protocols might miss these completely.
• Biopsy. During a liver biopsy, a small amount of tissue is removed through the end of a small needle for examination under a microscope. This procedure is conducted by an interventional radiologist who specializes in liver and other cancers. They use ultrasound to direct the needle to the precise location of the tumor. After the radiologist extracts a small tissue sample, it is sent to a pathologist who analyzes the tissue to make a diagnosis. The biopsy procedure typically lasts around five minutes, and a local anesthetic is used to mitigate the pain. A biopsy may not be needed when the AFP blood test or imaging indicates HCC.
• Biomarker testing of the tumor. Biomarkers can be used to detect HCC early with a high degree of accuracy. They provide a critical advantage for clinicians treating this specific type of cancer that typically reaches an advanced stage before causing symptoms in the patient. For a cancerous tumor, our pathologists conduct laboratory tests to identify specific genes, proteins and other factors — such as cell characteristics or genetic mutations — unique to the tumor. These test results inform our collaborative approach to treating your specific cancer.

A symptom is a physical or mental problem that could indicate the presence of an underlying condition, for example, nausea, pain, fatigue. A sign is an identifiable, measurable factor — think of a fever or a rash. Not all signs and symptoms mean you have liver cancer, but there are things to keep an eye out for. If you experience any of these signs or symptoms, talk with your primary care physician immediately.

• Discomfort in the abdomen on the right side
• Pain near the right shoulder blade or in the back
• A hard lump below the ribcage on the right side of the body
• Swollen abdomen
• Itching
• Yellowing of the skin and eyes (jaundice)
• Easy bruising or bleeding
• Loss of appetite
• Nausea
• Vomiting
• Unexplained weight loss