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Tests and diagnosis
By Mayo Clinic staff
Diagnosing liver cancer
Tests and procedures used to diagnose liver cancer include:
- Blood tests. Blood tests may reveal liver function abnormalities.
- Imaging tests. Your doctor may recommend imaging tests, such as an ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI).
- Removing a sample of liver tissue for testing. During a liver biopsy, a sample of tissue is removed from your liver and examined under a microscope. Your doctor may insert a thin needle through your skin and into your liver to obtain a tissue sample. Liver biopsy carries a risk of bleeding, bruising and infection.
Determining the extent of the liver cancer
Once cancer is diagnosed, your doctor will work to determine the extent (stage) of the liver cancer. Staging tests help determine the size and location of cancer and whether it has spread. Imaging tests used to stage liver cancer include CT, MRI, chest X-ray and bone scan.
The stages of liver cancer are:
- Stage I. At this stage, liver cancer is a single tumor confined to the liver that hasn't grown to invade any blood vessels.
- Stage II. Liver cancer at this stage can be a single tumor that has grown to invade nearby blood vessels, or it can be multiple small tumors in the liver.
- Stage III. This stage may indicate that the cancer is composed of several larger tumors. Or cancer may be one large tumor that has grown to invade the liver's main veins or to invade nearby structures, such as the gallbladder.
- Stage IV. At this stage, liver cancer has spread beyond the liver to other areas of the body.
- Marrero JA, et al. Modern diagnosis and management of hepatocellular carcinoma. Clinics in Liver Disease. 2009;13:233.
- What you need to know about liver cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/liver/allpages/print. Accessed May 13, 2009.
- Weber S, et al. Liver and bile duct cancer. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008:1569.
- Hepatobiliary cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/hepatobiliary.pdf. Accessed May 13, 2009.
- What is liver cancer? American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_liver_cancer_25.asp?sitearea=. Accessed May 27, 2009.
- Liver cancer: Questions to ask the doctor. Cancer.Net. http://www.cancer.net/patient/Cancer+Types/Liver+Cancer. Accessed May 13, 2009.
- Nguyen CT, et al. Hepatitis vaccination and prophylaxis. Clinics in Liver Disease. 2009;13:317.
- Hepatitis C. American Liver Foundation. http://www.liverfoundation.org/education/info/hepatitisc/. Accessed May 27, 2009.
- Bruix J, et al. AASLD practice guideline: Management of hepatocellular carcinoma. Hepatology. 2005;42:1208.
