Evaluation of hepatocellular carcinoma by contrast enhanced ultrasound : a novel technique.

Characterization of focal liver lesions remains a diagnostic challenge for the radiologists, more so when there is associated underlying chronic liver disease (CLD). Imaging plays a vital role and there has been a constant endeavor to improve the diagnostic accuracy of liver lesions. The introduction of mutiphasic CT and MRI has revolutionized the diagnostic ability of liver lesions. With the advent of ultrasound contrast agents (UCAs), it is possible to evaluate liver lesions using the non-invasive imaging technique of “contrast-enhanced ultrasonography” (CEUS).1-3 CEUS can overcome the limitations of grey scale and color doppler sonography4,5 and has been used for characterisation of focal liver lesions.2. It can depict arterialisation of hypervascular hepatocellular carcinoma (HCC)6,7 and can also help in assessment of the post-therapeutic response.8,9 We present two such cases of HCC evaluated by a recently available second generation ultrasound contrast agent, SonoVue (Bracco, UK).

Palliative treatment in advanced hepatocellular carcinoma: Has it made any difference.

Hepatocellular carcinoma (HCC) is a global health problem, the fifth most common cancer in the world.. HCC occurs in a histologically abnormal liver due to underlying chronic liver disease resulting as a sequele of the chronic viral infections, hepatitis B and C. Since these two viral infections are endemic in Asia and Africa, more than 80% of cases are encountered in these regions. In India, a large proportion of the population is “at risk” for developing chronic liver disease and, therefore, HCC. Due to the lack of screening programmes in the country, the majority of HCC patients are diagnosed at an advanced stage of the disease, and thus treatment remains a challenge. Palliative therapy forms the mainstay of treatment for this group of patients. The current era provides a plethora of options for the palliative management of HCC. This review concisely summarises the historical perspective and the current status of palliative treatment in advanced HCC.