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Zech, C. J.; Potthoff, A. and Ricke, J. (2018): Bildgebende radiologische Diagnostik und Verlaufsbeurteilung beim HCC. In: Onkologe, Vol. 24, No. 9: pp. 680-691

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Background. Radiological imaging is nowadays an integral part of making the diagnosis in hepatocellular carcinoma (HCC). Multidetector computed tomography (CT) and magnetic resonance imaging (MRI) play a decisive role in this. Contrast-enhanced ultrasound (CE-US) represents an alternative to these for the characterization of incidentally discovered hepatic lesions in B-image ultrasound in high-risk patients. Method. A search and analysis of the currently available literature were carried out. Results. The CT is a rapid and universally available imaging modality which is an important method in the diagnostics of HCC. It has profited from the technical developments over the last decade, which is particularly reflected in the more rapid acquisition in addition to reduced radiation doses. With MRI more diagnostic criteria for the evaluation and differential diagnosis of focal hepatic lesions in a cirrhotic liver can be acquired. Nowadays, it is sufficiently robust to generate adequate images from most patients. In the current national S3 guidelines on the diagnostics and treatment of HCC, CE-US is recommended as an alternative imaging procedure to CT and MRI for characterization of HCC in a high-risk group, when an unclear focal liver nodule is detected in B-image ultrasound, independent of its size. The advantage lies in the lower costs, rapid availability, lack of radiation exposure and lack of nephrotoxicity. In the clinical routine the response assessment with the mRECIST criteria for HCC has become widely established.

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