Treatment of hepatocellular carcinoma Ziad Hassoun, Gregory J. Gores  Clinical Gastroenterology and Hepatology  Volume 1, Issue 1, Pages 10-18 (January 2003) DOI: 10.1053/jcgh.2003.50003 Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 1 Actuarial rate of HCC development in 34 dysplastic nodules. (Data from Terasaki et al., Gastroenterology 1998;115:1216–1222.). Clinical Gastroenterology and Hepatology 2003 1, 10-18DOI: (10.1053/jcgh.2003.50003) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 2 CT scan of the liver demonstrating an early HCC. This lesion is hypervascular, thus enhancing after contrast injection and appearing as a hyperdense nodule. Clinical Gastroenterology and Hepatology 2003 1, 10-18DOI: (10.1053/jcgh.2003.50003) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 3 Management algorithm for a solitary HCC nodule. PLT, platelets. Clinical Gastroenterology and Hepatology 2003 1, 10-18DOI: (10.1053/jcgh.2003.50003) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 4 Management algorithm for early HCC. OLT, orthotopic liver transplantation; PEI, percutaneous ethanol injection; RFA, radiofrequency ablation. Clinical Gastroenterology and Hepatology 2003 1, 10-18DOI: (10.1053/jcgh.2003.50003) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 5 Management algorithm for large solitary or multicentric HCC. Clinical Gastroenterology and Hepatology 2003 1, 10-18DOI: (10.1053/jcgh.2003.50003) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 6 (A) HCC appearing as a hypoechoic nodule on ultrasound; (B) after PEI, the nodule becomes hyperechoic. Clinical Gastroenterology and Hepatology 2003 1, 10-18DOI: (10.1053/jcgh.2003.50003) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 7 CT scan performed after RFA of HCC, showing a cystic-density lesion, thus confirming treatment success. Clinical Gastroenterology and Hepatology 2003 1, 10-18DOI: (10.1053/jcgh.2003.50003) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 8 Chemoembolization. (A) The HCC nodule appears on the initial angiogram as a hypervascular lesion. (B) The angiogram performed at the end of the procedure demonstrates the occlusion of the artery feeding the tumor. Clinical Gastroenterology and Hepatology 2003 1, 10-18DOI: (10.1053/jcgh.2003.50003) Copyright © 2003 American Gastroenterological Association Terms and Conditions