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Liver Cancer Diagnosis

Liver cancer often is challenging to diagnose. It usually has no symptoms in the early stages, and tumors often cannot be felt from outside the body. If you have been diagnosed with liver cancer, it is essential to find out exactly where the cancer is and if it has spread. This helps doctors choose the best treatment for you.

Advanced Technology, Techniques

MD Anderson has the most advanced and accurate technology to pinpoint liver cancer, including triple-phase CT scans dedicated to the liver. Many times, spots on the liver that indicate cancer are small, and fine imaging is required to find them.

We have special techniques to find even the smallest spots on the liver. And our staff includes pathologists, diagnostic radiologists and specially trained technicians who are highly skilled in diagnosing liver cancer.

Liver Cancer Diagnostic Tests

If you have symptoms of liver cancer, the first step is a physical exam. The doctor will:

  • Feel your abdomen to examine the liver, spleen and nearby organs
  • Check your abdomen for ascites, an abnormal accumulation of fluid
  • Examine your skin and eyes for signs of jaundice

If the doctor suspects liver cancer, you may have one or more of the following tests to diagnose it and find out if it has spread.

Blood tests: One common blood test detects alpha-fetoprotein (AFP), which can be a sign of liver cancer. Other blood tests may measure how well the liver is working.

Imaging tests, which may include:

  • CT or CAT (computed axial tomography) scans: This is usually the most reliable test for evaluating the extent of liver cancer. Our technology includes the precise triple-phase CT scan.
  • Ultrasound
  • Angiogram: The doctor injects dye into an artery. This allows the blood vessels in the liver to be seen on an X-ray.

Biopsy: A sample of tissue from the tumor or the healthy part of the liver is removed and looked at under a microscope. Healthy tissue may be tested to see how well the liver is working. A biopsy may be obtained by:

  • Fine needle aspiration (FNA): A thin needle is inserted into the liver to remove a small amount of tissue.
  • Core biopsy: This is similar to FNA, but a thicker needle is used to remove small cylinder-shaped samples (cores).
  • Laparoscopy: A small incision (cut) is made in the abdomen, and a thin, lighted tube (laparoscope) is inserted to view the tumor.
  • Surgical biopsy: Tissue is removed during an operation.

Visit the Prevention section of our website to find out steps you can take to avoid cancer.

Liver Cancer Staging

If you are diagnosed with liver cancer, your doctor will determine the stage of the disease. Staging is a way of classifying cancer by how much disease is in the body and where it has spread when it is diagnosed. This helps the doctor plan the best way to treat the cancer. Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.

Liver Cancer Stages

(source: National Cancer Institute)

Stage I: There is one tumor, and it has not spread to nearby blood vessels.

Stage II: One of the following is found:

  • One tumor that has spread to nearby blood vessels
  • More than one tumor, none of which is larger than 5 centimeters

Stage IIIA: One of the following is found:

  • More than one tumor larger than 5 centimeters
  • One tumor that has spread to a major branch of blood vessels near the liver

Stage IIIB: There are one or more tumors of any size that have either:

  • Spread to nearby organs other than the gallbladder
  • Broken through the lining of the peritoneal cavity

Stage IIIC: The cancer has spread to nearby lymph nodes.

Stage IV: The liver cancer has spread beyond the liver to other places in the body, such as the bones or lungs. Tumors may be any size and also may have spread to nearby blood vessels and/or lymph nodes.

For adult primary liver cancer, stages also are grouped by how the cancer may be treated:

Localized resectable: The cancer is found in the liver only, has not spread and can be removed completely by surgery.

Localized and locally advanced unresectable: The cancer is found in the liver only and has not spread, but it cannot be removed completely by surgery.

Advanced: Cancer has spread throughout the liver or has spread to other parts of the body, such as the lungs and bone.

Clinical Trials

MD Anderson patients have access to clinical trials
offering promising new treatments that cannot be found anywhere else.

Knowledge Center

Find the latest news and information about liver cancer in our Knowledge Center, including blog posts, articles, videos, news releases and more.