Table 3. Diagnosis of Hepatocellular Carcinoma.

1. Noninvasive diagnosis: in high-risk groups (i.e., HBV/HCV infection, liver cirrhosis)

1) For liver nodules 1 cm found by surveillance:

If the typical hallmark of HCC* is identified on one or more (two or more†) imaging techniques‡

2) For nodules <1 cm found by surveillance:

If the typical hallmark of HCC* is identified in two or more imaging techniques‡ and increased serum AFP with an increasing trend over time is noted in patients with suppressed hepatitis activity

2. Pathologic diagnosis

^*Hypervascularity in arterial phase and washout in portal or delayed phase, ^†For 1-2-cm nodules, diagnosis should be based on identification of typical hallmark of HCC in one or more imaging techniques in optimal settings (Appendices 5 and 6) and in two or more imaging techniques in suboptimal settings, ^‡Dynamic computed tomography, dynamic magnetic resonance imaging, gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging magnetic resonance imaging.

AFP = α-fetoprotein, HBV = hepatitis B virus, HCC = hepatocellular carcinoma, HCV = hepatitis C virus