Liver Cancer: Tests After Diagnosis
After a diagnosis of liver cancer, you’ll likely have other tests. These tests help your healthcare providers learn more about your cancer. They can help show if the cancer has grown into nearby areas or spread to other parts of the body. The test results help your healthcare providers decide the best ways to treat the cancer. Some of these tests might also be done during or after treatment to see how well treatment is working. If you have any questions about these or other tests, talk with your healthcare team.
The tests you may have can include:
Imaging tests, such as computed tomography (CT) scan, magnetic resonance imaging (MRI), and ultrasound
Your healthcare provider may do a CT scan to look for tumors in your liver or other parts of your body. The scan takes X-rays of your body from many angles. A computer uses these X-rays to make detailed images of your internal organs. You may receive an injection of a contrast dye before the test to help outline any tumors. A complete CT scan takes several minutes. Metal objects can get in the way of the X-rays, so you can’t wear any jewelry. You may be asked to wear a hospital gown during the test. You won’t feel the scan. Some people, though, feel uncomfortable having to lie so still while the test is going on.
An MRI uses magnets, radio waves, and a computer to make very detailed pictures of the inside of your body. MRIs can be helpful when looking at liver tumors. This is because they can show the details of the tumor and nearby blood vessels. This might affect your treatment options.
MRIs are not painful, and they don’t use radiation. They can, though, take a long time to do – up to an hour. During that time, you’ll need to lie still on a table as it’s moved into a long, narrow tube. Some people say the test makes them feel claustrophobic. If you’ve had claustrophobia in the past, let your healthcare provider know before you have this test.
An ultrasound uses sound waves to make pictures of the inside of your body. A small instrument called a transducer gives off sound waves and picks up the echoes as they bounce off body organs. Ultrasound can be used to look for tumors in your liver. For the test, you’ll lie on a table while the transducer is moved along the skin over your abdomen. In most cases, your skin will be lubricated with gel first. The test is painless and fairly quick. Ultrasound can also be used during surgery. This is called an intraoperative ultrasound. In this case, the transducer is put right against your liver during the operation. This can help show tumors deep inside your liver.
This is a surgical procedure. In it, a thin, lighted tube with a tiny video camera on the end is put through a small cut in your abdomen. Your healthcare provider can then look at the surface of your liver and other organs. He or she can also take out small samples of any suspicious areas. This test might be done to help determine the stage (extent) of your cancer. It can also help plan treatment.
Your healthcare provider may test your blood. He or she may do this to check how well treatment is working, look for signs of the cancer coming back, or check how well the rest of your liver (or other organs) is working. Blood tests can include:
Alpha-fetoprotein (AFP) blood test
AFP is a protein in the blood that normally decreases right after birth. AFP levels are sometimes high in people with liver cancer. Comparing your AFP levels before and after treatment can show if the cancer is gone or is starting to come back. AFP levels can also be elevated in other diseases of the liver and in some other conditions. So, this test is used with other tests to evaluate liver cancer.
Liver function tests
These tests check your liver function. They can show liver irritation and inflammation. They can help show how well the rest of your liver is working. This might affect your treatment options.
Clotting factor tests
The liver normally makes certain proteins that help the blood clot. Clotting factor tests, such as the prothrombin time (PT), can help your healthcare provider know how well your liver is working.
Other blood tests
Your healthcare provider may do other tests to check blood mineral levels, blood cell levels, and the function of other organs. These include your kidneys.
Working with your healthcare provider
Your healthcare provider will talk with you about which tests you'll have. Make sure to get ready for the tests as instructed. Ask questions and talk about any concerns you have.
March 21, 2017
Clinical Features and Diagnosis of Primary Hepatocellular Carcinoma. UpToDate.
Alteri, Rick, MD,LoCicero, Richard, MD