Abstract

To the Editor:

Hepatocellular cancer (HCC) is one of the most dreaded complications of cirrhosis. With the advent of dynamic imaging like triphasic CT scans and MRI with gadoxetate disodium, the diagnosis of HCC can be made with certainty in most cases within a cirrhotic liver. In November 2005, the American Association of Study of Liver Diseases (AASLD) issued guidelines stating that if a hepatic lesion within a cirrhotic liver is greater than 2 cm in diameter and shows the characteristic features of HCC (ie, arterial hypervascularity and wash out in the early or delayed venous phase), only a single imaging modality is required for diagnosis.¹ This can be demonstrated on triphasic CT scan or MRI with gadolinium injection. To assess our adherence to the AASLD guidelines regarding use of liver biopsy in HCC, we reviewed the records of all patients with a diagnosis of HCC over a period of 5 years from January 2006 to December 2010.