Early hepatocellular carcinomas with a high incidence of iso-density or low density (signal) areas throughout the arterial, portal and equilibrium phases (LF1213816
level 1), hepatocellular carcinoma with a nodule-in-nodule finding (LF1214517 level 1), and dysplastic nodules (LF1214018) were not included in the studies. Of the articles adopted this time, the histological diagnostic criteria for hepatocellular carcinoma were mentioned in five articles. Three articles (LF121031 level 1, LF105467 level 1, LF0620011 level 1) cited the International Working Party (LF1214018), and two articles (LF058794 level 1, LF020016 level 1) made a reference to the diagnostic criteria established by Ferrell et al. (LF1213919
level 1). Of the three articles on lipiodol CT, only lipiodol was used in two studies (LF058794 level 1, LF103715 level 1), Cilomilast ic50 and lipiodol plus anticancer drug plus/minus gelatin sponge were used in the third study (LF004742 level 1). With regard to the diagnostic performance of each diagnostic imaging technique, the merits and demerits of studies using isolated or resected livers as the gold standards may be as follows: (1) Usually, the sensitivity is higher for resected livers than for BMS-907351 price isolated livers. This is probably attributable to small cancer nests not being identifiable at the time of surgery but being found in the explanted livers. More sensitive diagnosis is considered to be possible in isolated livers. However, (2) the time 上海皓元医药股份有限公司 from the final imaging test to liver transplantation (range : 32 days to 6 months, Table 1) is generally longer than that from the final imaging to resection. If a new focus develops during the waiting period for transplantation, the preoperative diagnostic imaging examination may have yielded a false-negative
result, reducing the sensitivity of diagnosis. (3) The main candidates for liver transplantation in Western countries are patients with advanced cirrhosis (Child–Pugh class C), and hepatocellular carcinoma is only a secondary indication. The diagnostic performance of imaging decreases as the severity of cirrhosis increases. Whereas, hepatectomy is often performed in patients with good liver function (Child–Pugh class A). (4) A section of resected liver and a CT/MRI image plane can be compared relatively easily, whereas it is difficult to maintain an isolated liver in a 3-D anatomical form as it is in the body after explantation. Therefore, comparison with CT/MRI is not always easy. (5) The slice thickness of an isolated liver tends to be generally thicker than that of a resected liver, and small lesions may be missed in thicker slices.