Tests that take pictures of the inside of the body are known as imaging scans. An ultrasound scan is usually the imaging scan first used to look for liver cancer and to monitor people with cirrhosis.
An ultrasound scan alone cannot confirm a diagnosis of liver cancer, so you will also have one or more other scans. You may have some imaging scans more than once during diagnosis and again during treatment.
Before having scans, tell the doctor if you have any allergies or have had a reaction to contrast during previous scans, if you have diabetes or kidney disease, or are pregnant or breastfeeding.
Ultrasound
Used to show if there is a tumour in the liver and how large it is. You will be asked not to eat or drink (fast) for about four hours before the ultrasound. You will be asked to lie on your back for the scan and a gel will be spread onto your abdomen (belly).
A small device called a transducer will be moved across the area. The transducer creates soundwaves that echo when they meet something solid, such as an organ or tumour. A computer turns these echoes into pictures.
An ultrasound is painless and usually takes only 15–20 minutes. If a solid lump is found, you will need other scans to show whether the lump is cancer. It is common to find non-cancerous (benign) lumps in the liver during an ultrasound.
CT scan
Uses x-ray beams to take detailed, cross-sectional pictures of the inside of your body. It helps show the features of the tumour in the liver. It may also show if the cancer has spread beyond the liver.
During the scan, a liquid dye (called contrast) is injected into one of your veins. This helps ensure that anything unusual can be seen more clearly. The dye may make you feel flushed and cause some discomfort in your abdomen.
These reactions usually go away in a few minutes, but tell the team if you feel unwell. Some people have an allergic reaction to the dye. They may need to take medicine before the scan to prevent such a reaction or avoid CT scans with dye altogether.
If you have had an allergic reaction to dye in the past, tell the radiology practice before your appointment.
The CT scanner is large and round like a doughnut. You will need to lie still on a table while the scanner moves around you. It can take 10–30 minutes to get ready for the CT scan, but the scan itself takes only a few minutes and is painless.
MRI scan
Uses a powerful magnet and radio waves to create detailed cross-sectional pictures of the liver and nearby organs. An MRI is used to show the size of the tumour and whether it is affecting the main blood vessels and bile ducts around the liver.
This scan is particularly helpful for diagnosing small tumours. Before having scans, tell the doctor if you have any allergies or have had a reaction to contrast during previous scans.
You should also let them know if you have diabetes or kidney disease, or are pregnant or breastfeeding.
During the scan, you will be injected with a dye (called contrast) that highlights the organs in your body. You will then be asked to lie on an examination table that slides completely into a large metal tube that is open at both ends.
The MRI scanner is noisy and narrow, and this can make some people feel anxious or uncomfortable (claustrophobic). If you think you may become distressed, mention this beforehand to your doctor or nurse.
You may be given a mild sedative to help you relax, and you will usually be offered headphones or earplugs. A liver MRI scan may take up to 30 minutes.
Bone scan
If a liver transplant is a potential treatment and/or you have pain in the bones, you may need a bone scan to be sure the cancer has not spread (metastasised) to the bones.