Washout

My MRI states A 9mm arterially enhancing focus in segment 4 which demonstrates washout and is consistent for HCC.  With a tumor this small is this 100% for sure I have HCC?

[Thomas D Schiano, MD]

unfortunately the description from the report does indeed sound like HCC.  Do you have cirrhosis? It can sometimes still be difficult to discern an HCC from a dysplastic nodule so we typically would repeat the scan in 3 months looking for interval growth.  also check an AFP level.

[Upbeat]

Thank You.
                  I was afraid of that. I do have cirrhosis. My AFT is normal.  Liver function is good.  I assume all I can do is another MRI in a couple of months to check the growth rate and after it grows, I can get on the transplant list.

[Thomas D Schiano, MD]

it can also be treated with therapies such as alcohol injection for a potential curative attempt

[Upbeat]

What would be the proper time frame for a new MRI to check the growth rate of my tumor? The radiology report says 2 months,  The Doctor office called and said 4 months.  I would think the sooner the better.  It takes awhile for the approval process for a liver transplant. Would I not be better off pre approved so when the Tumor reaches 2 cm I can get the meld jump.

[Thomas D Schiano, MD]

our protocol here is to repeat the scan in 3 months looking for interval growth. the best option would be a resection if you are a candidate.  You would not meet prioritization on a transplant list until the HCC is 2 cms so being listed much earlier than that offers no advantage.  Once you are on a list, it depends on what part of the country that you live in regarding what the ultimate waiting time would be.