Liver Cancer (cont.)
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Making the Diagnosis of Liver Cancer
The diagnosis of liver cancer is usually made incidentally, by noticing abnormal blood tests of liver function. Increasingly, people who are known to be at risk (such as people with active hepatitis B or C, or alcoholics with cirrhosis) are being screened by their doctors with periodic blood and imaging tests. Once a cancer is suspected, further studies can be done to find out how much of the liver is involved. The most common radiologic tests used are CT scans (computerized tomography, in which X-ray pictures are reassembled into body images), ultrasound (using sound waves to create pictures), and MRI (magnetic resonance imaging, which uses magnetic fields to get pictures of different body tissues). Other, more specialized tests are sometimes needed, such as an angiogram (taking X-ray pictures of the blood vessels within the liver and the tumor) or laparoscopy (inserting a small scope into the abdomen in the operating room to get a closer view of the liver). There are also certain tests of proteins made by the tumors that can be measured in the blood, such as AFP (alpha-fetoprotein) and CA19-9.
In order to make sure of the diagnosis, it may be necessary to remove a piece of the tumor in order to study it under the microscope and figure out exactly what kind of cancer it is. This is called a biopsy and can be done by placing a needle into the liver during ultrasound or CT scanning or during laparoscopy or surgery.
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