Diagnosis and intra-arterial therapies for primary liver cancer Hepatocellular vs. intrahepatic cholangiocellular carcinoma

Background Hepatocellular carcinoma (HCC) and intrahepatic cholangiocellular carcinoma (ICC) are the most prevalent and most important types of primary liver cancer. Timely diagnosis and treatment may reduce the lethality. Objectives In the following article an overview of epidemiology, clinical symptoms, risk factors, aspects of screening, and important tumor characteristics in cross-sectional imaging is provided. In addition, available treatment options, with a special focus on intra-arterially administered medication (e.g., transarterial chemoembolization [TACE] and selective intra-arterial radiotherapy [SIRT]) are discussed. Materials and methods Analysis, summary and discussion of published review articles and expert recommendations. Results Modern, multiparametric cross-sectional imaging allows the diagnosis of the most common primary liver tumors (HCC, ICC). With methods such as TACE and SIRT, interventional radiology offers minimally invasive and locally ablative therapy options for patients with advanced, inoperable disease, which may lead to a significant survival benefit. Conclusions Contrast-enhanced magnetic resonance imaging (MRI) with hepatocyte-specific contrast agents is currently the most sensitive and specific tool for the diagnosis and treatment assessment of HCC and ICC. Intra-arterial procedures such as TACE and SIRT play a role in patients with advanced, inoperable cancer and adequate liver function.