In order to diagnose hepatocellular carcinoma, providers may use a blood test called alpha-fetoprotein, or AFP, and one or more imaging tests. While an elevated AFP level can be an indicator of cancer, many people with hepatocellular carcinoma have normal AFP levels. For this reason, providers who suspect hepatocellular carcinoma do not rely on AFP alone.

Imaging tests that may be used to diagnose hepatocellular carcinoma include:

  • Ultrasound: Ultrasound uses high-frequency sound waves to create images of internal organs. This is often the first imaging test done when hepatocellular carcinoma is suspected.
  • CT scan: Computed tomography, or CT, scans use a combination of special x-rays and computer technology to create images of internal organs. A special dye called a contrast medium may be injected or swallowed to make internal structures appear more clearly.
  • MRI: Magnetic resonance imaging, or MRI, uses radio waves and magnets to create images of internal organs.
  • Angiography: In angiography, contrast material is injected into a large artery in the groin. X-ray pictures are then taken to evaluate the arterial blood supply to the liver. In patients with hepatocellular carcinoma, newly formed abnormal small blood vessels that feed the tumor can be seen.