Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements

Table 2 Imaging characteristics of cirrhotic and non-cirrhotic hepatocellular carcinoma

	CHCC	NCHCC
Imaging modality	Background of advance fibrosis (cirrhosis)	No background of advance fibrosis (cirrhosis)
CT	Homogenous with irregular but well defined margin	Initially hypoattenuating mass which can be come heterogenous (areas of necrosis/hemorrhage within the tumor) when tumor attains bigger size
	Multiple masses
		Large solitary mass (/dominant mass) with satellite nodules
	Extrahepatic extension less common
		Extrahepatic extension (with direct adjacent organ) is more often seen
		Metastasis frequently seen, vascular invasion less common (15%)
	Vascular invasion (encasement) more common (85%)
		Lymphadenopathy seen in 20% of cases.
MR	T1: Variable but mostly hypointense. T2: Hyperintense/isointense compared to surrounding liver	Unenhanced T1 image - Hypointense lesion (presence of hemorrhage/fat can increase the signal). T2 - Hyperintense (low grade/well differentiated can be iso/hypointense)
	DWI-high ADC when lesion is well differentiated	DWI - Used for small lesions. Shows low ADC

CHCC: Cirrhotic hepatocellular carcinoma; NCHCC: Non-cirrhotic hepatocellular carcinoma; CT: Computed tomography; MRI: Magnetic resonance; DWI: Diffuse weighted imaging; ADC: Apparent diffusion coefficient.