Liver Cancer and PET CT

Liver cancer occurs when the cells in the liver begin to grow uncontrollably, forming tumors. It usually starts in the hepatocytes, the main type of liver cell, and may go unnoticed in its early stages. The liver, an essential organ in the digestive system, performs vital functions like detoxifying the blood, storing nutrients, and producing bile to help digest fats. Liver cancer is often asymptomatic at the beginning and may only be detected once it has progressed or spread. Diagnosis of liver cancer involves several tests such as liver function tests, ultrasound, MRI, CT scan, PET-CT, and biopsy. PET-CT is a highly effective tool for detecting liver cancer as it combines metabolic and structural imaging to spot abnormalities at both the cellular and anatomical levels.

What is Liver Cancer?

Liver cancer refers to the abnormal and uncontrolled growth of cells within the liver, leading to tumor formation. Most primary liver cancers begin in hepatocytes (the main liver cells), and this type is known as hepatocellular carcinoma (HCC). Liver cancer is often detected late, when it becomes harder to treat. However, early detection significantly improves treatment outcomes. Surgical resection or liver transplantation is often preferred in early stages. Although there is no single known cause for liver cancer, various risk factors significantly increase the chances of developing it, including chronic viral hepatitis, excessive alcohol use, fatty liver disease, and exposure to aflatoxins.

What are the different types of Liver Cancer?

Liver cancer can be categorized based on the type of cell in which it begins. Major types include:

• Hepatocellular carcinoma (HCC) – Most common type, begins in hepatocytes
• Cholangiocarcinoma (bile duct cancer)
• Hepatoblastoma – Rare, usually occurs in children
• Angiosarcoma – Rare, begins in the blood vessels of the liver
• Secondary liver cancer (metastatic) – Cancer that spreads to the liver from other organs (e.g., colon, breast)

What are the symptoms of Liver Cancer?

Liver cancer symptoms often appear in the later stages and may include:

• Pain or discomfort in the upper right abdomen
• Unexplained weight loss
• Fatigue and weakness
• Jaundice (yellowing of skin and eyes)
• Abdominal swelling or bloating
• Nausea and loss of appetite
• Pale or chalky stools
• Fever or recurring infections

What are the causes of Liver Cancer?

There’s no single cause for liver cancer, but several known risk factors include:

• Chronic infection with Hepatitis B or C viruses
• Cirrhosis (scarring of the liver, often due to alcohol abuse or hepatitis)
• Non-alcoholic fatty liver disease (NAFLD)
• Excessive alcohol consumption
• Exposure to aflatoxins (toxins produced by mold on improperly stored grains or nuts)
• Family history of liver cancer
• Obesity and diabetes
• Smoking
• Inherited liver diseases like hemochromatosis or Wilson’s disease

What does PET CT scan detect in Liver Cancer?

PET CT is a highly effective diagnostic tool that helps in detecting various aspects of liver cancer, including:

• Staging of liver cancer
• Progression and spread of liver cancer
• Type and nature of liver cancer
• Early detection of liver abnormalities
• Monitoring recurrence or relapse of liver cancer
• Planning and assessment of treatment strategies
• Evaluating response to therapy or medications
• Identifying suitable sites for biopsy samples

What are the different types of tests used for the detection of Liver Cancer other than PET CT scan?

In addition to PET CT, several diagnostic tests are used for the detection and evaluation of liver cancer. These include:

Laboratory Tests

• Liver function test (LFT)
• Alpha-fetoprotein (AFP) assay
• Hepatitis B and C screening
• Prothrombin time

Imaging Tests

• CT scan
• MRI scan
• Abdominal ultrasound
• Contrast-enhanced ultrasound (CEUS)
• PET CT scan
• Angiography

Procedures/Surgical Tests

• Liver biopsy
• Laparoscopy
• Elastography (to assess fibrosis or cirrhosis)

Conclusion

Liver cancer is the condition in which liver cells multiply abnormally, forming tumors that can become life-threatening if left untreated. Most liver cancers begin in hepatocytes and often remain asymptomatic in early stages, which make timely detection essential. Common risk factors include hepatitis infections, cirrhosis, heavy alcohol use, obesity, and exposure to toxins. Symptoms may include abdominal pain, jaundice, swelling, unexplained weight loss, and general weakness. Early detection is key, and a variety of tests are available including blood tests, imaging studies like CT, MRI, ultrasound, and biopsy. However, PET CT stands out for its ability to detect cellular-level changes, making it highly reliable for staging and treatment planning. Detecting liver cancer early significantly improves the chances of successful treatment, and surgery or liver transplant is often recommended in early stages.