LIVER Flashcards
(5 cards)
What is the recommended follow-up for a liver nodule smaller than 1 cm detected on ultrasound?
A) Immediate biopsy
B) Four-phase contrast-enhanced CT or MRI
C) Repeat ultrasound in 4 months
D) No follow-up is needed
Correct Answer: C) Repeat ultrasound in 4 months
Rationale: If a nodule is smaller than 1 cm, it is not immediately classified as HCC. The guideline recommends repeating the ultrasound in 4 months to monitor changes before proceeding with advanced imaging or biopsy.
What imaging techniques are recommended for a liver nodule larger than 1 cm?
A) PET scan
B) Four-phase contrast-enhanced CT or multiphasic contrast-enhanced and/or gadoxetic-enhanced MRI
C) Simple X-ray
D) Single-phase non-contrast CT
Correct Answer: B) Four-phase contrast-enhanced CT or multiphasic contrast-enhanced and/or gadoxetic-enhanced MRI
Rationale: The guideline suggests using multiphasic contrast-enhanced imaging techniques, as they help identify radiologic hallmarks of HCC, including arterial phase contrast uptake and venous/delayed phase washout.
What is the next step if a liver nodule larger than 1 cm shows HCC radiologic hallmarks on imaging?
A) Biopsy
B) Follow-up in 6 months
C) Consider it as HCC
D) Ignore the findings
Correct Answer: C) Consider it as HCC
Rationale: If one imaging technique detects the radiologic hallmarks of HCC (arterial phase enhancement and venous/delayed phase washout), a diagnosis of HCC can be made without biopsy.
If the imaging findings are inconclusive after two biopsies, what is the recommended follow-up?
A) Immediate surgical removal
B) Repeat ultrasound in 4 months
C) No further follow-up is needed
D) Repeat biopsy every month
Correct Answer: B) Repeat ultrasound in 4 months
Rationale: If no definitive diagnosis is reached even after two biopsies, the guideline suggests monitoring the nodule with follow-up ultrasound at 4 months rather than immediate invasive procedures.
If a liver nodule shows a growing or changing pattern on repeat ultrasound, what is the next step?
A) Continue monitoring without further tests
B) Perform a biopsy
C) Perform four-phase contrast-enhanced CT or MRI
D) Ignore the nodule
Correct Answer: C) Perform four-phase contrast-enhanced CT or MRI
Rationale: A growing or changing pattern suggests a higher risk of malignancy. The next step is advanced imaging with contrast-enhanced CT or MRI to evaluate radiologic hallmarks of HCC.
