Early Signs of Liver Cancer in Color Ultrasound Reports

Color ultrasound reports can reveal early signs of liver cancer through irregular low-density shadows accompanied by blood flow signals. While color Doppler ultrasound is not the definitive diagnostic tool for liver cancer, it serves as an effective screening method. If such irregularities are detected, further diagnostic tests are necessary to confirm the presence of liver cancer.

The next step typically involves blood tests to measure serum alpha-fetal protein (AFP) levels. In addition, contrast-enhanced CT or MRI scans of the liver are required to confirm the diagnosis. These imaging techniques can identify the unique characteristics of liver tumors, particularly during the arterial and portal venous phases of contrast enhancement.

In liver cancer cases, contrast agents rapidly enter the tumor during the arterial phase, causing quick enhancement, followed by a fast washout in the portal venous phase — a pattern often described as "fast in, fast out." This distinct imaging behavior is a key indicator of hepatocellular carcinoma, the most common type of liver cancer.

For the diagnosis of small liver cancers, a combination of serum AFP testing and both plain and enhanced CT or MRI scans of the liver is essential. Small liver cancers are typically defined as single tumors less than 5 cm in diameter or 2–3 lesions each less than 3 cm. Importantly, AFP levels may not always be elevated in early-stage liver cancer — approximately 30% of patients with liver cancer maintain normal AFP levels. Therefore, relying solely on AFP testing can lead to missed diagnoses, making advanced imaging crucial for accurate detection.