Is a Liver Biopsy Necessary for Diagnosing Liver Cancer?

While pathological examination remains the gold standard for tumor diagnosis, a liver biopsy is not always required to confirm liver cancer. In fact, a clinical diagnosis of liver cancer can be made if one of the following three criteria is met.

Patients can be clinically diagnosed with liver cancer if they show two typical imaging features, such as ultrasound, contrast-enhanced CT, MRI, or selective hepatic arteriography, and have a lesion larger than 2 cm. These imaging techniques are highly effective in identifying malignant growths in the liver.

Another diagnostic criterion involves one clear imaging abnormality showing a lesion larger than 2 cm along with a significantly elevated alpha-fetoprotein (AFP) level above 400 ng/mL. This combination is a strong indicator of hepatocellular carcinoma.

If imaging results are inconclusive, a liver biopsy may be necessary to confirm the diagnosis. A positive biopsy result, especially when supported by imaging findings, allows for a definitive diagnosis. However, if the imaging evidence is insufficient or unclear, a liver biopsy becomes a crucial step in confirming the presence of cancer.

In summary, while a liver biopsy is a valuable diagnostic tool, it is not always required for diagnosing liver cancer. Modern imaging techniques and biomarker testing often provide enough evidence to make an accurate clinical diagnosis.