Liver Cancer: Tests After Diagnosis

After a diagnosis of liver cancer, you’ll likely need more tests. These tests help your healthcare providers learn more about the cancer. They can help show if it has grown into nearby tissues or spread to other parts of your body. This information is a key part of finding the stage of the cancer.

The test results help your healthcare providers work with you to decide the best ways to treat the cancer. Some of these tests might be done again during or after treatment to see how well treatment is working. If you have any questions about these or other tests, talk with your healthcare team.

Some of the tests used after diagnosis include:

• Imaging tests

• Laparoscopy

• Biopsy

• Blood tests

Imaging tests

CT scan

A CT scan can be used to look for tumors in your liver and other parts of your body. The scan takes a series of X-rays from many angles. A computer then uses these X-rays to make detailed 3-D images of your insides. A contrast dye may be injected into one of your veins before the test. Or you might be asked to drink it. It helps show better details. A complete CT scan takes several minutes. You won’t feel the scan. Some people, though, feel uncomfortable because you have to lie very still while the scans are taken.

MRI

An MRI uses magnets, radio waves, and a computer to make very detailed pictures of your insides. MRIs can show the details of the tumor and nearby blood vessels. They can also help see if the cancer has spread beyond the liver.

MRIs are not painful, and they don’t use radiation. Sometimes a contrast dye is put into your blood to get clearer pictures. MRIs can take a long time to do—up to an hour. During that time, you’ll need to lie still on a narrow table as it’s moved into a long, narrow tube. Some people find this test makes them feel claustrophobic. If you’ve had problems being in small, tight spaces in the past, let your healthcare provider know before you have this test.

Angiography

This is an X-ray, CT scan, or MRI of the blood vessels in and around your liver. A special dye is injected into your blood. Then X-rays or scans are taken as your blood carries the dye through your liver. This can show which vessels are going to the tumor. It helps your healthcare provider plan surgery or an embolization treatment.

To do this test, a small tube (catheter) is threaded through a blood vessel (usually in your groin) to your liver. The area is numbed first, but this can be uncomfortable. You have to stay very still while the catheter is in. Sometimes the dye is put into a vein in your hand or arm instead of the groin.

Laparoscopy

This is a surgical procedure. A thin, lighted tube with a tiny video camera on the end is put into your belly (abdomen) through a small cut in your skin. The tube is called a laparoscope. Your healthcare provider can use it to look at the surface of your liver and nearby organs. Small pieces (samples) of any suspicious areas can be taken out through the scope. This is called a biopsy.

This test might be done to help find out the stage of your cancer. It can also help plan treatment. 

You may be given medicines to make you sleepy and not feel any pain during the test.

Biopsy

Sometimes a biopsy is needed to be sure that a change in your liver is cancer. This is when some of the changed tissue is taken out and tested in the lab to see if it contains cancer cells.

Many times, imaging and blood tests can tell if you have liver cancer. So a biopsy may not be done until after surgery is done to take out the part of the liver with the tumor in it.

Lab tests are done on the tumor to learn more about the cancer. Healthcare providers look for things like certain genes and proteins to help them decide on your best treatment options.

Blood tests

Your healthcare provider may test your blood. This can be done to check how well treatment is working, look for signs of the cancer coming back, or check how well the rest of your liver or other organs are working. Blood tests can include:

Alpha-fetoprotein (AFP) blood test

AFP is a protein in the blood. AFP levels are sometimes high in people with liver cancer. Comparing your AFP levels before and after treatment can show if the cancer is gone or is starting to come back. AFP levels can also be high in other diseases of the liver and in some other conditions. So this test is used along with other tests for liver cancer.

Liver function tests

These tests show how well your liver is working. They can show liver irritation and inflammation. This might affect your treatment options.

Hepatitis panel

You may have blood tests to see if you have hepatitis B or C.

Clotting factor tests

The liver normally makes certain proteins that help the blood clot. Clotting factor tests such as the prothrombin time (PT) can help your healthcare provider know how well your liver is working.

Other blood tests

Your healthcare provider may do other tests to check blood mineral levels, blood cell levels, and the function of other organs. These include your kidneys and bone marrow.

Working with your healthcare provider

Your healthcare provider will talk with you about which tests you'll have. Be sure you know what the tests will be like and why they're needed. Get ready for the tests as instructed. Ask questions and talk about any concerns you have.