These are the tests which are used most frequently to evaluate liver cancer:
Blood tests: Some tumors produce measurable amounts of chemicals known as tumor markers in the blood. Blood tests to determine the presence of these markers can be used to help diagnose or monitor the disease process. Other tests measure the functions of the liver and other organs.
CEA: CEA is a marker that has been found to be elevated in some patients with colorectal cancer. Not all patients have elevation in the CEA, and thus this test is only useful in patients with known elevation.
AFP: alpha-feto protein is a marker used in patients with hepatocellular cancer. Not all hepatocellular cancers have an elevated AFP. This marker is only useful in patients with elevated AFP.
CA19-9: is a marker that has been shown to be helpful in the diagnosis and follow up in some patients with cholangiocarcinoma.
X-rays: Many different types of x-rays can been used in the diagnosis and management of patients with liver cancer.
Ultrasound (US): This test uses sound waves to form a picture that can be seen on a small television screen. The picture can show organs in the abdomen and possibly the presence of a tumor. Ultrasound is commonly performed by placing a probe on the surface of the abdomen.
Computed tomography (CT) scan: This test gives detailed pictures of the body and can show how far the cancer has spread. The CT scan is the primary test used to determine the number and size of tumors in the liver and whether the tumor can be surgically removed.
Magnetic resonance imaging (MRI): This test is obtained when further details of the liver and tumor anatomy are required. Through the use of a magnetic field, precise images of the liver can be obtained.
Paracentesis: With this procedure, a needle is placed into the abdominal cavity (but not into the liver) to remove excess abdominal fluid (ascites). This fluid can be tested for cancer cells or infection. Sometimes the fluid is removed in large quantities (for example, 3 to 5 quarts) in order to provide symptomatic relief.
Laparoscopy: This test is done in the operating room under general anesthesia. The surgeon guides a small camera through a half-inch incision in the abdomen. The organs in the abdomen can then be examined directly. This test is done to find out if the liver tumor has spread to other parts of the liver or other organs or structures inside the abdomen.