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Review
. 2025 Oct:191:112271.
doi: 10.1016/j.ejrad.2025.112271. Epub 2025 Jun 27.

Role of imaging-guided biopsy for hepatocellular carcinoma

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Free article
Review

Role of imaging-guided biopsy for hepatocellular carcinoma

Roberto Cannella et al. Eur J Radiol. 2025 Oct.
Free article

Abstract

Percutaneous imaging-guided biopsy of hepatocellular carcinoma (HCC) is a relatively safe procedure with an established diagnostic role, and a growing value in providing prognostic and treatment information for patient's management. Because of the high specificity and positive predictive value of tumoral features on cross-sectional imaging studies, the number of biopsies performed for HCC is limited to certain specific clinical scenarios. However, routine imaging fails to fully capture the tumor's molecular heterogeneity, and as research unravels the potential of tumoral histopathological and molecular stratification, biopsy is poised to transition from a diagnostic tool to a powerful prognostication instrument, contributing to guiding personalized treatment management for patients with HCC. In this review paper, we explore the role of percutaneous, imaging-guided biopsy in the diagnosis, prognosis, and treatment of HCC.

Keywords: Hepatocellular carcinoma; Image-guided biopsy; Liver cirrhosis; Liver neoplasm; Prognostic markers.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. R.C. has the following disclosures: speaker for Bayer; support for attending meetings from Bracco and Bayer; had research collaboration with Siemens Healthineers.

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