[Small hepatocellular carcinoma : Diagnostics according to guidelines and established in the clinical setting].

Clinical/methodical issue: The diagnosis of hepatocellular carcinoma (HCC)-especially the characterization of small lesions <2 cm-continues to be a radiological challenge.

Standard radiological methods: In the current S3 guideline on diagnosis and therapy of HCC, contrast-enhanced imaging examinations, such as contrast-enhanced ultrasonography (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI), are still the diagnostic standard.

Methodological innovations: HCC in the cirrhotic liver should be diagnosed by its typical contrast-enhanced pattern in the MRI. In addition, the use of quality assurance instruments such as LI-RADS (Liver Imaging Reporting and Data System) contributes to the desired consistency of findings, even with small ambiguous findings.

Performance: Many studies have shown that the LI-RADS classification reflects the likelihood of HCC and other malignant liver lesions.

Achievements: Guidelines and quality assurance instruments contribute to a more precise diagnosis in patients with suspected HCC.

Practical recommendations: A guideline-compliant diagnostic algorithm and the LI-RADS should be used across the board for accurate HCC diagnostics.