In short
Specialised liver CT or MRI can diagnose hepatocellular carcinoma without a biopsy in many people with cirrhosis. An AFP blood test may be raised but is not reliable on its own. A biopsy is used when imaging is unclear or a different cancer is possible. This is general information. A liver specialist interprets the scans.
The liver is a common place for other cancers to spread. Imaging and history distinguish primary liver cancer from metastases.
Why might I not need a biopsy?
In cirrhosis, a typical pattern on contrast MRI or CT is accepted as diagnostic for hepatocellular carcinoma in UK practice. That avoids the bleeding risk of a needle through a damaged liver.
What does AFP measure?
Alpha-fetoprotein can be raised in liver cancer. It is also raised for other reasons. It is a helper, not a screening test for the general public.
Help a patient afford cancer care
Gifts go to the Cancer Emergency Appeal’s wider fund for patients who cannot pay. They do not buy a guaranteed treatment or result.
Donate to cancer careWhat other tests are done?
Hepatitis B and C tests, liver function, and an assessment of cirrhosis (including whether transplant might be possible) shape the treatment plan.
Key takeaways
- Specialist MRI or CT often confirms hepatocellular carcinoma.
- AFP is not a stand-alone test.
- Hepatitis status changes treatment and prevention for others in the family.
Care like this is out of reach for millions
The diagnosis, screening and treatment described here are routine in the UK. In Pakistan, Indonesia and Malaysia, poverty can put them out of reach. The Cancer Emergency Appeal raises funds towards clinically recommended care for patients who cannot pay; gifts go to the wider fund and do not buy a guaranteed treatment or result.
Frequently asked questions
Is ultrasound enough?
It is used for surveillance. A mass still needs CT or MRI.
Why test for hepatitis?
Untreated infection drives liver cancer and can be treated. Household contacts may need vaccination.
Does WAN diagnose liver cancer in the UK?
No. We fund overseas treatment bills.
Editorial summary of published sources. A named oncology clinician has not signed off this guide. Use it to prepare questions for your healthcare team, not to diagnose symptoms or choose treatment. Editorial responsibility: Kaiser Khan. Updated 4 October 2026.
What are the sources for this guide?
Follow the original guidance for its evidence, dates and limitations. General background references are not a clinical review of this page.