Liver cancer occurs when cells of the liver grow uncontrollably and form a lump called a tumor or mass.

The liver is a large organ that sits under your ribs on the right side of the body. It serves many important functions such as:

  • helping your body store nutrients
  • digesting fats
  • healing wounds
  • breaking down medications

There are many different types of liver cancer. The most common type is called hepatocellular carcinoma.

If a doctor or healthcare professional thinks you might have liver cancer, they may request an ultrasound as one of several tests they use to confirm a diagnosis.

An ultrasound scan is an imaging test. It captures live, detailed images of your liver using high frequency sound waves. An ultrasound can help a doctor see if a tumor is growing in your liver.

Who gets liver cancer?

In the United States, liver cancer occurs more often in men than in women. It’s also more common in Asian Americans, American Indians, and Alaskan Natives.

The American Cancer Society estimates that there will be 41,260 new cases of liver cancer in the United States in 2022.

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An ultrasound scan works by transmitting a beam of sound waves into your body. It then records the waves that echo back. It’s also called sonography or ultrasonography.

During the exam, a sonographer or ultrasound technician places a small probe on your skin. The probe transmits the sound waves into the area of the body they want to examine. When these sound waves hit a boundary between tissues, they reflect back to the probe.

Sound waves bounce off different substances with varying speeds and intensities. For example, they pass through a fluid-filled cyst and send back very few echoes. But when they hit a solid tumor, the sound waves bounce more intensely.

A computer interprets this information to create a two-dimensional image on a screen.

There are many tests a doctor can use to help diagnose liver cancer. An ultrasound scan is often the first test they’ll use to look at your liver.

A doctor might want to do an ultrasound if you have any symptoms of liver disease. These include:

  • unexplained weight loss
  • swelling in the stomach
  • feeling full without eating much
  • nausea or vomiting
  • weakness
  • jaundice

If an ultrasound test shows tumors or masses on the liver, a doctor can further test these spots to check for cancer.

There are many benefits to using an ultrasound scan before other imaging tests.

In general, ultrasounds:

  • don’t require special preparation
  • are quick and painless
  • typically cost less than other imaging tests
  • don’t use radiation
  • can be done as an outpatient procedure
  • are widely available
  • are portable

Using ultrasound scans to screen for liver cancer

Even if you don’t have any symptoms, a doctor may want to perform regular ultrasound scans if you’re at a higher risk of liver cancer because of other underlying conditions.

These underlying conditions include:

Routine ultrasound scans can help find cancer in the earlier stages. Early detection could help improve your outcome.

If you have any health conditions that could increase your risk of liver cancer, ask a doctor if you’re a candidate for regular screenings.

Is an ultrasound alone enough to diagnose liver cancer?

Ultrasound alone isn’t enough to diagnose liver cancer. Ultrasounds can’t find all tumors, and they often miss many cancers when they’re still small.

An ultrasound scan also can’t tell the difference between a benign (noncancerous) tumor and a malignant (cancerous) tumor. And fatty tissue in the liver can also affect how well a doctor can see masses on the liver during an ultrasound.

For these reasons, doctors will often combine ultrasound imaging with other tests. They’ll consider the results of all tests before making a diagnosis.

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If there are tumors on your liver, an ultrasound scan will show a spot on the computer screen that stands out from the background liver tissue.

But liver tumors aren’t the only thing that can show up as spots on the liver during an ultrasound. Other possibilities include:

  • cysts
  • fatty liver tissue
  • liver abscesses
  • liver scarring

In general, doctors characterize spots on your liver as:

  • darker than background liver tissue (hypoechoic)
  • similar to background liver tissue (isoechoic)
  • brighter than background liver tissue (echogenic or hyperechoic)

Tumors could appear as bright or dark spots on the liver during an ultrasound. A doctor will look at various factors, such as size, shape, and other complex characteristics, to help differentiate between a solid tumor and other conditions.

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An ultrasound test is a simple procedure that usually takes 20 to 30 minutes. It takes place in a doctor’s office, clinic, or hospital.


Usually, you won’t need any special preparation for a liver ultrasound. In some cases, a doctor might ask you not to eat for up to 8 hours before the test.

Consider planning to arrive at least 15 minutes before your appointment time. Wearing loose-fitting clothing can also help the test go more smoothly. They might ask you to change into a hospital gown before the test.


An ultrasound technician or a doctor known as a medical sonographer performs the test.

Here are the steps:

  1. You’ll lie down on a table.
  2. The doctor or technician will put a water-based gel on your skin.
  3. The doctor or technician will place a hand-held instrument called a transducer over your abdomen, where your liver is located. The gel may feel cool.
  4. The doctor or technician will move the transducer around while firmly pressing it to the skin of your abdomen. You might feel slight pressure from the transducer, but it shouldn’t be painful.
  5. Once the imaging is complete, they’ll wipe the gel off your skin.

After the test

You won’t need any aftercare following an ultrasound test. You’re free to go home and eat and drink normally.

A sonographer typically won’t discuss your results with you. You’ll have to wait for a doctor to follow up with you. In some cases, a doctor might discuss the results with you right away, or this might take a few days or weeks.

If your test reveals lesions or masses on the liver, a doctor might want to repeat the test. They may also have you schedule a follow-up appointment for more tests.

A liver ultrasound is a safe, noninvasive procedure. Doctors have used it for decades with an excellent safety record.

Because ultrasound scans might depend on the technician’s skill level, a misdiagnosis is possible.

For this reason, an ultrasound test isn’t the only test a doctor will use to help diagnose liver cancer.

An ultrasound test isn’t enough on its own to diagnose liver cancer. You’ll need other tests, too.

A doctor may combine the ultrasound with a blood test for high alpha-fetoprotein (AFP). AFP is a protein often present on liver cancer cells. Research shows that testing for this biomarker significantly improves detection of early stage liver cancer.

If the ultrasound scan shows solid tumors in the liver, a doctor will likely want to do more imaging tests. They may order a CT scan or MRI to get more detailed images of your liver.

They may also need to do a liver biopsy to know for sure if the mass in the liver is cancer. A biopsy is a minor surgical procedure that involves taking a small piece of your liver to test it for cancer in a laboratory.

Ultrasound ablation as treatment for liver cancer

Doctors can also use ultrasound technology to help treat liver cancer. Ablation is a procedure that doctors use to destroy abnormal tissue.

High intensity focused ultrasound (HIFU) is a type of ablation procedure that focuses ultrasound energy on the tumor. The heat created by HIFU kills the cancer cells.

A doctor might recommend HIFU if you have only a few small tumors and surgery isn’t a good option.

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An ultrasound test is one test used to diagnose liver cancer. It uses sound waves to create an image of the liver. But it’s not the only test a doctor will use to make a diagnosis.

A doctor might want to do an ultrasound of the liver if you’re having symptoms of liver cancer, or they may want to do an ultrasound once or twice a year if you’re at high risk of liver cancer.

Liver cancer is often treatable. Once you receive a diagnosis, speak with a doctor about treatment options.

Resources for support

It’s important to connect with people who understand the stress caused by a liver cancer diagnosis. Ask a doctor about support groups in your area or try contacting the following organizations to locate a support group:

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