HCC
Primary liver cancer
Hepatocellular carcinoma begins in liver cells and often develops in a liver already affected by cirrhosis or chronic disease. Imaging pattern and liver reserve are central to planning.
Cancer care · Interventional oncology
Liver CancerSee the whole picture before choosing a treatment.
Selected primary and metastatic liver tumors can be treated through a tiny access point or precisely targeted under imaging. The first question is whether one of those options fits your diagnosis, liver function, anatomy, and broader cancer plan.
Already have a CT or MRI? Bring the images and report. A specialist can review them in the context of your oncology plan.
- Board-certified specialists
- Multidisciplinary planning
- Three Los Angeles-area clinics
Imaging review · Liver-directed care
Not every liver tumor is treated the same.Primary cancer, metastatic disease, and benign lesions follow different paths.
The treatment decision has four anchors.Tumor type · tumor burden · liver reserve · goals
01
Diagnosis before procedureThe scan and cancer type guide the conversation.
02
Liver function mattersTreatment must protect the healthy liver that remains.
03
One coordinated planImage-guided care works alongside—not outside—your cancer team.
A liver tumor is not one diagnosis.
A spot on the liver can represent a primary liver cancer, a cancer that spread from somewhere else, or a noncancerous lesion. Even after cancer is confirmed, the best treatment depends on how much liver is involved, how well the liver is working, whether disease is present elsewhere, and what the full care team is trying to accomplish.
EVSLA evaluates the image-guided part of that decision. A consultation may lead to liver-directed treatment, additional workup, coordination with another specialist, or the conclusion that an interventional procedure is not the right next step.
Clinical context: National Cancer Institute · AASLD · RadiologyInfo
ICC
Intrahepatic bile duct cancer
Cholangiocarcinoma that begins inside the liver has a different biology and treatment pathway. Liver-directed therapy may be considered only in selected situations.
MET
Metastatic tumors in the liver
These began elsewhere—such as the colon, breast, lung, or neuroendocrine system. The original cancer type and disease beyond the liver shape the plan.
The key distinction: “Liver cancer” and “cancer in the liver” do not always mean the same thing. That difference changes the treatment goal and which options belong in the conversation.
Sometimes there are symptoms. Often, the scan speaks first.
Early liver cancer may not cause obvious symptoms. Many tumors are found during surveillance, imaging for another concern, or follow-up of a different cancer.
Surveillance imaging
People with cirrhosis or certain chronic liver conditions may have regular ultrasound and blood testing that identifies a new concern.
An unexpected scan finding
A liver lesion may appear on ultrasound, CT, MRI, or PET imaging ordered for another symptom or health question.
Symptoms or lab changes
Upper-right abdominal discomfort, fullness, low appetite, unintended weight loss, fatigue, or jaundice can prompt evaluation—but none is specific to cancer.
Another cancer is being followed
Imaging may identify liver lesions during staging, treatment response assessment, or surveillance for a cancer that began elsewhere.
Know when not to wait.
Contact your cancer or liver team promptly for new or worsening jaundice, confusion, fever, vomiting blood, black stools, or severe abdominal pain. Call 911 for severe or life-threatening symptoms.
Make the scan, liver function, and cancer plan agree.
A procedure can be technically possible and still not be the right treatment. EVSLA reviews the images and clinical context together before recommending a path.
Request a Case Review1
Confirm what the imaging is showing
Multiphasic contrast CT or MRI can help characterize a lesion, map its relationship to vessels and bile ducts, and show the number and distribution of tumors. Prior studies help reveal change over time.
2
Establish the tumor type when needed
Some hepatocellular cancers can be diagnosed from characteristic imaging in at-risk patients. Other lesions may require biopsy or review of pathology from the cancer’s original site.
3
Measure liver reserve and overall fitness
Laboratory results, cirrhosis or portal hypertension, symptoms, kidney function, medications, and general health help determine what the liver and the patient can safely tolerate.
4
Define the goal with the larger team
The goal may be cure in a highly selected case, local control, downstaging, bridging to transplant, symptom relief, or support of a broader systemic treatment plan. The role of interventional radiology changes with that goal.
Three liver-directed options. Three different jobs.
Y90, microwave ablation, and TACE are not competing versions of the same treatment. Each approaches the tumor differently, and each has its own planning, safety, and follow-up requirements.
Treatment is a pathway—not a menu.Your team may recommend surgery, transplant, medication, external radiation, observation, supportive care, or a combination instead of or alongside an image-guided procedure.
Y90 Radioembolization
A small catheter is guided into the liver’s arterial supply to deliver radiation-containing microspheres close to selected tumors while limiting exposure to the rest of the body.
May enter the conversation when
Explore Y90 Radioembolization A primary or metastatic liver tumor is suited to arterial treatment and the mapping study, vascular anatomy, liver reserve, and broader oncology plan support it.
Microwave Ablation
Using CT or ultrasound guidance, a specialist places a thin antenna into the tumor and uses heat to destroy targeted tissue without removing part of the liver.
May enter the conversation when
Explore Microwave Ablation There are a limited number of smaller tumors in locations that can be safely reached and treated while protecting major vessels, bile ducts, bowel, and diaphragm.
TACE
Transarterial chemoembolization delivers chemotherapy into the artery feeding a tumor and then reduces that blood flow, concentrating treatment in the liver.
May enter the conversation when
Explore TACE Selected liver-dominant tumors—commonly certain hepatocellular cancers—are not suited to surgery or ablation and liver function is adequate for embolization.
The right option is chosen from the whole case.
No single scan measurement decides eligibility. A specialist combines imaging, laboratory results, prior care, and the intended treatment goal.
Primary cancer type and pathologyNumber, size, and location of tumorsLiver function and portal hypertensionVascular and biliary anatomyDisease elsewhere in the bodyPrior treatment and current goals
Bring the records. Leave with a clearer next step.
A focused review is most helpful when the specialist can see the actual images and understand what the rest of your care team has recommended.
Bring when available
- CT, MRI, ultrasound, or PET images through a portal, link, or disc—not only the written report
- Pathology reports and the location of any tissue samples
- Recent liver, kidney, blood count, and clotting laboratory results
- Prior surgery, radiation, chemotherapy, immunotherapy, or liver-directed treatment records
- Your current medication list and the questions you want answered
Your specialist will consider
- Whether the diagnosis and stage are sufficiently clear
- What outcome the cancer team is trying to achieve
- Whether a liver-directed procedure adds meaningful benefit
- Which option offers the best balance of tumor coverage and healthy-liver protection
- What coordination, preparation, recovery, and imaging follow-up would be required
Share the clinical question
Tell the scheduling team your diagnosis, where you are in care, and which records are available.
Review the imaging
The specialist evaluates the tumor pattern, anatomy, liver reserve, and treatment context.
Coordinate the recommendation
When appropriate, EVSLA aligns the interventional plan with your oncology or liver team.
Know what comes next
You receive a clear explanation of fit, alternatives, preparation, recovery, and follow-up.
A consultation is a decision-making visit. It does not commit you to a procedure.
Image-guided expertise, connected to the rest of your care.
EVSLA’s board-certified interventional radiologists evaluate the imaging, explain whether a liver-directed option may fit, and coordinate next steps with the clinicians already treating your cancer.
Harout Dermendjian, MD
Board-Certified Vascular & Interventional RadiologistHis specialty training includes oncology and other image-guided treatments, with a direct, steady approach to complex decisions.
Meet Dr. Dermendjian
Kartik Kansagra, MD
Board-Certified Vascular & Interventional RadiologistHe brings clear communication and a collaborative approach to complex vascular and minimally invasive image-guided care.
Meet Dr. Kansagra
Sipan Mathevosian, MD
Board-Certified Interventional & Diagnostic RadiologistHis UCLA fellowship training and interventional oncology experience support careful planning for selected embolization and ablation cases.
Meet Dr. MathevosianYou do not need to choose a physician before requesting care. EVSLA will help route the case based on the clinical question, records, and availability.
Start the conversation close to home.
Choose the clinic most convenient for your evaluation. Procedure location and availability depend on the treatment and clinical need, and the scheduling team will confirm the appropriate site.
Location 03
La Cañada Flintridge
1407 Foothill Blvd
La Cañada Flintridge, CA 91011
Common questions about liver cancer care.
Clear answers about diagnosis, eligibility, coordination, and what to bring to a consultation.
Does every liver tumor need treatment?
No. Some liver lesions are benign, and some cancers are best observed or treated in another way. The right next step depends on what the lesion is, how much of the liver is involved, liver function, overall cancer stage, symptoms, and goals.
How do I know whether Y90, microwave ablation, or TACE is right for me?
A specialist reviews the cancer type, number, size and location of tumors, liver function, vascular anatomy, disease outside the liver, prior treatments, and the larger oncology plan. These procedures are not interchangeable, and some patients are better served by surgery, transplant, medication, radiation, observation, or supportive care.
What is the difference between primary and metastatic liver cancer?
Primary liver cancer begins in the liver. Metastatic liver cancer began in another organ and later spread to the liver. That distinction changes staging, treatment goals, and which specialists and therapies should be involved.
Will I need a liver biopsy before treatment?
Not always. In some at-risk patients, hepatocellular carcinoma can be diagnosed using characteristic findings on multiphasic CT or MRI. Other lesions may require tissue diagnosis. Your team decides based on the imaging, medical history, and how the result would change care.
Does an EVSLA consultation replace my oncologist or liver specialist?
No. Image-guided liver treatment is usually one part of multidisciplinary care. EVSLA can review the interventional radiology options and coordinate recommendations with oncology, hepatology, surgery, transplant, radiation oncology, and other members of your care team as appropriate.
What should I bring to a liver tumor consultation?
Bring the actual CT, MRI, or PET images when possible, not only the reports. Also bring pathology results, recent laboratory results, a medication list, prior cancer treatment records, and the questions you want answered.
Can image-guided treatment cure liver cancer?
Some ablation procedures may be used with curative intent for carefully selected small tumors. Other liver-directed treatments may be used to control disease, reduce tumor burden, bridge to transplant, support downstaging, or relieve symptoms. The intended goal and expected benefit must be individualized.
Will insurance cover a consultation or liver-directed treatment?
Coverage depends on your plan, network, diagnosis, medical necessity, referrals, and prior authorization requirements. EVSLA can review available benefit information, but verification is not a guarantee of payment.
Find out whether liver-directed treatment belongs in your plan.
Share where you are in the process and what imaging you have. EVSLA can help coordinate an evaluation and explain what records are needed before the visit.
Request Consultation Call (818) 626–3710Requesting a consultation does not guarantee eligibility for a procedure.