Hello Khalid R. Majeed

Tissue sample is essential as it can identify the cell type of the tumor, and, increasingly, they can be used to determine whether a patient’s tumor contains particular genetic alterations that may make them candidates for targeted therapies. However, tissue sample would require invasive procedures such as surgery. Moreover, after the initial testing and analysis, not enough additional tissue may be left for comprehensive molecular profiling, or it may also happen that the tissue may not be of sufficient quality for molecular profiling.

So, to overcome these drawbacks, you could gather genetic information about a patient’s cancer, by capturing and analyzing DNA and other types of genetic material released by the tumor cells into the blood. You could use circulating tumor DNA (ctDNA) that are released into a person's blood by tumor cells as they die. A sample of blood can be used to look for and measure the amount of ctDNA and identify specific mutations (changes) in the DNA. It may be of great help as comprehensive molecular profiling can be made available to both patients and physicians and can be a great source of additional tumor genetic information when tissue samples are not available.

Also, for patients with advanced cancer, such blood tests using ctDNA may be most valuable to help monitor changes in patient’s disease over time and direct treatments when tumor recur or progress. Some studies also suggest that it may eventually be able to help direct care for patients with earlier-stage disease or help monitor disease progression in people with precancerous lesions.

Best.

Surveillance of high-risk individuals for HCC is commonly performed using the serum marker alfa-fetoprotein (AFP) often in combination with ultrasonography,Various other serologic markers are currently being tested to help improve surveillance accuracy. Diagnosis of HCC often requires more sophisticated imaging modalities such as CT scan and MRI, which have multiphasic contrast enhancement capabilities. Serum AFP used alone can be helpful if levels are markedly elevated, which occurs in fewer than half of cases at time of diagnosis. Confirmation by liver biopsy can be performed under circumstances when the diagnosis of HCC remains unclear.