Benign and malignant mimickers of infiltrative hepatocellular carcinoma: tips and tricks for differential diagnosis on CT and MRI

Vernuccio, Federica; Porrello, Giorgia; Cannella, Roberto; Vernuccio, Laura; Midiri, Massimo; Giannitrapani, Lydia; Soresi, Maurizio; Brancatelli, Giuseppe

doi:10.1016/j.clinimag.2020.10.011

Cited by 22 publications

(18 citation statements)

References 76 publications

(1 reference statement)

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“…BFGF, a polypeptide growth factor with a molecular weight of 15-16 kd and consisting of 146 amino acids [ 13 ], is located on human chromosome 4. It is a mitogen and an important angiogenic factor for cells of mesodermal and ectodermal origin [ 14 ]. It exerts physiological effects by binding to the cell surface specific receptor FGFR.…”

Section: Discussionmentioning

confidence: 99%

Correlation of CT Perfusion Parameters and Vascular Endothelial Growth Factor (VEGF) and Basic Fibroblast Growth Factor (BFGF) in Patients with Primary Liver Cancer

Chen

Zhang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the correlation of CT perfusion-related parameters with serum vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (BFGF) in patients with primary liver cancer. Methods. A total of 100 patients with primary liver cancer who were treated in our hospital from June 2019 to June 2021 were selected as the observation group, and 90 patients with benign liver lesions during the same period were selected as the control group. The CT perfusion-related parameters (perfusion volume and perfusion index) and serum VEGF and BFGF levels were compared between the two groups. Pearson correlation was used to analyze the correlation between CT perfusion-related parameters and serum VEGF and BFGF levels. Results. Compared to the control group, significantly higher HAP and lower HPP and TLP were observed in the observation group. The perfusion volume indexes of patients with different stages of liver cancer in the observation group were statistically different ( P < 0.05 ). Compared to the control group, the observation group witnessed significantly higher HAPI and lower HPPI. There were statistically significant differences in the perfusion index of patients with different stages of primary liver cancer in the observation group ( P < 0.05 ). The serum VEGF and BFGF levels in the observation group were significantly higher than those in the control group, and the serum VEGF and BFGF levels in patients with different stages of primary liver cancer in the observation group were statistically different ( P < 0.05 ). Pearson correlation analysis showed that HAP and HAPI were positively correlated with VEGF and BFGF (r = 0.986, P ≤ 0.001 ; r = 0.983, P ≤ 0.001 ), and HPP, TLP, and HPPI were negatively correlated with VEGF and BFGF (r = −0.992, P ≤ 0.001 ; r = -0.993, P ≤ 0.001 ; r = −0.995, P ≤ 0.001 ). Conclusion. CT perfusion-related parameters and serum VEGF and BFGF levels in patients with primary liver cancer are abnormally expressed, and there is a strong correlation between the two, which might aid clinical diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Correlation of CT Perfusion Parameters and Vascular Endothelial Growth Factor (VEGF) and Basic Fibroblast Growth Factor (BFGF) in Patients with Primary Liver Cancer

Chen

Zhang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Large or huge HCC is often found associated with infiltrative pathological characteristics, ie, micro- or macro-vascular invasion, 19 , 29 , 30 which is usually presented as a non-smooth tumor margin or macrovascular invasion at imaging. 24 , 31 In our study, huge HCC had a higher proportion of non-smooth tumor margin or macrovascular invasion than large HCC (85.7% vs 65.7%).…”

Section: Discussionmentioning

confidence: 99%

Drug-Eluting Bead Transarterial Chemoembolization Combined with FOLFOX-Based Hepatic Arterial Infusion Chemotherapy for Large or Huge Hepatocellular Carcinoma

Huang¹,

Huang²,

Zhan³

et al. 2021

JHC

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“…HPH has shown to increase sensitivity in liver observation assessment, even the small ones (10–19 mm). This last clinical scenario is particularly challenging, reaching a failure rate of 87% when only major criteria are identified in small liver lesions [ 179 ].…”

Section: Li-radsmentioning

confidence: 99%

“…Vernuccio et al recorded a sensitivity of 84% applying HPH to LR-3 small observations with APHE upgraded to the LR-4 category [ 180 ]. This sensitivity value resulted considerably higher compared to those of LI-RADS major criteria (from 0% to 35%) [ 179 ].…”

Section: Li-radsmentioning

confidence: 99%

A Narrative Review on LI-RADS Algorithm in Liver Tumors: Prospects and Pitfalls

et al. 2022

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Liver cancer is the sixth most detected tumor and the third leading cause of tumor death worldwide. Hepatocellular carcinoma (HCC) is the most common primary liver malignancy with specific risk factors and a targeted population. Imaging plays a major role in the management of HCC from screening to post-therapy follow-up. In order to optimize the diagnostic-therapeutic management and using a universal report, which allows more effective communication among the multidisciplinary team, several classification systems have been proposed over time, and LI-RADS is the most utilized. Currently, LI-RADS comprises four algorithms addressing screening and surveillance, diagnosis on computed tomography (CT)/magnetic resonance imaging (MRI), diagnosis on contrast-enhanced ultrasound (CEUS) and treatment response on CT/MRI. The algorithm allows guiding the radiologist through a stepwise process of assigning a category to a liver observation, recognizing both major and ancillary features. This process allows for characterizing liver lesions and assessing treatment. In this review, we highlighted both major and ancillary features that could define HCC. The distinctive dynamic vascular pattern of arterial hyperenhancement followed by washout in the portal-venous phase is the key hallmark of HCC, with a specificity value close to 100%. However, the sensitivity value of these combined criteria is inadequate. Recent evidence has proven that liver-specific contrast could be an important tool not only in increasing sensitivity but also in diagnosis as a major criterion. Although LI-RADS emerges as an essential instrument to support the management of liver tumors, still many improvements are needed to overcome the current limitations. In particular, features that may clearly distinguish HCC from cholangiocarcinoma (CCA) and combined HCC-CCA lesions and the assessment after locoregional radiation-based therapy are still fields of research.

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Benign and malignant mimickers of infiltrative hepatocellular carcinoma: tips and tricks for differential diagnosis on CT and MRI

Cited by 22 publications

References 76 publications

Correlation of CT Perfusion Parameters and Vascular Endothelial Growth Factor (VEGF) and Basic Fibroblast Growth Factor (BFGF) in Patients with Primary Liver Cancer

Correlation of CT Perfusion Parameters and Vascular Endothelial Growth Factor (VEGF) and Basic Fibroblast Growth Factor (BFGF) in Patients with Primary Liver Cancer

Drug-Eluting Bead Transarterial Chemoembolization Combined with FOLFOX-Based Hepatic Arterial Infusion Chemotherapy for Large or Huge Hepatocellular Carcinoma

A Narrative Review on LI-RADS Algorithm in Liver Tumors: Prospects and Pitfalls

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