Cirrhotic Nodule Transformation to Hepatocellular Carcinoma: Natural History and Predictive Biomarkers on Contrast-Enhanced Ultrasound

Lin, Manxia; Lu, David; Duan, Yu; Liao, Pen An; Sayre, James W.; Xie, Xiaoyan; Kuang, Ming

doi:10.2214/ajr.19.21739

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…It was concluded that shorter contrast–arrival times in lesions compared with background liver was associated with a higher degree of malignancy [ 26 ]. A different study determined 0.5 s as the minimum difference in contrast arrival time between the nodule and liver as a criterion for HCC [ 27 ]. On the contrary, arterial phase iso- or hypo-enhancement and late arterial phase iso-enhancement were associated with a lower degree of malignancy [ 28 ].…”

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

“…CEUS advantages and disadvantages are summarized in Table 1 . In cases followed-up with CEUS or US, an increase in size or change in echogenicity indicates malignant transformation [ 27 ]. According to the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines, CEUS can be used in cases with inconclusive CT or MRI or if the patient is not suitable for biopsy, as well as for monitoring changes in enhancement in nodules requiring follow-up [ 23 ].…”

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

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Current Imaging Diagnosis of Hepatocellular Carcinoma

Chartampilas

Rafailidis

Georgopoulou

et al. 2022

Cancers

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Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer related death worldwide. Radiology has traditionally played a central role in HCC management, ranging from screening of high-risk patients to non-invasive diagnosis, as well as the evaluation of treatment response and post-treatment follow-up. From liver ultrasonography with or without contrast to dynamic multiple phased CT and dynamic MRI with diffusion protocols, great progress has been achieved in the last decade. Throughout the last few years, pathological, biological, genetic, and immune-chemical analyses have revealed several tumoral subtypes with diverse biological behavior, highlighting the need for the re-evaluation of established radiological methods. Considering these changes, novel methods that provide functional and quantitative parameters in addition to morphological information are increasingly incorporated into modern diagnostic protocols for HCC. In this way, differential diagnosis became even more challenging throughout the last few years. Use of liver specific contrast agents, as well as CT/MRI perfusion techniques, seem to not only allow earlier detection and more accurate characterization of HCC lesions, but also make it possible to predict response to treatment and survival. Nevertheless, several limitations and technical considerations still exist. This review will describe and discuss all these imaging modalities and their advances in the imaging of HCC lesions in cirrhotic and non-cirrhotic livers. Sensitivity and specificity rates, method limitations, and technical considerations will be discussed.

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Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%