Contrast enhanced CT-scan to diagnose intrahepatic cholangiocarcinoma in patients with cirrhosis

Iavarone, M.; Piscaglia, Fabio; Vavassori, S.; Galassi, M.; Sangiovanni, A.; Venerandi, Laura; Forzenigo, L.V.; Golfieri, Rita; Bolondi, Luigi; Colombo, Massimo

doi:10.1016/j.jhep.2013.02.013

Cited by 114 publications

(94 citation statements)

References 21 publications

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“…If MF-iCCA occurs in context of cirrhotic liver, after exclusion of a metastatic lesion, differential diagnosis with HCC is obligatory 4,5 . In this context, contrast-enhanced MRI studies on patients with iCCA show a lack of HCC hallmarks (such as contrast medium wash-in in the arterial phase followed by wash-out in the late phase) in all cases; however, by CT, this finding occurs only in large nodules (>3 cm) as smaller nodules frequently show a pattern of contrast medium wash-in and wash-out similar to HCC [198][199][200] . The most frequent imaging patterns displayed by iCCA in the cirrhotic liver are a progressive homogeneous contrast uptake until the delayed (around 5ʹ) phase (MRI, CT) or an arterial peripheral-rim enhancement (CT) 198,199 .…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

“…In this context, contrast-enhanced MRI studies on patients with iCCA show a lack of HCC hallmarks (such as contrast medium wash-in in the arterial phase followed by wash-out in the late phase) in all cases; however, by CT, this finding occurs only in large nodules (>3 cm) as smaller nodules frequently show a pattern of contrast medium wash-in and wash-out similar to HCC [198][199][200] . The most frequent imaging patterns displayed by iCCA in the cirrhotic liver are a progressive homogeneous contrast uptake until the delayed (around 5ʹ) phase (MRI, CT) or an arterial peripheral-rim enhancement (CT) 198,199 . Currently, identifi cation of rare primitive liver cancers -such as HCC with stem cell features (CK19 + HCC), cholangiolocellular carcinoma and combined HCC-CCA -by imaging procedures is still a challenge 17,201 .…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

Bañales

Cardinale

Carpino

et al. 2016

Nat Rev Gastroenterol Hepatol

1,064

1,139

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Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

Bañales

Cardinale

Carpino

et al. 2016

Nat Rev Gastroenterol Hepatol

1,064

1,139

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“…Four included studies described the dynamic postcontrast imaging features of ICC on CT and MR images with extracellular and hepatobiliary contrast agents (112)(113)(114)(115). While there are varying descriptions of APHE patterns, treatment.…”

Section: Review: Li-rads Major Features For Hepatocellular Carcinoma mentioning

confidence: 99%

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

et al. 2018

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The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). It assigns category codes reflecting relative probability of HCC to imaging-detected liver observations based on major and ancillary imaging features. LI-RADS also includes imaging features suggesting malignancy other than HCC. Supported and endorsed by the American College of Radiology (ACR), the system has been developed by a committee of radiologists, hepatologists, pathologists, surgeons, lexicon experts, and ACR staff, with input from the American Association for the Study of Liver Diseases and the Organ Procurement Transplantation Network/United Network for Organ Sharing. Development of LI-RADS has been based on literature review, expert opinion, rounds of testing and iteration, and feedback from users. This article summarizes and assesses the quality of evidence supporting each LI-RADS major feature for diagnosis of HCC, as well as of the LI-RADS imaging features suggesting malignancy other than HCC. Based on the evidence, recommendations are provided for or against their continued inclusion in LI-RADS.q RSNA, 2017 Online supplemental material is available for this article.An Tang REVIEW: LI-RADS Major Features for Hepatocellular Carcinoma DiagnosisTang et al selection of five major features was based on expert opinion, the literature review was performed to ensure that imaging-based diagnostic criteria were able to achieve near-100% specificity for the noninvasive diagnosis of HCC. This review focused on the evidence supporting the inclusion of imaging features and did not attempt to gather evidence on the composition of the LI-RADS diagnostic algorithm and probability of HCC for different combinations of criteria (other than the hallmark combination of APHE and washout appearance) in the LI-RADS diagnostic table.Each subgroup was charged with developing key research questions and then critically reviewing the literature to answer research questions thematically related to its assigned topic. Search StrategyThe PICO (patient population, intervention, comparison, and outcome) format frequently used in structured reviews does not lend itself well to studies of diagnostic performance. Rather than using PICO-style questions to guide the searches, therefore, the subgroups formulated free-form questions in advance with feedback from the other subgroups. A total of 10 questions were formulated under the framework and with the understanding that their answers would inform recommendations for removing or continuing to include the corresponding LI-RADS features. After the questions were formulated, each subgroup searched the PubMed develop a standardized Liver Imaging Reporting and Data System (LI-RADS) for interpretation, reporting, and data collection of imaging studies in patients at risk for developing HCC (1). The committee was composed mainly of diagnostic radiologists, but also hepatologists, surgeons, patho...

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“…Smaller nodules of CCA often have an enhancement and wash-out pattern similar to HCC. 58,59 10. Answers: A, B and C Cirrhotic patients who are malnourished are more likely to have portal hypertension, portosystemic collaterals, and varices.…”

Section: Answers: B and Cmentioning

confidence: 99%

Hepatobiliary Quiz Answers – 18 (2016)

Rathi

Dhiman

2016

Journal of Clinical and Experimental Hepatology

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Contrast enhanced CT-scan to diagnose intrahepatic cholangiocarcinoma in patients with cirrhosis

Cited by 114 publications

References 21 publications

Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

Hepatobiliary Quiz Answers – 18 (2016)

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