Correlation between Dynamic Computed Tomographic and Histopathological Findings in the Diagnosis of Small Hepatocellular Carcinoma

Sakabe, Katsu; Yamamoto, Takatsugu; Kubo, Shoji; Hirohashi, Kazuhiro; Hamuro, Masao; Nakamura, Kenji; Inoue, Yuichi; Kaneda, Kenji; Suehiro, Shigefumi

doi:10.1159/000082318

Cited by 21 publications

(10 citation statements)

References 57 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diagnosis of HCC in the early stage and surgical resection of the tumor or transplantation of the liver substantially increase patient survival (3). However, there is considerable overlap of computed tomography (CT) (2, 4-10) and magnetic resonance imaging (MRI) (9, 11-21) appearances of prominent regenerative nodules, dysplastic nodules and well-differentiated HCCs.…”

mentioning

confidence: 99%

SPIO-Enhanced MRI Findings of Well-Differentiated Hepatocellular Carcinomas: Correlation with MDCT Findings

et al. 2009

View full text Add to dashboard Cite

ObjectiveThis study was designed to assess superparamagnetic iron oxide (SPIO)-enhanced MRI findings of well-differentiated hepatocellular carcinomas (HCCs) correlated with their multidetector-row CT (MDCT) findings.Materials and MethodsSeventy-two patients with 84 pathologically proven well-differentiated HCCs underwent triple-phase MDCT and SPIO-enhanced MRI at a magnetic field strength of 1.5 Tesla (n = 49) and 3.0 Tesla (n = 23). Two radiologists in consensus retrospectively reviewed the CT and MR images for attenuation value and the signal intensity of each tumor. The proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2*-weighted images were compared in terms of tumor size (< 1 cm and > 1 cm), five CT attenuation patterns based on arterial and equilibrium phases and magnetic field strength, by the use of univariate and multivariate analyses.ResultsSeventy-eight (93%) and 71 (85%) HCCs were identified by CT and on SPIO-enhanced T2- and T2*-weighted images, respectively. For the CT attenuation pattern, one (14%) of seven isodense-isodense, four (67%) of six hypodense-hypodense, four (80%) of five isodense-hypodense, 14 (88%) of 16 hyperdense-isodense and 48 (96%) of 50 hyperdense-hypodense HCCs were hyperintense (Cochran-Armitage test for trend, p < 0.001). Based on the use of multivariate analysis, the CT attenuation pattern was the only factor that affected the proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2*-weighted images (p < 0.001). Tumor size or magnetic field strength was not a factor that affected the proportion of hyperintense HCCs based on the use of univariate and multivariate analysis (p > 0.05).ConclusionMost well-differentiated HCCs show hyperintensity on SPIO-enhanced MRI, although the lesions show various CT attenuation patterns. The CT attenuation pattern is the main factor that affects the proportion of hyperintense well-differentiated HCCs as depicted on SPIO-enhanced MRI.

show abstract

mentioning

confidence: 99%

SPIO-Enhanced MRI Findings of Well-Differentiated Hepatocellular Carcinomas: Correlation with MDCT Findings

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Most of them proved that the tumor cellular differentiation was well correlated with imaging findings [29][30][31]; nevertheless this correlation has not been included in this study.…”

Section: Discussionmentioning

confidence: 99%

Contrast enhanced ultrasound and magnetic resonance imaging in hepatocellular carcinoma diagnosis

Dumitrescu

Gheonea²,

Săndulescu

et al. 2013

Med Ultrason

View full text Add to dashboard Cite

Background: The new developments in imaging technology, including contrast enhanced ultrasound (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI), allow a better diagnosis of both malignant and benign liver lesions. Material and methods: A retrospective trial of 126 patients was conducted in the Gastroenterology and Imaging Departments of the University of Medicine and Pharmacy Craiova, Romania. CEUS and MRI were the imaging techniques used for diagnosis of focal liver lesions (FLL), especially for hepatocellular carcinoma (HCC). Histopathology was used only in 15 cases. For each method of investigation we calculated the sensitivity, specificity, positive and negative predictive values (PPV and NPV), positive and negative likelihood ratio (+LR, -LR), accuracy and we compared the ROC curves. Statistical analysis also included the Chi-square and Kappa tests. Results: Seventy six cases were diagnosed as HCC, with average size of 5.2±3.3 cm in diameter. The sensitivity and specificity were 71.4% and 95.6% for CEUS and 91.4%, 98.9% respectively, for MRI. When comparing the ROC curves, we found a higher area under curve for MRI (0.952) then for CEUS (0.835) (p=0.005), and 95% confidence interval of 0.0343 to 0.199. No statistically significant difference in diagnosis of FLL was found between CEUS and MRI (p > 0.05) and the agreement between the two imaging techniques was good (k = 0.78). Conclusions: CEUS can be used as the first step in the diagnosis of liver lesions, but MRI remains the gold standard diagnostic method for liver tumors.

show abstract

“…There is a clear sequence of lesions that precede the emergence of hepatocellular carcinoma (HCC) 1–5 . The earliest lesion is multifocal low‐grade dysplasia in which clusters of hepatocytes are found with similar phenotype but differing from hepatocytes in adjacent tissue.…”

Section: International Working Party Histologic Criteria To Distinguimentioning

confidence: 99%

“…There is a clear sequence of lesions that precede the emergence of hepatocellular carcinoma (HCC). [1][2][3][4][5] The earliest lesion is multifocal low-grade dysplasia in which clusters of hepatocytes are found with similar phenotype but differing from hepatocytes in adjacent tissue. The nuclear atypia is either minimal or not evident, although the uniformity of the nuclei and the exclusion of older polyploid nuclei is a clue to the presence of this form of dysplasia.…”

mentioning

confidence: 99%

International consensus on histologic diagnosis of early hepatocellular neoplasia

Wanless

2007

Hepatology Research

View full text Add to dashboard Cite

1. The precursor lesions for the development of hepatocellular carcinoma are believed to be high-grade dysplastic nodules. These lesions have atypical and proliferative features that distinguish them from normal or cirrhotic liver but are not sufficient for the diagnosis of carcinoma. 2. Individual HGDN are often heterogeneous and complete sampling may reveal regions of carcinoma within these otherwise benign lesions. 3. Invasion of stroma is considered a definitive feature of HCC. However, this feature is not always present in early HCC and is seldom found in needle biopsies. 4. Accurate diagnosis of dysplastic nodules and well-differentiated HCC requires skill and experience. However, accurate diagnosis with needle biopsies may be impossible if the highest grade of atypia is not sampled. Fine needle aspiration is not appropriate for small lesions that are expected to be early hepatic neoplasia. This technique should be reserved for suspected moderate- or poorly differentiated HCC.

show abstract

Correlation between Dynamic Computed Tomographic and Histopathological Findings in the Diagnosis of Small Hepatocellular Carcinoma

Cited by 21 publications

References 57 publications

SPIO-Enhanced MRI Findings of Well-Differentiated Hepatocellular Carcinomas: Correlation with MDCT Findings

SPIO-Enhanced MRI Findings of Well-Differentiated Hepatocellular Carcinomas: Correlation with MDCT Findings

Contrast enhanced ultrasound and magnetic resonance imaging in hepatocellular carcinoma diagnosis

International consensus on histologic diagnosis of early hepatocellular neoplasia

Contact Info

Product

Resources

About