Correlation between the blood supply and grade of malignancy of hepatocellular nodules associated with liver cirrhosis: evaluation by CT during intraarterial injection of contrast medium.

Hayashi, Makiko; Matsui, Osamu; Ueda, Koji; Kawamori, Yasuhiro; Kadoya, Masumi; Yoshikawa, Jun; Gabata, Toshifumi; Takashima, Tsutomu; Nonomura, Akitaka; Nakanuma, Yasuni

doi:10.2214/ajr.172.4.10587130

Cited by 322 publications

(239 citation statements)

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“…Hemodynamic characterization is also useful to evaluate tumor vascularity in hepatocellular carcinoma. Hepatocellular carcinomas show variable hemodynamic features depending on histological grading (17). Targeted transarterial chemoembolization therapy can be used to treat hepatocellular carcinomas with a low local recurrence rate and minimum damage to nontumorous liver parenchyma (18).…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic characterization of focal hepatic lesions: Role of ferucarbotran‐enhanced dynamic MR imaging using T2‐weighted multishot spin‐echo echo‐planar sequence

Hori

Murakami

Kim

et al. 2006

Magnetic Resonance Imaging

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Purpose:To investigate the role of ferucarbotran-enhanced dynamic MR imaging using multishot spin-echo echo-planar sequence in the evaluation of hemodynamics of focal hepatic lesions. Materials and Methods:Sixty-three focal hepatic lesions (24 benign and 39 malignant) from 53 consecutive patients who underwent both ferucarbotran-enhanced MR imaging and dynamic computed tomography (CT) were included in this study. MR imaging was performed with a 1.5-T scanner with a phased-array coil. T2-weighted multishot spin-echo echo-planar sequences (TR/TE ϭ 1714 -2813/80 msec) were obtained during a single breathhold before and 15, 60, 120, 180, and 600 seconds after intravenous injection of ferucarbotran. The enhancement patterns of lesions were classified into three categories by a study coordinator on the basis of dynamic CT images as hypervascular, hypovascular, and hemangioma type. The study coordinator created mean contrast-to-noise ratio of lesions vs. time curves for each enhancement pattern for quantitative analyses. Moreover, three radiologists separately and blindly reviewed MR images, and then assigned three confidence scores for the three enhancement patterns to each lesion. Sensitivity, specificity, and receiver operating characteristic analyses were performed. Results:Quantitative analyses showed characteristic enhancement curves for each enhancement pattern. Mean sensitivities/specificities were 0.816/0.882, 0.897/0.863, and 0.800/0.989 for hypervascular, hypovascular, and hemangioma types, respectively. Mean areas under the receiver operating characteristic curve were 0.886 for hypervascular type and 0.913 for hypovascular type. Conclusion:Ferucarbotran-enhanced dynamic MR imaging can be used to successfully characterize the hemodynamics of focal hepatic lesions.

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Section: Discussionmentioning

confidence: 99%

Hemodynamic characterization of focal hepatic lesions: Role of ferucarbotran‐enhanced dynamic MR imaging using T2‐weighted multishot spin‐echo echo‐planar sequence

Hori

Murakami

Kim

et al. 2006

Magnetic Resonance Imaging

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“…In imaging analysis, a ''borderline lesion'' was defined as a nodule showing hypodensity on CTHA indicating decreased intranodular arterial supply and isodensity or slight hypodensity on CTAP indicating the same or decreased but not absent intranodular portal supply relative to the surrounding liver parenchyma [7,8]. When early phase of a CTHA image indicated a region of hyperdensity relative to the surrounding area in the nodule and its largest diameter was not larger than half of the largest diameter of the entire borderline lesion measured on axial images, it was defined as an HF [7,8].…”

Section: Definition Of a Hf In Borderline Lesionsmentioning

confidence: 99%

“…It has been verified that, during multistep hepatocarcinogenesis, a hypervascular de-differentiated HCC component appears in a hypovascular borderline lesion [3,[5][6][7][8]. This focus grows to finally occupy the entire nodule, resulting in progression to a more malignant and entirely hypervascular HCC (so-called classic HCC) [8].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, in accordance with the progression of these changes, the drainage vessels change from hepatic veins in borderline lesions to hepatic sinusoids and then to portal veins in hypervascular classic HCCs [9]. Angiography-assisted CT, including CT during arterial portography (CTAP), CT during hepatic arteriography (CTHA) and single-level dynamic CTHA, is well known to be the most accurate modality to evaluate these hemodynamic changes during hepatocarcinogenesis [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Hemodynamics and progression of a hypervascular focus in a borderline lesion of hepatocellular carcinoma: analysis by angiography-assisted CT and histopathology

et al. 2013

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Purpose To investigate the hemodynamics and progression of a hypervascular focus (HF) in a borderline lesion by dual-phase CT during hepatic arteriography (CTHA) and reveal the process of the transformation to hypervascular overt hepatocellular carcinoma (HCC). Materials and methods This study was performed with the approval of our institutional ethics committee, and informed consent for the retrospective usage of clinical materials was obtained from all the patients. The 121 nodules in 76 consecutive patients with liver cirrhosis and chronic hepatitis showing an HF in a borderline lesion on angiography-assisted CT were analyzed. Hemodynamic changes were observed in 24 patients who underwent repeated angiography-assisted CT. Histopathological analysis was conducted in eight nodules. Results HF was classifiable into type A (stain disappeared), B (stain prolonged), C (stain was washed out and corona-like drainage into the outer nodule was seen) and D (stain was washed out and corona-like drainage into the whole outer nodule was seen) on the late phase of CTHA and was seen to progress in this order on follow-up observation. Histopathologically, de-differentiated foci showed significantly higher expression of sinusoidal capillarization and unpaired arteries than background nodules and showed pseudocapsule, compressive and replacing growth at the border of the background nodule. Conclusion HF showed multi-step progression and transformation to hypervascular overt HCC.

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“…Arterialization (which means presence of new unpaired arteries not accompanied by bile duct [56]) and sinusoidal capillarization (involving transformation of fenestrated hepatic sinusoidal endothelial cells into continuous capillaries, coupled with collagenization of the extravascular spaces of Disse and deposition of laminin and basement membranes near the endothelial cells and hepatocytes [57]) are highest in HCC, develop from OAH and gradually increase [58]. Accordingly, the intranodular portal supply relative to the surrounding liver parenchyma is decreased, whereas the intranodular arterial supply is increased in accordance with elevation of the grade of malignancy of the nodules [59]. Arterialization can induce a partial transition of LSECs to capillary-type endothelial cells (sinusoidal capillarization) [60].…”

Section: Sprouting Angiogenesis In Hccmentioning

confidence: 99%

Angiogenesis: multiple masks in hepatocellular carcinoma and liver regeneration

Chen

Shi

et al. 2010

Hepatol Int

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Hepatocellular carcinoma (HCC) is naturally resistant to radiotherapy and cytotoxic chemotherapy, leaving surgery as the mainstream therapeutic approach. However, the 5-year recurrence rate after curative resection is as high as 61.5%. The background hepatitis B-or C-induced cirrhosis and the presence of micrometastases at the time of surgery have been regarded as two main causes of recurrence. Recently, accumulating evidence suggests that growth factors and cytokines released during the physiological process of post-surgical liver regeneration could induce the activation of dormant micrometastatic lesions. The establishment of neovasculature to support either liver regeneration or HCC growth involves multiple cell types including liver sinusoidal endothelial cells, Kupffer cells, hepatic stellate cells, and circulating endothelial progenitors. The crosstalks among these cells are driven by multiple molecules and signaling pathways, including vascular endothelial growth factors and their receptors, platelet-derived growth factor, the angiopoietin/Tie family, hepatocyte growth factor/c-Met signaling, and others. Anti-angiogenic agent targeting liver cancer vasculature has been reported to be able to generate limited survival benefit of the patients. In this review, discussions are focused on various angiogenic mechanisms of HCC and liver regeneration, as well as the prevailing anti-angiogenic strategies.

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Correlation between the blood supply and grade of malignancy of hepatocellular nodules associated with liver cirrhosis: evaluation by CT during intraarterial injection of contrast medium.

Abstract: OBJECTIVE.The purpose of this study is to evaluate the correlation between the intranodu-

Cited by 322 publications

References 0 publications

Hemodynamic characterization of focal hepatic lesions: Role of ferucarbotran‐enhanced dynamic MR imaging using T2‐weighted multishot spin‐echo echo‐planar sequence

Hemodynamic characterization of focal hepatic lesions: Role of ferucarbotran‐enhanced dynamic MR imaging using T2‐weighted multishot spin‐echo echo‐planar sequence

Hemodynamics and progression of a hypervascular focus in a borderline lesion of hepatocellular carcinoma: analysis by angiography-assisted CT and histopathology

Angiogenesis: multiple masks in hepatocellular carcinoma and liver regeneration

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