Diagnosis of small hepatocellular carcinoma: correlation of MR imaging and tumor histologic studies.

Ebara, Masaaki; Ohto, Masao; Watanabe, Yuji; Kimura, Kozaburo; Saisho, Hiromitsu; Tsuchiya, Yoshikazu; Okuda, K; Arimizu, N; Kondo, Fukuo; Ikehira, Hiroo

doi:10.1148/radiology.159.2.3008213

Cited by 171 publications

(65 citation statements)

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“…In tumors larger than 2 cm the level of detection is about 95%. However, in tumors smaller than 2 cm this level is reduced to 30% (22). The diagnostic efficacy of MR for the detection of HCC seems to be similar to or even lower than that of CT.…”

Section: Magnetic Resonancementioning

confidence: 87%

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Diagnosis, staging and treatment of hepatocellular carcinoma

França

Elías

Lima

et al. 2004

Braz J Med Biol Res

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Hepatocellular carcinomas are aggressive tumors with a high dissemination power. An early diagnosis of these tumors is of great importance in order to offer the possibility of curative treatment. For an early diagnosis, abdominal ultrasound and serum alpha-fetoprotein determinations at 6-month intervals are suggested for all patients with cirrhosis of the liver, since this disease is considered to be the main risk factor for the development of the neoplasia. Helicoidal computed tomography, magnetic resonance and/or hepatic arteriography are suggested for diagnostic confirmation and tumor staging. The need to obtain a fragment of the focal lesion for cytology and/or histology for a diagnosis of hepatocellular carcinoma depends on the inability of imaging methods to diagnose the lesion. Several classifications are currently available for tumor staging in order to determine patient prognosis. All take into consideration not only the stage of the tumor but also the degree of hepatocellular dysfunction, which is known to be the main factor related to patient survival. Classifications, however, fail to correlate treatment with prognosis and cannot suggest the ideal treatment for each tumor stage. The Barcelona Classification (BCLC) attempts to correlate tumor stage with treatment but requires prospective studies for validation. For single tumors smaller than 5 cm or up to three nodules smaller than 3 cm, surgical resection, liver transplantation and percutaneous treatment may offer good anti-tumoral results, as well as improved patient survival. Embolization or chemoembolization are therapeutic alternatives for patients who do not benefit from curative therapies. Correspondence

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Section: Magnetic Resonancementioning

confidence: 87%

“…HCC is better evaluated in potentiated sequences in T2, where it frequently appears to be hyperintense (22,23). In potentiated sequences in T1, because of the larger amount of water inside them, which increases the relaxation time, HCC are found to be hypointense.…”

Section: Magnetic Resonancementioning

confidence: 99%

Diagnosis, staging and treatment of hepatocellular carcinoma

França

Elías

Lima

et al. 2004

Braz J Med Biol Res

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“…Table 2. Sensitivity, specificity, positive predictive value, and negative predictive values of MR imaging findings for diagnosis of hepatocellular carcinoma in the cirrhotic liver, according to lesion size Size Parameter Sensitivity Specificity PPV NPV representative findings of overt HCCs (3,26). During interpretation of initial MR imaging, precontrast imaging features can influence the determination of the PP and DP imaging findings in equivocal cases.…”

Section: Discussionmentioning

confidence: 99%

Small hypervascular hepatocellular carcinoma: limited value of portal and delayed phases on dynamic magnetic resonance imaging

Lee

Chung

et al. 2008

Acta Radiol

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Yu JS, Lee JH, Chung JJ, Kim JH, Kim KW. Small hypervascular hepatocellular carcinoma: limited value of portal and delayed phases on dynamic magnetic resonance imaging. Acta Radiol 2008;49:735Á743.Background: Characterization of small nodules in the cirrhotic liver is always challenging in clinical practice. In the differential diagnosis of small hypervascular lesions, it has been reported that portal venous or delayed hypointensity is a useful sign to characterize hepatocellular carcinomas (HCCs) during dynamic magnetic resonance (MR) imaging. However, few studies have assessed the diagnostic value of this sign. Purpose: To determine the diagnostic value of portal-phase (PP) and delayed-phase (DP) images for the diagnosis of small hypervascular HCCs during intravenous (IV) contrastenhanced dynamic MR imaging of cirrhotic liver. Material and Methods: A total of 69 small (6Á20 mm) hypervascular HCCs in 53 cirrhotic patients were subjected to a retrospective analysis of the signal intensities (hypo-, iso-, or hyperintense) and rim enhancement on PP and 5-min DP images from three-phased dynamic MR imaging according to the pre-contrast T1-and T2-weighted imaging features. After exclusion of 33 subcapsular wedge-shaped pseudolesions and three hemangiomas by typical imaging features, 74 centrally located small hypervascular benign or pseudolesions were used as a control group for comparative analyses. Results: The sensitivities of PP hypointensity, DP hypointensity, and rim enhancement in the diagnosis were 11%, 29%, and 18%, respectively, for 6Á10-mm hypervascular HCCs, and 42%, 63%, and 58%, respectively, for 16Á20-mm lesions. After exclusion of the 48 lesions showing T2-weighted hyperintensity (HCCs, n039; benign lesions, n09), the overall sensitivity for diagnosis of small hypervascular HCCs decreased (8.3%, 25.0%, and 8.3%, respectively). Conclusion: Although DP provides a better sensitivity than PP, both PP and DP have very limited diagnostic value for diagnosis of small hypervascular HCCs during dynamic MR imaging of the cirrhotic liver.

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“…The performance of CT and MRI is affected by the size of the lesions [204,205]. Although CT and MRI are reported to have a sensitivity of 60-94.4% and 58.5-93%, respectively, in tumors larger than 1 cm, their sensitivities for detecting tumors smaller than 1 cm are reduced by 33-45 and 33-67%, respectively [204,[206][207][208]. Furthermore, small, arterially enhancing nodules are common in the cirrhotic liver, and majority of these nodules are benign [209][210][211].…”

Section: Ct Mri and Other Imaging Modalitiesmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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Diagnosis of small hepatocellular carcinoma: correlation of MR imaging and tumor histologic studies.

Cited by 171 publications

References 0 publications

Diagnosis, staging and treatment of hepatocellular carcinoma

Diagnosis, staging and treatment of hepatocellular carcinoma

Small hypervascular hepatocellular carcinoma: limited value of portal and delayed phases on dynamic magnetic resonance imaging

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

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