Differential diagnosis of focal liver lesions: role of spin-echo and contrast-enhanced dynamic MR imaging.

Yamashita, Yasuyuki; Hatanaka, Yoshimi; Yamamoto, H.; Arakawa, Akihiko; Matsukawa, Tetsuya; Miyazaki, Toshiyuki; Takahashi, Manabu

doi:10.1148/radiology.193.1.8090922

Cited by 92 publications

(47 citation statements)

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“…The lesions were hypodense in 71% of the cases observed in our study (n=5) and isodense in 29% cases (n=2) in plain study and they showed early discontinuous peripheral enhancement in arterial phase with progressive centripetal filling in the delayed phase in all the cases as described by Hanafusa et al 9 and Yashimata et al 10 in their studies. The peripheral enhancement of the lesions was equal to the attenuation of aorta in all the phases studied.…”

Section: Haemangiomasupporting

confidence: 76%

Role of Triple Phase MDCT in the Characterisation of Liver Lesions

Sengodan¹,

Aiyappan²,

Karpagam³

2017

jemds

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BACKGROUNDMDCT is a very useful investigative technique for all liver pathologies. The conspicuity of a liver lesion on CT depends on the attenuation difference between the lesion and the normal liver. The difference in blood supply results in different enhancement patterns between various liver tumours in the various phases of contrast enhancement. Intravenous contrast is needed to increase the conspicuity of lesions. Multidetector computed tomography with plain, arterial, portal venous and delayed phase is very useful in identifying and characterising various liver lesions depending on their vascular nature. In our study, we evaluated the role of Multidetector computed tomography in the characterisation of liver lesions in patients presenting to our hospital.

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Section: Haemangiomasupporting

confidence: 76%

Role of Triple Phase MDCT in the Characterisation of Liver Lesions

Sengodan¹,

Aiyappan²,

Karpagam³

2017

jemds

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“…Emphasis has been given to conventional "%weighted MR imaging for tissue characterization of focal liver lesions, with both qualitative and quantitative measures employed (1,2,11, 13,[29][30][31][32][33][34][35]. However, morphologic characterization does not always allow discrimination between malignant and benign lesions (especially if both have prolonged T 2 relaxation times) and quantitative measurements have been helpful in specific conditions (1 4).…”

Section: Discussionmentioning

confidence: 99%

MRI in characterization of focal liver lesions: Comparison of T2 weighting by conventional spin‐echo and turbo spin‐echo sequences

Giovagnoni

Paci

Valeri

et al. 1996

Magnetic Resonance Imaging

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Forty-one patients with 61 proved focal liver lesions underwent MRI of the liver at 1.0 T, with the aim of evaluating the usefulness of turbo spin-echo (TSE) sequences in characterizing focal liver lesions, by comparing them with conventional spin-echo (CSE) sequences. Two different TSE protocols were employed. with constant echo time and varying repetition time: TSE-S (3000 msec) and TSE-L (5100 msec). All images were evaluated quantitatively (signal-to-noise ration 'SNR') and qualitatively: because benign lesions were all liquid (12 cysts and 10 hemangiomas), they were well characterized morphologically on the basis of signal intensity. Mean SNR was significantly different between metastases and benign lesions (P < .0001) with all T2 sequences. Among the single T2 sequences tested, logistic regression analysis showed TSE-L to have the best predictive ability of the nature of focal lesions, with a G value of 42.02, compared to 29.87 of TSE-S and 25.55 of CSE second echo (SE II). The combination of TSE-L with TSE-S did not modify these results, whereas the combination of TSE-L with CSE only resulted in slight improvement (G = 46.95). Comparison of the receiver operating characteristic (ROC) curves showed only SE II (area under the ROC curve of .8312) to be significantly inferior to the best single sequence, or TSE-L (area under the ROC curve of .9176; P = .027). All sequences were equivalent in qualitative evaluation with good reproducibility, sensitivity ranging from .94 to 1.0 and specificity ranging from .86 to .93. This study confirms the value of TSE sequences in characterization of focal liver lesions. Time of acquisition is strongly reduced with these sequences, whereas results are fairly similar to those obtained with CSE. TSE sequences could therefore replace CSE for the study of focal liver lesions.

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“…Classically, HCC is characterized by arterial enhancement with washout on delayed venous phases [16,17]. On MRI, small HCC lesions tend to be isointense with rapid contrast enhancement, but larger HCC nodules may instead appear T1 hypointense and T2 hyperintense [18,19].…”

Section: Target Identificationmentioning

confidence: 99%

Liver-Directed Radiotherapy for Hepatocellular Carcinoma

Keane

Hong

2016

Liver Cancer

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Background: The incidence of hepatocellular carcinoma (HCC) continues to increase world-wide. Many patients present with advanced disease with extensive local tumor or vascular invasion and are not candidates for traditionally curative therapies such as orthotopic liver transplantation (OLT) or resection. Radiotherapy (RT) was historically limited by its inability to deliver a tumoricidal dose; however, modern RT techniques have prompted renewed interest in the use of liver-directed RT to treat patients with primary hepatic malignancies. Summary: The aim of this review was to discuss the use of external beam RT in the treatment of HCC, with particular focus on the use of stereotactic body radiotherapy (SBRT). We review the intricacies of SBRT treatment planning and delivery. Liver-directed RT involves accurate target identification, precise and reproducible patient immobilization, and assessment of target and organ motion. We also summarize the published data on liver-directed RT, and demonstrate that it is associated with excellent local control and survival rates, particularly in patients who are not candidates for OLT or resection. Key Messages: Modern liver-directed RT is safe and effective for the treatment of HCC, particularly in patients who are not candidates for OLT or resection. Liver-directed RT, including SBRT, depends on accurate target identification, precise and reproducible patient immobilization, and assessment of target and organ motion. Further prospective studies are needed to fully delineate the role of liver-directed RT in the treatment of HCC.

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Differential diagnosis of focal liver lesions: role of spin-echo and contrast-enhanced dynamic MR imaging.

Abstract: A specific diagnosis of liver lesions can be obtained in most cases by combining parameters obtained from SE and dynamic MR images.

Cited by 92 publications

References 0 publications

Role of Triple Phase MDCT in the Characterisation of Liver Lesions

Role of Triple Phase MDCT in the Characterisation of Liver Lesions

MRI in characterization of focal liver lesions: Comparison of T2 weighting by conventional spin‐echo and turbo spin‐echo sequences

Liver-Directed Radiotherapy for Hepatocellular Carcinoma

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