Differentiation between dysplastic nodule and early-stage hepatocellular carcinoma: The utility of conventional MR imaging

Chou, Chen‐Te; Chou, Jung-Mao; Chang, Ting-Chen; Huang, Su‐Cheng; Chen, Chia‐Bang; Chen, Yao‐Li; Chen, Ran‐Chou

doi:10.3748/wjg.v19.i42.7433

Cited by 30 publications

(16 citation statements)

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“…Therefore, it enables the assessment of tumor vascularity as well as other hepatocellular-specific properties within the tumor. Thus Gd-EOB-DTPA has been proven valuable in detection and differential diagnosis of focal liver lesions, especially between early HCC and dysplastic nodule(DN) [ 3 , 9 ]. As HCCs in different degree of differentiation retain variable degree of normal liver function, they could potentially be classified using Gd-EOB-DTPA [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Gd-EOB-DTPA-enhanced magnetic resonance imaging combined with T1 mapping predicts the degree of differentiation in hepatocellular carcinoma

et al. 2016

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BackgroundVariable degrees of differentiation in hepatocellular carcinoma(HCC)under Edmondson-Steiner grading system has been proven to be an independent prognostic indicator for HCC. Up till now, there has been no effective radiological method that can reveal the degree of differentiation in HCC before surgery. This paper aims to evaluate the use of Gd-EOB-DTPA-Enhanced Magnetic Resonance Imaging combined with T1 mapping for the diagnosis of HCC and assessing its degree of differentiation.MethodsForty-four patients with 53 pathologically proven HCC had undergone Gd-EOB-DTPA enhanced MRI with T1 mapping before surgery. Out of the 53 lesions,13 were grade I, 27 were gradeII, and 13 were grade III. The T1 values of each lesion were measured before and at 20 min after Gd-EOB-DTPA administration (T1p and T1e). The absolute reduction in T1 value (T1d) and the percentage reduction (T1d %) were calculated. The one-way ANOVA and Pearson correlation were used for comparisons between the T1 mapping values.ResultsThe T1d and T1d % of grade I, II and III of HCC was 660.5 ± 422.8ms、295.0 ± 99.6ms、276.2 ± 95.0ms and 54.0 ± 12.2 %、31.5 ± 6.9 %、27.7 ± 6.7 % respectively. The differences between grade Iand II, grade Iand III were statistically significant (p < 0.05), but there was no statically significant difference between grade II and III. The T1d % was the best marker for grading of HCC, with a Spearman correlation coefficient of −0.676.ConclusionsT1 mapping before and after Gd-EOB-DTPA administration can predict degree of differentiation in HCC.

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Section: Introductionmentioning

confidence: 99%

Gd-EOB-DTPA-enhanced magnetic resonance imaging combined with T1 mapping predicts the degree of differentiation in hepatocellular carcinoma

et al. 2016

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“…[24–27]. In our experience, a high signal intensity on T2 should be certainly considered a sign of malignant transformation because it was encountered only in HCCs, although with a poor detection rate (53.3 %) [28]. Our study certainly has some limits.…”

Section: Discussionmentioning

confidence: 84%

Qualitative analysis of small (≤2 cm) regenerative nodules, dysplastic nodules and well-differentiated HCCs with gadoxetic acid MRI

et al. 2016

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BackgroundThe characterization of small lesions in cirrhotic patients is extremely difficult due to the overlap of imaging features among different entities in the step-way of the hepatocarcinogenesis. The aim of our study was to evaluate the role of gadoxetic-acid MRI in the differentiation of small (≤2 cm) well-differentiated hepatocellular carcinomas from regenerative and dysplastic nodules.MethodsSeventy-three cirrhotic patients, with 118 focal liver lesions (≤2 cm) were prospectively recruited. MRI examination was performed with a 3T magnet and the study protocol included T1 - and T2-weighted pre-contrast sequences and T1 -weighted gadoxetic-acid enhanced post-contrast sequences obtained during the arterial, venous, late dynamic and hepatobiliary phases. All lesions were pathologically confirmed. Two radiologists blinded to clinical and pathological information evaluated two imaging datasets; another radiologist analysed the signal intensity characteristics of each lesion. Sensitivity, specificity and diagnostic accuracy were considered for statistical analysis.ResultsGood agreement was reported between the two readers (κ 0.70). Both readers reported a significantly improved sensitivity (57.7 and 66.2 vs 74.6 and 83.1) and diagnostic accuracy (0.717 and 0.778 vs 0.843 and 0.901) with the adjunction of the hepatobiliary phase 57.7 vs 74.6 and 66.2 vs 83.1 (p ≤ 0.04).ConclusionsGadoxetic-acid MRI is a reliable tool for the characterization of HCC and lesions at high risk to further develop.

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“…In a report that classified the signal intensity of DWI into three stages (iso/slight, moderate, and obvious) in 254 resected HCC, the prevalence of well-differentiated HCC was high and that of moderately or poorly differentiated HCC was low in the iso/slight intensity imaging group compared to the obvious intensity imaging group: the pathology of well/moderate/poor HCC was 38.9%/57.4%/3.7% for the iso/slight intensity group and 5.8%/77.4%/16.8% for the obvious intensity group [18] . Other reports showed that DWI features were linked to poor differentiation on pathology, vascular invasion, and recurrence risk factor after resection of small HCC [19,20] .…”

Section: Daa-svr Hcc (N = 26)mentioning

confidence: 89%

Distinctive magnetic resonance imaging findings of hepatocellular carcinoma after hepatitis C virus eradication with direct-acting antivirals

Shimizu¹,

Tsuchiya²,

Kurosaki³

et al. 2020

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Aim: The aim of the present study was to evaluate the characteristics of the magnetic resonance imaging features of hepatocellular carcinoma (HCC) that developed early after the eradication of hepatitis C virus (HCV) by directacting antiviral (DAA) treatment. Methods: This study included 26 patients who achieved sustained viral response with DAA and developed HCC thereafter within one year (DAA-SVR HCC). The radiologic characteristics of these patients were evaluated by contrast-enhanced magnetic resonance imaging, including diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI). For comparison, 80 HCC patients with positive HCV RNA (HCV-positive HCC) were included. Among 42 patients where tumor biopsy was available, histological grade and radiologic findings were compared. Results: The rates of high intensity on DWI and T2WI were significantly higher in DAA-SVR HCC compared to HCVpositive HCC (DWI: 100% vs. 67.5%, P < 0.001; T2WI: 92.6% vs. 67.5%, P = 0.01). HCC with high intensity on DWI or T2WI was more likely to have moderately or poorly differentiated HCC compared to well-differentiated HCC (DWI: 69.7% vs. 30.3%, P = 0.02; T2WI: 66.7% vs. 27.3%, P = 0.03). Conclusion: High intensity on DWI and hyperintensity on T2WI were distinctive features of HCC that developed within one year after the end of DAA treatment.

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Differentiation between dysplastic nodule and early-stage hepatocellular carcinoma: The utility of conventional MR imaging

Abstract: In the follow-up for a cirrhotic nodule, increased signal intensity on T2WI may be a sign of malignant transformation. Furthermore, a noted loss of hyperintensity on T1WI and the detection of arterial enhancement might indicate further progression of the histological grade.

Cited by 30 publications

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Gd-EOB-DTPA-enhanced magnetic resonance imaging combined with T1 mapping predicts the degree of differentiation in hepatocellular carcinoma

Gd-EOB-DTPA-enhanced magnetic resonance imaging combined with T1 mapping predicts the degree of differentiation in hepatocellular carcinoma

Qualitative analysis of small (≤2 cm) regenerative nodules, dysplastic nodules and well-differentiated HCCs with gadoxetic acid MRI

Distinctive magnetic resonance imaging findings of hepatocellular carcinoma after hepatitis C virus eradication with direct-acting antivirals

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