Dynamic contrast-enhanced MR imaging of fibrolamellar hepatocellular carcinoma

Corrigan, K. E.; Semelka, Richard C.

doi:10.1007/bf00201518

Cited by 54 publications

(15 citation statements)

References 12 publications

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“…Some parts of the tumour may demonstrate late enhancement, rendering the tumour more homogeneous. On 2-min post-gadolinium images, fibrolamellar carcinoma may be isointense or slightly hypointense to liver parenchyma due to contrast agent wash-out [67]. Compared with FNH, the central scar is generally much larger, more irregular and more heterogeneous in signal intensity and contrast enhancement.…”

Section: Fibrolamellar Carcinomamentioning

confidence: 99%

Clinical value of MRI liver-specific contrast agents: a tailored examination for a confident non-invasive diagnosis of focal liver lesions

et al. 2008

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Screening of the liver for hepatic lesion detection and characterization is usually performed with either ultrasound or CT. However, both techniques are suboptimal for liver lesion characterization and magnetic resonance (MR) imaging has emerged as the preferred radiological investigation. In addition to unenhanced MR imaging techniques, contrast-enhanced MR imaging can demonstrate tissue-specific physiological information, thereby facilitating liver lesion characterization. Currently, the classes of contrast agents available for MR imaging of the liver include non-tissue-specific extracellular gadolinium chelates and tissue-specific hepatobiliary or reticuloendothelial agents. In this review, we describe the MR features of the more common focal hepatic lesions, as well as appropriate imaging protocols. A special emphasis is placed on the clinical use of non-specific and liver-specific contrast agents for differentiation of focal liver lesions. This may aid in the accurate diagnostic workup of patients in order to avoid invasive procedures, such as biopsy, for lesion characterization. A diagnostic strategy that considers the clinical situation is also presented.

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Section: Fibrolamellar Carcinomamentioning

confidence: 99%

Clinical value of MRI liver-specific contrast agents: a tailored examination for a confident non-invasive diagnosis of focal liver lesions

et al. 2008

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“…However, fibrolamellar HCC and sclerosing type HCC have been reported to show marked enhancement that continued to the delayed phase [7,8]. The lack of enhancement of central portions in fibrolamellar HCC may help differential diagnosis [7]. However, it may be difficult to differentiate ICC with marked hypervascularity, as in our cases, from sclerosing HCC, which contains hepatoma cells with abundant fibrous stroma.…”

Section: Discussionmentioning

confidence: 65%

“…This prolonged enhancement is very important for differentiating ICC with marked hypervascularity from HCC. However, fibrolamellar HCC and sclerosing type HCC have been reported to show marked enhancement that continued to the delayed phase [7,8]. The lack of enhancement of central portions in fibrolamellar HCC may help differential diagnosis [7].…”

Section: Discussionmentioning

confidence: 98%

Intrahepatic cholangiocarcinoma with marked hypervascularity

et al. 1999

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Two rare cases of small intrahepatic cholangiocarcinoma with marked hypervascularity are reported. Dynamic computed tomographic and magnetic resonance images of the two cases revealed strong enhancement of the whole tumor on the early phase and prolonged enhancement on the late and delayed phases. In both cases, the tumors turned out to be well-differentiated tubular cholangiocarcinoma that contained a large number of tumor cells and few interstitial fibrous tissues. These results suggest that some intrahepatic cholangiocarcinoma should be differentiated from other hypervascular hepatic tumors, especially hepatocellular carcinoma, and that prolonged enhancement of the tumor on late and delayed phases of dynamic images could be of diagnostic value.

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“…FNH and FLC share similar features such as a central scar, but unlike FNH, the central scar in FLC does not always enhance on delayed images. 13,19 The role of hepatobiliary MR contrast agents is unclear at this time but is potentially helpful if FLCs are hypointense on delayed hepatobiliary phase imaging in contrast to the majority of FNHs, as was seen in one of our patients and in the reported literature. 20,21 Conventional HCCs typically do not contain a central scar, although a minority (6%) can in the setting of cirrhosis.…”

Section: Discussionmentioning

confidence: 72%

CT and MRI of primary and metastatic fibrolamellar carcinoma: a case series of 37 patients

Gian

McErlean²,

Ang³

et al. 2014

BJR

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Objective: Fibrolamellar carcinoma (FLC) is a rare disease, with limited radiographic reported information. We assessed the imaging patterns of primary and metastatic FLC. Methods: CT and MR examinations of patients with FLC were retrospectively reviewed. Imaging features were assessed for primary and recurrent liver tumours, including dimension, enhancement characteristics, and presence or absence of central scars. Locations of nodal and extranodal metastases were also recorded. Results: Of 37 patients (18 males and 19 females; average age, 23.5 years) with FLC, 24 had imaging of their primary tumour; 13 had metastases at presentation and 7 developed metastases on follow-up. The remaining 13 patients had follow-up imaging of metastatic disease. Primary FLC had a mean diameter .11 cm, with central scars in ten (46%) patients. Most tumours enhanced heterogeneously (96%) and showed arterial enhancement (81%). On MRI, 62% of FLCs were hypointense on T 1 weighted imaging and 54% were hyperintense on T 2 weighted imaging. 13 patients (54%) had nodal metastases at presentation, mostly in the upper abdomen (92%) and commonly in the chest (38%). Extrahepatic metastases were most frequently pulmonary or peritoneal. Predominantly small and homogeneous intrahepatic recurrences were detected on follow-up in 15 patients. Conclusion: FLC often presents as a large hepatic tumour with nodal and distant metastases. Thoracic adenopathy and lung metastases were frequently found in our series, suggesting the need for pre-operative and follow-up chest imaging. Advances in knowledge: Thoracic nodal and lung metastases are common in FLC; therefore, dedicated chest imaging should be part of the evaluation of a patient with FLC.

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Dynamic contrast-enhanced MR imaging of fibrolamellar hepatocellular carcinoma

Cited by 54 publications

References 12 publications

Clinical value of MRI liver-specific contrast agents: a tailored examination for a confident non-invasive diagnosis of focal liver lesions

Clinical value of MRI liver-specific contrast agents: a tailored examination for a confident non-invasive diagnosis of focal liver lesions

Intrahepatic cholangiocarcinoma with marked hypervascularity

CT and MRI of primary and metastatic fibrolamellar carcinoma: a case series of 37 patients

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