Enhancement pattern of small hepatocellular carcinoma (HCC) at contrast-enhanced US (CEUS), MDCT, and MRI: Intermodality agreement and comparison of diagnostic sensitivity between 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines

Furlan, Alessandro; Marin, Daniele; Cabassa, Paolo; Taibbi, Adele; Brunelli, Elena; Agnello, Francesco; Lagalla, Roberto; Brancatelli, Giuseppe

doi:10.1016/j.ejrad.2011.07.010

Cited by 43 publications

(34 citation statements)

References 19 publications

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“…Yet, sensitivities for nodules between 20 and 30 mm, reported in our results, were lower than those reported in the literature. Indeed the studies conventionally define cut‐off at 20 mm, with two groups: smaller and larger than 20 mm with no upper limit. Thus, imaging performance for nodules larger than 20 mm is probably raised by the largest nodules.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

EASL and AASLD recommendations for the diagnosis of HCC to the test of daily practice

Aubé

Oberti

Lonjon

et al. 2017

Liver International

112

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Section: Discussionmentioning

confidence: 99%

“…Indeed, these recommendations are based more on expert opinions than controlled studies. Only a few single‐centre studies have prospectively validated these recommendations. Moreover, apart from the studies by Khalili et al., Sangiovani et al.…”

Section: Introductionmentioning

confidence: 99%

EASL and AASLD recommendations for the diagnosis of HCC to the test of daily practice

Aubé

Oberti

Lonjon

et al. 2017

Liver International

112

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“…Patients with hepatic encephalopathy (coma scale ≥II) or poorly controlled hepatocellular carcinoma were excluded. Diagnosis of liver cirrhosis was based on laboratory results and imaging tests (ultrasonography and computed tomography) revealing a hepatic cirrhotic appearance, splenomegaly, esophageal varices, and ascites . The study was approved by the Institutional Review Board Ethics Committee of the Tokushukai Medical Group.…”

Section: Methodsmentioning

confidence: 99%

Close correlation between urinary sodium excretion and response to tolvaptan in liver cirrhosis patients with ascites

Uojima

Kinbara

Hidaka

et al. 2016

Hepatology Research

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Aim: To assess the correlation between response to tolvaptan and treatment-related factors in liver cirrhosis patients.Methods: This single-center retrospective study was carried out at Shonan Kamakura General Hospital in Kanagawa, Japan, between October 2013 and September 2015. Forty-three liver cirrhosis patients (mean age, 65.7 years) with insufficient responses to conventional diuretics for at least 7 days were enrolled. All patients received oral tolvaptan (7.5 mg/day for 7 days) and guideline-directed medical therapy including sodium intake restrictions. A responder to tolvaptan was defined as a patient having a ≥2-kg decrease in body weight 1 week after commencing drug treatment, and a non-responder was defined as a patient not losing ≥2 kg in body weight 1 week after commencing treatment. We investigated the correlation of change in body weight for 1 week after drug administration compared to baseline clinical characteristics. Results:The mean body weight change from the baseline on the final dosing day was À2.47 ± 3.34 kg (P < 0.0001). There were 20 (46.5%) responders to tolvaptan. Urinary sodium and volume excretion was higher in responders than in non-responders (108.2 ± 70.5 vs 42.6 ± 36.7, P = 0.0003; 1462.8 ± 625.7 vs 960.9 ± 600.6, P = 0.0073). Logistic regression analyses for responders to tolvaptan were carried out, and independent correlation of the responders was urinary sodium excretion (P = 0.0114; hazard ratio, 0.9418; 95% confidence interval, 0.8768À0.9896) in the multivariate analyses. Conclusion:In decompensated liver cirrhosis patients, urinary excretion sodium showed good correlation with tolvaptan response.

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“…Nevertheless, there is clear evidence from recent studies that CEUS is indeed a useful primary imaging method in the characterization of HCC and diagnostically comparable to CT/MRI for the diagnosis of a typical vascular pattern of HCC in small (\2 cm) nodules [2,3,[12][13][14]. With regard to detection of a so far unknown nodule, however, the role of CEUS is limited.…”

Section: State Of the Artmentioning

confidence: 99%

“…This is related to the washout rather than the arterial hypervascularity [3,13]. The typical vascular profile of HCC has been described and validated using extracellular contrast media in dynamic imaging; it is thus related to the specific pharmacokinetics of different contrast agents for different imaging techniques.…”

Section: Aimmentioning

confidence: 99%

Imaging of Liver Tumors in Patients with Chronic Liver Disease

et al. 2014

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Imaging techniques have become the accepted mainstay for the assessment of liver lesions in cirrhosis and, thanks to the improvement of their diagnostic capabilities in recent years, have further limited the need to resort to bioptic sampling. Hepatocellular carcinoma (HCC) is the most common cause of de-novo liver nodules in cirrhosis, and its diagnosis relies on noninvasive contrast-enhanced imaging studies. Diagnostic criteria have been extensively validated, and the vascular pattern deemed typical for HCC is an arterial hyperenhancement of the nodule followed by washout in the portal or late phase. This pattern provides a positive predictive value for the diagnosis of HCC of about 97 % in nodules in cirrhosis according to the literature. However, the need for a more precise differentiation from other malignancies arising in cirrhosis, making up the remaining about 3 %, and specifically intrahepatic cholangiocarcinoma, has over time led to changes in the recommendations for the noninvasive diagnosis of HCC in cirrhosis. The present review aims to report recently published interesting studies that have brought new insights into the problem of the characterization and differential diagnosis of liver tumors in chronic liver diseases.

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Enhancement pattern of small hepatocellular carcinoma (HCC) at contrast-enhanced US (CEUS), MDCT, and MRI: Intermodality agreement and comparison of diagnostic sensitivity between 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines

Cited by 43 publications

References 19 publications

EASL and AASLD recommendations for the diagnosis of HCC to the test of daily practice

EASL and AASLD recommendations for the diagnosis of HCC to the test of daily practice

Close correlation between urinary sodium excretion and response to tolvaptan in liver cirrhosis patients with ascites

Imaging of Liver Tumors in Patients with Chronic Liver Disease

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