Hepatic nodules with arterial phase hyperenhancement and washout on enhanced computed tomography/magnetic resonance imaging: how to avoid pitfalls

Tang, Mimi; Liang, Yin; Lin, Zhi; Shen, Bingqi; Huang, Mengqi; Li, Zi Ping; Li, Xuehua; Feng, Shi Ting

doi:10.1007/s00261-020-02560-0

Cited by 7 publications

(8 citation statements)

References 44 publications

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“…Hypervascular lesions that may mimic HCC in patients with cirrhosis or chronic liver disease include perfusion alterations, hemangiomas, focal nodular hyperplasia (FNH)-like nodules, high-grade dysplastic nodules (HGDN), small ICCs, combined hepatocellular-cholangiocarcinomas (cHCC-CCAs) and, rarely, hypervascular metastases in a cirrhotic liver [ 54 , 57 , 58 , 59 , 60 , 61 ] ( Table 5 ).…”

Section: Ctmentioning

confidence: 99%

Current Imaging Diagnosis of Hepatocellular Carcinoma

Chartampilas

Rafailidis

Georgopoulou

et al. 2022

Cancers

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Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer related death worldwide. Radiology has traditionally played a central role in HCC management, ranging from screening of high-risk patients to non-invasive diagnosis, as well as the evaluation of treatment response and post-treatment follow-up. From liver ultrasonography with or without contrast to dynamic multiple phased CT and dynamic MRI with diffusion protocols, great progress has been achieved in the last decade. Throughout the last few years, pathological, biological, genetic, and immune-chemical analyses have revealed several tumoral subtypes with diverse biological behavior, highlighting the need for the re-evaluation of established radiological methods. Considering these changes, novel methods that provide functional and quantitative parameters in addition to morphological information are increasingly incorporated into modern diagnostic protocols for HCC. In this way, differential diagnosis became even more challenging throughout the last few years. Use of liver specific contrast agents, as well as CT/MRI perfusion techniques, seem to not only allow earlier detection and more accurate characterization of HCC lesions, but also make it possible to predict response to treatment and survival. Nevertheless, several limitations and technical considerations still exist. This review will describe and discuss all these imaging modalities and their advances in the imaging of HCC lesions in cirrhotic and non-cirrhotic livers. Sensitivity and specificity rates, method limitations, and technical considerations will be discussed.

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Section: Ctmentioning

confidence: 99%

Current Imaging Diagnosis of Hepatocellular Carcinoma

Chartampilas

Rafailidis

Georgopoulou

et al. 2022

Cancers

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“…Furthermore, we want to focus the attention on our main results obtained from the analysis of arterial phase, this aspect highlights and confirms the key role of CT arterial phase in detection and characterization of NENs [ 32 , 33 ]. In fact, some previous radiomic studies on NENs reported that their consistent data were obtained in the analysis of arterial phase, limiting the role of portal phase [ 10 , 27 ].…”

Section: Discussionmentioning

confidence: 81%

CT-based radiomics for prediction of therapeutic response to Everolimus in metastatic neuroendocrine tumors

et al. 2022

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Aim To test radiomic approach in patients with metastatic neuroendocrine tumors (NETs) treated with Everolimus, with the aim to predict progression-free survival (PFS) and death. Materials and methods Twenty-five patients with metastatic neuroendocrine tumors, 15/25 pancreatic (60%), 9/25 ileal (36%), 1/25 lung (4%), were retrospectively enrolled between August 2013 and December 2020. All patients underwent contrast-enhanced CT before starting Everolimus, histological diagnosis, tumor grading, PFS, overall survival (OS), death, and clinical data collected. Population was divided into two groups: responders (PFS ≤ 11 months) and non-responders (PFS > 11 months). 3D segmentation was performed on whole liver of naïve CT scans in arterial and venous phases, using a dedicated software (3DSlicer v4.10.2). A total of 107 radiomic features were extracted and compared between two groups (T test or Mann–Whitney), radiomics performance assessed with receiver operating characteristic curve, Kaplan–Meyer curves used for survival analysis, univariate and multivariate logistic regression performed to predict death, and interobserver variability assessed. All significant radiomic comparisons were validated by using a synthetic external cohort. P < 0.05 is considered significant. Results 15/25 patients were classified as responders (median PFS 25 months and OS 29 months) and 10/25 as non-responders (median PFS 4.5 months and OS 23 months). Among radiomic parameters, Correlation and Imc1 showed significant differences between two groups (P < 0.05) with the best performance (internal cohort AUC 0.86–0.84, P < 0.0001; external cohort AUC 0.84–0.90; P < 0.0001). Correlation < 0.21 resulted correlated with death at Kaplan–Meyer analysis (P = 0.02). Univariate analysis showed three radiomic features independently correlated with death, and in multivariate analysis radiomic model showed good performance with AUC 0.87, sensitivity 100%, and specificity 66.7%. Three features achieved 0.77 ≤ ICC < 0.83 and one ICC = 0.92. Conclusions In patients affected by metastatic NETs eligible for Everolimus treatment, radiomics could be used as imaging biomarker able to predict PFS and death.

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“…Lebermetastasen von gastrointestinalen oder Mammakarzinomen können aufgrund ihrer ausgeprägten peripheren und peritumoralen Anreicherung jedoch ein ähnliches Erscheinungsbild wie eine hypervaskuläre Läsion aufweisen [33]. Lebermetastasen sind in nicht-zirrhotischen Lebern jedoch deutlich häufiger und umgekehrt [21,37].…”

Section: Hypervaskularisierung Und Wash-outunclassified

Primäre und sekundäre Lebertumore

Mansour,

Seidensticker,

Heimer

2023

Angewandte Nuklearmedizin

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ZusammenfassungDie Leber kann von verschiedenen Malignomen betroffen sein. Bei gewissen Risikofaktoren steigt die Wahrscheinlichkeit der Entwicklung von lebereigenen Tumoren (primären Lebertumoren) an. Die häufigsten Tumormanifestationen sind allerdings sekundär durch Metastasen bedingt. Zwischen den verschiedenen zur Verfügung stehenden radiologischen Modalitäten bestehen in der Detektion und Charakterisierung von Leberläsionen relevante Unterschiede. Dabei werden konventioneller und kontrastmittelverstärkter Ultraschall (CEUS), Computertomografie (CT) und die Magnetresonanztomografie (MRT) routinehaft eingesetzt. Diese Diagnostikmethoden weisen dabei im gegenseitigen Vergleich Vor- und Nachteile auf. Ziel dieser Übersichtsarbeit ist es, die Rolle der einzelnen Modalitäten, häufige Bildmerkmale und die Rolle der unterschiedlichen Kontrastmittel in der Diagnostik von primären und sekundären Lebertumoren zusammenzufassen.

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Hepatic nodules with arterial phase hyperenhancement and washout on enhanced computed tomography/magnetic resonance imaging: how to avoid pitfalls

Cited by 7 publications

References 44 publications

Current Imaging Diagnosis of Hepatocellular Carcinoma

Current Imaging Diagnosis of Hepatocellular Carcinoma

CT-based radiomics for prediction of therapeutic response to Everolimus in metastatic neuroendocrine tumors

Primäre und sekundäre Lebertumore

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