Hepatocellular carcinoma: Prospective assessments of the T-factor with CT, US, and MR imaging

Abstract

The capabilities of computed tomography (CT), ultrasonography (US), and magnetic resonance (MR) imaging were studied in order to determine the role of each of these noninvasive examinations for estimating the T-factor of hepatocellular carcinomas (HCCs). Fifty-one patients with surgically proven HCCs received CT (50 patients), US (46 patients), and MR (44 patients). The images of CT, US, and MR were prospectively evaluated for main tumor size, intrahepatic metastases, and vascular invasion, which compose the T-factor of HCC, and compared to pathological results. The sizes of the main tumor were estimated correctly by all examinations. For estimating intrahepatic metastases, US (74%) and MR (73%) were superior to CT (65%). For estimating portal invasion, CT (79%) was superior to US (70%) and MR (66%), because CT could demonstrate the segmental staining caused by portal invasion. The estimates of hepatic venous invasion were difficult during any of the examinations. We conclude that presurgical evaluations of the T-factor require the use of US and CT or MR and CT.

Hepatocellular carcinoma with sarcomatous change: characteristic findings of two-phased incremental CT

“…The frequency of metastasis is higher than that of the usual HCC. Lymphatic metastases (100%) and intrahepatic metastases (83%) were more frequently observed in the present cases than in the usual HCC (13%, 47%) [12,13]. HCCSC reportedly show invasive and sinusoidal growth patterns without fibrous capsules [10], and this was also seen in our cases.…”

Radiological assessment of hepatic vein invasion by hepatocellular carcinoma using combined computed tomography hepatic arteriography and computed tomography arterial portography

“…However, detection of peripheral branch HVI (minute HVI) using computed tomography (CT), magnetic resonance imaging (MRI), or ultrasonography (US) remains difficult. 7 Combined CT hepatic arteriography (CTHA) and CT arterial portography (CTAP) are highly sensitive for evaluating hemodynamics in the liver. 8 Because some secondary changes in hepatic fl ow are anticipated when HVI is present, it seems reasonable to focus on this modality.…”