Imaging features of fibrolamellar hepatocellular carcinoma in gadoxetic acid-enhanced MRI

Palm, Viktoria; Sheng, Ruofan; Mayer, Philipp; Weiss, Karl-Heinz; Springfeld, Christoph; Mehrabi, Arianeb; Longerich, Thomas; Berger, Anne; Kauczor, Hans‐Ulrich; Weber, Tim Frederik

doi:10.1186/s40644-018-0143-y

Cited by 26 publications

(16 citation statements)

References 24 publications

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“…A fibrolamellar HCC scar demonstrates hypointensity at T2-weighted MRI (17). In addition, fibrolamellar HCC is hypointense, as compared with the background liver parenchyma, during the HBP (17,48).…”

Section: Oatp1b3 Expression and Hyperintensity Of Fnh During The Hbpmentioning

confidence: 99%

Hyperintense Liver Masses at Hepatobiliary Phase Gadoxetic Acid–enhanced MRI: Imaging Appearances and Clinical Importance

et al. 2020

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Gadoxetic acid, a hepatobiliary-specific contrast medium used for MRI, is becoming increasingly important in the detection and characterization of hepatic mass lesions. This medium is taken up by functioning hepatocytes, and the liver parenchyma is strongly enhanced in the hepatobiliary phase (HBP), during which hepatic mass lesions without functioning hepatocytes commonly show hypointensity. However, some hepatic mass lesions show hyperintensity in the HBP. Focal nodular hyperplasia (FNH) and FNHlike lesions show hyperintensity in the HBP owing to the uptake of gadoxetic acid by hyperplastic normal hepatocytes. The tumor cells of some types of hepatocellular adenoma (eg, β-catenin-activated type, inflammatory type) and hepatocellular carcinoma (eg, green hepatoma) can show uptake of gadoxetic acid. Retention of gadoxetic acid in the extracellular space can cause hyperintensity of fibrotic tumors or hemangiomas during the HBP owing to the extracellular contrast agent characteristics of gadoxetic acid. During the HBP, peritumoral retention is observed in some tumors, such as hepatocellular carcinomas, gastrointestinal stromal tumors, and neuroendocrine tumors. Gadoxetic acid is excreted into the bile; therefore, biliary tract enhancement can be observed in the cystic components of intraductal papillary neoplasms of the bile duct. Intratumoral bile ducts can be observed in malignant lymphomas. Knowledge of these specific mechanisms, which can cause hyperintensity during the HBP depending on the pathologic or molecular background, is important not only for precise imaging-based diagnoses but also for understanding the pathogenesis of hepatic mass lesions. ©

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Section: Oatp1b3 Expression and Hyperintensity Of Fnh During The Hbpmentioning

confidence: 99%

Hyperintense Liver Masses at Hepatobiliary Phase Gadoxetic Acid–enhanced MRI: Imaging Appearances and Clinical Importance

et al. 2020

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Section: Combined Hepatocholangiocarcinomamentioning

confidence: 99%

“…FLCs are also hypointense on the hepatobiliary phase (using hepatobiliary contrast agents). 95 FLCs do not usually produce detectable AFP and less than 10% of patients have AFP levels above 200 ng/ml. 90 Tumour and non-tumour liver biopsy is usually advised in clinical practice, with the exception of patients eligible for frontline surgery irrespective of the results of biopsy.…”

Section: Systemic Treatmentsmentioning

confidence: 99%

New insights into the pathophysiology and clinical care of rare primary liver cancers

et al. 2021

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Summary Hepatocholangiocarcinoma, fibrolamellar carcinoma, hepatic haemangioendothelioma and hepatic angiosarcoma represent less than 5% of primary liver cancers. Fibrolamellar carcinoma and hepatic haemangioendothelioma are driven by unique somatic genetic alterations ( DNAJB1-PRKCA and CAMTA1-WWTR1 fusions, respectively), while the pathogenesis of hepatocholangiocarcinoma remains more complex, as suggested by its histological diversity. Histology is the gold standard for diagnosis, which remains challenging even in an expert centre because of the low incidences of these liver cancers. Resection, when feasible, is the cornerstone of treatment, together with liver transplantation for hepatic haemangioendothelioma. The role of locoregional therapies and systemic treatments remains poorly studied. In this review, we aim to describe the recent advances in terms of diagnosis and clinical management of these rare primary liver cancers.

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“…The central scar is hypointense in T2-weight images, and FL-HCC demonstrates portal venous hypoenhancement. Calcification is more consistent with FL-HCC but may not be reliably identified on MRI [ 150 , 151 ].…”

Section: Malignant Tumors In School-aged Children and Adolescentsmentioning

confidence: 99%

Pediatric Primary Hepatic Tumors: Diagnostic Considerations

2021

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The liver is the third most common site of abdominal tumors in children. This review article aims to summarize current evidence surrounding identification and diagnosis of primary hepatic tumors in the pediatric population based upon clinical presentation, epidemiology, and risk factors as well as classical imaging, histopathological, and molecular diagnostic findings. Readers will be able to recognize the features and distinguish between benign and malignant hepatic tumors within different age groups.

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Imaging features of fibrolamellar hepatocellular carcinoma in gadoxetic acid-enhanced MRI

Cited by 26 publications

References 24 publications

Hyperintense Liver Masses at Hepatobiliary Phase Gadoxetic Acid–enhanced MRI: Imaging Appearances and Clinical Importance

Hyperintense Liver Masses at Hepatobiliary Phase Gadoxetic Acid–enhanced MRI: Imaging Appearances and Clinical Importance

New insights into the pathophysiology and clinical care of rare primary liver cancers

Pediatric Primary Hepatic Tumors: Diagnostic Considerations

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