Impact of hepatobiliary phase liver MRI versus Contrast-Enhanced Ultrasound after an inconclusive extracellular gadolinium-based contrast-enhanced MRI for the diagnosis of benign hepatocellular tumors

Abstract

HBP-MRI or CEUS should be performed after an inconclusive CE-MRI. Both can change patient management by avoiding unnecessary biopsy or surveillance. The use of HBP-MRI should be advocated over CEUS in larger (>35 mm) lesions.

OATPB1/B3 and MRP3 expression in hepatocellular adenoma predicts Gd‐EOB‐DTPA uptake and correlates with risk of malignancy

“…We observed that HT expression in FNH is characterized by a periseptal pattern, with little variation in different cases, matching the iso/hyperintense contrast uptake on the HBP of Gd‐EOB‐DTPA‐enhanced MRI that is consistently reported in the literature . By contrast, in HCA, HT expression is heterogeneous, resulting in a variable intracellular uptake of the hepatospecific contrast agent .…”

“…We observed that HT expression in FNH is characterized by a periseptal pattern, with little variation in different cases, matching the iso/ hyperintense contrast uptake on the HBP of Gd-EOB-DTPA-enhanced MRI that is consistently reported in the literature. 24,25,27,30,32,34 By contrast, in HCA, HT expression is heterogeneous, resulting in a variable intracellular uptake of the hepatospecific contrast agent. 27 Our results refine those reported in a previous study, based on outdated pathological classifications, showing consistently low OATPB1/B3 mRNA levels and IHC expression in 9 HCA.…”

“…The introduction of hepatobiliary phase (HBP) Gd‐EOB‐DTPA‐enhanced MRI has improved the diagnostic performance in the differential diagnosis of HCA vs FNH, with a reported 91%‐100% sensitivity and 87%‐100% specificity . Gd‐EOB‐DTPA is a hepatospecific contrast agent transported through hepatocytes by hepatocyte transporters proteins (HT), namely organic anion‐transporting polypeptides B1/B3 (OATPB1/B3) and multidrug resistance‐associated proteins 2 and 3 (MRP2, MRP3) .…”

“…17,21 The introduction of hepatobiliary phase (HBP) Gd-EOB-DTPAenhanced MRI has improved the diagnostic performance in the differential diagnosis of HCA vs FNH, with a reported 91%-100% sensitivity and 87%-100% specificity. [22][23][24][25] Gd-EOB-DTPA is a hepatospecific contrast agent transported through hepatocytes by hepatocyte transporters proteins (HT), namely organic anion-transporting polypeptides B1/B3 (OATPB1/B3) and multidrug resistance-associated proteins 2 and 3 (MRP2, MRP3). 26 OATPB1/B3 is expressed at hepatocytes basolateral pole and allows the contrast agent influx/backflux from and to the sinusoidal space; MRP3 is also expressed at the basolateral pole, allowing a complementary sinusoidal backflux; MRP2 is expressed at hepatocytes canalicular pole and is responsible of biliary efflux.…”

Can point shear wave elastography differentiate focal nodular hyperplasia from hepatocellular adenoma

“…For CE‐MRI with hepatocellular specific contrast, the sensitivity is estimated at 91%–100% and the specificity at 87%–100% . When the diagnosis remains uncertain, these patients may undergo a tumor biopsy . In order to avoid a percutaneous biopsy and the associated risk of complications or even the surgical resection of a suspect lesion that turns out to be FNH, improvement of the diagnostic process is needed.…”