Nuclear imaging of solid hepatic masses

Kinnard, Margaret; Alavi, Abass; Rubin, Raymond A.; Lichtenstein, Gary R.

doi:10.1016/s0037-198x(05)80024-0

Cited by 20 publications

(15 citation statements)

References 110 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The diagnosis of FNH is based on the demonstration in imaging studies of the central scar, but this can also be seen as a zone of fibrosis in fibrolamellar hepatocellular carcinoma [82], hepatic adenoma, and intrahepatic cholangiocarcinoma. A second element that is fundamental to the diagnosis of FNH is the presence on color and power Doppler of the spoke-wheel pattern of vascularization with arterial flow characterized by low resistance and high peak flow.…”

Section: Differential Diagnosismentioning

confidence: 99%

Diagnosis and management of hepatic focal nodular hyperplasia

Venturi

Piscaglia

Vidili

et al. 2007

Journal of Ultrasound

View full text Add to dashboard Cite

Focal nodular hyperplasia (FNH) is the second most common benign tumor of the liver, after hemangioma. It is generally found incidentally and is most common in reproductive-aged women, but it also affects males and can be diagnosed at any age. Patients are rarely symptomatic, but FNH sometimes causes epigastric or right upper quadrant pain. The main clinical task is to differentiate it from other hypervascular hepatic lesions such as hepatic adenoma, hepatocellular carcinoma, or hypervascular metastases, but invasive diagnostic procedures can generally be avoided with the appropriate use of imaging techniques. Magnetic resonance (MR) imaging is more sensitive and specific than conventional ultrasonography (US) or computed tomography (CT), but Doppler US and contrast-enhanced US (CEUS) can greatly improve the accuracy in the diagnosis of FNH. Once a correct diagnosis has been made, in most cases there is no indication for surgery, and treatment includes conservative clinical follow-up in asymptomatic patients.Sommario L'iperplasia nodosa focale (FNH) è il tumore epatico benigno più frequente dopo l'angioma. E' di solito rilevata in modo occasionale, per lo più nelle donne in età fertile, anche se si può riscontrare in entrambi i sessi e ad ogni età. I soggetti portatori raramente sono sintomatici, nonostante l'FNH possa essere causa di dolore ai quadranti addominali superiori. Nella gestione dell'FNH il problema clinico principale è rappresentato dalla difficoltà di differenziarla dalle altre lesioni epatiche ipervascolarizzate, come l'adenoma, l'epatocarcinoma o le metastasi ipervascolari, tuttavia utilizzando le opportune tecniche diagnostiche è oggi possibile evitare il ricorso ad esami invasivi. La Risonanza Magnetica (RM) ha una sensibilità e una specificità superiori rispetto a quelle dell'ecografia convenzionale e della Tomografia Assiale Computerizzata (TC) per la diagnosi di FNH. L'uso dell'angioecografia perfusionale (CEUS) e dell'eco-Doppler può tuttavia aumentare in modo significativo la confidenza diagnostica

show abstract

Section: Differential Diagnosismentioning

confidence: 99%

Diagnosis and management of hepatic focal nodular hyperplasia

Venturi

Piscaglia

Vidili

et al. 2007

Journal of Ultrasound

View full text Add to dashboard Cite

show abstract

“…Because FNH contains Kupffer cells, it concentrates sulfur colloid [68,99] . In approximately one-half of cases the degree of radiotracer accumulation is similar to that of the normal hepatic parenchyma, and in 10% of cases increased concentration of colloid is seen [68,99,100] . In the remaining 40% of patients FNH appears as a photopenic defect, indicating that the Kupffer cells in the lesion have concentrated the sulfur colloid to a lesser degree than the surrounding liver.…”

Section: Focal Nodular Hyperplasiamentioning

confidence: 99%

“…In the remaining 40% of patients FNH appears as a photopenic defect, indicating that the Kupffer cells in the lesion have concentrated the sulfur colloid to a lesser degree than the surrounding liver. Regenerative nodules, focal hepatic steatosis, and some hepatocellular adenomas may also concentrate sulfur colloid [100,101] . However, in the proper clinical setting, the CT or MRI features in combination with normal uptake within the mass on sulfur colloid scan strongly suggest the diagnosis of FNH.…”

Section: Focal Nodular Hyperplasiamentioning

confidence: 99%

Distinguishing benign from malignant liver tumours

Heiken

2007

Cancer Imaging

View full text Add to dashboard Cite

Liver masses are very common and most are benign. It is therefore important to avoid unnecessary interventions for benign lesions, while at the same time ensuring accurate diagnosis of hepatic malignancies. Many cancer patients, like the general population, have incidental benign liver lesions. In planning treatment for cancer patients, it is critical to avoid inappropriate treatment decisions based on misdiagnosis of a benign lesion as a metastasis or primary liver malignancy. This article describes the salient imaging features of the common benign liver masses and outlines a general approach to distinguishing between benign and malignant hepatic lesions.

show abstract

“…A technetium-99m pertechnetatelabeled red blood cell pool study is a very good test for hepatic hemangiomas, with a sensitivity of 75% to 85% for lesions larger than 2 cm and a specificity of nearly 100%. It is best used in lesions larger than 2 cm to 1) confirm a suspected hemangioma seen as a hyperechoic lesion on ultrasound, and 2) clarify a doubtful lesion on CT imaging [60,61]. Angiography can be used when other methods have failed to yield a definitive diagnosis, usually for small hemangiomas that coexist with other lesions, or when large cavernous hemangiomas lack enhancement [45].…”

Section: Detection and Differentiation Of Benign Hepatic Neoplasms Anmentioning

confidence: 99%

“…Angiography can be used when other methods have failed to yield a definitive diagnosis, usually for small hemangiomas that coexist with other lesions, or when large cavernous hemangiomas lack enhancement [45]. Contrast is seen to rapidly fill large spaces within the hemangioma, giving rise to a "cotton" or "wool" appearance that persists [61]. However, angiography may be negative in smaller lesions.…”

Section: Detection and Differentiation Of Benign Hepatic Neoplasms Anmentioning

confidence: 99%

Benign neoplasms of the liver

Porayko

Choudhary

2001

Curr Treat Options Gastro

View full text Add to dashboard Cite

Tumors of the liver often are discovered incidentally in asymptomatic individuals during diagnostic imaging or exploratory laparotomy performed for alternative reasons. Hemangiomas are the most common benign liver tumors, followed in prevalence by focal nodular hyperplasia (FNH); other benign tumors are rare. The growth and development of hemangiomas, FNH, and hepatic adenomas especially, have been linked to hormonal (eg, estrogen) stimulation. Differentiating between benign and malignant neoplasms of the liver can be challenging. Radiologic imaging is essential for preliminary identification and classification of hepatic tumors, but tissue biopsy or surgical excision sometimes is required for a definitive diagnosis. Individuals with hemangioma or FNH usually are asymptomatic, have a benign course, and can be managed conservatively. In contrast, hepatic adenomas need to be followed more carefully and often are excised to provide symptomatic relief, remove the risk of rupture, and avoid potential malignant transformation. Liver transplantation in patients with benign hepatic neoplasms is exceedingly uncommon, and is recommended only when alternative methods of treatment are not feasible or have failed to control significant symptoms.

show abstract

Nuclear imaging of solid hepatic masses

Cited by 20 publications

References 110 publications

Diagnosis and management of hepatic focal nodular hyperplasia

Diagnosis and management of hepatic focal nodular hyperplasia

Distinguishing benign from malignant liver tumours

Benign neoplasms of the liver

Contact Info

Product

Resources

About