Role of diffusion-weighted imaging, apparent diffusion coefficient and correlation with hepatobiliary phase findings in the differentiation of hepatocellular carcinoma from dysplastic nodules in cirrhotic liver

Inchingolo, Riccardo; Gaetano, Anna Maria De; Curione, Davide; Ciresa, M.; Miele, Luca; Pompili, Maurizio; Vecchio, Fabio Maria; Giuliante, Felice; Bonomo, Lorenzo

doi:10.1007/s00330-014-3500-7

Cited by 45 publications

(42 citation statements)

References 36 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alongside with other functional imaging modalities, such as 18-flourdeoxyglucose positron emission tomography/computed tomography (FGD-PET/CT), the diffusionweighted imaging (DWI) derived apparent diffusion coefficient (ADC) has been identified as a prognostic imaging biomarker (Charles-Edwards and deSouza 2006). DWI has shown promising results in differentiating tumor subtypes and histopathological patterns of tumor aggressiveness (Inchingolo et al 2015). It has been demonstrated that morphological tumor response of common primary cancers and liver metastases was associated with ADC changes after both systemic and locoregional interventional therapies (Kukuk et al 2014;Liang et al 2016).…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of pretreatment diffusion-weighted magnetic resonance imaging for outcome prediction of colorectal cancer liver metastases undergoing 90Y-microsphere radioembolization

Schmeel

Simon

Luetkens

et al. 2017

J Cancer Res Clin Oncol

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Prognostic value of pretreatment diffusion-weighted magnetic resonance imaging for outcome prediction of colorectal cancer liver metastases undergoing 90Y-microsphere radioembolization

Schmeel

Simon

Luetkens

et al. 2017

J Cancer Res Clin Oncol

View full text Add to dashboard Cite

show abstract

“…This discrepancy may be explained by the spectrum of DNs and HCCs and their spectrum of signal intensities on the HBP. Inchingolo et al showed that the signal intensity on DWI and HBP was useful in the differentiation between HCCs and DNs, and between HCCs plus high-grade DNs and low-grade DNs [61]. For cirrhotic nodules with atypical vascular enhancement patterns, Golfieri et al reported that hypointensity on the HBP was predictive of malignancy [62].…”

Section: Hcc Vs Other Hepatocellular Nodulesmentioning

confidence: 99%

Recent Advances in the Imaging Diagnosis of Hepatocellular Carcinoma: Value of Gadoxetic Acid-Enhanced MRI

Joo

Lee

2015

Liver Cancer

View full text Add to dashboard Cite

Magnetic resonance imaging (MRI) using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DPTA), or gadoxetic acid for short, is a hepatocyte-specific contrast agent which is now increasingly used for the detection and characterization of focal hepatic lesions, particularly in patients at high-risk of developing hepatocellular carcinomas (HCC). In fact, several recent guidelines now recognize gadoxetic acid-enhanced MRI (Gd-EOB-MRI) as the primary diagnostic imaging modality for the noninvasive diagnosis of HCC, although it must be noted that several major guidelines still include only extracellular contrast media-enhanced computed tomography and MRI. The primary merits of Gd-EOB-MRI lie in the fact that it can provide not only dynamic imaging, but also hepatobiliary phase (HBP) imaging which can lead to high lesion-to-liver contrast and give additional information regarding hepatocyte uptake via organic anion transporting polypeptides. This, in turn, allows higher sensitivity in detecting small HCCs and helps provide additional information regarding the multistep process of hepatocarcinogenesis. Indeed, many recent studies have investigated the diagnostic value of Gd-EOB-MRI for early HCCs as well as its role as a potential imaging biomarker in predicting outcome. We herein review the recent advances in the imaging diagnosis of HCCs focusing on the applications of Gd-EOB-MRI and the challenging issues that remain.

show abstract

“…The nodules were further reorganized into three groups. A group of benign nodules included the regenerative and low‐grade dysplastic nodules, a group of nodules with intermediate malignancy included the high‐grade dysplastic nodules and early hepatocellular carcinomas, and a group of progressed hepatocellular carcinomas included overt, moderately, or poorly differentiated hepatocellular carcinomas, as previously proposed …”

Section: Methodsmentioning

confidence: 99%

“…The characterization of these nodules is important for determining patient prognosis and allowing the best treatment at an early stage . It has been suggested that cirrhotic hepatic nodules be classified into three groups based on their relative malignant potential: a benign group consisting of regenerative nodules and low‐grade dysplastic nodules, a group of nodules with intermediate malignancy consisting of high‐grade dysplastic nodules and early hepatocellular carcinomas, and a group of overtly malignant lesions consisting of progressed hepatocellular carcinomas …”

mentioning

confidence: 99%

Comparison of pulsed and oscillating gradient diffusion‐weighted MRI for characterizing hepatocellular nodules in liver cirrhosis: ex vivo study in a rat model

Wagner

Doblas

Poté

et al. 2019

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Background In contrast to classical pulsed gradient diffusion‐weighted MRI, oscillating gradient diffusion‐weighted MR imaging (DWI) is sensitive to short distance diffusion changes at the intracellular level. Purpose To compare the diagnostic performance of pulsed and oscillating DWI for characterizing hepatocellular nodules in a rat model of hepatic cirrhosis. Study Type Prospective, experimental study. Animal Model Cirrhosis was induced by weekly intraperitoneal injection of diethylnitrosamine in Wistar rats. Field Strength/Sequence Ex vivo liver MRI was performed at 7T with T1‐weighted, T2‐weighted, pulsed, and oscillating gradient diffusion‐weighted sequences. Assessment Apparent diffusion coefficient from pulsed (ADCpulsed) and oscillating gradient (ADCoscillating) sequences was calculated in 82 nodules identified on the T1/T2‐weighted images and on pathological examination. Two pathologists classified the nodules in three categories: benign (regenerative and low‐grade dysplastic nodules), with intermediate malignancy (high‐grade dysplastic nodules and early hepatocellular carcinomas) and overtly malignant (progressed hepatocellular carcinomas). Statistical Tests Differences between groups were assessed with Kruskal–Wallis and Mann–Whitney tests. Results ADC, mainly ADCoscillating, increased in the group of nodules with intermediate malignancy (ADCpulsed: 0.75 ± 0.25 × 10‐3 mm2/s vs. 0.64 ± 0.07 × 10‐3 mm2/s in benign nodules, P = 0.025; ADCoscillating: 0.81 ± 0.20 × 10‐3 mm2/s vs. 0.65 ± 0.13 × 10‐3 mm2/s, P = 0.0008) and ADCpulsed decreased in the group of progressed hepatocellular carcinomas (ADCpulsed: 0.60 ± 0.08 × 10‐3 mm2/s, P = 0.042; ADCoscillating: 0.68 ± 0.08 × 10‐3 mm2/s, P = 0.1). Data Conclusion ADC during hepatocarcinogenesis in rats increased in nodules with intermediate malignancy and decreased in progressed hepatocellular carcinomas. Our results suggest that oscillating gradient DWI is more sensitive to the early steps of hepatocarcinogenesis and might be useful for differentiating between high‐grade dysplastic nodules / early hepatocellular carcinomas and regenerating nodules / low‐grade dysplastic nodules. Level of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:1065–1074.

show abstract

Role of diffusion-weighted imaging, apparent diffusion coefficient and correlation with hepatobiliary phase findings in the differentiation of hepatocellular carcinoma from dysplastic nodules in cirrhotic liver

Abstract: • Usefulness of DWI and ADC is shown in differential diagnosis of cirrhotic nodules. • Correlation of DWI with DPI improves differential diagnosis of cirrhotic nodules. • Characterization of atypically enhancing lesions becomes more confident.

Cited by 45 publications

References 36 publications

Prognostic value of pretreatment diffusion-weighted magnetic resonance imaging for outcome prediction of colorectal cancer liver metastases undergoing 90Y-microsphere radioembolization

Prognostic value of pretreatment diffusion-weighted magnetic resonance imaging for outcome prediction of colorectal cancer liver metastases undergoing 90Y-microsphere radioembolization

Recent Advances in the Imaging Diagnosis of Hepatocellular Carcinoma: Value of Gadoxetic Acid-Enhanced MRI

Comparison of pulsed and oscillating gradient diffusion‐weighted MRI for characterizing hepatocellular nodules in liver cirrhosis: ex vivo study in a rat model

Contact Info

Product

Resources

About