Computed tomography for the diagnosis of hepatocellular carcinoma in adults with chronic liver disease

Nadarević, Tin; Giljača, Vanja; Colli, Agostino; Fraquelli, Mirella; Casazza, Giovanni; Miletić, Damir; Štimac, Davor

doi:10.1002/14651858.cd013362.pub2

Cited by 22 publications

(14 citation statements)

References 231 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Biliary leak Cholescintigraphy NA [5] Gallstones ERCP PTC [6,7] Cholecystitis Cholescintigraphy NA [8,9] Cholestasis Cholescintigraphy PET-CT [8,10] Hepatic fibrosis Ultrasound elastography MRI, MRE [11][12][13][14][15][16] Liver cancer Ultrasonography CT/MRI [13,17] Liver metastasis MRI/CT NA [15,18] Liver steatosis Ultrasonography NA [12] Obstructed/dilated ducts Cholescintigraphy NA [19,20] ERCP: endoscopic retrograde cholangiopancreatography; MRE: magnetic resonance elastography; NA: none available; PET: positron emission tomography; PTC: percutaneous transhepatic cholangiography Some alternative tests used in liver function evaluation are classical, such as these performed using hepatotropic agents, i.e., efficiently accumulated by the liver or cholephilic compounds, i.e., substances in most part taken up by the liver and secreted into bile. A significant limitation in using these agents to estimate whole liver function is that most of them are not homogeneously distributed throughout the hepatobiliary system.…”

Section: Liver Pathology Image Techniques Alternatives Referencesmentioning

confidence: 99%

Monitoring the hepatobiliary function using image techniques and labeled cholephilic compounds

et al. 2023

View full text Add to dashboard Cite

Evaluation of the hepatobiliary function is critical for the clinicians, not only for the diagnosis of a large variety of liver diseases but also in the follow-up and management of some patients, for instance, those with different degrees of cholestasis suffering from a drug-induced liver injury (DILI) or scheduled for liver resection. Currently, the determination of global liver function mainly relies on laboratory tests, clinical scores, and data from images obtained with ultrasonography, computed tomography (CT), or magnetic resonance. Nuclear medicine scanning, displaying either planar or three-dimensional spatial distribution of liver function, is enhanced when using hepatotropic tracers based on classical radioisotopes such as technetium-99m (99mTc) and with higher resolution using metabolized probes such as those based on monosaccharide derivatives labeled with 18F. Other cholephilic compounds, and hence selectively secreted into bile, have been proposed to visualize the correct function of the liver parenchyma and the associated secretory machinery. This review aims to summarize the state-of-the-art regarding the techniques and chemical probes available to monitor liver and gallbladder function, in some cases based on imaging techniques reflecting the dynamic of labeled cholephilic compounds.

show abstract

Section: Liver Pathology Image Techniques Alternatives Referencesmentioning

confidence: 99%

Monitoring the hepatobiliary function using image techniques and labeled cholephilic compounds

et al. 2023

View full text Add to dashboard Cite

show abstract

“…On CT, non‐rim‐like hyperenhancement in the arterial phase and washout in the portal‐venous and delayed phases are the key indicators of HCC. About 40% of HCCs have unusual morphological characteristics, however, which makes diagnosis difficult for radiologists 36,37 . Most HCC lesions exhibit the standard MRI features of arterial enhancement with washout in the portal venous phase, hypointensity on T1‐weighted images, and hyperintensity on T2‐weighted images 20 …”

Section: Ct and Mri Imagingmentioning

confidence: 99%

“…About 40% of HCCs have unusual morphological characteristics, however, which makes diagnosis difficult for radiologists. 36,37 Most HCC lesions exhibit the standard MRI features of arterial enhancement with washout in the portal venous phase, hypointensity on T1-weighted images, and hyperintensity on T2-weighted images. 20 On cross-sectional imaging, it may be challenging to distinguish infiltrating HCC from underlying heterogeneous cirrhosis.…”

Section: Ct and Mri Imagingmentioning

confidence: 99%

“…20 On cross-sectional imaging, it may be challenging to distinguish infiltrating HCC from underlying heterogeneous cirrhosis. 20,28,37 Interestingly, the resemblance between the two clinical entities is not limited to gross anatomy and imaging features, as histopathologic studies have suggested that tumor nodules have the same microscopic and macroscopic appearance as regenerating nodules in the cirrhotic liver. 8 In contrast to nodular HCC, infiltrating HCC frequently disappears into the cirrhotic liver's background and lacks a distinct, well-defined mass.…”

Section: Ct and Mri Imagingmentioning

confidence: 99%

See 1 more Smart Citation

Diffuse infiltrative hepatocellular carcinoma: Multimodality imaging manifestations

Madani

Mirza‐Aghazadeh‐Attari

Mohseni

et al. 2022

Journal of Surgical Oncology

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) is the most prevalent primary liver cancer, being the third most common cause of cancer-related death globally. HCC most frequently develops in the context of hepatic cirrhosis. HCC can manifest as various morphologic subtypes. Each pattern exhibits distinct behaviors in terms of imaging features, disease progression, response to therapy, and prognosis. While the nodular

show abstract

“…[ 5 ] A recent Cochrane meta‐analysis has reported that detection sensitivity is 78% and specificity is 91% for HCC lesions of any size. [ 6 ] For analysis focusing on small lesions, sensitivity has been reported to be as low as 40%. [ 7 ] Thus, HCC lesions are at danger of being missed at an early course of the disease when treatment is most promising.…”

Section: Introductionmentioning

confidence: 99%

A flexible three‐dimensional heterophase computed tomography hepatocellular carcinoma detection algorithm for generalizable and practical screening

Cheng

Cai²,

Teng

et al. 2022

Hepatol Commun

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) can be potentially discovered from abdominal computed tomography (CT) studies under varied clinical scenarios (e.g., fully dynamic contrast-enhanced [DCE] studies, noncontrast [NC] plus venous phase [VP] abdominal studies, or NC-only studies). Each scenario presents its own clinical challenges that could benefit from computer-aided detection (CADe) tools. We investigate whether a single CADe model can be made flexible enough to handle different contrast protocols and whether this flexibility imparts performance gains. We developed a flexible three-dimensional deep algorithm, called heterophase volumetric detection (HPVD), that can accept any combination of contrast-phase inputs with adjustable sensitivity depending on the clinical purpose. We trained HPVD on 771 DCE CT scans to detect HCCs and evaluated it on 164 positives and 206 controls. We compared performance against six clinical readers, including two radiologists, two hepatopancreaticobiliary surgeons, and two hepatologists. The area under the curve of the localization receiver operating characteristic for NC-only, NC plus VP, and full DCE CT yielded 0.71 (95% confidence interval [CI], 0.64-0.77), 0.81 (95% CI, 0.75-0.87), and 0.89 (95% CI, 0.84-0.93), respectively. At a high-sensitivity operating point of 80% on DCE CT, HPVD achieved 97% specificity, which is comparable to measured physician performance. We also demonstrated performance improvements over more typical and less flexible nonheterophase detectors. Conclusion: A single deep-learning algorithm can be effectively applied to diverse HCC detection clinical scenarios, indicating that HPVD could serve as a useful clinical aid for at-risk and opportunistic HCC surveillance.

show abstract

Computed tomography for the diagnosis of hepatocellular carcinoma in adults with chronic liver disease

Cited by 22 publications

References 231 publications

Monitoring the hepatobiliary function using image techniques and labeled cholephilic compounds

Monitoring the hepatobiliary function using image techniques and labeled cholephilic compounds

Diffuse infiltrative hepatocellular carcinoma: Multimodality imaging manifestations

A flexible three‐dimensional heterophase computed tomography hepatocellular carcinoma detection algorithm for generalizable and practical screening

Contact Info

Product

Resources

About