CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part I. Development, Growth, and Spread: Key Pathologic and Imaging Aspects

Choi, Jin Young; Lee, Jeong Min; Sirlin, Claude B.

doi:10.1148/radiol.14132361

Cited by 437 publications

(404 citation statements)

References 139 publications

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“…The perlesion sensitivity of MRI for detecting nodular HCC of all sizes is 77% to 100%, whereas that of CT is 68% to 91%. 2 For HCC ≥2 cm, MRI and CT showed a detection rate of 100% for each modality; for HCC between 1 and 2 cm, MRI and CT showed detection rates of 89% and 65% (P = .03); and for HCC ≤1 cm, detection rates of 34% and 10% were seen. In addition to its higher detection rates, MRI is considered to be more specific, with fewer false-positive lesions than CT detects in differentiating between HCC and regenerative nodules.…”

Section: Diagnosis Of Hepatocellular Carcinomamentioning

confidence: 83%

“…The key distinguishing feature, present in early HCCs but not in high-grade dysplastic nodules, is stromal invasion. 2 Histologic features of HCC include advanced architectural distortion, nuclear atypia, necrosis, and microscopic invasion of stroma and portal tracts. Small HCCs tend to be well differentiated.…”

Section: Dysplastic Nodulesmentioning

confidence: 99%

“…In the typical pathway, a regenerative nodule progresses first to a dysplastic nodule (low grade, then possibly high grade), then to a welldifferentiated HCC, and finally to a moderately or poorly differentiated HCC. 2 Hepatocellular carcinoma appears to be a progressive disease of the liver in which multiple neoplastic processes can be present at one time, and there is a high risk of disease recurrence. Liver resection, liver transplant, and percutaneous tumor ablation are considered to be curative treatment options for HCC at different stages of the disease.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, all guidelines endorse multiphasic computed tomography (CT) and magnetic resonance imaging (MRI) with extracellular agents as first-line modalities for this purpose. 2 …”

Section: Introductionmentioning

confidence: 99%

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Untitled

Çoşkun

2017

Exp Clin Transplant

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Hepatocellular carcinoma is the fifth most common tumor in patients worldwide and the third most common cause of cancer-related death, after lung and stomach cancer. Cirrhosis of the liver is the strongest predisposing factor for hepatocellular carcinoma, with approximately 80% of cases of hepatocellular carcinoma developing in a cirrhotic liver. The annual incidence of hepatocellular carcinoma is 2.0% to 6.6% in patients with cirrhosis compared with 0.4% in patients without cirrhosis. The 5-year survival rates of patients undergoing curative therapies for hepatocellular carcinoma, including liver transplant, hepatic resection, and percutaneous ablative techniques, range between 40% and 75%. Orthotropic liver transplant offers the prima facie cure for both hepatocellular carcinoma and liver cirrhosis. In hepatocellular carcinoma confined to the liver without macrovascular invasion, patients with a single tumor ≤ 5 cm or up to 3 tumors ≤ 3 cm each had a 5-year survival rate of 75% and a disease-free survival rate of 83%. In the adult population, liver transplant for hepatocellular carcinoma yields good results for patients whose tumor masses do not exceed the Milan criteria. The diagnosis of hepatocellular carcinoma using imaging tests has had a substantial impact on transplant decisions. Radiologists should be aware of this responsibility and exercise the utmost scrutiny before making a diagnosis of hepatocellular carcinoma. Erroneous diagnosis of hepatocellular carcinoma based on imaging tests could deny deserving patients the opportunity of a life-saving liver transplant and result in unnecessary liver transplants for others. Contrast-enhanced magnetic resonance imaging and helical computed tomography are the best imaging techniques currently available for the noninvasive diagnosis of hepatocellular carci noma. With technological advances in hardware and software, diffusionweighted imaging can be readily applied to the liver with resulting improved image quality.

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Section: Diagnosis Of Hepatocellular Carcinomamentioning

confidence: 83%

Section: Dysplastic Nodulesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Currently, all guidelines endorse multiphasic computed tomography (CT) and magnetic resonance imaging (MRI) with extracellular agents as first-line modalities for this purpose. 2 …”

Section: Introductionmentioning

confidence: 99%

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Untitled

Çoşkun

2017

Exp Clin Transplant

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“…Cirrhotic and healthy controls had matched age and sex with HCC patients. All included cases of HCC was diagnosed on the basis of the presence of typical vascular enhancement pattern of liver lesion (s) in contrast enhanced dynamic CT scan or MRI [18]. Diagnosis of cirrhosis was based on combined historical, clinical, laboratory and radiological findings.…”

Section: Methodsmentioning

confidence: 99%

Serum Soluble Cd25 in Hepatocellular Carcinoma, Shall We Be Able to Change the Natural History?

Sameea¹,

Zakareya

Metwaly³

et al. 2017

IJMMR

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Background. Although hepatocellular carcinoma (HCC) is one of the most common malignancy related IntroductionHepatocellular carcinoma is one of the most serious and life threatening complications of chronic liver disease. It represents the 5 th most common malignancy in men, the 7 th in women and the 3 rd malignancy related mortality worldwide. Curative treatment strategy can be achieved if detected in early stages [1][2][3][4]. The role of serum α fetoprotein (AFP), the widely used classical biomarker for HCC, has been stepped down in the recent European and American surveillance guidelines because of low sensitivity and specificity. This is based on the knowledge that almost 80% of small HCCs do not show increased levels of AFP, and the sensitivity decreases to 25% in tumors smaller than 3 cm [5][6][7][8]. Looking for a new marker with a better

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