Early hepatocellular carcinoma that develops within macroregenerative nodules: growth rate depicted at serial MR imaging.

Sadek, Ahmed Galal; Mitchell, David; Siegelman, Evan S.; Outwater, Eric K.; Matteucci, T; Hann, Hie Won

doi:10.1148/radiology.195.3.7754006

Cited by 99 publications

(54 citation statements)

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“…Previously, the imaging findings of HCC have been described by several authors who also evaluated the imaging findings of smaller lesions (5,12,(21)(22)(23). Yamashita et al (24) evaluated the histological subtypes and differentiation degree of HCC in correlation with dynamics enhancement patterns, illustrating a correlation between degree and pattern of enhancement with tumor differentiation and internal architecture.…”

Section: Discussionmentioning

confidence: 99%

MR imaging of hepatocellular carcinoma: Relationship between lesion size and imaging findings, including signal intensity and dynamic enhancement patterns

Bos

Hussain

Dwarkasing

et al. 2007

Magnetic Resonance Imaging

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Purpose: To assess the relationship between lesion size and MR imaging findings of pathologically-proven hepatocellular carcinoma (HCC). Materials and Methods:In a retrospective, single-center study, 37 consecutive patients were identified between 1999 and 2005 that underwent preoperative MRI and surgical resection of HCC. A total of 47 lesions (mean size ϭ 6.85 cm, range ϭ 1-25 cm) were assessed for signal intensity (SI), enhancement patterns, and secondary morphologic features. Interobserver rating, percentage enhancement, and contrast-to-noise-ratio (CNR) were determined. Lesions were assessed for combinations of typical MRI features. Regression analysis was used to assess relations between MRI findings and tumor size. Results:On fat-suppressed T2-weighted (T2w) fast-spinecho, smaller lesions had lower SI compared to larger lesions (P Ͻ 0.05). In the arterial phase, smaller lesions showed significantly higher percentage enhancement compared to larger lesions (P Ͻ 0.05). In the delayed phase, smaller lesions showed less pronounced washout (P Ͻ 0.05). Heterogeneity of the lesions, including fatty infiltration, internal nodules, or mosaic pattern, was observed significantly more frequently in larger lesions (P Ͻ 0.001). The classic combination of high T2w signal, strong arterial enhancement, and delayed phase washout was present in 23 of 44 lesions (52%). Conclusion:Smaller HCC often showed lower SI on T2w, more intense arterial enhancement, and less pronounced delayed washout compared to larger HCC.

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Section: Discussionmentioning

confidence: 99%

MR imaging of hepatocellular carcinoma: Relationship between lesion size and imaging findings, including signal intensity and dynamic enhancement patterns

Bos

Hussain

Dwarkasing

et al. 2007

Magnetic Resonance Imaging

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“…The histopathologic volume of PZ cancer in each sextant (V) was calculated from the long-and short-axis diameters by using the formula V ϭ (4/3) ⅐ ⅐ (D/2) 3 (29), where D is the average of the longand short-axis diameters. SAS, version 9.0 (SAS Institute, Cary, NC); Stata, version 9.0 (Stata, College Station, Tex); and S-PLUS, version 7.0 (Insightful, Seattle, Wash), statistical software was used for data processing and statistical analyses.…”

Section: Statistical Analysesmentioning

confidence: 99%

Prostate Cancer: Sextant Localization at MR Imaging and MR Spectroscopic Imaging before Prostatectomy—Results of ACRIN Prospective Multi-institutional Clinicopathologic Study

et al. 2009

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Purpose:To determine the incremental benefit of combined endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging, as compared with endorectal MR imaging alone, for sextant localization of peripheral zone (PZ) prostate cancer. Materials and Methods:This prospective multicenter study, conducted by the American College of Radiology Imaging Network (ACRIN) from February 2004 to June 2005, was institutional review board approved and HIPAA compliant. Research associates were required to follow consent guidelines approved by the Office for Human Research Protection and established by the institutional review boards. One hundred thirty-four patients with biopsy-proved prostate adenocarcinoma and scheduled to undergo radical prostatectomy were recruited at seven institutions. T1-weighted, T2-weighted, and spectroscopic MR sequences were performed at 1.5 T by using a pelvic phased-array coil in combination with an endorectal coil. Eight readers independently rated the likelihood of the presence of PZ cancer in each sextant by using a five-point scalefirst on MR images alone and later on combined MR-MR spectroscopic images. Areas under the receiver operating characteristic curve (AUCs) were calculated with sextant as the unit of analysis. The presence or absence of cancer at centralized histopathologic evaluation of prostate specimens was the reference standard. Reader-specific receiver operating characteristic curves for values obtained with MR imaging alone and with combined MR imaging-MR spectroscopic imaging were developed. The AUCs were estimated by using MannWhitney statistics and appropriate 95% confidence intervals. Results:Complete data were available for 110 patients (mean age, 58 years; range, 45-72 years). MR imaging alone and combined MR imaging-MR spectroscopic imaging had similar accuracy in PZ cancer localization (AUC, 0.60 vs 0.58, respectively; P Ͼ .05). AUCs for individual readers were 0.57-0.63 for MR imaging alone and 0.54 -0.61 for combined MR imaging-MR spectroscopic imaging. Conclusion:In patients who undergo radical prostatectomy, the accuracy of combined 1.5-T endorectal MR imaging-MR spectroscopic imaging for sextant localization of PZ prostate cancer is equal to that of MR imaging alone. RSNA, 2009 Supplemental Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, use the Radiology Reprints form at the end of this article. Prostate cancer is the most common noncutaneous cancer and the second most common cause of cancer-related deaths in American men. In 2007, an estimated 218 890 new cases of prostate cancer were diagnosed and more than 27 000 men died of the disease (1). Additional indicators, including disability-adjusted life-years, estimated costs based on the Surveillance Epidemiology and End Results Program of the National Cancer Institute, and Medicare expenditures, illuminate the heavy burden that prostate cancer places on society (2,3). However, while the lifetime risk of recei...

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“…On T1-weighted gradient-echo images, such lesions typically show markedly low signal intensity of a large nodule, with internal foci that are isointense to the liver. At MR imaging, the recognition of HCC while still small is important because the tumor is aggressive and has a fast doubling time (24). Small HCC may also appear as small areas of slightly higher signal intensity than the surrounding liver on T2-weighted images.…”

Section: Small Hccmentioning

confidence: 99%

Benign versus Malignant Hepatic Nodules: MR Imaging Findings with Pathologic Correlation

Hussain¹,

Zondervan²,

IJzermans³

et al. 2002

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According to the currently used nomenclature, there are only two types of hepatocellular nodular lesions: regenerative lesions and dysplastic or neoplastic lesions. Regenerative nodules include monoacinar regenerative nodules, multiacinar regenerative nodules, cirrhotic nodules, segmental or lobar hyperplasia, and focal nodular hyperplasia. Dysplastic or neoplastic nodules include hepatocellular adenoma, dysplastic foci, dysplastic nodules, and hepatocellular carcinoma (HCC). Many of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of HCC, which comprises the following steps: regenerative nodule, low-grade dysplastic nodule, high-grade dysplastic nodule, small HCC, and large HCC. State-of-the-art magnetic resonance (MR) imaging facilitates detection and characterization in most cases of hepatic nodules. State-of-the-art MR imaging includes single-shot fast spin-echo imaging, in-phase and opposed-phase T1-weighted gradient-echo imaging, T2-weighted fast spin-echo imaging with fat saturation, and two-dimensional or three-dimensional dynamic multiphase contrast material-enhanced imaging.

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Early hepatocellular carcinoma that develops within macroregenerative nodules: growth rate depicted at serial MR imaging.

Abstract: HCC, which manifests initially as a small focus within a macroregenerative nodule, has the potential for rapid growth. This growth rate should be considered when plans are formulated for follow-up and/or treatment.

Cited by 99 publications

References 0 publications

MR imaging of hepatocellular carcinoma: Relationship between lesion size and imaging findings, including signal intensity and dynamic enhancement patterns

MR imaging of hepatocellular carcinoma: Relationship between lesion size and imaging findings, including signal intensity and dynamic enhancement patterns

Prostate Cancer: Sextant Localization at MR Imaging and MR Spectroscopic Imaging before Prostatectomy—Results of ACRIN Prospective Multi-institutional Clinicopathologic Study

Benign versus Malignant Hepatic Nodules: MR Imaging Findings with Pathologic Correlation

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