Hepatic neuroendocrine tumors: gadoxetic acid-enhanced magnetic resonance imaging findings with an emphasis on differentiation between primary and secondary tumors

Ik, Dong; Kang, Tae Wook; Jang, Kyoung Mi; Kim, Young Kon; Kim, Seong Hyun; Ha, Sang Yun; Sohn, Insuk

doi:10.1007/s00261-018-1653-6

Cited by 15 publications

(13 citation statements)

References 25 publications

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“…our study included many mimickers of HCC, such as intrahepatic cholangiocarcinoma, cholangiolocellular carcinoma, neuroendocrine tumor, and hypervascular pseudolesion, which can be misdiagnosed as HCC because of non-rim APHE [29][30][31][32] and hypointensity on HBP. 33 According to the Liver Cancer Study Group of Japan registry data in 2006-2007, the ratio of intrahepatic cholangiocarcinoma vs. HCC was 208:15250 (≈1:73) in patients with chronic liver disease.…”

Section: Discussionmentioning

confidence: 99%

Optimal Combination of Features on Gadoxetate Disodium-enhanced MR Imaging for Non-invasive Differential Diagnosis of Hepatocellular Carcinoma: The JAMP-HCC Study

et al. 2021

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Purpose:To determine the optimal combination of gadoxetate disodium-enhanced magnetic resonance imaging (MRI) findings for the diagnosis of hepatocellular carcinoma (HCC) and to compare its diagnostic ability to that of dynamic computed tomography (CT) in patients with chronic liver disease. Methods:This multi-institutional study consisted of two parts: Study 1, a retrospective study to determine the optimal combination of gadoxetate disodium-enhanced MRI findings (decision tree and logistic model) to distinguish HCC (n = 199) from benign (n = 81) or other malignant lesions (n = 95) (375 nodules in 269 patients) and Study 2, a prospective study to compare the diagnostic ability of gadoxetate disodiumenhanced MRI to distinguish HCC (n = 73) from benign (n = 15) or other malignant lesions (n = 12) with that of dynamic CT (100 nodules in 83 patients). Two radiologists independently evaluated the imaging findings (Study 1 and 2) and made a practical diagnosis (Study 2). Results:In Study 1, rim or whole enhancement on arterial phase images, signal intensities on T 2 -weighted/ diffusion-weighted/portal venous/transitional/hepatobiliary phase images, and signal drop on opposedphase images were independently useful for differential diagnosis. In Study 2, the accuracy, sensitivity, negative predictive value, and negative likelihood ratio of the CT decision tree (reader 2) were higher than those of MRI Model 2 (P = 0.015-0.033). There were no other significant differences in diagnostic ability (P = 0.059-1.000) and radiologist-made practical diagnosis (P = 0.059-1.000) between gadoxetate disodiumenhanced MRI and CT. Conclusion:We identified the optimal combination of gadoxetate disodium-enhanced MRI findings for HCC diagnosis. However, its diagnostic ability was not superior to that of dynamic CT.

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Section: Discussionmentioning

confidence: 99%

Optimal Combination of Features on Gadoxetate Disodium-enhanced MR Imaging for Non-invasive Differential Diagnosis of Hepatocellular Carcinoma: The JAMP-HCC Study

et al. 2021

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“…When tumors were discovered, they had reached the middle or advanced stage, and the size of tumors was very large. [1][2][3][8][9][10] In literature, it was reported that the size of tumors usually ranged from 0.4 cm to19 cm (mean 6.84 + 4.29 cm) [11] when they were detected. Consequently, leading to delayed treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, when the lesion is large, it exhibits peripheral enhancement. In 2018, the use of indoleacetic acid-enhanced MRI was reported by Cha et al [3] in an attempt to identify primary and metastatic NET.…”

Section: Imaging Characteristicsmentioning

confidence: 99%

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Primary hepatic neuroendocrine tumors

2019

Medicine

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Rationale: Primary hepatic neuroendocrine tumors (PHNET) are extremely rare, which makes it difficult for doctors not deeply to be aware of their imaging and pathological characteristics. Therefore, it is challenging to diagnose PHNET accurately without biopsy or surgical excision. The purpose of this study is (1) to introduce the magnetic resonance imaging (MRI) and pathological characteristics of primary neuroendocrine tumors, so as to facilitate early diagnosis of PHNET to be made by doctors,(2) and to introduce the treatment of PHNET.

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“…Histopathological assessment including positive synaptophysin (Syn) immunostaining and neuron-specific enolase are said to be a decisive diagnostic procedure. Long post-operative observation, with no primary sites identified in imaging, is crucial for the acknowledgment of a formal diagnosis [3].…”

Section: Introductionmentioning

confidence: 99%

Liver transplantation as an option of treatment for a giant primary hepatic neuroendocrine tumour

Oczkowicz

Caban

Zemczak

et al. 2019

Endokrynologia Polska

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There are no clear guidelines for the treatment of hepatic neuroendocrine tumours. Surgical resections-though rarely radical-seem to be the treatment of choice. Thermoablation, chemoembolisation, or cytoreductive surgery of hepatic focal lesions are often recommended. Pharmacological treatment is based on somatostatin analogues. Liver transplantation is available for a strictly selected group of patients with hepatic neuroendocrine tumours [5]. In the case described above, there were a number of factors that affected the decision about eligibility: first of all-very slow growth of the tumour, its size, and typical multifocality, which made it impossible to perform resection, lack of neoplastic focus outside the liver, and low Ki-67 proliferation index of ≤ 2%. The surgical risk was escalated due to the giant tumour mass and the laparotomy, which was performed twice.

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Hepatic neuroendocrine tumors: gadoxetic acid-enhanced magnetic resonance imaging findings with an emphasis on differentiation between primary and secondary tumors

Abstract: Using these specific MR imaging criteria, secondary hNETs could be differentiated from primary hNETs with a high degree of accuracy in patients with histopathologically proven hNETs.

Cited by 15 publications

References 25 publications

Optimal Combination of Features on Gadoxetate Disodium-enhanced MR Imaging for Non-invasive Differential Diagnosis of Hepatocellular Carcinoma: The JAMP-HCC Study

Optimal Combination of Features on Gadoxetate Disodium-enhanced MR Imaging for Non-invasive Differential Diagnosis of Hepatocellular Carcinoma: The JAMP-HCC Study

Primary hepatic neuroendocrine tumors

Liver transplantation as an option of treatment for a giant primary hepatic neuroendocrine tumour

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