Hepatocellular Carcinoma and Intrahepatic Peripheral Cholangiocarcinoma: Enhancement Patterns with Quadruple Phase Helical CT—A Comparative Study

Loyer, Evelyne M.; Chin, Hsiao; DuBrow, Ronelle A.; David, Cynthia L.; Eftekhari, Farzin; Charnsangavej, Chusilp

doi:10.1148/radiology.212.3.r99se32866

Cited by 111 publications

(68 citation statements)

References 19 publications

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“…While there is ample evidence supporting the classic imaging features of ICC, few studies test the ability of these features to help differentiate ICC from HCC, and fewer studies focus on these lesions in patients with defined risk factors or cirrhosis (ie, the LI-RADS population) (87,116,117,119,(121)(122)(123). The studies that have attempted to determine the discriminatory power of diagnostic imaging for differentiating HCC from ICC have focused on atypical HCC in the comparator group.…”

Section: Review: Li-rads Major Features For Hepatocellular Carcinoma mentioning

confidence: 99%

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

et al. 2018

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The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). It assigns category codes reflecting relative probability of HCC to imaging-detected liver observations based on major and ancillary imaging features. LI-RADS also includes imaging features suggesting malignancy other than HCC. Supported and endorsed by the American College of Radiology (ACR), the system has been developed by a committee of radiologists, hepatologists, pathologists, surgeons, lexicon experts, and ACR staff, with input from the American Association for the Study of Liver Diseases and the Organ Procurement Transplantation Network/United Network for Organ Sharing. Development of LI-RADS has been based on literature review, expert opinion, rounds of testing and iteration, and feedback from users. This article summarizes and assesses the quality of evidence supporting each LI-RADS major feature for diagnosis of HCC, as well as of the LI-RADS imaging features suggesting malignancy other than HCC. Based on the evidence, recommendations are provided for or against their continued inclusion in LI-RADS.q RSNA, 2017 Online supplemental material is available for this article.An Tang REVIEW: LI-RADS Major Features for Hepatocellular Carcinoma DiagnosisTang et al selection of five major features was based on expert opinion, the literature review was performed to ensure that imaging-based diagnostic criteria were able to achieve near-100% specificity for the noninvasive diagnosis of HCC. This review focused on the evidence supporting the inclusion of imaging features and did not attempt to gather evidence on the composition of the LI-RADS diagnostic algorithm and probability of HCC for different combinations of criteria (other than the hallmark combination of APHE and washout appearance) in the LI-RADS diagnostic table.Each subgroup was charged with developing key research questions and then critically reviewing the literature to answer research questions thematically related to its assigned topic. Search StrategyThe PICO (patient population, intervention, comparison, and outcome) format frequently used in structured reviews does not lend itself well to studies of diagnostic performance. Rather than using PICO-style questions to guide the searches, therefore, the subgroups formulated free-form questions in advance with feedback from the other subgroups. A total of 10 questions were formulated under the framework and with the understanding that their answers would inform recommendations for removing or continuing to include the corresponding LI-RADS features. After the questions were formulated, each subgroup searched the PubMed develop a standardized Liver Imaging Reporting and Data System (LI-RADS) for interpretation, reporting, and data collection of imaging studies in patients at risk for developing HCC (1). The committee was composed mainly of diagnostic radiologists, but also hepatologists, surgeons, patho...

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Section: Review: Li-rads Major Features For Hepatocellular Carcinoma mentioning

confidence: 99%

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

et al. 2018

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“…At computed tomography, peripheral cholangiocarcinoma appears as an irregular mass with markedly low attenuation and internal stippled hyperattenuating foci (14,53,103). Dynamic computed tomography and magnetic resonance imaging reveal rim-like or band-like peripheral contrast enhancement of variable thickness around the tumor during the early phase, with progressive and concentric filling of contrast material at later phase (25,53,72,75). This phenomenon is explained by slow diffusion of contrast materials into the interstitial spaces of the tumor (47).…”

Section: Imaging Findingsmentioning

confidence: 99%

Clonorchiasis and Cholangiocarcinoma: Etiologic Relationship and Imaging Diagnosis

et al. 2004

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Despite a gradual decrease in prevalence, clonorchiasis is still prevalent in East Asia. A large and compelling body of evidence links clonorchiasis and cholangiocarcinoma, although the mechanisms involved are not completely understood. Clonorchiasis induces biliary epithelial hyperplasia and metaplasia, and this could facilitate at least one stage of the carcinogenesis, which is promoting effect. In areas of endemic infection, more clonorchiasis cases are now diagnosed incidentally during radiological examinations such as cholangiography, ultrasonography, and computed tomography. Radiological findings are regarded as pathognomonic for clonorchiasis since they reflect the unique pathological changes of this disorder. These radiological examinations currently play important roles in the diagnosis, staging, and decision-making process involved in the treatment of cholangiocarcinoma. The morphological features and radiological findings of clonorchiasis-associated cholangiocarcinoma are essentially combinations of the findings for the two diseases. The morphological features of clonorchiasis- associated cholangiocarcinoma, observed in radiological examinations, do not differ from those of the usual cholangiocarcinoma. In patients diagnosed with or suspected to have clonorchiasis, radiological findings should be carefully scrutinized for occult cholangiocarcinoma

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“…giving mean intensity (111 HU) which is lower than the other organs and relative to surrounding liver parenchyma; and during the arterial phase HCC intensity value reached the maximum enhancement with mean intensity of (146 HU), but it is still lower than the surrounding normal liver parenchyma, therefore the tumor appear as hypo-attenuating as shown in Figure (3, 4), while during the venous phase the intensity of the tumor were decreased and clearly washout as detected with mean intensity of (137 HU). In contrast the intensity of surrounding normal liver tissue were increased during the hepatic arterial phase showing the plateau at (172.1 HU) and decreased to (158 HU) in venous phase as shown in Figure (4), such phenomena has been ascribed to intra-lesions enhancement of the contrast medium during the arterial phase [21,22] which in turn related to the differences in blood supply.…”

Section: Resultsmentioning

confidence: 95%

Characterization of Hepatocellular Carcinoma Using CT Intensity and K-means

2016

IJSR

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The aim of this study was to characterize the hepatocellular carcinoma HCC CT intensity relative to normal liver tissue and other abdominal organs kidney, pancreas and stomach. The method used was the texture analysis which is depends on the collection of CT Number in Hounsfield Unit as excerpted from the k-means technique and the CT system used was tri-phases multidetector computerized tomography MDCT. The analyzed data showed that: the detected mean size of HCC lesions was 11.2±5.3 cm 2 . And the mean intensity in HU of the selected abdominal classes i.e. HCC, liver, kidney, spleen and stomach were (111, 146, 137), (128, 172.1, 158), (172, 221, 207.6), (142, 188, 174), (151, 196, 182.7) during plain, arterial and venous phases respectively. While the ultimate golden scored was the intensity% of HCC relative to normal liver, kidney, spleen and stomach through the different imaging phases (plain, arterial and venous), were: 1%, 26%, 83%, 42% and 80% respectively.

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Hepatocellular Carcinoma and Intrahepatic Peripheral Cholangiocarcinoma: Enhancement Patterns with Quadruple Phase Helical CT—A Comparative Study

Abstract: The variation over time in the intensity of contrast enhancement in HCC and cholangiocarcinoma differs sufficiently to make this a useful diagnostic criterion. The delayed phase is particularly important because it amplifies this difference.

Cited by 111 publications

References 19 publications

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

Clonorchiasis and Cholangiocarcinoma: Etiologic Relationship and Imaging Diagnosis

Characterization of Hepatocellular Carcinoma Using CT Intensity and K-means

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