Histopathologically confirmed focal nodular hyperplasia of the liver: Gadoxetic acid-enhanced MRI characteristics

Grieser, Christian; Steffen, Ingo G.; Seehofer, Daniel; Kramme, Incken-Birthe; Uktolseya, Robert; Scheurig-Muenkler, Christian; Hamm, Bernd; Denecke, Timm

doi:10.1016/j.mri.2012.11.006

Cited by 33 publications

(33 citation statements)

References 26 publications

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“…Whereas focal nodular hyperplasia requires neither follow-up nor treatment, inflammatory and b-catenin HCAs require intervention. Fortunately, 90% of focal nodular hyperplasia undergo homogeneous gadoxetic retention in the HBP series in contrast to the heterogeneous retention pattern of inflammatory and b-catenin HCAs, which we found in our cohort as well (13,15,26). In addition, the higher T2-weighted signal intensity may favor the diagnosis of an adenoma (17,26).…”

Section: Gastrointestinal Imaging: Hepatocellular Adenoma With Gadoxecontrasting

confidence: 63%

“…Fortunately, 90% of focal nodular hyperplasia undergo homogeneous gadoxetic retention in the HBP series in contrast to the heterogeneous retention pattern of inflammatory and b-catenin HCAs, which we found in our cohort as well (13,15,26). In addition, the higher T2-weighted signal intensity may favor the diagnosis of an adenoma (17,26). Furthermore, clinical risk factors can be useful to determine which of these lesions should, at least, be followed up (17).…”

Section: Gastrointestinal Imaging: Hepatocellular Adenoma With Gadoxementioning

confidence: 46%

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Morphologic and Molecular Features of Hepatocellular Adenoma with Gadoxetic Acid–enhanced MR Imaging

Ba‐Ssalamah¹,

Antunes

Feier³

et al. 2015

Radiology

102

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Purpose:To evaluate the diagnostic performance of imaging features of gadoxetic acid-enhanced magnetic resonance (MR) imaging to differentiate among hepatocellular adenoma (HCA) subtypes by using the histopathologic results of the new immunophenotype and genotype classification and to correlate the enhancement pattern on the hepatobiliary phase (HBP) with the degrees of expression of organic anion transporting polypeptide (OATP1B1/3), multidrug resistance-associated protein 2 (MRP) (MRP2), and MRP 3 (MRP3) transporters. Materials and Methods:This retrospective study was approved by the institutional review board, and the requirement for informed consent waived. MR imaging findings of 29 patients with 43 HCAs were assessed by two radiologists independently then compared with the histopathologic analysis as the standard of reference. Receiver operating characteristic curves and Spearman rank correlation coefficient were used to test the diagnostic performance of gadoxetic acid-enhanced MR imaging features, which included the retention or washout at HBP and degree of transporter expression. Interreader agreement was assessed by using the k statistic with 95% confidence interval. Results:The area under the curve for the diagnosis of inflammatory HCA was 0.79 (95% confidence interval: 0.64, 0.90); for the steatotic type, it was 0.90 (95% confidence interval: 0.77, 0.97); and for the b-catenin type, it was 0.87 (95% confidence interval: 0.74, 0.95). There were no imaging features that showed a significant statistical correlation for the diagnosis of unclassified HCAs. On immunohistochemical staining, OATP1B1/3 expression was the main determinant for the retention, whereas MRP3 was the key determinant for washout of gadoxetic acid at HBP (P , .001). MRP2 appeared to have no role. Conclusion:Gadoxetic acid-enhanced MR imaging features may suggest the subtype of HCA. The degree of OATP1B1/3 and MRP3 expression correlated statistically with gadoxetic acid retention and washout, respectively, in the HBP.q RSNA, 2015

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Section: Gastrointestinal Imaging: Hepatocellular Adenoma With Gadoxecontrasting

confidence: 63%

Section: Gastrointestinal Imaging: Hepatocellular Adenoma With Gadoxementioning

confidence: 46%

Morphologic and Molecular Features of Hepatocellular Adenoma with Gadoxetic Acid–enhanced MR Imaging

Ba‐Ssalamah¹,

Antunes

Feier³

et al. 2015

Radiology

102

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“…Among the HBP hyperintense nodules, FNH in patients without chronic liver disease and FNH-like nodules in patients with chronic liver disease are the most common lesions whose typical enhancement features on Gd-EOB-MRI include i) hyperenhancement on the hepatic arterial phase (HAP), ii) no washout during PVP/TP, iii) hyperintensity in the area of hepatocyte hyperplasia and iv) central stellate hypointensity in the area of the fibrous scar on the HBP [64] (fig. 5).…”

Section: Hcc Vs Other Hepatocellular Nodulesmentioning

confidence: 99%

Recent Advances in the Imaging Diagnosis of Hepatocellular Carcinoma: Value of Gadoxetic Acid-Enhanced MRI

Joo

Lee

2015

Liver Cancer

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Magnetic resonance imaging (MRI) using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DPTA), or gadoxetic acid for short, is a hepatocyte-specific contrast agent which is now increasingly used for the detection and characterization of focal hepatic lesions, particularly in patients at high-risk of developing hepatocellular carcinomas (HCC). In fact, several recent guidelines now recognize gadoxetic acid-enhanced MRI (Gd-EOB-MRI) as the primary diagnostic imaging modality for the noninvasive diagnosis of HCC, although it must be noted that several major guidelines still include only extracellular contrast media-enhanced computed tomography and MRI. The primary merits of Gd-EOB-MRI lie in the fact that it can provide not only dynamic imaging, but also hepatobiliary phase (HBP) imaging which can lead to high lesion-to-liver contrast and give additional information regarding hepatocyte uptake via organic anion transporting polypeptides. This, in turn, allows higher sensitivity in detecting small HCCs and helps provide additional information regarding the multistep process of hepatocarcinogenesis. Indeed, many recent studies have investigated the diagnostic value of Gd-EOB-MRI for early HCCs as well as its role as a potential imaging biomarker in predicting outcome. We herein review the recent advances in the imaging diagnosis of HCCs focusing on the applications of Gd-EOB-MRI and the challenging issues that remain.

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“…To date, several reports have shown that the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI (Gd-EOB-DTPA-MRI) is particularly helpful for the diagnosis of FNHs, as most FNHs show high or iso signal intensity (SI) relative to the liver parenchyma on the HBP, unlike most other solid tumours in the liver [8][9][10][11][12][13][14][15][16][17]. FNH is a non-neoplastic condition formed by mono-acinar nodules composed of normalfunctioning hepatocytes and abnormal bile ducts that do not communicate with the surrounding biliary system.…”

Section: Introductionmentioning

confidence: 99%

“…Several individual studies have been performed to evaluate the diagnostic value of Gd-EOB-DTPA-MRI for the diagnosis of FNH; however, the majority of these studies have been retrospective, descriptive studies with low-level evidence [8][9][10][11][12][13][14][15][16][17]. To our knowledge, there has been no attempt to generate a systematic summary regarding the imaging findings and diagnostic value of Gd-EOB-DTPA-MRI that would have a great impact on more evidence-based management of patients with FNHs.…”

Section: Introductionmentioning

confidence: 99%

The diagnostic value of Gd-EOB-DTPA-MRI for the diagnosis of focal nodular hyperplasia: a systematic review and meta-analysis

Suh

Kim

et al. 2014

Eur Radiol

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Histopathologically confirmed focal nodular hyperplasia of the liver: Gadoxetic acid-enhanced MRI characteristics

Cited by 33 publications

References 26 publications

Morphologic and Molecular Features of Hepatocellular Adenoma with Gadoxetic Acid–enhanced MR Imaging

Morphologic and Molecular Features of Hepatocellular Adenoma with Gadoxetic Acid–enhanced MR Imaging

Recent Advances in the Imaging Diagnosis of Hepatocellular Carcinoma: Value of Gadoxetic Acid-Enhanced MRI

The diagnostic value of Gd-EOB-DTPA-MRI for the diagnosis of focal nodular hyperplasia: a systematic review and meta-analysis

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