Imaging features of histological subtypes of hepatocellular carcinoma: Implication for LI-RADS

Cannella, Roberto; Burgio, Marco Dioguardi; Beaufrère, Aurélie; Trapani, Loïc; Paradis, Valérie; Hobeika, Christian; Cauchy, François; Benameur, M.; Vilgrain, Valérie; Sartoris, Riccardo; Ronot, Maxime

doi:10.1016/j.jhepr.2021.100380

Cited by 44 publications

(44 citation statements)

References 24 publications

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“…This association between macrotrabecular-massive growth pattern and higher AFP expression was recently confirmed by the recent studies of Cannella et al 23 Ridder et al 49 ( Supplementary Material Figure S1 ).…”

Section: Prognosissupporting

confidence: 69%

“…In a recent Italo-French study, 23 the larger size, the presence of tumor in vein (TIV), at least 1 LR-M feature (LI-RADS major features, ie non-rim APHE, non-peripheral “washout”, and enhancing “capsule”), infiltrative appearance and necrosis or severe ischaemia were significantly more frequent in MTM-HCCs than in other subtypes on contrast-enhanced CT).…”

Section: Radiological Features Of Macrotrabecular-massive Hepatocellu...mentioning

confidence: 97%

“…22 Coherently with Renne, Cannella et al found MTM-HCC in 7.8% of 295 HCCs cases. 23 In a recent American study, 24 MTM-HCC was reported in 7.1% of 378 HCC. However, the macrotrabecular pattern was more commonly seen in HCCs arising in non-fibrotic liver tissues compared with HCCs in cirrhosis (13.68% vs 4.95%) (Table 1).…”

mentioning

confidence: 95%

“…15 Hence, the presence of substantial necrosis on imaging may lead to consideration for lesion biopsy with therapeutic and prognostic intent, especially as the MTM-HCC subtype can be accurately diagnosed in biopsy samples. 11 In a recent Italo-French study, 23 the larger size, the presence of tumor in vein (TIV), at least 1 LR-M feature (LI-RADS major features, ie non-rim APHE, non-peripheral "washout", and enhancing "capsule"), infiltrative appearance and necrosis or severe ischaemia were significantly more frequent in MTM-HCCs than in other subtypes on contrast-enhanced CT). In addition, TIV and larger size tended to be more frequent in MTM-HCCs on MRI too.…”

mentioning

confidence: 99%

“…In addition, TIV and larger size tended to be more frequent in MTM-HCCs on MRI too. 23 Imaging findings of MTM-HCC could help select HCC patients who show poor outcomes after curative treatment as potential candidates for clinical trials of neoadjuvant strategies (Figure 2).…”

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confidence: 99%

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Macrotrabecular-Massive Hepatocellular Carcinoma: Light and Shadow in Current Knowledge

Sessa¹,

Mulé²,

Brustia³

et al. 2022

JHC

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The subject of this narrative review is macrotrabecular-massive hepatocellular carcinoma (MTM-HCC). Despite their rarity, these tumours are of general interest because of their epidemiological and clinical features and for representing a distinct model of the interaction between the angiogenetic system and neoplastic cells. The MTM-HCC subtype is associated with various adverse biological and pathological parameters (the Alfa-foetoprotein (AFP) serum level, tumour size, vascular invasion, and satellite nodules) and is a key determinant of patient prognosis, with a strong and independent predictive value for early and overall tumour recurrence. Gene expression profiling has demonstrated that angiogenesis activation is a hallmark feature of MTM-HCC, with overexpression of both angiopoietin 2 (ANGPT2) and vascular endothelial growth factor A (VEGFA).

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Section: Prognosissupporting

confidence: 69%

Section: Radiological Features Of Macrotrabecular-massive Hepatocellu...mentioning

confidence: 97%

mentioning

confidence: 95%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Macrotrabecular-Massive Hepatocellular Carcinoma: Light and Shadow in Current Knowledge

Sessa¹,

Mulé²,

Brustia³

et al. 2022

JHC

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Correlations behind macrotrabecular‐massive and vessels encapsulating tumor cluster patterns in hepatocellular carcinoma

et al. 2023

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Macrotrabecular‐massive hepatocellular carcinoma (MTM‐HCC) is a subtype of HCC with a very poor prognosis and exhibits biological behaviors and clinical presentations that distinguish it from conventional HCC. Vessels encapsulating tumor clusters (VETC) is a unique pattern of vascular growth that is more common in patients with MTM‐HCC. This unique interaction between the angiogenic system and tumor cells is of general interest. Early diagnosis and appropriate treatment of HCC with MTM and VETC patterns help prevent early recurrence and improve prognosis. This review summarizes the existing findings for HCC with MTM and VETC patterns.

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Nomogram Estimating Vessels Encapsulating Tumor Clusters in Hepatocellular Carcinoma From Preoperative Gadoxetate Disodium‐Enhanced MRI

Chen

et al. 2022

Magnetic Resonance Imaging

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Background Vessels encapsulating tumor clusters (VETC) pattern is a novel microvascular pattern associated with poor outcomes of hepatocellular carcinoma (HCC). Preoperative estimation of VETC has potential to improve treatment decisions. Purpose To develop and validate a nomogram based on gadoxetate disodium‐enhanced MRI for estimating VETC in HCC and to evaluate whether the estimations are associated with recurrence after hepatic resection. Study Type Retrospective. Population A total of 320 patients with HCC and histopathologic VETC pattern assessment from three centers (development cohort:validation cohort = 173:147). Field Strength/Sequence A3.0 T/turbo spin‐echo T2‐weighted, spin‐echo echo‐planar diffusion‐weighted, and 3D T1‐weighted gradient‐echo sequences. Assessment A set of previously reported VETC‐ and/or prognosis‐correlated qualitative and quantitative imaging features were assessed. Clinical and imaging variables were compared based on histopathologic VETC status to investigate factors indicating VETC pattern. A regression‐based nomogram was then constructed using the significant factors for VETC pattern. The nomogram‐estimated VETC stratification was assessed for its association with recurrence. Statistical Tests Fisher exact test, t‐test or Mann–Whitney test, logistic regression analyses, Harrell's concordance index (C‐index), nomogram, Kaplan–Meier curves and log‐rank tests. P value < 0.05 was considered statistically significant. Results Pathological VETC pattern presence was identified in 156 patients (development cohort:validation cohort = 83:73). Tumor size, presence of heterogeneous enhancement with septations or with irregular ring‐like structures, and necrosis were significant factors for estimating VETC pattern. The nomogram incorporating these indicators showed good discrimination with a C‐index of 0.870 (development cohort) and 0.862 (validation cohort). Significant differences in recurrence rates between the nomogram‐estimated high‐risk VETC group and low‐risk VETC group were found (2‐year recurrence rates, 50.7% vs. 30.3% and 49.6% vs. 31.8% in the development and validation cohorts, respectively). Data Conclusion The nomogram integrating gadoxetate disodium‐enhanced MRI features was associated with VETC pattern preoperatively and with postoperative recurrence in patients with HCC. Evidence Level 4 Technical Efficacy Stage 2

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Imaging features of histological subtypes of hepatocellular carcinoma: Implication for LI-RADS

Cited by 44 publications

References 24 publications

Macrotrabecular-Massive Hepatocellular Carcinoma: Light and Shadow in Current Knowledge

Macrotrabecular-Massive Hepatocellular Carcinoma: Light and Shadow in Current Knowledge

Correlations behind macrotrabecular‐massive and vessels encapsulating tumor cluster patterns in hepatocellular carcinoma

Nomogram Estimating Vessels Encapsulating Tumor Clusters in Hepatocellular Carcinoma From Preoperative Gadoxetate Disodium‐Enhanced MRI

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