Imaging of liver cancer

Ariff, Ben; Lloyd, Claire; Khan, Sameer; Shariff, Mohamed; Thillainayagam, Andrew V.; Bansi, Devinder S.; Khan, Shahid A.; Taylor‐Robinson, Simon D.; Lim, Adrian

doi:10.3748/wjg.15.1289

Cited by 99 publications

(67 citation statements)

References 97 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore HCC surveillance has been recommended by expert associations to improve survival of patients by identifying tumors in earlier stages [2][3][4] . Conventional or baseline ultrasound (BUS) is often used as the first-line tool for HCC surveillance, as well as for the detection of HCC or other focal liver lesions (FLLs) because of its efficiency, availability, non-invasiveness, and relatively low cost [5] . However, in view of the low ability of BUS to demonstrate tumor vascularity, it is sometimes difficult to differentiate benign FLLs (generally having a preferential portal venous blood supply) from malignant ones (generally having a preferential hepatic arterial supply) using BUS alone [6] .…”

Section: Introductionmentioning

confidence: 99%

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Wong

Xu²,

Xie³

2009

WJR

View full text Add to dashboard Cite

Patients with liver cirrhosis are at increased risk of hepatocellular carcinoma (HCC). Conventional or baseline ultrasound (BUS) is often used as the first-line tool for HCC surveillance or detection, but the accuracy of BUS in HCC detection or differentiation from other focal liver lesions (FLLs) is limited. Contrast-enhanced ultrasound (CEUS) represents a recent revolution in the field of ultrasonography and it has become increasingly important in the detection and evaluation of FLLs. In CEUS, HCC typically exhibits arterial hyper-enhancement and portal-venous washout represented by hypoenhanced lesions in the portal venous and late phases. The detection rate of HCC was significantly higher with CEUS compared with BUS. Even regenerative or some dysplastic nodules may exhibit arterial hyperenhancement as they are differentiated from HCC by its iso-enhancing pattern in portal and late phases. The contrast-enhancement patterns of other different types of benign and malignant FLLs, as well as their detection rates with CEUS, were also discussed.

show abstract

Section: Introductionmentioning

confidence: 99%

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Wong

Xu²,

Xie³

2009

WJR

View full text Add to dashboard Cite

show abstract

“…Although CT is the most commonly used imaging modality in HCC, it remains relatively insensitive for the detection of small HCC or intrahepatic metastases, especially in cirrhotic patients [6]. MRI provides higher lesion to liver contrast than CT, and …”

Section: Discussionmentioning

confidence: 99%

“…Many studies have reported that the treatment response and survival of hepatocellular carcinoma (HCC) patients are related to the delivered radiation dose [1][2][3]. Recently, detailed information on HCC and liver motion gained from the use of advanced techniques, such as a fiducial marker combined with fourdimensional (4D) planning CT, has enabled the delivery of higher doses of radiation therapy (RT) with reduced normal liver toxicity [3][4][5].Although triphasic CT can provide much information about HCC, the lesion/liver contrast is higher in MRI than in CT [6,7]. To take advantage of these benefits, there have been many efforts to incorporate liver MRI in the RT planning process [8,9].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of anatomical landmark position differences between respiration-gated MRI and four-dimensional CT for radiation therapy in patients with hepatocellular carcinoma

Yu¹,

Kim²,

Park³

et al. 2013

BJR

View full text Add to dashboard Cite

Objective: To measure the accuracy of position differences in anatomical landmarks in gated MRI and four-dimensional CT (4D-CT) fusion planning for radiation therapy in patients with hepatocellular carcinoma (HCC). Methods: From April to December 2009, gated MR and planning 4D-CT images were obtained from 53 inoperable HCC patients accrued to this study. Gated MRI and planning 4D-CT were conducted on the same day. Manual image fusions were performed by matching the vertebral bodies. Liver volumes and three specific anatomical landmarks (portal vein conjunction, superior mesenteric artery bifurcation, and other noticeable points) were contoured from each modality. The points chosen nearest the centre of the four landmark points were compared to measure the accuracy of fusion. Results: The average distance differences (¡standard deviation) of four validation points were 5.1 mm (¡4.6 mm), 5.6 mm (¡6.2 mm), 5.4 mm (¡4.5 mm) and 5.1 mm (¡4.8 mm). Patients who had ascites or pulmonary disease showed larger discrepancies. MRI-CT fusion discrepancy was significantly correlated with positive radiation response (p,0.05).Conclusions: Approximately 5-mm anatomical landmark positional differences in all directions were found between gated MRI and 4D-CT fusion planning for HCC patients; the gap was larger in patients with ascites or pulmonary disease. Advances in knowledge: There were discrepancies of approximately 5 mm in gated MRI-CT fusion planning for HCC patients. Many studies have reported that the treatment response and survival of hepatocellular carcinoma (HCC) patients are related to the delivered radiation dose [1][2][3]. Recently, detailed information on HCC and liver motion gained from the use of advanced techniques, such as a fiducial marker combined with fourdimensional (4D) planning CT, has enabled the delivery of higher doses of radiation therapy (RT) with reduced normal liver toxicity [3][4][5].Although triphasic CT can provide much information about HCC, the lesion/liver contrast is higher in MRI than in CT [6,7]. To take advantage of these benefits, there have been many efforts to incorporate liver MRI in the RT planning process [8,9]. Moreover, several groups have demonstrated the feasibility of using cine-MRI and 4D-MRI to measure liver tumour motion for RT planning [10][11][12]. However, a consensus has not yet been reached on the best strategies to compensate for liver motion and adapt RT planning and delivery using planning 4D-CT combined with liver MRI.The primary goal of this prospective study was to evaluate the accuracy of gated MRI and 4D-CT fusion planning by measuring the discrepancies in the specific anatomical landmark points of the liver between exhalephase images of gated liver MRI and 4D-CT. We also evaluated possible factors affecting gated liver MRI and 4D-CT fusion discrepancy and RT response. Materials and methods EligibilityThis study investigated the accuracy of gated liver MRI and 4D-CT fusion planning for RT in patients with HCC. The eligibility criteria were a diagnosis of HCC base...

show abstract

“…Metastatic diseases account for the majority of malignant lesions in the liver and up to 25 % of patients with known solid malignant tumors have hepatic metastases at the time of diagnosis [22]. Liver metastases can originate from numerous primary cancers (colorectal, mammary, lung, pancreatic, gastric, esophageal, melanoma and sarcoma among others).…”

Section: Fdg In Liver Metastases From Other Malignanciesmentioning

confidence: 99%

FDG and other radiopharmaceuticals in the evaluation of liver lesions

Grassi

Morigi

Nanni

et al. 2014

Clin Transl Imaging

View full text Add to dashboard Cite

Liver nodules are common findings in medical practice, both in patients with and in those without chronic liver disease. These lesions have to be interpreted according to clinical history and biochemical findings. Conventional imaging (US, CT and MRI) is still the gold standard for evaluating liver nodules, while diagnostic flowcharts do not currently include PET/CT. Since the 1990s many studies have been conducted to assess a possible role for FDG PET or PET/ CT in several liver pathologies. According to the literature, FDG PET (and later PET/CT) could be useful in detecting, staging and grading hepatocellular carcinoma, often leading to a change in therapy, and may even detect intrahepatic cholangiocarcinoma with adequate sensitivity. Moreover, FDG can allow more accurate staging of hepatic involvement deriving from other tumors (often underestimated by conventional imaging) and, therefore, more appropriate therapy in affected patients. Finally, FDG PET can also be used to evaluate 90 Y microsphere therapy response. Other conditions (e.g., primary hepatic lymphoma when conventional imaging is inconclusive) may benefit from the use of FDG PET/CT, while benign lesions (e.g., focal nodular hyperplasia) show low FDG avidity. As regards non-FDG tracers, choline and acetate (ACE) have been evaluated in comparison with FDG and found to show good efficacy in detecting and staging wellor moderately differentiated HCC. However, their sensitivity in poorly differentiated HCC is very low, suggesting that dualtracer investigation (FDG and choline/FDG and ACE) could be useful when non-invasive grading is required. Despite promising results, PET evaluation of liver nodules still seems to be far from routine application, mostly because of costrelated issues.

show abstract

Imaging of liver cancer

Cited by 99 publications

References 97 publications

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Evaluation of anatomical landmark position differences between respiration-gated MRI and four-dimensional CT for radiation therapy in patients with hepatocellular carcinoma

FDG and other radiopharmaceuticals in the evaluation of liver lesions

Contact Info

Product

Resources

About