Iso- or hyperintensity of hepatocellular adenomas on hepatobiliary phase does not always correspond to hepatospecific contrast-agent uptake: importance for tumor subtyping

Reizine, Edouard; Ronot, Maxime; Pigneur, F.; Purcell, Yvonne; Mulé, Sebastien; Burgio, Marco Dioguardi; Caldéraro, Julien; Amaddeo, Giuliana; Laurent, Alexis; Vilgrain, Valérie; Luciani, Alain

doi:10.1007/s00330-019-06150-7

Cited by 22 publications

(14 citation statements)

References 43 publications

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“…Because retention of gadoxetic acid was not shown to differentiate IHCA from bex3 HCA, other researchers quantitatively evaluated lesion uptake by measuring the lesion‐to‐liver contrast enhancement ratio (LLCER) comparing the precontrast and hepatobiliary phases. Results showed that all IHCAs had a negative LLCER, indicating that HCAs did not take up gadoxetic acid, while six of seven bex3HCAs had a positive LLCER, indicating that HCAs had retained gadoxetic acid . This suggests that positive contrast uptake on hepatobiliary phase MRI might be a good indicator of the presence of bex3 activation.…”

Section: What's New For Diagnosing Hepatocellular Adenomas?mentioning

confidence: 97%

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Imaging of liver tumours: What’s new?

Vilgrain

Raynaud

Paulatto

et al. 2020

Liver International

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Liver tumours are very common and malignant tumours represent a major cause of cancer‐related death. Imaging plays an important role at many different stages of the care pathway. This review discusses new aspects and new roles for imaging and for MRI, in particular. MRI is already the best tool for the characterization and staging of benign and malignant liver tumours and it could also become a useful screening tool, especially for hepatocellular carcinoma. Liver imaging will be increasingly quantitative in the future, integrating new approaches such as those of artificial intelligence.

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Section: What's New For Diagnosing Hepatocellular Adenomas?mentioning

confidence: 97%

“…indicating that HCAs did not take up gadoxetic acid, while six of seven bex3HCAs had a positive LLCER, indicating that HCAs had retained gadoxetic acid. 15 This suggests that positive contrast uptake on hepatobiliary phase MRI might be a good indicator of the presence of bex3 activation.…”

Section: What ' S Ne W For D Iag Nos Ing Hepatocellul Ar Adenoma S?mentioning

confidence: 99%

Imaging of liver tumours: What’s new?

Vilgrain

Raynaud

Paulatto

et al. 2020

Liver International

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“…The "atoll sign" (peripheral high signal intensity) on T2WI has been proposed to be a characteristic finding of IHCAs (11). The obscure scar may be a possible sign of the BHCAs, but the specificity of these features remains very low (12). All types of HCAs show hypervascularization in the arterial phase.…”

Section: Populations (3)mentioning

confidence: 99%

A case study of glycogen storage disease type Ia presenting with multiple hepatocellular adenomas: an analysis by gadolinium ethoxybenzyl-diethylenetriamine-pentaacetic acid magnetic resonance imaging

Li¹,

Jing²,

Cheng³

et al. 2021

Quant Imaging Med Surg

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Glycogen storage disease type Ia (GSD Ia) is a rare disease caused by a deficiency of hepatic glucose-6-phosphatase (G6Pase). Here, we report a 17-year-old Chinese boy with GSD Ia. Clinical manifestations of the patient included hepatomegaly, growth retardation, doll face, and biochemical abnormalities, including hypoglycaemia, hyperuricaemia, and hyperlipidaemia. The computed tomography (CT) and gadolinium ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) magnetic resonance imaging (MRI) revealed multiple masses in the left and right hemiliver. These masses presented as different dynamic enhanced patterns in the Gd-EOB-DTPA MRI. In addition, a large amount of glycogen deposit was detected in the liver tissue biopsy. Liver puncture confirmed that the masses were hepatocellular adenomas (HCAs). Genetic analyses confirmed the presence of liver metabolic disease, and the final clinical diagnostic was GSD Ia. The patient's clinical manifestations were significantly improved following regular treatment with raw corn starch for 9 months. Unfortunately, it was suspected that parts of the adenoma had undergone malignant transformation.

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“…2 However, in contrast to previously published data from Reizine et al, we found that surrounding steatosis is not the only cause of hyperintensity on precontrast images. 3 Intrinsic hyperintensity is demonstrably an additional source of false-positive iso/hyperintensity in HBP. This can easily be appreciated on in-phase T 1 -weighted images and is probably due to residue from microscopic bleeds.…”

Section: T 1 -Weighted Hyperintensity Before Contrast Injectionmentioning

confidence: 99%