MR imaging features for improved diagnosis of hepatocellular carcinoma in the non-cirrhotic liver: Multi-center evaluation

Fischer, MA; Raptis, Dimitrios; Donati, OF; Hunziker, Roger; E, Schade; Sotiropoulos, G.C.; McCall, John L.; Bartlett, Adam; Bachellier, Philippe; Frilling, Andrea; Breitenstein, Stefan; Clavien, P.‐A.; Alkadhi, Hatem; Patak, MA

doi:10.1016/j.ejrad.2015.06.029

Cited by 26 publications

(21 citation statements)

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“…In addition to traditional relative enhancement criteria (such as washout), hepatic artery and portal vein blood supply coefficients could be used to classify hypervascular liver lesions, achieving high specificity (97%) and high sensitivity (76%) for malignancy. Fischer et al [3] included 55 HCCs, 28 FNHs, and 24 HCAs to identify the key MRI features that can potentially be used to differentiate between HCC and benign hepatocellular tumors in the non-cirrhotic liver. Multivariate analysis revealed T1-hypointensity, T2-hypo-or hyperintensity, lack of central tumor-enhancement, presence of satellite-lesions, and lack of liver-specific contrast media uptake were independent MRI features indicating HCC.…”

Section: Discussionmentioning

confidence: 99%

“…Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third most common cause of cancer death worldwide [1,2]. Approximately 80% of cases of HCC occur in patients with liver cirrhosis, arising from hepatitis B and C infections or alcoholism [2,3]. In patients with liver cirrhosis, noninvasive diagnosis of HCC can be established by a characteristic feature of arterial phase hyperenhancement followed by portal venous or delayed phase washout on multiphasic contrast CT or MRI.…”

Section: Introductionmentioning

confidence: 99%

“…In patients with liver cirrhosis, noninvasive diagnosis of HCC can be established by a characteristic feature of arterial phase hyperenhancement followed by portal venous or delayed phase washout on multiphasic contrast CT or MRI. However, an increasing number of HCC arises in a non-cirrhotic liver [3], probably due to transient hepatitis B infection or due to diffuse liver damage caused by non-alcoholic fatty liver disease. In such non-cirrhotic cases, other benign hypervascular liver lesions (hepatocellular adenoma [HCA] and focal nodular hyperplasia [FNH]) should be taken into the differential diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…Various imaging modalities have been applied in the distinction between HCC and FNH, such as CT [1,9,10], Doppler ultrasound [11,12] and MRI [1,3,5,[13][14][15]. In previous studies, the gadoxetic acid-enhanced MRI is being increasingly used in differentiating focal liver lesions.…”

Section: Introductionmentioning

confidence: 99%

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A CT-based radiomics nomogram for differentiation of focal nodular hyperplasia from hepatocellular carcinoma in the non-cirrhotic liver

et al. 2020

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Background: The purpose of this study was to develop and validate a radiomics nomogram for preoperative differentiating focal nodular hyperplasia (FNH) from hepatocellular carcinoma (HCC) in the non-cirrhotic liver. Methods: A total of 156 patients with FNH (n = 55) and HCC (n = 101) were divided into a training set (n = 119) and a validation set (n = 37). Radiomics features were extracted from triphasic contrast CT images. A radiomics signature was constructed with the least absolute shrinkage and selection operator algorithm, and a radiomics score (Radscore) was calculated. Clinical data and CT findings were assessed to build a clinical factors model. Combined with the Rad-score and independent clinical factors, a radiomics nomogram was constructed by multivariate logistic regression analysis. Nomogram performance was assessed with respect to discrimination and clinical usefulness. Results: Four thousand two hundred twenty-seven features were extracted and reduced to 10 features as the most important discriminators to build the radiomics signature. The radiomics signature showed good discrimination in the training set (AUC [area under the curve], 0.964; 95% confidence interval [CI], 0.934-0.995) and the validation set (AUC, 0.865; 95% CI, 0.725-1.000). Age, Hepatitis B virus infection, and enhancement pattern were the independent clinical factors. The radiomics nomogram, which incorporated the Rad-score and clinical factors, showed good discrimination in the training set (AUC, 0.979; 95% CI, 0.959-0.998) and the validation set (AUC, 0.917; 95% CI, 0.800-1.000), and showed better discrimination capability (P < 0.001) compared with the clinical factors model (AUC, 0.799; 95% CI, 0.719-0.879) in the training set. Decision curve analysis showed the nomogram outperformed the clinical factors model in terms of clinical usefulness. Conclusions: The CT-based radiomics nomogram, a noninvasive preoperative prediction tool that incorporates the Rad-score and clinical factors, shows favorable predictive efficacy for differentiating FNH from HCC in the noncirrhotic liver, which might facilitate clinical decision-making process.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A CT-based radiomics nomogram for differentiation of focal nodular hyperplasia from hepatocellular carcinoma in the non-cirrhotic liver

et al. 2020

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“…Actualmente, dos de estos agentes están disponibles comercialmente: Gadobenato de dimeglumina (Gd-BOPTA) y ácido gadoxético (Gd-EOB-DTPA). [6][7][8][9] Ese último, por su disponibilidad en nuestro medio, será el enfoque de la presente revisión.…”

Section: Introductionunclassified

Agentes hepatoespecíficos, usos actuales: más allá de la caracterización de lesiones focales

et al. 2018

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Palabras Clave► hígado ► medio de contraste ► resonancia magnética Resumen Con el ácido gadoxético, el realce dinámico de las lesiones focales es igual a los demás medios de contraste extracelulares, por lo que su utilidad principal está en la obtención de una fase hepatobiliar que permita diferenciar y caracterizar lesiones que contienen hepatocitos como en el caso de la hiperplasia nodular focal (HNF) y los nódulos regenerativos. Las lesiones que no tienen hepatocitos o que son carentes de conductos biliares, demuestran baja señal con respecto al parénquima hepático en esa fase, lo que ocurre con los adenomas hepatocelulares (AHC), nódulos displásicos de alto grado, carcinoma hepatocelular (CHC) y metástasis entre otras. Hacer esta diferenciación cambia el manejo de la lesión focal, permitiendo en la mayoría de los casos caracterizar las lesiones que contienen hepatocitos que no requieren biopsia, como las benignas, de aquellas que si pudieran requerir la confirmación histológica. Otros usos de estos medios de contraste órgano específicos es la evaluación de la integridad de la vía biliar especialmente en pacientes posquirúrgicos y la diferenciación de quistes que tienen comunicación con la vía biliar de aquellos que son quistes hepáticos simples. El objetivo de este artículo es realizar una revisión sobre la evidencia actual del papel emergente de los contrastes órgano específicos, incluyendo no solo la evaluación de las lesiones focales hepáticas, sino también otras utilidades como el análisis de la patología biliar.

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Magnetic resonance imaging for the diagnosis of hepatocellular carcinoma in adults with chronic liver disease

Nadarević

Colli

Giljača

et al. 2022

Cochrane Database of Systematic Reviews

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MR imaging features for improved diagnosis of hepatocellular carcinoma in the non-cirrhotic liver: Multi-center evaluation

Cited by 26 publications

References 30 publications

A CT-based radiomics nomogram for differentiation of focal nodular hyperplasia from hepatocellular carcinoma in the non-cirrhotic liver

A CT-based radiomics nomogram for differentiation of focal nodular hyperplasia from hepatocellular carcinoma in the non-cirrhotic liver

Agentes hepatoespecíficos, usos actuales: más allá de la caracterización de lesiones focales

Magnetic resonance imaging for the diagnosis of hepatocellular carcinoma in adults with chronic liver disease

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