MR Imaging of Hypervascular Liver Masses: A Review of Current Techniques

Silva, Alvin C.; Evans, James B.; McCullough, Ann E.; Jatoi, Mashal; Vargas, Hugo E.; Hara, Amy K.

doi:10.1148/rg.292085123

Cited by 104 publications

(68 citation statements)

References 61 publications

(68 reference statements)

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“…Hepatic hemangiomas, usually solitary, are well-circumscribed lesions containing blood-filled spaces lined by endothelium on a thin fibrous stroma [15]. Occasionally, giant hemangiomas (>4-6 cm) may cause nonspecific abdominal symptoms related to mass effect [16]. In two-thirds of the cases, hemangiomas appear as homogenously hyperechoic masses on US [17].…”

Section: Methodsmentioning

confidence: 99%

“…On contrast-enhanced US, CT or MRI, hemangiomas may demonstrate either a characteristic pattern of peripheral nodular discontinuous enhancement that progresses centripetally to uniform enhancement, or immediate uniform enhancement which follows the blood pool on subsequent phases, termed “flash-filling hemangioma” (Fig. 2) [16]. On T2-weighted MRI, hemangiomas tend to have a markedly hyperintense appearance, also called “light bulb bright” appearance.…”

Section: Methodsmentioning

confidence: 99%

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Liver Imaging Techniques: Recognition of Uveal Melanoma Metastases

et al. 2018

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Background: The liver is the most common site for metastases of several primary malignancies including uveal melanoma. Methods: Review of imaging characteristics of incidental common benign liver lesions including hepatic cyst, hemangioma, focal nodular hyperplasia, and hepatic adenoma and contrasting them with uveal melanoma metastases. Results: Benign hepatic lesions may be cystic or, if solid, relatively stable in size over time. For hepatic lesions larger than 10 mm in size, characteristic imaging features typically allow for confident diagnosis. When lesions are small (less than 10 mm), definitive characterization can be difficult. Moreover, lesions smaller than 10 mm can be difficult to biopsy under ultrasound or computed tomography (CT) guidance, and short-term follow-up will often be useful to assess for stability or progression. Overall, magnetic resonance imaging is more specific than CT scan and at least as sensitive as CT for detecting uveal melanoma liver metastases. Conclusions: New multiple enhancing solid liver lesions should raise suspicion of uveal melanoma liver metastases. Discussion of challenging cases with the radiologist may be beneficial, as pertinent information such as size, location, and molecular prognostication status of the primary tumor can guide radiological interpretation of hepatic lesions.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Liver Imaging Techniques: Recognition of Uveal Melanoma Metastases

et al. 2018

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“…The other 10 patients had normal background liver, but four of the 10 patients had a total of 15 metastatic liver tumors originating from a gastrointestinal stromal tumor (n = 9), rectal cancer (n = 5), or renal cell carcinoma (n = one). The HCCs and metastatic liver tumors were diagnosed using validated imaging criteria, 3,4,[15][16][17][18] elevated tumor markers (e.g., ¡-fetoprotein and des-£-carboxy prothrombin for HCC, carcinoembryonic antigen, or carbohydrate antigen 19-9 for metastatic liver tumor) and follow-up imaging studies performed at least 6 months after the DWI, which showed tumor shrinkage with treatment or tumor progression without treatment.…”

Section: Clinical Study Patientsmentioning

confidence: 99%

“…DWI provides functional information, such as that of the motion or diffusion of water molecules, and can be used to detect and characterize malignant and nonmalignant lesions. [1][2][3][4][5][6][7] However, DWI suffers from low spatial resolution because it must maintain a usable signal-to-noise ratio (SNR) compared to conventional T 2 -weighted imaging. 8 In addition, DWI is generally scanned using an echo planar imaging (EPI) technique, which occasionally yields artifacts, such as ghosting, distortion, and chemical shift artifacts.…”

Section: Introductionmentioning

confidence: 99%

Optimization and Clinical Feasibility of Free-breathing Diffusion-weighted Imaging of the Liver: Comparison with Respiratory-Triggered Diffusion-weighted Imaging

Takayama

Nishie

Asayama

et al. 2015

MRMS

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Purpose: We compared the image quality of free-breathing diffusion-weighted imaging (FB-DWI) to that of respiratory-triggered DWI (RT-DWI) after proper optimization.Materials and Methods: Three healthy subjects were scanned to optimize magnetic resonance (MR) parameters of FB-DWI to improve image quality, including spatial resolution, image noise, and chemical shift artifacts. After this optimization, we scanned 32 patients with liver disease to assess the clinical feasibility of the optimized FB-DWI. Of the 32 patients, 14 had a total of 28 hepatocellular carcinomas (HCCs), four had a total of 15 metastatic liver tumors, and the other 14 had no tumor. Qualitatively, we compared the image quality scores of FB-DWI with those of RT-DWI with the Wilcoxon signed-rank test. Quantitatively, we compared the signal-to-noise ratios (SNRs) of the liver parenchyma, lesion-to-nonlesion contrast-to-noise ratios (CNRs) and apparent diffusion coefficient (ADC) values of the liver parenchyma and liver tumor by the paired t-test.Results: The average scores of image quality for sharpness of liver contour, image noise, and chemical shift artifacts were significantly higher for FB-DWI than RT-DWI (P < 0.05). SNRs, CNRs, and ADC values of the liver parenchyma and tumors did not differ significantly between the 2 DWI methods.Conclusion: Compared with RT-DWI, the optimized FB-DWI provided better spatial resolution, fewer artifacts, and comparable SNRs, lesion-to-nonlesion CNRs, and ADC values.

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“…Conventional T2-or T1-weighted MRI highlight anatomical changes to characterize hepatic nodules within a cirrhotic background [10,11]. MR angiography using gadolinium agent contrast enhancement (CE) is a clinical imaging standard tool for evaluating and detection HCC based on blood supply and vascular integrity.…”

Section: List Of Figuresmentioning

confidence: 99%

Magnetic resonance characterisation of developing hepatocellular carcinoma in a diet induced model of liver cancer in the rat

Alghamdi¹

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Non-alcoholic fatty liver disease (NAFLD), a disorder associated with abnormal lipid accumulation within hepatocytes, is considered benign disorder in nature. However, in some cases it may progress to inflammation, nonalcoholic steatohepatitis (NASH), then cirrhosis, precancerous nodules and finally to hepatocellular carcinoma (HCC). NAFLD and NASH are both reversible with appropriate clinical intervention and lifestyle changes. In developed countries, the non-alcoholic fatty liver disease (NAFLD) is becoming one of the most common causes of precancerous and HCC lesions [1]. Unfortunately, most nodular lesions are detected too late with a poor prognosis. The discovery of markers that can predict which livers may progress to HCC would allow early intervention and potentially halting progress to HCC. This would be of great benefit at any stage up to precancerous lesions, however the earlier the better.Development of end stage liver malignancy would be decreased, resulting in decreased mortality from this disease.Histology is considered the reference standard for the assessment of fatty disease and nodular lesion in liver. However, there are significant drawbacks including invasiveness, small sample size and observer-dependence which limits its usefulness in evaluating liver disease.Magnetic resonance imaging is a non-invasive modality that can provide information on anatomical and physiological changes in the liver (e.g. fatty liver disease and HCC). MRI images are primarily assessed visually by expert radiologists looking for anatomical and contrast changes in the images compared to normal tissue. This qualitative method requires inspection of all datasets for abnormalities. Visual interpretation is subjective, labour intensive, and depends on the experience of the radiologist. This can introduce inter-observer variation and is suitable only when the pathology leads to sufficient contrast changes in the images acquired.MRI also allows the calculation of quantitative parameters like T1, T2 and diffusion values. These parameters are dependent on physical, chemical and microstructural properties of the tissue. When standard protocols are used, the calculation of these parameters should be independent of the observer. This has the potential for more precise characterization of changes that occur over time. Clinically, here has been limited utilization of these methods, as they generally require longer acquisition times and significant post processing of the images. Declaration by authorThis thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text.

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MR Imaging of Hypervascular Liver Masses: A Review of Current Techniques

Cited by 104 publications

References 61 publications

Liver Imaging Techniques: Recognition of Uveal Melanoma Metastases

Liver Imaging Techniques: Recognition of Uveal Melanoma Metastases

Optimization and Clinical Feasibility of Free-breathing Diffusion-weighted Imaging of the Liver: Comparison with Respiratory-Triggered Diffusion-weighted Imaging

Magnetic resonance characterisation of developing hepatocellular carcinoma in a diet induced model of liver cancer in the rat

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