Multimodality Imaging of Hepatocellular Carcinoma: From Diagnosis to Treatment Response Assessment in Everyday Clinical Practice

Pizzi, Andrea Delli; Mastrodicasa, Domenico; Cianci, Roberta; Serafini, Francesco; Mincuzzi, Erica; Fabio, Francesca Di; Giammarino, Alberto; Mannetta, Gianluca; Basilico, Raffaella; Caulo, Massimo

doi:10.1177/0846537120923982

Cited by 3 publications

(2 citation statements)

References 55 publications

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“…The features taken into account include size and echogenicity [ 19 ]. In the setting of HCC screening and surveillance, US LI-RADS ® yielded a sensitivity of 58–89% and a specificity >90% [ 20 ]. US in general has a reported sensitivity of 98% and specificity of 85% for overall HCC detection [ 21 ].…”

Section: Ultrasoundmentioning

confidence: 99%

“…Classes LR1–2 can return to follow-up, LR-3 needs a second modality sooner than 6 months, while LR-4 and LR-5 require biopsy or treatment [ 33 ]. An important difference between CT/MRI and CEUS is that the latter technique does not visualize arterio-portal shunts, meaning that any arterially hyperenhancing lesion represents a true lesion and not a false finding [ 20 ]. Upon meta-analysis, CEUS is 93% sensitive and 90% specific in differentiating benign from malignant FLL [ 38 ].…”

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

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Current Imaging Diagnosis of Hepatocellular Carcinoma

Chartampilas

Rafailidis

Georgopoulou

et al. 2022

Cancers

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Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer related death worldwide. Radiology has traditionally played a central role in HCC management, ranging from screening of high-risk patients to non-invasive diagnosis, as well as the evaluation of treatment response and post-treatment follow-up. From liver ultrasonography with or without contrast to dynamic multiple phased CT and dynamic MRI with diffusion protocols, great progress has been achieved in the last decade. Throughout the last few years, pathological, biological, genetic, and immune-chemical analyses have revealed several tumoral subtypes with diverse biological behavior, highlighting the need for the re-evaluation of established radiological methods. Considering these changes, novel methods that provide functional and quantitative parameters in addition to morphological information are increasingly incorporated into modern diagnostic protocols for HCC. In this way, differential diagnosis became even more challenging throughout the last few years. Use of liver specific contrast agents, as well as CT/MRI perfusion techniques, seem to not only allow earlier detection and more accurate characterization of HCC lesions, but also make it possible to predict response to treatment and survival. Nevertheless, several limitations and technical considerations still exist. This review will describe and discuss all these imaging modalities and their advances in the imaging of HCC lesions in cirrhotic and non-cirrhotic livers. Sensitivity and specificity rates, method limitations, and technical considerations will be discussed.

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Section: Ultrasoundmentioning

confidence: 99%

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

Current Imaging Diagnosis of Hepatocellular Carcinoma

Chartampilas

Rafailidis

Georgopoulou

et al. 2022

Cancers

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State-of-the-art imaging of hepatocellular carcinoma

Afyouni,

Zandieh,

Nia

et al. 2024

Journal of Gastrointestinal Surgery

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Multi-phasic magnetic resonance imaging of hemodynamic interchanges in hepatocarcinogenesis

Elzeneini,

Abdelmohsen,

Yousef

2023

Egypt J Radiol Nucl Med

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Background Liver cirrhosis and hepatocellular cancer deem a substantial global health burden and are the end result of a variety of chronic liver diseases. Guidelines have been introduced to secure standardized approaches in the diagnosis and management of hepatocellular carcinoma (HCC). Established guidelines agree upon the distinctive dynamic enhancement findings of HCC, characterized by arterial phase wash-in and venous or delayed phase washout. The indeterminate focal hepatic lesions constitute a diagnostic dilemma. The aim of the study was quantification of hepatic vascular parameters using dynamic contrast-enhanced (DCE)-MRI to study liver hemodynamic disturbances that can differentiate between focal hepatic lesions during hepatocellular carcinogenesis. Results The study was conducted on 95 patients with comparing perfusion abnormalities across different liver cirrhosis pathologies, and the comparison revealed the correlation of hemodynamics with hepatocarcinogenesis and grades of cirrhosis. Relative enhancement curves were graphed to illustrate the different enhancement patterns across the spectrum of hepatonodular lesions of cirrhosis and among types of de novo and recurrent HCC. Statistical significance was highest between dysplastic nodules (DNs) and HCCs (maximal relative enhancement (MRE) 0.88, wash-in ratio (WIR) 0.84, washout ratio (WOR) 0.78, time to peak (TTP) 0.74, area under curve (AUC 0.73, T0 0.70), compared to those between cirrhotic liver and DNs (MRE 0.74, To 0.62). Least significances were between de novo and recurrent HCCs (TTP 0.66, r AUC 0.66, MRE 0.63). Performances between non-cirrhotic and cirrhotic liver [WOR 0.81, time to peak (TTP) 0.80, r AUC 0.63] surpassed those among different grades of cirrhosis (the highest was between non-tumoral and tumoral cirrhosis: TTP 0.74, MRE 0.68, WIR 0.65, WOR 0.65). Conclusions Dynamic contrast-enhanced magnetic resonance imaging hemodynamic metrics promise potential usefulness as non-invasive biomarkers in assessment of liver cirrhosis, characterization of cirrhotic nodules, and evaluation of multistep hepatocarcinogenesis.

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Multimodality Imaging of Hepatocellular Carcinoma: From Diagnosis to Treatment Response Assessment in Everyday Clinical Practice

Cited by 3 publications

References 55 publications

Current Imaging Diagnosis of Hepatocellular Carcinoma

Current Imaging Diagnosis of Hepatocellular Carcinoma

State-of-the-art imaging of hepatocellular carcinoma

Multi-phasic magnetic resonance imaging of hemodynamic interchanges in hepatocarcinogenesis

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