Scirrhous Hepatocellular Carcinoma on Gadoxetic Acid–Enhanced Magnetic Resonance Imaging and Diffusion-Weighted Imaging

Park, Min Jung; Kim, Young Kon; Park, Hyun Jeong; Hwang, Jiyoung; Lee, Won Jae

doi:10.1097/rct.0b013e31829d44c1

Cited by 44 publications

(34 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, these imaging findings are also commonly observed in other malignant liver tumors containing fibrosis such as IHCC, fibrolamellar HCC, and metastases (7,8,14). Although Park et al (7) reported that arterial hyperenhancement representing 20% or more of the tumor diameter is a helpful MR imaging finding for discrimination of scirrhous HCC from IHCC, it is difficult to differentiate scirrhous HCC from other hepatic tumors with fibrosis based on imaging features in daily practice because of its low incidence and overlapping imaging findings with other tumor types (4,15).…”

Section: Discussionmentioning

confidence: 99%

“…These imaging findings of scirrhous type HCC were consistent with characteristic histopathologic features of central fibrosis and peripheral tumor cellular tissue. Yoshikawa et al (13) reported that histologically fibrous tissue showed delayed enhancement on CT, and Kim et al (4) demonstrated that the common enhancement pattern of scirrhous HCC was peripheral rim-like enhancement on the arterial and portal venous phases followed by central enhancement on the equilibrium phase on dynamic enhanced CT. A previous study (7) described that a target appearance on HBP and DW image was a common feature of scirrhous HCC on gadoxetic acid-enhanced and DW MR imaging. However, these imaging findings are also commonly observed in other malignant liver tumors containing fibrosis such as IHCC, fibrolamellar HCC, and metastases (7,8,14).…”

Section: Discussionmentioning

confidence: 99%

“…Yoshikawa et al (13) reported that histologically fibrous tissue showed delayed enhancement on CT, and Kim et al (4) demonstrated that the common enhancement pattern of scirrhous HCC was peripheral rim-like enhancement on the arterial and portal venous phases followed by central enhancement on the equilibrium phase on dynamic enhanced CT. A previous study (7) described that a target appearance on HBP and DW image was a common feature of scirrhous HCC on gadoxetic acid-enhanced and DW MR imaging. However, these imaging findings are also commonly observed in other malignant liver tumors containing fibrosis such as IHCC, fibrolamellar HCC, and metastases (7,8,14). Although Park et al (7) reported that arterial hyperenhancement representing 20% or more of the tumor diameter is a helpful MR imaging finding for discrimination of scirrhous HCC from IHCC, it is difficult to differentiate scirrhous HCC from other hepatic tumors with fibrosis based on imaging features in daily practice because of its low incidence and overlapping imaging findings with other tumor types (4,15).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Synchronous Occurrence of Classic and Scirrhous Hepatocellular Carcinomas: A Case Report

et al. 2018

View full text Add to dashboard Cite

Scirrhous hepatocellular carcinoma (HCC) is a subtype of HCC that is characterized by abundant fibrous stroma admixed with tumor cells. Although imaging findings of scirrhous HCC differ from those of classic HCC, it is difficult to diagnose this rare neoplasm. Like classic HCC, scirrhous HCC frequently develops in patients with liver cirrhosis, but there has been no report of synchronous occurrence of classic and scirrhous HCCs. Here, we report synchronous classic and scirrhous HCCs in a 62-year-old man with early liver cirrhosis who underwent gadoxetic acid-enhanced and diffusion-weighted magnetic resonance imaging.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Synchronous Occurrence of Classic and Scirrhous Hepatocellular Carcinomas: A Case Report

et al. 2018

View full text Add to dashboard Cite

show abstract

“…However, most of these studies have not explicitly separated the appearance of ICC in patients with from those without chronic liver disease or risk factors for HCC (86,113,117,119,122 …”

Section: Resultsmentioning

confidence: 99%

“…While there is ample evidence supporting the classic imaging features of ICC, few studies test the ability of these features to help differentiate ICC from HCC, and fewer studies focus on these lesions in patients with defined risk factors or cirrhosis (ie, the LI-RADS population) (87,116,117,119,(121)(122)(123). The studies that have attempted to determine the discriminatory power of diagnostic imaging for differentiating HCC from ICC have focused on atypical HCC in the comparator group.…”

Section: Review: Li-rads Major Features For Hepatocellular Carcinoma mentioning

confidence: 99%

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

et al. 2018

View full text Add to dashboard Cite

The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). It assigns category codes reflecting relative probability of HCC to imaging-detected liver observations based on major and ancillary imaging features. LI-RADS also includes imaging features suggesting malignancy other than HCC. Supported and endorsed by the American College of Radiology (ACR), the system has been developed by a committee of radiologists, hepatologists, pathologists, surgeons, lexicon experts, and ACR staff, with input from the American Association for the Study of Liver Diseases and the Organ Procurement Transplantation Network/United Network for Organ Sharing. Development of LI-RADS has been based on literature review, expert opinion, rounds of testing and iteration, and feedback from users. This article summarizes and assesses the quality of evidence supporting each LI-RADS major feature for diagnosis of HCC, as well as of the LI-RADS imaging features suggesting malignancy other than HCC. Based on the evidence, recommendations are provided for or against their continued inclusion in LI-RADS.q RSNA, 2017 Online supplemental material is available for this article.An Tang REVIEW: LI-RADS Major Features for Hepatocellular Carcinoma DiagnosisTang et al selection of five major features was based on expert opinion, the literature review was performed to ensure that imaging-based diagnostic criteria were able to achieve near-100% specificity for the noninvasive diagnosis of HCC. This review focused on the evidence supporting the inclusion of imaging features and did not attempt to gather evidence on the composition of the LI-RADS diagnostic algorithm and probability of HCC for different combinations of criteria (other than the hallmark combination of APHE and washout appearance) in the LI-RADS diagnostic table.Each subgroup was charged with developing key research questions and then critically reviewing the literature to answer research questions thematically related to its assigned topic. Search StrategyThe PICO (patient population, intervention, comparison, and outcome) format frequently used in structured reviews does not lend itself well to studies of diagnostic performance. Rather than using PICO-style questions to guide the searches, therefore, the subgroups formulated free-form questions in advance with feedback from the other subgroups. A total of 10 questions were formulated under the framework and with the understanding that their answers would inform recommendations for removing or continuing to include the corresponding LI-RADS features. After the questions were formulated, each subgroup searched the PubMed develop a standardized Liver Imaging Reporting and Data System (LI-RADS) for interpretation, reporting, and data collection of imaging studies in patients at risk for developing HCC (1). The committee was composed mainly of diagnostic radiologists, but also hepatologists, surgeons, patho...

show abstract

Hepatocellular Carcinomas with Increased Stromal Reactions

Zimmermann¹

2016

Tumors and Tumor-Like Lesions of the Hepatobiliary Tract

View full text Add to dashboard Cite

show abstract

Scirrhous Hepatocellular Carcinoma on Gadoxetic Acid–Enhanced Magnetic Resonance Imaging and Diffusion-Weighted Imaging

Abstract: Although the features of sHCC on gadoxetic acid-enhanced MRI and DWI are similar to those of ICC, the proportion of hyperenhancement of 20% or more on the arterial phase is a helpful feature in distinguishing sHCC from ICC.

Cited by 44 publications

References 28 publications

Synchronous Occurrence of Classic and Scirrhous Hepatocellular Carcinomas: A Case Report

Synchronous Occurrence of Classic and Scirrhous Hepatocellular Carcinomas: A Case Report

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

Hepatocellular Carcinomas with Increased Stromal Reactions

Contact Info

Product

Resources

About