The Use of Imaging in the Diagnosis and Staging of Hepatobiliary Malignancies

Miller, George; Schwartz, Lawrence H.; D’Angelica, Michael I.

doi:10.1016/j.soc.2007.04.001

Cited by 47 publications

(39 citation statements)

References 83 publications

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“…31 Diagnostic HCC imaging involves use of one or more of the following modalities: triphasic helical CT; triphasic dynamic contrast–enhanced MRI; or contrast-enhanced ultrasonography, although the latter modality is not commonly available in the United States. 4,32,33 The term triphasic refers to the 3 phases of scanning: an arterial phase, portal venous phase, and the venous phase after a delay. 10 The classic imaging profile associated with an HCC lesion is characterized by intense arterial uptake or enhancement followed by contrast washout or hypointensity in the delayed venous phase.…”

Section: Hccmentioning

confidence: 99%

“…10 The classic imaging profile associated with an HCC lesion is characterized by intense arterial uptake or enhancement followed by contrast washout or hypointensity in the delayed venous phase. 4,33,34 …”

Section: Hccmentioning

confidence: 99%

“…Triphasic CT or MRI results are also used when evaluating the HCC tumor burden; to detect the presence of metastatic disease, nodal disease, and vascular invasion; to assess whether evidence of portal hypertension is present; to provide an estimate of the size and location of HCC and the extent of chronic liver disease; and, for patients being considered for resection, to provide an estimate of the future liver remnant (FLR) in relation to the total liver volume (see section on “Partial Hepatectomy”). 33 …”

Section: Hccmentioning

confidence: 99%

See 2 more Smart Citations

Hepatobiliary Cancers

Benson¹,

Abrams²,

Ben‐Josef³

et al. 2009

J Natl Compr Canc Netw

701

129

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Section: Hccmentioning

confidence: 99%

Section: Hccmentioning

confidence: 99%

Section: Hccmentioning

confidence: 99%

See 1 more Smart Citation

Hepatobiliary Cancers

Benson¹,

Abrams²,

Ben‐Josef³

et al. 2009

J Natl Compr Canc Netw

701

129

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“…Alternatively, intrahepatic cholangiocarcinoma may be detected incidentally as an isolated intrahepatic mass on imaging. 59 In contrast, patients with extrahepatic cholangiocarcinoma are likely to present with jaundice followed by evidence of a biliary obstruction or abnormality on subsequent imaging.…”

Section: Diagnosismentioning

confidence: 99%

Hepatobiliary Cancers, Version 2.2014

Benson¹,

D’Angelica²,

Abrams³

et al. 2014

J Natl Compr Canc Netw

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“…Abou-Alfa (New York): I am interested in the radiographic vascular details and specific CT imaging technique used, as the presence of arterial enhancement of liver lesions is consistent with HCC. Recommended radiographic evaluations in the evaluation of HCC are a triphasic CT or MRI, on which there is contrast washout in the delayed venous phase [4]. For lesions larger than 2 cm, as in this case, only one radiographic modality demonstrating arterial enhancement is needed to be consistent with an HCC diagnosis.…”

mentioning

confidence: 99%

A Woman with Remotely Treated Pancreas Cancer and New Abdominal Pain: A Discussion of Evaluation and Management

Epstein

O'Reilly

Lowery

et al. 2010

J Gastrointest Canc

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Case HistoryDr. Epstein (New York): A 70-year-old woman with a remotely treated exocrine pancreas cancer presented with right upper quadrant abdominal pain. A CT scan of the abdomen and pelvis revealed multiple bilobar liver lesions of various sizes from 1.3 to 4.9 cm in diameter, new since a scan performed a few years previously (Fig. 1). The patient's pancreas cancer, diagnosed as adenocarcinoma at that time, was resected 25 years ago at Memorial Sloan-Kettering Cancer Center (MSKCC), treated with adjuvant chemoradiation post-operatively, and then followed regularly without evidence of disease thereafter. In light of the new CT findings, a CT-guided liver biopsy was performed at an outside institution, demonstrating poorly differentiated carcinoma. Immunohistochemical staining revealed strongly positive CK7, MOC-31, and CK/18; hepar-1 was focally positive; TTF-1, CK20, and GCDFP-15 were negative.Dr. Lowery (New York): Is it possible that this represents a late recurrence of the patient's pancreas cancer, or is this more likely a second primary tumor?Dr. O'Reilly (New York): A recurrence of exocrine pancreas cancer more than two decades after its original multimodality treatment would be highly unusual, as the majority of recurrences occur within the first 2 years after treatment. A small number of adenocarcinomas of the pancreas do have late recurrences in the lung and may follow a somewhat more indolent disease course than is typically experienced. The fact that the patient has enjoyed such a long disease-free survival after treatment of a usually highly lethal malignancy is surprising in and of itself. We were therefore eager to have the liver pathology reviewed at our institution, and comparison made to the patient's original pancreas cancer specimen. Case History (Continued):Dr. Epstein (New York): The liver specimens were interpreted at MSKCC as consistent with poorly differentiated hepatocellular carcinoma (HCC; Fig. 2). These slides were compared to the patient's pancreas cancer specimen and morphologically were deemed to be distinct in appearance (Fig. 3), further making the case for this as a new primary. Notably, the original pancreas specimen was further characterized as medullary phenotype pancreas cancer, an entity not described at the time of the patient's original diagnosis.Dr. Al-Olayan (Riyadh): Would our pathology colleagues at MSKCC please expound upon the entity of medullar1y phenotype pancreas cancer?Dr. Shia (New York): As mentioned, this is a relatively newly described entity (first reported in

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The Use of Imaging in the Diagnosis and Staging of Hepatobiliary Malignancies

Cited by 47 publications

References 83 publications

Hepatobiliary Cancers

Hepatobiliary Cancers

Hepatobiliary Cancers, Version 2.2014

A Woman with Remotely Treated Pancreas Cancer and New Abdominal Pain: A Discussion of Evaluation and Management

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