Focal Lesions of the Liver and Radiomics: What Do We Know? (original) (raw)
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La Radiologia medica, 2016
To assess the diagnostic performance of magnetic resonance imaging (MRI) with gadoxetic acid in the identification of hepatocellular carcinoma (HCC) nodules by comparison with histological findings. In a cohort of patients suffering from cirrhosis of various etiologies (chronic hepatitis C virus (HCV) or hepatitis B virus (HBV), alcohol abuse, cryptogenic forms), we selected 17 patients affected by HCC who were eligible for liver transplantation on the basis of a computed-tomography (CT) total-body examination. Such patients also underwent an MRI examination under basal conditions, and with four dynamic phases, as well as a hepatobiliary phase acquired after at least 20 min and recognized by the excretion of contrast agent into the bile duct, following intravenous administration of 0.05 mol/kg of gadoxetic acid (gadoxetate disodium, Primovist(®); Bayer, Osaka, Japan). The MRI images were then evaluated in a double-blinded experimental setup by two radiologists experienced in imaging...
Focal liver lesions: Practical magnetic resonance imaging approach
World Journal of Hepatology, 2015
With the widespread of cross-sectional imaging, a growth of incidentally detected focal liver lesions (FLL) has been observed. A reliable detection and characterization of FLL is critical for optimal patient management. Maximizing accuracy of imaging in the context of FLL is paramount in avoiding unnecessary biopsies, which may result in post-procedural complications. A tremendous development of new imaging techniques has taken place during these last years. Nowadays, Magnetic resonance imaging (MRI) plays a key role in management of liver lesions, using a radiation-free technique and a safe contrast agent profile. MRI plays a key role in the non-invasive correct characterization of FLL. MRI is capable of providing comprehensive and highly accurate diagnostic information, with the additional advantage of lack of harmful ionizing radiation. These properties make MRI the mainstay for the noninvasive evaluation of focal liver lesions. In this paper we review the state-of-the-art MRI liver protocol, briefly discussing different sequence types, the unique characteristics of imaging non-cooperative patients and discuss the role of hepatocyte-specific contrast agents. A review of the imaging features of the most common benign and malignant FLL is presented, supplemented by a schematic representation of a simplistic practical approach on MRI.
Current methods of focal liver lesion diagnosis
Polish Annals of Medicine, 2013
Keywords: MDCT MRI DW-MRI Liver Focal Lesion a b s t r a c t Introduction: The widespread availability of non-invasive radiological and diagnostic imaging techniques significantly contributed to the detectability of focal lesions in the liver. Ultrasonography, computed tomography (CT) multidetector CT (MDCT), conventional magnetic resonance imaging (MRI), diffusion-weighted magnetic resonance imaging (DW-MRI) and isotope imaging are used for focal liver diagnosis.
ROLE OF MRI IN CHARACTERIZATION OF FOCAL LIVER LESIONS
National Journal of Medical Research, 2020
Introduction: The increasing and widespread use of imaging studies has led to an increase in detection of incidental Focal Liver Lesions. It is important to diagnose not only malignant liver lesions, but also benign solid and cystic liver lesions. Objectives: Role of MRI imaging in characterization of various focal liver lesions detected incidentally on Ultrasonography. Methods: The present study included 50 patients with various focal Liver Lesions detected incidentally on Ultrasonography. MRI Liver of the patients having incidentally detected Focal Liver Lesions on Ultrasonography and Inconclusive Ultrasonography findings was done to characterize the various focal liver lesions. Biopsy was done in patients with findings raising a possibility of a malignant lesion. Result: Of the 50 patients, 30 patients were male and 20 were female. Age of patients ranged from 1 year to 79 years. Spectrum of diseases based on imaging findings includes: Simple hepatic cyst (5/50, 10%), Hemangioma(5/50, 10%) , Focal nodular hyperplasia(2/50, 4%), Hydatid cyst(4/50, 8%), abscess(3/50, 6%), hepatocellular carcinoma(9/50, 18%), metastases(12/50, 24%) and indeterminate radiological diagnosis(10/50, 20%). USG guided liver biopsy was done in 31 patients revealed Hepatocellular carcinoma in 7, Cholangiocarcinoma in 2, metastases in 20 patients and Hepatic adenoma in 2 patients. Conclusion: MRI has an excellent lesion detection rate. Nearly all the lesions detected on Ultrasonography were detected on MRI imaging. MRI is excellent for the characterization of various Focal Liver Lesions. It was possible to reach to a specific radiological diagnosis in most of the patients.
Description of focal liver lesions with using Gd-EOB-DTPA enhanced MRI
Clujul Medical, 2015
Imaging procedures play a fundamental role in the therapeutic management of focal liver lesions. The goals of imaging are to detect and correctly characterize focal liver lesions. This review highlights the performances of newer, liver-specific, contrast media in the diagnosis of focal liver lesions, particularly Gd-EOB-DTPA (Primovist), the most frequently used liver specific contrast media. It has been shown, in different papers, that Gd-EOB-DTPA has better performances compared to either triphasic contrast enhanced computed tomography or dynamic MRI in both detection and characterization of hepatocellular carcinoma on the cirrhotic liver. Therefore liver MRI with Primovist is considered, in many centers, the "state-of-the-art" imaging examination of the liver before surgery or liver transplantation. Gd-EOB-DTPA is also useful in the differential diagnosis of benign hypervascular focal liver lesions such as adenomas or focal nodular hyperplasias.
Non-invasive diagnosis of focal liver lesions: an individualized approach
Cancer Imaging, 2012
Modern cross-sectional imaging with multidetector computed tomography (MDCT) or magnetic resonance imaging (MRI) often reveals small focal liver lesions, which puts pressure on the reporting radiologist to characterize these tiny lesions. On the other hand, in patients with underlying diffuse liver disease, such as cirrhosis or severe steatosis, the detection of focal liver lesions can be quite difficult. Strategies for optimal detection and characterization of focal liver lesions should be developed according to the clinical situation, the likelihood of malignant disease and the presence of underlying diffuse liver disease. The presence or absence of a clinical history of cancer determines the algorithm for further characterization: work-up with contrast-enhanced MRI, biopsy or follow-up. In patients with chronic liver disease, recent guidelines on the detection of hepatocellular carcinoma (HCC) favour the use of multiphasic MRI or MDCT, which allows confident diagnoses of HCC 41 cm. For lesions 51 cm in chronic liver disease, follow-up is recommended. In patients with moderate to severe steatosis, contrast-enhanced MDCT has low diagnostic yield for the detection of liver lesions; contrast-enhanced MRI is far superior. This review describes successful strategies for the detection and characterization of focal liver lesions in different clinical scenarios.
Detection and characterization of benign focal liver lesions with multislice CT
European Radiology, 2006
MDCT is a rapidly evolving technique that significantly improves CT imaging for several indications including depiction of focal benign lesions. Imaging mainly profits from improved longitudinal spatial resolution allowing highquality non-axial reformations and 3D reconstructions and CT angiography as well as rapid accurate multiphase imaging with short breath-holding periods. This review provides an overview of the current status of MDCT with respect to liver imaging and the implications for characterizing benign focal liver lesions. MDCT currently allows the acquisition of thin slices in daily routine diagnostics providing an improved detection rate of small liver lesions. Whereas large benign focal liver lesions exhibit typical patterns of morphology, attenua-tion and perfusion, which also may be assessed with single-slice scanners, small lesions remain challenging even with MDCT, since the specific criteria for confident diagnosis become more ambiguous. Here, MR imaging provides more detailed information about tissue components and the availability of liver-specific contrast agents, adding further impact to this technique. With respect to dose considerations, the number of necessary multiphase scans as well as the application of very thin collimation should be strictly checked for each patient undergoing MDCT based on the individual clinical situation and question.
MR characterization of focal liver lesions: pearls and pitfalls
Magnetic resonance imaging clinics of North America, 2014
Magnetic resonance (MR) can characterize specific tissue subtypes, thus facilitating focal liver lesion diagnosis. Focal liver lesions that are isointense to hyperintense to liver on T1-weighted images are usually hepatocellular in origin. Chemical shift imaging can narrow the differential diagnosis by detecting the presence of lipid or iron. T2 and heavily T2-weigthed fast spin echo imaging can differentiate solid from nonsolid focal liver lesions. The authors illustrate these MR imaging pearls and the uncommon exceptions (pitfalls). The authors hope that you will find this less traditional contribution to the Magnetic Resonance Clinics of North America helpful in clinical practice.