Comparison of diffusion-weighted MR imaging and multidetector-row CT in the detection of liver metastases in patients operated for pancreatic cancer. Recurrence was detected by imaging in eight (47.0%) patients. The resultant water-only images have been shown to improve the uniformity of fat suppression at 3 T, compared with conventional spectral fat suppression technique [16]. There may be a large number of patients with benign indeterminate lesions who are not evaluated by hepatobiliary specialists. Vilgrain V, Esvan M, Ronot M, Caumont-Prim A, Aub C, Chatellier G. A meta-analysis of diffusion-weighted and gadoxetic acid-enhanced MR imaging for the detection of liver metastases. Tsoi KM, Lowe M, Tsuda Y, Lex JR, Fujiwara T, Almeer G, Gregory J, Stevenson J, Evans SE, Botchu R, Jeys LM. Liver metastases in candidates for hepatic resection: comparison of helical CT and gadolinium- and SPIO-enhanced imaging. Learn about. Chen L, Zhang L, Bao J, et al. Hepatic angiosarcoma: findings on multiphasic contrast-enhanced helical CT do not mimic hepatic hemangioma. (df) Pre-contrast, post-contrast arterial phase, and delayed phase images show avid arterial enhancement, which persists. (c) The gadoxetic-enhanced T1-weighted GRE image in the hepatobiliary phase shows two additional small subcapsular metastases (arrows) not seen on unenhanced MRI or MDCT (not shown). Diffuse HCC in the right lobe with tumor thrombus in the portal vein. The reader should learn how to optimize CT and MR imaging in his/her own practice, understand how to apply and interpret CT and MR imaging for the management of focal liver lesions, and appreciate the expanding role of liver-specific MR contrast agents for lesion characterization. 17.12). there is a 3.2 cm low-attenuation lesion in the left adnexa. To describe the approach of the family physician to clinical problems. In the hepatobiliary phase of contrast enhancement, FNH typically show contrast uptake, whereas NHF1A-inactivated HCA and the majority of other HCA subtypes do not [44]. https://doi.org/10.3350/cmh.2018.0107 (2019). On MR imaging, the presence of a hypointense rim on T1- and T2-weighted images and a multiloculated appearance are diagnostic features. Oncol. Thus, we propose that IOUS should be used as an adjunct to preoperative imaging techniques to improve the staging of CRLM and thereby help select the most appropriate treatment. Liver Lesions Cancer. How Are Indeterminate Pulmonary Nodules at Diagnosis Associated with Survival in Patients with High-Grade Osteosarcoma? 17.7). Contrast-enhanced multiphasic MDCT is the most important liver imaging technique in many institutions. In the hepatobiliary phase (d) there is marked hypointensity of the lesion due to lack of hepatocellular uptake in the lesion and enhancement of surrounding liver parenchyma. Nonetheless, quantitative ADC values may be useful to support lesion characterization and for identifying early tumor response to treatment, which is currently being investigated. AJR Am J Roentgenol. With MR imaging, lesions are hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images [48]. Evaluation of patients with small, subcentimeter nodules Semin Respir Crit Care Med. AJR Am J Roentgenol. An MR examination of the liver routinely includes dynamic contrast-enhanced pulse sequences and diffusion-weighted imaging (DWI). Focal nodular hyperplasia (FNH) is a benign lesion that can cause confusion when incidentally detected during abdominal imaging. Oncol. Springer, Cham. Unable to load your collection due to an error, Unable to load your delegates due to an error. LIVER MRI IS increasingly used for detection and characterization of focal liver lesions and for the evaluation of diffuse liver disease (1-6). On CT, FL-HCC appears as a large, well-defined vascular mass with lobulated surface and often a central scar and calcifications in up to 70% of cases [64, 65]. Radiologic Features of Hepatic Masses Without Underlying Other ways you may be able to lower your risk of developing liver lesions include: Liver lesions are common. These liver-specific agents are taken up into hepatocytes to varying extent (gadobenate dimeglumine 45%; gadoxetic acid ~50%), resulting in avid T1 enhancement of the liver parenchyma in the hepatobiliary phase, which is performed at 20 min for gadoxetic acid and about 12 h for gadobenate dimeglumine after contrast administration. Nault JC, Paradis V, Cherqui D, Vilgrain V, Zucman-Rossi J. Molecular classification of hepatocellular adenoma in clinical practice. Intralesional fat is uncommon and, when present, is often patchy or heterogeneous. The reported incidence is at least one hepatic lesion too small to characterize in 29.4% of women without definite liver metastasis on CT [ 6 ]. Not "TSTC" anymore KRAS mutation detected in approximately 3050% of CRC is a predictor of oncologic outcomes8. Jai Young Cho. These hepatic tumors are characterized by multiple, peripheral-based lesions that progressively become confluent masses. & Kim, M.-J. Size Most incidental liver lesions <1 cm are benign, while some small lesions may be difficult to definitively characterize by imaging methods . Hepatocellular carcinoma: imaging patterns on gadoxetic acid-enhanced MR images and their value as an imaging biomarker. Additional possible causes of liver lesions include: The cause of benign lesions can vary depending on the type of lesion: Anybody can develop liver lesions, but some people are at a higher risk than others. Small benign lesions often dont cause symptoms and dont require treatment. PubMed Conversion surgery after cetuximab or bevacizumab plus FOLFIRI chemotherapy in colorectal cancer patients with liver- and/or lung-limited metastases. Ital. PubMed (2021). Inactivating mutations of hepatocyte nuclear factor 1 alpha (HNF1A) are observed in 4050% of HCA. Benign and malignant portal vein thrombosis: differentiation by CT characteristics. Liver Intraoperative ultrasound could be considered as an adjunct to MRI in patients with indeterminate nodules owing to its high positive predictive value. Bonanni, L. et al. The mean carcinoembryonic antigen level at diagnosis was 27.7ng/mL (range 1520ng/mL). (2020). Purysko AS, Remer EM, Coppa CP, et al. (a) Typical large subcapsular abscess with an air-fluid level and a reactive pleural effusion. They may also treat the cysts with surgery or medication. WebA small subset of sporozoite is taken up by CD11c+ dendritic cells in the skin resulting in a nonproductive infection. Using liver-specific MR contrast agents, FNH frequently shows enhancement on delayed images after administration of hepatobiliary contrast agents (such as gadoxetic acid or gadobenate dimeglumine) because of the presence of normal biliary ductules within the lesion and the expression of OATP receptors (Fig. The sensitivity and specificity of IOUS for detecting malignant indeterminate nodules were 73.68% and 93.75%, respectively. At contrast-enhanced T1-weighted MRI, they are hypervascular, often with contrast washout in the portal venous or delayed phase. Like all cancers, cancerous lesions of the liver are caused by changes to the DNA that make cells replicate uncontrollably. Liver-specific MR contrast agents are helpful for characterization of FNH and adenoma and may increase the reader confidence in HCC characterization. 2011;21:73843. T2-weighted MR imaging for characterization of focal liver lesions: conventional spin-echo vs fast spin-echo. 7. J Comput Assist Tomogr. J. Primary hepatic angiosarcoma: findings at CT and MR imaging. 2006;59:4604. Pancreatitis Stevens WR, Gulino SP, Batts KP, et al. Address correspondence and reprint requests to Dr. H. K. Lim at Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Kangnam-gu 135-710, Seoul, Korea. Of the 389 patients who underwent MRI, 60 patients with indeterminate or equivocal nodules detected by gadoxetic acid-enhanced MRI between January 2008 and October 2018 were included in the present study. The positive predictive value was 96.6%. Epithelioid hemangioendothelioma (EHE) is a rare tumor of vascular origin, not to be confused with infantile hemangioendothelioma, which is a very different tumor. 17.18). A few patients had extrahepatic metastasis to the lung (n=4) and lymph nodes (n=1). (a) Pre-contrast T1-weighted image shows an isointense lesion with a central hypointense scar, which shows minimal mass effect upon adjacent vasculature. The most common risk factor worldwide for liver cancer is chronic hepatitis B or hepatitis C infection. At MR imaging, such a nodule can exhibit higher signal intensity on T2-weighted images and display hypervascularity on arterial-phase images. Radiographics. Jhaveri KS, Halankar J, Aguirre D, et al. Leconte I, Van Beers BE, Lacrosse M, et al. Lesions more than 1 cm that demonstrate arterial-phase hypervascularity and venous- or delayed phase washout are triaged for treatment with a diagnosis of HCC. (2017). (b, c) Another patient with fever and right upper quadrant pain. WebWhat does this mean on my ct scan? 25, 1220. mAs 230) reconstructed with standard filtered back projection shows colorectal liver metastases. Liver imaging. Search for Similar Articles Internet Explorer). Treatment response was assessed in accordance with the response evaluation criteria in solid tumor (RECIST) version 1.1 (Eisenhauer et al. Oudkerk M, Torres CG, Song B, et al. Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer. To help identify the clinical content of family medicine. 2015;277:95103. IR uses loop-wise raw data correction to reduce image noise, thus allowing imaging to be performed at reduced kVp or mAs, with lower radiation dose but comparable image quality. The liver is an essential organ that plays a key role in your health. This work is supported by Grant No. 2005;29:18190. Ann. Radiographics. To retrospectively evaluate the prevalence and clinical importance of hepatic lesions considered too small to characterize (TSTC) at initial computed tomography (CT) Intrahepatic bile duct dilatation due to liver metastases from colorectal carcinoma. Llovet JM, et al. On MR imaging, FL-HCC are typically hypointense on T1- and hyperintense on T2-weighted images, with the central scar being hypointense on both sequences (Fig. (2021). J Magn Reson Imaging. Hepatic angiosarcoma is a rare tumor. A total of 473 patients admitted to the hospital with either synchronous or metachronous CRLM were assessed for inclusion in this retrospective study. Incidental lesion in the left lobe of the liver (arrows). Overall survival by the existence of liver lesions. J Comput Assist Tomogr. Abdominal CT: comparison of adaptive statistical iterative and filtered back projection reconstruction techniques. ( 2 ) reported that liver lesions Hammerstingl R, Huppertz A, Breuer J, et al. HHS Vulnerability Disclosure, Help For primary CRC, lymphatic invasion was found in 56.7%, perineural invasion in 63.3%, and venous invasion in 45.0% of patients. The .gov means its official. Effects of injection rates of contrast material on arterial phase hepatic CT. AJR Am J Roentgenol. two of whom underwent repeat surgery for the recurrence, and the nodule was confirmed to be pathologically benign in one patient (Fig. Incidental pancreatic cystic lesions: is there a relationship with the development of pancreatic adenocarcinoma and all-cause mortality? The T stage of the primary was mostly T3 or above. 17.2), especially during dynamic contrast-enhanced acquisitions [17]. On CT, hepatic cysts are well circumscribed and typically show attenuation values similar to water (015 HU), although smaller cysts may show higher attenuation values due to partial volume effects. Excellent interobserver agreement ( > 0.60) was found for all parameters in SLAHs larger than 5 mm. Purpose: 2010;195:3816. Second, we only included patients who underwent surgery for CRLM. Ward J, Robinson PJ, Guthrie JA, et al. They are usually discovered incidentally at abdominal imaging. The dendritic cells traffic to the skin dLN and present the processed sporozoite antigens to nave CD8+ T cells. For these reasons, a three- to four-phasic MDCT protocol is utilized at most centers to evaluate HCC. Although the majority of inflammatory HCA are hypointense on hepatobiliary phase using liver-specific contrast media, about 30% may appear iso- or hyperintense. Treatment for liver cancer depends on factors such as: The 5-year survival rate of liver cancer continues to rise in the United States. Farraher SW, Jara H, Chang KJ, et al. Gastroenterology. Exceptions include cystic or mucinous metastases, gastrointestinal stromal tumor (GIST), and neuroendocrine tumor metastases. If benign liver lesions are large and Radiology. Sci Rep 11, 13744 (2021).
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