scholarly journals Pathobiological and Radiological Approach For Hepatocellular Carcinoma Subclassification

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Francesco Vasuri ◽  
Matteo Renzulli ◽  
Silvia Fittipaldi ◽  
Stefano Brocchi ◽  
Alfredo Clemente ◽  
...  

Abstract Many advances have been made in the imaging diagnosis and in the histopathological evaluation of HCC. However, the classic imaging and histopathological features of HCC are still inadequate to define patient’s prognosis. We aimed to find the link between new proposed morphovascular patterns of hepatocellular carcinoma (HCC) and magnetic resonance imaging (MRI) features to identify pre-operatory markers of biologically aggressive HCC. Thirty-nine liver nodules in 22 patients were consecutively identified. Histopathological analysis and immunohistochemistry for CD34 and Nestin were performed to identify the four different HCC morphovascular patterns. MRI was performed using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid. Three out of four morphovascular HCC patterns showed peculiar MRI features: in particular Pattern D (solid aggressive HCCs with CD34+/Nestin+ new-formed arteries) were isointense on T1-WI in 83% of cases and hyperintense on T2-WI in 50%. Five histologically-diagnosed HCC were diagnosed as non-malignant nodules on MRI due to their early vascularization and low aggressiveness (Pattern A). The comparison between histology and MRI confirms that a subclassification of HCC is possible in a pre-operatory setting. MRI seems to reinforce once more the identity of the different morphovascular HCC patterns and the possibility to pre-operatively identify HCCs with features of biological aggressiveness.

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052094341
Author(s):  
Shuang-Yu Wang ◽  
Lei Yin ◽  
Chen Wang ◽  
Ming-Ping Ma

Objective Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. We aimed to summarize and analyze the atypical magnetic resonance imaging (MRI) features of HCC to improve its diagnostic accuracy. Methods We retrospectively analyzed MRI data for 66 patients with HCC with atypical MRI features confirmed by operation and pathology. Results Twelve patients had high signals and 18 patients had significant decreases in opposed phase signals in T1WI plain scans. Nine patients had high signals and six patients had large cystic lesions in apparent diffusion coefficient images. Dynamic enhancement showed progressive enhancement in 15 patients, ring enhancement in three, irregular patchy enhancement in three, ‘nodule-in-nodule’ enhancement in six, delayed central patchy enhancement in six, delayed central ‘star-like aristate scars’ (T2WI revealed high signal intensity) in 21, and poor blood supply in three patients. Conclusions MRI can make a clear diagnosis of typical HCC, and atypical cases can also be distinguished from other tumors or tumor-like lesions by MRI. The analysis of atypical signs may improve the diagnostic accuracy of MRI for HCC.


2017 ◽  
Vol 50 (2) ◽  
pp. 115-125 ◽  
Author(s):  
Miguel Ramalho ◽  
António P. Matos ◽  
Mamdoh AlObaidy ◽  
Fernanda Velloni ◽  
Ersan Altun ◽  
...  

Abstract In the second part of this review, we will describe the ancillary imaging features of hepatocellular carcinoma (HCC) that can be seen on standard magnetic resonance imaging (MRI) protocol, and on novel and emerging protocols such as diffusion weighted imaging and utilization of hepatocyte-specific/hepatobiliary contrast agent. We will also describe the morphologic sub-types of HCC, and give a simplified non-invasive diagnostic algorithm for HCC, followed by a brief description of the liver imaging reporting and data system (LI-RADS), and MRI assessment of tumor response following locoregional therapy.


1996 ◽  
Vol 110 (2) ◽  
pp. 182-184 ◽  
Author(s):  
Sebastien Janssens de Varebeke ◽  
Arthur De Schepper ◽  
Esther Hauben ◽  
Frank Declau ◽  
Eric Van Marck ◽  
...  

AbstractA case of a rare and unusual variant of neurofibroma, diffuse neurofibroma (paraneurofibroma), in a young patient is presented. The clinical, radiological and histopathological features of this case are reported. The magnetic resonance imaging (MRI) features of the diffuse neurofibroma are comparable with those described in other neurofibromas.


2009 ◽  
Vol 95 (4) ◽  
pp. 532-534 ◽  
Author(s):  
Lorenzo Preda ◽  
Stefania Rizzo ◽  
Maria Sole Prevedoni Gorone ◽  
Roberta Fasani ◽  
Angelo Maggioni ◽  
...  

Imaging evaluation of uterine masses is important to assess the type of lesion and to target surgery, if surgical excision is necessary. This can be decisive in fertile women with benign masses resembling malignancies, in order to avoid overtreatment. In this study, the magnetic resonance imaging (MRI) appearance of cotyledonoid dissecting leiomyoma of the uterus, a rare benign variant of leiomyoma mimicking malignancy, is presented.


2011 ◽  
Vol 38 (11) ◽  
pp. 2475-2481 ◽  
Author(s):  
YIH JIA POH ◽  
NICOLA DALBETH ◽  
ANTHONY DOYLE ◽  
FIONA M. McQUEEN

Objective.Magnetic resonance imaging (MRI) is commonly used in autoimmune inflammatory arthritis to define disease activity and damage, but its role in gout remains unclear. The aim of our study was to identify and describe the MRI features of gout.Methods.Over a 10-year period we identified patients with gout who underwent MRI scanning of the hands or feet. Scans were reviewed for erosions, synovitis, tenosynovitis, tendinosis, bone edema, and tophi by a musculoskeletal radiologist and 2 rheumatologists in a blinded manner. MRI features in patients with uncomplicated gout were compared with features where concomitant osteomyelitis was diagnosed.Results.A total of 47 patients with gout (51 scans) were included: 33 (70%) had uncomplicated gout and 14 (30%) had gout complicated by osteomyelitis. MRI features included tophi in 36 scans (71%), erosions in 35 (69%), bone edema in 27 (53%), synovitis in 15 (29%), tenosynovitis in 8 (16%), and tendinosis in 2 (4%). Uncomplicated gout and gout plus osteomyelitis did not differ for most MRI features. However, “severe bone marrow edema” was much more common in gout plus osteomyelitis, occurring in 14/15 scans (93%) compared with 3/36 scans (8%) in uncomplicated gout (OR 154.0, 95% CI 14.7–1612, p < 0.0001). Sensitivity and specificity of “severe bone edema” for concomitant osteomyelitis were 0.93 (95% CI 0.68–0.99) and 0.92 (95% CI 0.78–0.98), respectively.Conclusion.MRI reveals that gout affects the joints, bones, and tendons. Bone edema in patients with chronic tophaceous gout is frequently mild and this contrasts with the “severe bone edema” observed in patients with concomitant osteomyelitis.


2012 ◽  
Vol 18 (11) ◽  
pp. 1650-1652 ◽  
Author(s):  
Sebastian Jander ◽  
Bernd Turowski ◽  
Bernd C Kieseier ◽  
Hans-Peter Hartung

In this report we describe a multiple sclerosis patient who developed a relapse with magnetic resonance imaging (MRI) features of tumefactive demyelination after switching therapy from natalizumab to fingolimod. Tumefactive lesions emerged 16 weeks after stopping natalizumab and eight weeks after commencing fingolimod therapy but had been absent at the time of diagnosis and throughout the preceding course of the disease. Thus, the first-time occurrence of atypical lesion features may have been caused by the change in immunotherapy. The possible relevance of natalizumab withdrawal vs fingolimod introduction is discussed against the background of recently published case studies.


2017 ◽  
Vol 50 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Miguel Ramalho ◽  
António P. Matos ◽  
Mamdoh AlObaidy ◽  
Fernanda Velloni ◽  
Ersan Altun ◽  
...  

Abstract Magnetic resonance imaging (MRI) is the modern gold standard for the noninvasive evaluation of the cirrhotic liver. The combination of arterial phase hyperenhancement and delayed wash-out allows a definitive diagnosis of hepatocellular carcinoma (HCC) in patients with liver cirrhosis or chronic liver disease, without the requirement for confirmatory biopsy. That pattern is highly specific and has been endorsed in Western and Asian diagnostic guidelines. However, the sensitivity of the combination is relatively low for small HCCs. In this two-part review paper, we will address MRI of the cirrhotic liver. In this first part, we provide a brief background on liver cirrhosis and HCC, followed by descriptions of imaging surveillance of liver cirrhosis and the diagnostic performance of the different imaging modalities used in clinical settings. We then describe some of the requirements for the basic MRI technique, as well as the standard MRI protocol, and provide a detailed description of the appearance of various types of hepatocellular nodules encountered in the setting of the carcinogenic pathway in the cirrhotic liver, ranging from regenerative nodules to HCC.


1985 ◽  
Vol 1 (3) ◽  
pp. 515-536 ◽  
Author(s):  
Paul F. Gross

Magnetic resonance imaging (MRI) is a rapidly evolving medical technology which has become widely diffused before comprehensive assessment of its safety, efficacy, cost-effectiveness, and relative cost-effectiveness compared with diagnostic modalities that it seems most likely to replace could be made. In early 1982 there were fewer than ten units worldwide. In August 1984, there were about 150 units and the figure will be closer to 300 by the end of 1985.


2012 ◽  
Vol 39 (4) ◽  
pp. 841-843 ◽  
Author(s):  
NICOLA DALBETH ◽  
KAREN PUI ◽  
MARIA LOBO ◽  
ANTHONY DOYLE ◽  
PETER B. JONES ◽  
...  

Objective.To examine the association between magnetic resonance imaging (MRI) features of distal phalanx (DP) disease and the progression of nail pathology in psoriatic arthritis (PsA).Methods.Clinical nail assessment and hand MRI scans were done on 34 patients with PsA. Twenty patients had repeat nail assessments after 1 year.Results.Nails with onycholysis and hyperkeratosis at baseline were more likely to have corresponding DP bone erosion and proliferation on MRI. DP bone edema on baseline MRI was associated with development of onycholysis and hyperkeratosis in corresponding nails.Conclusion.Our data suggest that DP inflammation is central in the development of psoriatic nail disease.


Sign in / Sign up

Export Citation Format

Share Document