Accurate Assessment of Vascularity of Focal Hepatic Lesions in                    Arterial Phase Imaging

Abstract Background Despite the recent advances in liver imaging, the detection and characterization of small hepatic focal lesions is still a real challenge. Particularly in cancer patients where the characterization of a small HFL as thus the precise tumor staging is critical for optimal treatment planning. Aim of the Work To explore the effectiveness, and hence the clinical utility, of MRI detection and characterization of small focal hepatic lesions either only discovered on MRI or as a further work up of CT/US-indeterminate lesions. Patients and Methods We reviewed our database for individuals who underwent liver MR imaging between March 2018 and March 2019 for the evaluation of small hepatic lesions that were discovered for the first time or had been previously visualized on routinely performed CT and had been considered indeterminate. Results The present study included 44 patients of which 26 were males (59.1%) and 18 were females (40.9%). The age range of the study group was 19 to 77 years. The mean age for Malignant lesions was 51 years. The right lobe of liver was involved in 23 cases (52.3%), left lobe in 5 cases (11.4%) and both lobes in 16 cases (36.4%). There were 30 (68.18%) benign, 13 (29.54%) malignant lesions and 1 (2.3%) indeterminate, hemangiomas were predominant in benign lesions whereas hepatocellular carcinomas were predominant in malignant lesions. N'TRI could characterize 92% cases. Conclusion The diagnostic process of small hepatic focal lesions, either detection or characterization or both, continues to represent a challenge. Contrast-enhanced MR can accurately detect and characterize majority of small hepatic focal lesions.

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In Vivo P-31 -MR-Spectroscopy of Focal Hepatic Lesions

Investigative Radiology ◽

10.1097/00004424-199501000-00009 ◽

1995 ◽

Vol 30 (1) ◽

pp. 56-63 ◽

Cited By ~ 6

Author(s):

GISBERT BRINKMANN ◽

UWE H. MELCHERT ◽

LARS EMDE ◽

HEIKE WOLF ◽

CLAUS MUHLE ◽

...

Keyword(s):

Mr Spectroscopy ◽

Focal Hepatic Lesions ◽

Hepatic Lesions

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P0341 FOCAL HEPATIC LESIONS - A RARE PRESENTATION OF A POTENTIALLY FATAL DISEASE

European Journal of Internal Medicine ◽

10.1016/s0953-6205(09)60361-7 ◽

2009 ◽

Vol 20 ◽

pp. S117

Author(s):

Andreia Gonçalves ◽

Bruno Valente ◽

André Lencastre ◽

Isabel Baptista

Keyword(s):

Fatal Disease ◽

Rare Presentation ◽

Focal Hepatic Lesions ◽

Hepatic Lesions

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Diagnosis of Focal Hepatic Lesions

JAMA ◽

10.1001/jama.1974.03230490051024 ◽

1974 ◽

Vol 229 (11) ◽

pp. 1463 ◽

Cited By ~ 8

Author(s):

James H. Pritchard

Keyword(s):

Focal Hepatic Lesions ◽

Hepatic Lesions

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Noninvasive Diagnosis of Hepatocellular Carcinoma on Sonazoid-Enhanced US: Value of the Kupffer Phase

Diagnostics ◽

10.3390/diagnostics12010141 ◽

2022 ◽

Vol 12 (1) ◽

pp. 141

Author(s):

Hiroshi Takahashi ◽

Katsutoshi Sugimoto ◽

Naohisa Kamiyama ◽

Kentaro Sakamaki ◽

Tatsuya Kakegawa ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Diagnostic Performance ◽

Late Phase ◽

Imaging Feature ◽

Arterial Phase ◽

Liver Imaging ◽

Noninvasive Diagnosis ◽

Contrast Enhanced ◽

Treatment Naïve ◽

Hepatic Lesions

The aim of this study was to compare the diagnostic performance of Contrast-Enhanced US Liver Imaging Reporting and Data System (CEUS LI-RADS) version 2017, which includes portal- and late-phase washout as a major imaging feature, with that of modified CEUS LI-RADS, which includes Kupffer-phase findings as a major imaging feature. Participants at risk of hepatocellular carcinoma (HCC) with treatment-naïve hepatic lesions (≥1 cm) were recruited and underwent Sonazoid-enhanced US. Arterial phase hyperenhancement (APHE), washout time, and echogenicity in the Kupffer phase were evaluated using both criteria. The diagnostic performance of both criteria was analyzed using the McNemar test. The evaluation was performed on 102 participants with 102 lesions (HCCs (n = 52), non-HCC malignancies (n = 36), and benign (n = 14)). Among 52 HCCs, non-rim APHE was observed in 92.3% (48 of 52). By 5 min, 73.1% (38 of 52) of HCCs showed mild washout, while by 10 min or in the Kupffer phase, 90.4% (47 of 52) of HCCs showed hypoenhancement. The sensitivity (67.3%; 35 of 52; 95% CI: 52.9%, 79.7%) of modified CEUS LI-RADS criteria was higher than that of CEUS LI-RADS criteria (51.9%; 27 of 52; 95% CI: 37.6%, 66.0%) (p = 0.0047). In conclusion, non-rim APHE with hypoenhancement in the Kupffer phase on Sonazoid-enhanced US is a feasible criterion for diagnosing HCC.

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