scholarly journals Hepatobiliary phase signal intensity: A potential method of diagnosing HCC with atypical imaging features among LR-M observations

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257308
Author(s):  
Jae Hyon Park ◽  
Yong Eun Chung ◽  
Nieun Seo ◽  
Jin-Young Choi ◽  
Mi-Suk Park ◽  
...  
Keyword(s):  
Signal Intensity ◽  
Liver Parenchyma ◽  
Potential Method ◽  
Hepatobiliary Phase ◽  
Imaging Features ◽  
Fibrous Stroma ◽  
Phase Signal ◽  
Histologic Differentiation ◽  
Edmondson Grade

Herein, we assessed whether hepatobiliary phase (HBP) signal intensity (SI) can be used to differentiate HCC and non-HCC malignancies within LR-M observations. 106 LR-M patients based on LI-RADS v2018 who underwent gadoxetate-disodium magnetic resonance imaging and surgery from January 2009 to December 2018 were included. SI of LR-M observation on HBP was analyzed by two radiologists and categorized into dark, low and iso-to-high groups. Tumor was classified as dark when more than 50% of tumor showed hypointensity compared to spleen, as low when more than 50% of tumor showed hyperintensity compared to spleen but hypointensity compared to liver parenchyma, and as iso-to-high if there was even a focal iso-intensity or hyperintensity compared to liver parenchyma. Analysis of clinicopathological factors and association between imaging and histology was performed. Out of 106 LR-M, 42 (40%) were showed dark, 61 (58%) showed low, and 3 (3%) showed iso-to-high SI in HBP. Three iso-to-high SI LR-M were HCCs (P = 0.060) and their major histologic differentiation was Edmondson grade 1 (P = 0.001). 43 out of 61 (71%) low SI LR-M were iCCA or cHCC-CCA (P = 0.002). Inter-reader agreement of HBP SI classification was excellent, with a kappa coefficient of 0.872. LR-M with iso-to-high SI in HBP is prone to being HCC while LR-M with low SI in HBP is prone to being tumor with fibrous stroma such as iCCA and cHCC-CCA. Classification of LR-M based on HBP SI may be a helpful method of differentiating HCC from non-HCC malignancies.

scholarly journals Evaluation of the liver function by the liver parenchyma, spleen and portal vein signal intensity during the hepatobiliary phase in Gd-EOB-DTPA-enhanced MRI

2020 ◽  
Author(s):  
Ming Yang ◽  
Yue Zhang ◽  
Wenlu Zhao ◽  
Wen Cheng ◽  
Han Wang ◽  
...  
Keyword(s):  
Liver Function ◽  
Portal Vein ◽  
Signal Intensity ◽  
Liver Parenchyma ◽  
International Normalized Ratio ◽  
Imaging Biomarkers ◽  
Hepatobiliary Phase ◽  
Enhanced Mri ◽  
Pugh Class ◽  
Class C

Abstract Background: Previous studies used the signal intensity (SI) to reflect liver function. However, there are still few studies on the assessment of liver function via the portal vein, and no study has pointed out that in terms of SI (liver, spleen, portal vein), which one can better reflect liver function. Therefore, the aim of this study is to investigate whether these parameters can be used to evaluate liver function in patients with cirrhosis and determine which parameter is best.Methods: A total of 120 patients with normal livers (n = 41) or Child–Pugh class A (n = 50), B (n = 21) or C (n = 8) disease who underwent Gd-EOB-DTPA-enhanced MRI were retrospectively reviewed. Comparisons of the SI of the liver parenchyma, portal vein, and spleen and liver-to-portal vein (LPC), liver-to-spleen (LSC), and portal vein-to-spleen (PSC) contrast ratios on the 15-min hepatobiliary phase images were performed among groups, and the correlations among liver function parameters (total bilirubin, direct bilirubin, indirect bilirubin, aspartate aminotransferase, alanine aminotransferase, albumin, creatinine, platelet count, prothrombin time and international normalized ratio), liver function scores and MRI date were also quantitatively analyzed.Results: Significant differences were observed in the SI of the liver parenchyma, LPC and LSC among groups. These values all decreased gradually from normal livers to Child–Pugh class C cirrhotic livers (P < 0.001). The SI of the portal vein constantly and slightly increased from normal livers to Child–Pugh class C cirrhotic livers, but there were no differences among groups in portal vein signal and PSC (P > 0.05). LPC had a stronger correlation with Child-Pugh score and MELD score than LSC and liver parenchyma SI. The order of the AUCs of these parameters, from largest to smallest, was as follows: LPC, LSC, and liver parenchyma SI (P > 0.05).Conclusion: Liver parenchyma SI, LSC and LPC may be used as alternative imaging biomarkers for assessing liver function, while the portal vein signal and PSC could not reflect liver function. Furthermore, LPC values can more effectively distinguish severity among patients with cirrhosis than liver parenchyma SI and LSC.

scholarly journals Evaluation of the liver function by the liver parenchyma, spleen and portal vein signal intensity during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI

2020 ◽  
Author(s):  
Ming Yang ◽  
Yue Zhang ◽  
Wenlu Zhao ◽  
Wen Cheng ◽  
Han Wang ◽  
...  
Keyword(s):  
Liver Function ◽  
Mr Imaging ◽  
Portal Vein ◽  
Signal Intensity ◽  
Contrast Ratio ◽  
Liver Parenchyma ◽  
Hepatobiliary Phase ◽  
Unified Study ◽  
Pugh Class ◽  
Class C

Abstract Background: Assessment of liver function is essential for the treatment and prognosis of patients with cirrhosis, previous studies used signal intensity of hepatobiliary phase to reflect liver function on gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced MR imaging. But none of these studies has conducted a unified study on liver, spleen and portal vein. Thus, the aim of this study is to conduct a unified study, investigate whether they can be used to evaluate the liver function in patients with cirrhosis and find out which one is better.Methods: A total of 120 patients with normal (n = 41), Child–Pugh class A (n = 50), B (n = 21) or C (n = 8) who underwent Gd-EOB-DTPA-enhanced 3 Tesla MR imaging were retrospectively reviewed. Comparison of MRI date (signal intensity of liver parenchyma, portal vein, spleen, and liver-to-portal vein [LPC], liver-to-spleen [LSC], portal vein-to-spleen [PSC] contrast ratio) on hepatobiliary phase 15 min among groups, and liver function parameters was quantitatively analyzed as well.Results: A significantly difference was observed between the SI of liver parenchyma, LPC and LSC among groups (P < 0.001). They all decreased gradually from normal to cirrhotic livers with Child–Pugh class C (P < 0.001). The SI of portal vein constantly and slightly increased from normal to Child–Pugh class C, but there were not differences among the groups (P > 0.05). LPC is more correlated with Child-Pugh score or MELD score than LSC and liver parenchyma SI. A receiver operating characteristic curve analysis revealed that the AUC in order from the large to the small are: LPC, LSC, and the liver parenchyma SI (0.892, 0.889, 0.836), but the differences of AUCs among them were not significant.Conclusion: Liver parenchyma SI, LSC and LPC might be used as alternatives imaging biomarker for assessing liver function. Furthermore, LPC values can more efficaciously indicate the severity between patients with cirrhosis than SI of liver parenchyma and LSC. Although the portal vein signal shows a certain upward trend, it could not be used to reflect liver function.

scholarly journals Brief communication (Original). Correlation between liver signal intensity in hepatobiliary phase of Gd-EOB-DTPA enhancement and liver function reserves

2014 ◽  
Vol 8 (3) ◽  
pp. 411-415
Author(s):  
Natthaporn Tanpowpong ◽  
Teerasak Phewplung
Keyword(s):  
Liver Function ◽  
Signal Intensity ◽  
Signal To Noise Ratio ◽  
Interobserver Reliability ◽  
Statistical Significance ◽  
Three Dimensional ◽  
Negative Relationship ◽  
Liver Parenchyma ◽  
Meld Score ◽  
Hepatobiliary Phase

Abstract Background: Gadolinium diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) is a developed agent with preferential uptake by hepatocytes. A rapid and specific hepatocyte uptake with biliary excretion was observed of approximately 50% of the injected dose. The amount of contrast uptake is thought to be related to reserve liver function. Objectives: To evaluate correlation between liver signal intensity in the hepatobiliary phase of Gd-EOB-DTPA and reserved liver function by using the model score for end-stage liver disease (MELD). Methods:All patients who underwent magnetic resonance (MR) imaging with Gd-EOB-DTPA were retrospectively collected. The patients with serum creatinine level higher than 1.5 mg/dL or patients without available data to estimate MELD score were excluded. Thirty-six patients were enrolled. A signal-to-noise ratio (SNR) in the liver parenchyma on a fat-suppressed three dimensional fast spoiled-gradient recalled echo sequence images before and 20 minutes after contrast injection were measured and calculated on PACS by two radiologists. The MELD score was determined and interobserver reliability was estimated. Results: Among 36 patients, we found a negative relationship between the percentage enhancement and the MELD score (P < 0.01, r = 0.545). The SNR at 20 minutes after Gd-EOB-DTPA injection also had a negative relationship with the MELD score with statistical significance (P < 0.01, r = 0.460). Interobserver reliability was 0.675. Conclusion: The percentage enhancement in hepatobiliary phase of Gd-EOB-DTPA can predict reserved liver function.

Magnetic Resonance Imaging of Uncommon Hepatic Mesenchymal Tumours: Haemangioendothelioma and Angiosarcoma

2019 ◽  
Vol 15 (4) ◽  
pp. 362-368
Author(s):  
Andrzej Cieszanowski ◽  
Agnieszka Anysz-Grodzicka ◽  
Joanna Podgorska ◽  
Beata Jagielska ◽  
Jakub Pałucki
Keyword(s):  
Contrast Enhancement ◽  
Correct Diagnosis ◽  
Malignant Potential ◽  
Hepatobiliary Phase ◽  
Imaging Features ◽  
Liver Tumours ◽  
Aged Woman ◽  
High Apparent Diffusion Coefficient ◽  
Adc Values ◽  
Mesenchymal Tumours

<P>Background: Primary Hepatic Epithelioid Haemangioendothelioma (HEHE) and Primary Hepatic Angiosarcoma (PHA) are rare mesenchymal tumours with different malignant potential. Whereas HEHE demonstrates low to intermediate malignant potential, PHA is an aggressive malignancy with poor prognosis. The knowledge of typical imaging features of these lesions may facilitate correct diagnosis; however, the ultimate diagnosis of HEHE and PHA is based on histopathologic examination. </P><P> Discussion: The most typical findings helpful in diagnosing HEHE are: Presence of multiple, confluent nodules located at the liver periphery (in young to middle-aged woman), retraction of the liver capsule, marked hyperintensity on T2-weighted images, “target-sign” appearance, progressive centripetal contrast enhancement, and relatively high Apparent Diffusion Coefficient (ADC) values. More than &#8805;50% of nodules are hyper- or isointense on Hepatobiliary Phase (HBP) images. Conclusion: The imaging features suggestive of PHA are: Occurrence of metastases (lungs, spleen) at the time of diagnosis, presence of a large dominant mass with smaller satellites, heterogeneity and areas of haemorrhage in a dominant mass, progressive contrast enhancement, slightly elevated ADC values as compared to other malignant liver tumours.</P>

scholarly journals Radiogenomics of Glioblastoma: Machine Learning–based Classification of Molecular Characteristics by Using Multiparametric and Multiregional MR Imaging Features

Radiology ◽  
2016 ◽  
Vol 281 (3) ◽  
pp. 907-918 ◽  
Author(s):  
Philipp Kickingereder ◽  
David Bonekamp ◽  
Martha Nowosielski ◽  
Annekathrin Kratz ◽  
Martin Sill ◽  
...  
Keyword(s):  
Machine Learning ◽  
Mr Imaging ◽  
Molecular Characteristics ◽  
Imaging Features

scholarly journals Imaging Features of Aggressive Giant Cell Tumors of the Mobile Spine: Retrospective Analysis of 101 Patients From Single Center

2021 ◽  
pp. 219256822098228
Author(s):  
Bei Yuan ◽  
Lihua Zhang ◽  
Shaomin Yang ◽  
Hanqiang Ouyang ◽  
Songbo Han ◽  
...  
Keyword(s):  
Giant Cell ◽  
Vertebral Body ◽  
Signal Intensity ◽  
Imaging Features ◽  
Single Center ◽  
Giant Cell Tumors ◽  
Ct Guided ◽  
Cortical Destruction ◽  
Mobile Spine ◽  
T2 Weighted Images

Study Design: Retrospective study. Objectives: Giant cell tumors (GCTs) of the mobile spine can be locally aggressive. This study described and classified the typical and atypical appearance of aggressive spinal GCTs according to imaging findings to help the imaging diagnosis, especially for patients with rapid neurological deficit that may require emergent surgery without biopsy. Methods: Computed tomography (CT) and magnetic resonance imaging (MRI) scans of patients diagnosed with aggressive spinal GCTs at single center were reviewed. Results: Overall, 101 patients with 100 CT images and 94 MR images were examined. All lesions were osteolytic with cortical destruction; 95 lesions showed epidural extension; 90 were centered in the vertebral body; 82 showed pathological fracture and/or collapse of the vertebral body; 78 had pseudotrabeculation on CT; 80 showed low-to-iso signal intensity or heterogeneous high-signal intensity with cystic areas on the T2-weighted images; 9 showed fluid–fluid level on T2-weighted images; and 61 patients showed marked enhancement on contrast-enhanced CT and/or MRI. Forty-one lesions (40.6%) had at least 1 atypical radiographic feature: 19 involved ≥2 segments; 11 were centered in the posterior neural arch; 10 had a paravertebral mass over 2 segments; 16 showed partial margin sclerosis with partial cortical destruction on CT scans; and 3 showed mineralization within the tumor on CT. Eighty-eight patients underwent CT-guided biopsy with a diagnostic accuracy rate of 94.3%. Conclusions: Spinal GCTs might appear more radiologically atypical, and about 40% of the lesions may have at least 1 atypical feature. CT-guided biopsies are recommended for definitive diagnosis.

scholarly journals Inter-observer agreement on the assessment of relative liver lesion signal intensity on hepatobiliary phase imaging with gadoxetate (Gd-EOB-DTPA)

2015 ◽  
Vol 41 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Sharon Ngu ◽  
Lizza Lebron-Zapata ◽  
Christy Pomeranz ◽  
Seth Katz ◽  
Scott Gerst ◽  
...  
Keyword(s):  
Signal Intensity ◽  
Liver Lesion ◽  
Observer Agreement ◽  
Hepatobiliary Phase ◽  
Phase Imaging

scholarly journals Prediction of Microvascular Invasion in Hepatocellular Carcinoma: Preoperative Gd-EOB-DTPA-Dynamic Enhanced MRI and Histopathological Correlation

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Mengqi Huang ◽  
Bing Liao ◽  
Ping Xu ◽  
Huasong Cai ◽  
Kun Huang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prediction Model ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Microvascular Invasion ◽  
Arterial Phase ◽  
Hepatobiliary Phase ◽  
Imaging Features ◽  
Tumor Margin ◽  
Enhanced Mri

Objective. To investigate the imaging features observed in preoperative Gd-EOB-DTPA-dynamic enhanced MRI and correlated with the presence of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients. Methods. 66 HCCs in 60 patients with preoperative Gd-EOB-DTPA-dynamic enhanced MRI were retrospectively analyzed. Features including tumor size, signal homogeneity, tumor capsule, tumor margin, peritumor enhancement during mid-arterial phase, peritumor hypointensity during hepatobiliary phase, signal intensity ratio on DWI and apparent diffusion coefficients (ADC), T1 relaxation times, and the reduction rate between pre- and postcontrast enhancement images were assessed. Correlation between these features and histopathological presence of MVI was analyzed to establish a prediction model. Results. Histopathology confirmed that MVI were observed in 17 of 66 HCCs. Univariate analysis showed tumor size (p=0.003), margin (p=0.013), peritumor enhancement (p=0.001), and hypointensity during hepatobiliary phase (p=0.004) were associated with MVI. A multiple logistic regression model was established, which showed tumor size, margin, and peritumor enhancement were combined predictors for the presence of MVI (α=0.1). R2 of this prediction model was 0.353, and the sensitivity and specificity were 52.9% and 93.0%, respectively. Conclusion. Large tumor size, irregular tumor margin, and peritumor enhancement in preoperative Gd-EOB-DTPA-dynamic enhanced MRI can predict the presence of MVI in HCC.

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