Ultrasonography and computer tomography evaluation of hepatocellular carcinoma with cytohistopathological correlation

The prevalence of hepatocellular carcinoma (HCC) in Bangladesh is 35% among all liver diseases. Sonographic examinations were performed for the evaluation of 38 cases of HCC; then, CT examina-tions were done of these cases subsequently. Expert opinion was taken in each case for both modalities. Age, sex, clinical features, location of the hepatic lesion, multiplicity, echo-character, CT density, and, contrast enhancement were evaluated in all cases. Histocytopathology reports were collected from the patients and were correlated with the ultrasonography and CT findings. Thirty five cases were detected as HCC on ultrasonography and 36 cases in CT scan. In ultrasonography, most of the lesions (82.9%) were found in right lobe, maximum lesions (45.7%) were hypoechoic and lesion showed mosaic pattern in 68.6% cases, lateral shadowing in 34.3% and posterior acoustic enhancement in 45.7% cases. Significant difference found between mosaic pattern and lateral shadowing (p<0.05). On CT scan, majority of lesions (50%) were hypodense, 91.7% lesions were contrast enhanced. Pattern of enhancement was mostly heterogeneous. Both of the modalities found sensitive but CT was found more sensitive, specific and accurate than ultrasonography in detecting HCC.Â Keywords: Computer tomography; Cytohistopathological; Hepatocellular carcinoma; UltrasonographyDOI: 10.3329/bmrcb.v33i2.1209Bangladesh Med Res Counc Bull 2007; 33: 73-77Â

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Contrast-enhanced ultrasound features of hepatocellular carcinoma in dogs

Veterinary Record ◽

10.1136/vr.105282 ◽

2019 ◽

Vol 186 (6) ◽

pp. 187-187

Author(s):

Tommaso Banzato ◽

Giuseppe Rubini ◽

Riccardo Orlandi ◽

Paolo Bargellini ◽

Federico Bonsembiante ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Contrast Enhancement ◽

Significant Influence ◽

Cellular Differentiation ◽

Lesion Size ◽

Arterial Phase ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Significant Difference ◽

Chi Squared

BackgroundThis study aimed to describe the contrast-enhanced ultrasound (CEUS) features of canine hepatocellular carcinoma (HCC) in relation to cellular differentiation and lesion size.MethodsSixty dogs with a cytological diagnosis of HCC and that underwent a CEUS examination were retrospectively selected. The wash-in and wash-out patterns of contrast enhancement, along with the time to wash-in and the time to wash-out, of each lesion were recorded. A dimensional cut-off value of 3 cm was adopted for classification.ResultsCellular differentiation had a significant influence on both wash-in (chi-squared=16.99; P<0.001) and wash-out (chi-squared=10.9; P=0.004) patterns of contrast enhancement. Lesion size had a lower, but still significant, influence on both wash-in (chi-squared=12.7; P=0.005) and wash-out (chi-squared=7.42; P=0.024) patterns. A homogeneous hyperenhancement in the arterial phase followed by homogeneous wash-out were suggestive of a well-differentiated HCC. The cellular differentiation of lesions with inhomogeneous hyperenhancement or hypoenhancement/no enhancement as well as an inhomogeneous wash-out or no wash-out could not be inferred.ConclusionsNo significant difference in the time to wash-in and the time to wash-out in relation to cellular differentiation or lesion size was evident. CEUS has the potential to improve efficiency in the diagnosis of HCCs in dogs.

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Delayed response to proton beam treatment of hepatocellular carcinoma

BJR|case reports ◽

10.1259/bjrcr.20180125 ◽

2020 ◽

Vol 6 (1) ◽

pp. 20180125

Author(s):

Chee-Wai Cheng ◽

Mitchell Machtay ◽

Jennifer Dorth ◽

Olga Sergeeva ◽

Hangsheng Xia ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Ct Scan ◽

Proton Beam ◽

Arterial Phase ◽

Delayed Response ◽

Data Set ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Imaging Response

Hepatocellular carcinoma (HCC) has become one of the leading causes of cancer death worldwide. There has been anecdotal report regarding the effectiveness of proton beam treatment for HCC. In this pre-clinical investigation, the woodchuck model of viral hepatitis infection-induced HCC was used for proton beam treatment experiment. The radiopaque fiducial markers that are biodegradable were injected around the tumor under ultrasound guidance to facilitate positioning in sequential treatments. An α cradle mode was used to ensure reproducibility of animal positioning on the treatment couch. A CT scan was performed first for contouring by a radiation oncologist. The CT data set with contours was then exported for dose planning. Three fractionations, each 750 CcGyE, were applied every other day with a Mevion S250 passive scattering proton therapy system. Multiphase contrast-enhanced CT scans were performed after the treatment and at later times for follow-ups. 3 weeks post-treatment, shrinking of the HCC nodule was detected and constituted to a partial response (30% reduction along the long axis). By week nine after treatment, the nodule disappeared during the arterial phase of multiphase contrast-enhanced CT scan. Pathological evaluation corroborated with this imaging response. A delayed, but complete imaging response to proton beam treatment applied to HCC was achieved with this unique and clinically relevant animal model of HCC.

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CT-Scan Findings of Patients Presented with Hepatic Mass attended at Tertiary Care Hospital in Bangladesh

Journal of Current and Advance Medical Research ◽

10.3329/jcamr.v2i1.22580 ◽

2015 ◽

Vol 2 (1) ◽

pp. 7-11

Author(s):

Wahida Begum ◽

Khondker Shaheed Hussain ◽

Tariqul Islam ◽

Sharmin Sultana Rupa

Keyword(s):

Ct Scan ◽

The Other ◽

P Value ◽

Care Hospital ◽

Benign Lesions ◽

Multiple Lesion ◽

Hepatic Mass ◽

Significant Difference ◽

Right Lobe ◽

Malignant Lesions

Background: CT-scan findings give a well delineated impression on hepatic mass. Objective: The purpose of the present study was to observe the CT-scan findings of hepatic mass. Methodology: This cross sectional study was carried out in the department of Radiology and Imaging MMC in collaboration with the same department of BSMMU, DMC, Dhaka during the period of 1st January 2006 to 31st December 2007 to establish the usefulness of CT scan in the diagnosis of hepatic mass and its validity by determining sensitivity, specificity, PV, NPV, and accuracy. A total of 50 patients were admitted in the Department of Medicine and Department of Hepatobiliary of MMCH, BSMMU, and DMCH with the clinical diagnosis of fever, abdominal pain, anorexia, nausea/vomiting, loss of appetite, jaundice, weight loss and ascites. They were sent to the department of Radiology and Imaging and of respected hospitals for CT evaluation, confirmation and to see the extension for planning of proper management. Result: A total number of 50 hepatic mass patients were recruited in this study. CT findings of all patients showed 29 had lesions on right lobe, six patients had on left lobe and 15 patients had lesion on both lobe (p value <0.05). Among all patients 28 had multiple lesion, of them 71.4% was malignant and 28.6% was benign. On the other side 22 patients had solitary lesion, of them 36.4% was malignant and 63.6% was benign (p value <0.05). Among all malignant lesions 17 (60.7%) were hypodense, followed by 6 (21.4%) were isodense and 5 (17.9%) had mixed pattern of density. 12 (42.9%) patients of malignant diseases had ill-defined margin and 16 (57.1%) had well defined margin. 6 (27.3%) patients of benign lesions had ill-defined and 16 (72.7%) had well defined margin. No significant difference was observed. All malignant lesions (100%) and 77.3% benign lesions were enhanced after giving contrast. 16 (57.1%) malignant lesions were mildly enhanced, 10 (35.7%) were moderate and 2 (7.1%) were intensely enhanced. On the other side 8 (47.1%) benign lesions were mild, 35.5% were moderate and 3 (17.6%) were intensely enhanced. Conclusion: In conclusion hepatic mass is more common in right lobe of the liver of which multiple lesion is commonly found.Journal of Current and Advance Medical Research 2015;2(1):7-11DOI: http://dx.doi.org/10.3329/jcamr.v2i1.22580

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Enhancement pattern of small hepatocellular carcinoma (HCC) at contrast-enhanced US (CEUS), MDCT, and MRI: Intermodality agreement and comparison of diagnostic sensitivity between 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines

European Journal of Radiology ◽

10.1016/j.ejrad.2011.07.010 ◽

2012 ◽

Vol 81 (9) ◽

pp. 2099-2105 ◽

Cited By ~ 28

Author(s):

Alessandro Furlan ◽

Daniele Marin ◽

Paolo Cabassa ◽

Adele Taibbi ◽

Elena Brunelli ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Diseases ◽

American Association ◽

Diagnostic Sensitivity ◽

Small Hepatocellular Carcinoma ◽

Enhancement Pattern ◽

Contrast Enhanced

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718 CONTRAST-ENHANCED CT SCAN DIFFERENTIATES HEPATOCELLULAR CARCINOMA AND INTRAHEPATIC CHOLANGIOCARCINOMA IN CIRRHOSIS

Journal of Hepatology ◽

10.1016/s0168-8278(12)60731-4 ◽

2012 ◽

Vol 56 ◽

pp. S283-S284

Author(s):

M. Iavarone ◽

S. Vavassori ◽

A. Sangiovanni ◽

M. Fraquelli ◽

L.V. Forzenigo ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Ct Scan ◽

Intrahepatic Cholangiocarcinoma ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

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Diagnosis of Non-Hepatocellular Carcinoma Malignancies in Patients With Risks for Hepatocellular Carcinoma: CEUS LI-RADS Versus CT/MRI LI-RADS

Frontiers in Oncology ◽

10.3389/fonc.2021.641195 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yi-Xin Hu ◽

Jing-Xian Shen ◽

Jing Han ◽

Si-Yue Mao ◽

Ru-Shuang Mao ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Imaging ◽

Imaging Features ◽

Hepatocelluar Carcinoma ◽

Undifferentiated Sarcoma ◽

Primary Hepatic Malignancies ◽

Contrast Enhanced ◽

Significant Difference ◽

Kappa Value ◽

Hepatic Malignancies

ObjectiveData regarding direct comparison of contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) and Computed Tomography/Magnetic Resonance Imaging (CT/MR) LI-RADS in diagnosis of non-hepatocelluar carcinoma (non-HCC) malignancies remain limited. Our study aimed to compare the diagnostic performance of the CEUS LI-RADS version 2017 and CT/MRI LI-RADS v2018 for diagnosing non-HCC malignancies in patients with risks for HCC.Materials and MethodsIn this retrospective study, 94 liver nodules pathologically-confirmed as non-HCC malignancies in 92 patients at risks for HCC from January 2009 to December 2018 were enrolled. The imaging features and the LI-RADS categories on corresponding CEUS and CT/MRI within 1 month were retrospectively analyzed according to the ACR CEUS LI-RADS v2017 and ACR CT/MRI LI-RADS v2018 by two radiologists in consensus for each algorithm. The sensitivity of LR-M category, inter-reader agreement and inter-modality agreement was compared between these two standardized algorithms.ResultsNinety-four nodules in 92 patients (mean age, 54 years ± 10 [standard deviation] with 65 men [54 years ± 11] and 27 women [54 years ± 8]), including 56 intrahepatic cholangiocarcinomas, 34 combined hepatocellular cholangiocarcinomas, two adenosquamous carcinomas of the liver, one primary hepatic neuroendocrine carcinoma and one hepatic undifferentiated sarcoma were included. On CEUS, numbers of lesions classified as LR-3, LR-4, LR-5 and LR-M were 0, 1, 10 and 83, and on CT/MRI, the corresponding numbers were 3, 0, 14 and 77. There was no significant difference in the sensitivity of LR-M between these two standardized algorithms (88.3% of CEUS vs 81.9% of CT/MRI, p = 0.210). Seventy-seven lesions (81.9%) were classified as the same LI-RADS categories by both standardized algorithms (five for LR-5 and 72 for LR-M, kappa value = 0.307). In the subgroup analysis for ICC and CHC, no significant differences were found in the sensitivity of LR-M category between these two standardized algorithms (for ICC, 94.6% of CEUS vs 89.3% of CT/MRI, p = 0.375; for CHC, 76.5% of CEUS vs 70.6% of CT/MRI, p = 0. 649).ConclusionCEUS LI-RADS v2017 and CT/MRI LI-RADS v2018 showed similar value for diagnosing non-HCC primary hepatic malignancies in patients with risks.

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Pitfalls in Neuroimaging of Headache: A Case Report and Review of the Literature

Case Reports in Otolaryngology ◽

10.1155/2013/735147 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3

Author(s):

V. Vallamkondu ◽

M. Shakeel ◽

A. Hussain ◽

D. McAteer

Keyword(s):

Ct Scan ◽

Contrast Enhancement ◽

Common Symptom ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Noncontrast Ct ◽

Red Flag ◽

Ct Brain ◽

Persistent Headache

Headache is a common symptom, with a lifetime prevalence of over 90% of the general population in the United Kingdom (UK). It accounts for 4.4% of consultations in primary care and 30% of neurology outpatient consultations. Neuroimaging is indicated in patients with red flag features for secondary headaches. The guidelines recommend CT or MRI scan to identify any intracranial pathology. We present a unique case where the initial noncontrast CT scan failed to identify a potential treatable cause for headache. A middle aged man presented with headache and underwent a CT scan without contrast enhancement. The scan was reported as normal. The headache persisted for years and the patient underwent a staging CT scan to investigate an oropharyngeal cancer. This repeat CT scan utilized contrast enhancement and revealed a meningioma. Along with other symptoms, headache is an established presenting complaint in patients with meningioma. The contrast enhanced CT brain proved superior to a nonenhanced CT scan in identifying the meningioma. In a patient with persistent headache where other causes are excluded and a scan is to be requested, perhaps contrast enhanced CT is a better option than a plain CT scan of brain.

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The Effect of CT Scan Parameters on the Measurement of CT Radiomic Features: A Lung Nodule Phantom Study

Computational and Mathematical Methods in Medicine ◽

10.1155/2019/8790694 ◽

2019 ◽

Vol 2019 ◽

pp. 1-12 ◽

Cited By ~ 7

Author(s):

Young Jae Kim ◽

Hyun-Ju Lee ◽

Kwang Gi Kim ◽

Seung Hyun Lee

Keyword(s):

Radiation Dose ◽

Ct Scan ◽

Lung Nodule ◽

Reconstruction Algorithm ◽

Image Features ◽

Slice Thickness ◽

Reconstruction Algorithms ◽

Significant Difference ◽

The Difference ◽

Ct Density

The purpose of this study was to explore the effects of CT slice thickness, reconstruction algorithm, and radiation dose on quantification of CT features to characterize lung nodules using a chest phantom. Spherical lung nodule phantoms of known densities (−630 and + 100 HU) were inserted into an anthropomorphic thorax phantom. CT scan was performed ten times with relocations. CT data were reconstructed using 12 different imaging settings; three different slice thicknesses of 1.25, 2.5, and 5.0 mm, two reconstruction kernels of sharp and standard, and two radiation dose of 30 mAs and 12 mAs. Lesions were segmented using a semiautomated method. Twenty representative CT quantitative features representing CT density and texture were compared using multiple regression analysis. In 100 HU nodule phantoms, 18 and 19 among 20 computer features showed significant difference between different mAs and reconstruction algorithms, respectively (p≤0.05). 20, 19, and 19 computer features showed difference between slice thickness of 5.0 vs 1.25, 5.0 vs 2.5, and 2.5 vs 1.25 mm, respectively (p≤0.05). In −630 HU nodule phantoms, 18 and 19 showed significant difference between different mAs and reconstruction algorithms, respectively (p≤0.05). 18, 11, and 17 computer features showed difference between slice thickness of 5.0 vs 1.25, 5.0 vs 2.5, and 2.5 vs 1.25 mm, respectively (p≤0.05). When comparing the absolute value of regression coefficient, the effect of slice thickness in 100 HU nodule and reconstruction algorithm in −630 HU nodule was greater than the effect of remaining scan parameters. The slice thickness, mAs, and reconstruction algorithm had a significant impact on the quantitative image features. In clinical studies involving deep learning or radiomics, it should be noted that differences in values can occur when using computer features obtained from different CT scan parameters in combination. Therefore, when interpreting the statistical analysis results, it is necessary to reflect the difference in the computer features depending on the scan parameters.

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