The Role of Multimodality Imaging Techniques on Differential Diagnosis of Precancerous Nodules and Hepatocellular Carcinoma

In this pandemic of Coronavirus disease 2019 (COVID-19), a vast proportion of healthcare resources, including imaging tools, have been dedicated to the management of affected patients; yet, the frequent reports of unknown presentations and complications of disease over time have been changing the usual standard of care and resource allocation in health centers. As of now, we have witnessed multisystemic symptoms requiring the collaboration of different clinical teams in COVID-19 patients' care. Compared to previous viral pandemics, imaging modalities are now playing an essential role in the diagnosis and management of patients. This widespread utility of imaging modalities calls for a deeper understanding of potential radiologic findings in this disease and identifying the most compatible imaging protocol with safety precautions. Although initially used for respiratory tract evaluation, imaging modalities have also been used for cardiovascular, neurologic, and gastrointestinal evaluation of patients with COVID-19. In this narrative review article, we provide multimodality and multisystemic review of imaging techniques and features that can aid in the diagnosis and management of COVID-19 patients.

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Hypertrophic cardiomyopathy

The ESC Textbook of Cardiovascular Imaging ◽

10.1093/med/9780198849353.003.0043 ◽

2021 ◽

pp. 629-644

Author(s):

Nuno Cardim ◽

Alexandra Toste ◽

Robin Nijveldt

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Multimodality Imaging ◽

Imaging Techniques ◽

Genetic Diagnosis ◽

Left Ventricular ◽

Morphological Data ◽

Clinical Settings ◽

Functional Information ◽

Clinical Questions

Imaging plays a major role in the evaluation of hypertrophic cardiomyopathy (HCM) patients, offering answers to clinical questions. Imaging techniques provide a broad spectrum of information, including morphological data, functional information, and ischaemia assessment, useful in many clinical settings of HCM. The clinical diagnosis of HCM is based on unexplained left ventricular hypertrophy (LVH) by imaging, though the role of genetic diagnosis has increased. A multimodality imaging (MMI) approach is encouraged in HCM. Each technique must be selected to provide solutions to the specific problems, avoiding duplicated data, and taking into account its technical characteristics, availability, benefits, risks, and costs.

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The Role of the Diffusion Sequence in Magnetic Resonance Imaging for the Differential Diagnosis between Hepatocellular Carcinoma and Benign Liver Lesions

Medicine and Pharmacy Reports ◽

10.15386/cjmed-567 ◽

2016 ◽

Vol 89 (2) ◽

pp. 241-249 ◽

Cited By ~ 1

Author(s):

Cosmin-Nicolae Caraiani ◽

Dan Marian ◽

Claudia Militaru ◽

Adriana Calin ◽

Radu Badea

Keyword(s):

Magnetic Resonance Imaging ◽

Hepatocellular Carcinoma ◽

Differential Diagnosis ◽

Liver Lesions ◽

Resonance Imaging ◽

Liver Mri ◽

Adc Value ◽

The Mean ◽

Benign Liver

Background and aim. To assess the role of diffusion weighted imaging sequence (DWI), routinely used in hepatic magnetic resonance imaging (MRI) for the differentiation of hepatocellular carcinoma (HCC) from benign liver lesions.Methods. A number of 56 liver MRI examinations were retrospectively analyzed independently by two experienced radiologists, blinded to each other results. A total number of 70 Focal Liver Lesions (FLLs) assessed by liver MRI in 56 patients were included in the present study. All lesions were retrospectively analyzed by two experienced radiologists, independently from each other and who were not aware of the previous results given by using different imaging techniques. All included FLLs had a final histological diagnosis, or the final diagnosis was based on consensus reading by two experienced radiologists. The signal of the included FLLs was qualitatively appreciated on the b-800 sequences and on the apparent diffusion coefficient (ADC) map. The ADC value of each FLL was measured and the ADC ratio between the ADC value of the assessed FLL and that of the surrounding liver parenchyma was calculated.Results. The mean ADC value for benign FLLs as assessed by the two independent readers was 1.75 x 10¯³and 1.72 x 10¯³. The mean ADC value for HCC nodules was 0.92 x 10¯³ for the first reader and 0.91 x 10¯³ for the second reader respectively. The mean ADC ratio for benign FLLs was 1.81 and 1.84 for the two readers, respectively. The ADC ratio for HCC nodules was 0.91 and 0.91, respectively. The ADC value is an indicator which is less prone to interobserver variability (correlation of 0.919→1). The ADC ratio has, as the analysis of the ROC curve shows, the best predictive value for differentiation between benign FLLs and HCC nodules. Analysis of the signal intensity on the DWI b-800 image alone is of no significance in differentiating benign FLLs from HCC nodules (p>0.005).Conclusions. The ADC value and the ADC ratio assessed on liver DWI are useful diagnostic tools in the differential diagnosis of benign FLLs vs HCC nodules. Quantitative methods such as calculating the ADC value or ADC ratio have better diagnostic value than qualitative techniques.

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The differential diagnosis of benign and malignant ovarian neoplasms (history)

Journal of obstetrics and women s diseases ◽

10.17816/jowd65668-78 ◽

2016 ◽

Vol 65 (6) ◽

pp. 68-78

Author(s):

Mariya A Egunova ◽

Irina G Kutsenko

Keyword(s):

Ovarian Cancer ◽

Differential Diagnosis ◽

Ovarian Neoplasms ◽

Imaging Techniques ◽

Advantages And Disadvantages ◽

Radiation Imaging ◽

Preoperative Stage ◽

High Incidence ◽

History Of

The history of the differential diagnosis of ovarian neoplasms at the preoperative stage is presented in the review article. This is still a problem due to the high incidence of tumors and tumor-like formations of ovaries, the continuing upward trend in the index of ovarian cancer, along with a slight decrease in mortality and 5-year survival. Considerable success of surgical treatment and chemotherapy in the early stages of ovarian cancer suggests the earliest possible detection and accuracy of differential diagnosis of ovarian neoplasms. It highlights the role of the different research methods, including radiation imaging techniques, tumor markers and their potential advantages and disadvantages.

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Non-Invasive Diagnosis of Abdomino-Pelvic Masses: Role of Multimodality Imaging

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.106621 ◽

2013 ◽

Vol 3 ◽

pp. 6

Author(s):

Vijayanadh Ojili ◽

Sree Harsha Tirumani ◽

Kedar N. Chintapalli ◽

Gowthaman Gunabushanam

Keyword(s):

Virtual Colonoscopy ◽

Multimodality Imaging ◽

Imaging Techniques ◽

Non Invasive ◽

Pelvic Masses ◽

Degree Of Confidence ◽

Evidence Based Guidelines ◽

High Degree ◽

Index Cases

Recent advances in radiology have greatly increased the ability to make highly accurate diagnosis. Biopsy of many commonly seen lesions is no longer performed as the radiological findings are pathognomonic. This gives rise to the concept of ‘virtual biopsy’, a term coined on the lines of other imaging techniques such as virtual colonoscopy. Virtual biopsy is not a new imaging technique but a new concept which refers to the use of existing imaging modalities to evaluate the morphological features of tumors and arriving at a non-invasive diagnosis with a high degree of confidence obviating the need for true biopsy. Elements of virtual biopsy have already been incorporated into some evidence-based guidelines, and it is expected that with further technological advancements, an increasing number of tumors may be diagnosed and managed accordingly. A wider acceptance of virtual biopsy could further reduce the need for invasive biopsies and its attendant costs and risks. In this review article, we use index cases to further emphasize this concept.

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Primary Fibrosarcoma of the Kidney: Clinico-pathological Features of a Case

Urologia Journal ◽

10.1177/039156039306000412 ◽

1993 ◽

Vol 60 (4) ◽

pp. 349-353

Author(s):

S. Ambrosi ◽

G. Gherardi ◽

G.P. Manca ◽

G. Martina ◽

F. Andreassi

Keyword(s):

Differential Diagnosis ◽

Imaging Techniques ◽

Left Kidney ◽

Tumour Cells ◽

Radical Excision ◽

Tumour Mass ◽

High Grade ◽

Pathological Features ◽

Pleomorphic Cells

A case of primary renal sarcoma in a 72-year-old woman is described. Upon imaging techniques, including digitalized angiography, the tumour mass proved to be located in the upper left kidney. Despite gross infiltration of adjacent anatomic structures, radical excision of the tumour was possible. Histologically, the neoplasm was diffusely necrotic and composed of spindle and pleomorphic cells. This picture was considered consistent with the diagnosis of “high grade” fibrosarcoma. The immunohistochemical profile of the tumour cells confirmed this contention. The role of immunohistochemistry in the differential diagnosis of these malignancies is discussed.

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The role of imaging techniques in clinical decision making for the management of hepatocellular carcinoma

Hepatology ◽

10.1002/hep.25618 ◽

2012 ◽

Vol 56 (2) ◽

pp. 786-786 ◽

Cited By ~ 2

Author(s):

Gin-Ho Lo

Keyword(s):

Hepatocellular Carcinoma ◽

Decision Making ◽

Clinical Decision Making ◽

Imaging Techniques ◽

Clinical Decision

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Differential diagnosis of benign and malignant vertebral compression fractures using conventional and advanced MRI techniques

BJR|Open ◽

10.1259/bjro.20180033 ◽

2019 ◽

Vol 1 (1) ◽

Author(s):

Valeria Romeo ◽

Lorenzo Ugga ◽

Arnaldo Stanzione ◽

Sirio Cocozza ◽

Renato Cuocolo ◽

...

Keyword(s):

Differential Diagnosis ◽

Functional Data ◽

Imaging Techniques ◽

Vertebral Compression Fractures ◽

Diagnostic Challenge ◽

Contrast Resolution ◽

Compression Fractures ◽

Pictorial Review ◽

Aided Diagnosis

Atraumatic vertebral compression fractures (VCFs) are commonly encountered in clinical practice and often represent a diagnostic challenge. MRI plays a major role in the differential diagnosis of benign and malignant VCFs, due to its high contrast resolution and the possibility to obtain quantitative and functional data with the employment of advanced sequences. Computer-aided diagnosis systems are also applied on MRI images for this purpose, showing promising results. In this setting, aim of this pictorial review is to elucidate the role of MRI in the differential diagnosis of VCFs with a specific focus on advanced and post-processing imaging techniques.

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Atrial thrombi or cardiac tumours? The image-challenge of intracardiac masses: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa026 ◽

2020 ◽

Vol 4 (2) ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Matteo Castrichini ◽

Stefano Albani ◽

Bruno Pinamonti ◽

Gianfranco Sinagra

Keyword(s):

Differential Diagnosis ◽

Multimodality Imaging ◽

Imaging Techniques ◽

Diagnostic Strategy ◽

Imaging Evaluation ◽

Cardiac Tumours ◽

Appropriate Treatment ◽

Intracardiac Masses ◽

Cardiac Masses ◽

Atrial Thrombi

Abstract Background Cardiac masses (CM) encompass a broad set of lesions that can be either neoplastic or non-neoplastic. A stepwise diagnostic strategy through multimodality imaging evaluation is the cornerstone for the appropriate approach. Case summary We report the case of an 83-year-old man presenting at the emergency department for acute heart failure showing bilateral atrial masses without unequivocal aetiological aspects at several imaging techniques, emphasizing the critical aspects in the differential diagnosis. Discussion In the complex field of CM, a proper differential diagnosis is very important in order to start the appropriate treatment; however, sometimes it could be challenging despite a multimodality imaging approach, therefore still requiring histologic examination.

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