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Liver and ultrasound and and contrast and HCC

Tae-Hyung Kim, So Yeon Kim, An Tang, Jeong Min Lee
The goal of this review is to present the similarities and differences among the latest guidelines for noninvasive diagnosis of hepatocellular carcinoma (HCC) of American Association for the Study of Liver Disease (AASLD), European Association for the Study of the Liver (EASL), Liver Imaging Reporting and Data System (LI-RADS), Asian Pacific Association for the Study of the Liver (APASL), and Korean Liver Cancer Association- National Cancer Center (KLCA-NCC) of Korea. In 2018, major guideline updates have been proposed by the AASLD, EASL and KLCA-NCC; AASLD newly incorporated LI-RADS into their HCC diagnostic algorithm...
February 14, 2019: Clinical and Molecular Hepatology
Qing Lu, Xiao-Long Zhang, Hong Han, Bei-Jian Huang, Hong Ding, Wen-Ping Wang
OBJECTIVES: To retrospectively evaluate the value of contrast-enhanced ultrasound (CEUS) perfusion parameters in the differential diagnosis of hepatocellular carcinomas (HCCs) and metastatic liver tumors (MLTs) with hypervascularity. METHODS: Sixty-seven HCCs and 55 MLTs with arterial homogeneous/heterogeneous hyperenhancement on CEUS imaging and a normal liver background were included in this retrospective study. Six CEUS perfusion parameters were compared between HCCs and MLTs with different sizes and HCC differentiations: rise time (RT), time to peak (TTP), mean transit time, wash-out time (WT), maximum intensity (IMAX), and area under the curve (AUC)...
January 30, 2019: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Amita Kamath, Alexandra Roudenko, Elizabeth Hecht, Claude Sirlin, Victoria Chernyak, Kathryn Fowler, Donald G Mitchell
Unique among solid organ tumors, hepatocellular carcinoma (HCC), may be diagnosed by imaging alone, without the need for biopsy. The Liver Imaging Reporting and Data System (LI-RADS) was developed to provide high-specificity diagnosis of HCC based on imaging while also standardizing the assessment and reporting of the entire spectrum of lesions and pseudolesions encountered in patients at risk for this malignancy. In this pictorial review, we discuss management recommendations associated with CT/MR LI-RADS observations...
January 22, 2019: Abdominal Radiology
Mi Na Kim, Seong Gyu Hwang, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Kwang-Hyub Han, Seung Up Kim, Sang Hoon Ahn
Background/Aims: Antiviral therapy (AVT) reduces the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB). This multicenter retrospective study investigated the effects of AVT and hepatitis B virus (HBV)-related factors on the risk of HCC development in a cohort with heterogeneous HBV status. Methods: A total of 1,843 patients with CHB from two institutions were included in this study. Ultrasound and laboratory tests, including the α-fetoprotein test, were conducted regularly to detect HCC development...
December 21, 2018: Gut and Liver
Franz J Putz, Niklas Verloh, Anna Erlmeier, Roland C Schelker, Andreas G Schreyer, Matthias G Hautmann, Christian Stroszczynski, Bernhard Banas, Ernst M Jung
AIM: To assess the influence of difficult examination conditions onto the diagnostic performance of CEUS (contrast-enhanced ultrasound) in focal liver lesions (FLL). METHODS: 77 liver CEUS examinations of 75 patients were analysed retrospectively. CEUS was performed as the first diagnostic procedure by one experienced sonographer after bolus injection of 1.0 up to 2.4 ml sulphur hexafluoride microbubbles using a high-end ultrasound device with a high resolution multifrequency probe (1-6 MHz)...
December 18, 2018: Clinical Hemorheology and Microcirculation
Min Woo Lee, Hyo Keun Lim
Hepatocellular carcinomas (HCCs) frequently recur despite initial successful surgical resection or local ablation therapy. Diagnostic methods for small HCCs have improved with the introduction of gadoxetic acid-enhanced liver magnetic resonance imaging and diffusion-weighted imaging (DWI). Currently, sub-centimeter recurrent nodules showing typical hallmark imaging findings of HCC are frequently detected in patients with a treatment history for HCC. With five typical magnetic resonance findings, including arterial enhancement, washout on portal or transitional phase, high signal intensity on both T2-weighted image and DWI, and low signal intensity on hepatobiliary phase, sub-centimeter recurrent HCC can be diagnosed with high accuracy...
December 14, 2018: World Journal of Gastroenterology: WJG
Zeno Sparchez, Tudor Mocan, Pompilia Radu, Lavinia Patricia Mocan, Mihaela Sparchez, Daniel Corneliu Leucuta, Nadim Al Hajjar
AIMS: To report on the long-term impact of tumor and non-tumor related parameters on local recurrence, distant recurrence and survival in patients with naïve or recurrent type hepatocellular carcinoma (HCC) treated by radiofrequency ablation (RFA). METHODS: We performed 240 RFA sessions on 133 patients with 156 HCC nodules developed on a background of liver cirrhosis and analyzed the outcomes. RESULTS: Contrast-enhanced ultrasound performed one month after RFA showed complete ablation in 119 out of 133 (89...
December 2018: Journal of Gastrointestinal and Liver Diseases: JGLD
Li-Da Chen, Si-Min Ruan, Yuan Lin, Jin-Yu Liang, Shun-Li Shen, Hang-Tong Hu, Yang Huang, Wei Li, Zhu Wang, Xiao-Yan Xie, Ming-De Lu, Ming Kuang, Wei Wang
OBJECTIVE: To develop a contrast-enhanced ultrasound (CEUS) M-score and compare it with LR-M in CEUS Liver Imaging Reporting and Data System (LI-RADS). METHODS: We retrospectively enrolled 105 consecutive high-risk patients with hepatocellular carcinoma (HCC) and 105 with intrahepatic cholangiocarcinoma (ICC). The subjects were selected by propensity score matching between November 2003 and December 2017. A CEUS M-score for predicting ICC was constructed based on specific CEUS features by the least absolute shrinkage and selection operator regularised regression...
December 19, 2018: European Radiology
Hiroko Naganuma, Hideaki Ishida, Masahiro Ogawa, Tutomu Sato, Masato Sageshima, Katunori Suzuki, Yoko Ohyama
PURPOSE: Hepatocellular carcinoma (HCC) on normal liver is very rare. The goal of this study was to determine the clinical manifestations and the role of ultrasonography (US) in the diagnosis of HCC arising in normal liver. METHODS: The clinical data and US findings in 12 cases of surgically resected HCC in normal liver were retrospectively analyzed. RESULTS: The patients were asymptomatic, had no hepatocarcinogenic factor, and hepatic function tests were almost normal in most cases...
November 28, 2018: Journal of Clinical Ultrasound: JCU
Nina M Muñoz, Adeeb A Minhaj, Kiersten L Maldonado, Charles V Kingsley, Andrea C Cortes, Houra Taghavi, Urszula Polak, Jennifer M Mitchell, Joe E Ensor, James A Bankson, Asif Rashid, Rony Avritscher
OBJECTIVES: To compare the accuracy of contrast-enhanced ultrasound (CEUS) and Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for the assessment of changes in tissue vascularization as result of sorafenib treatment in a rat model of hepatocellular carcinoma (HCC). METHODS: Male Buffalo rats with orthotopic liver tumors treated daily with 7.5 mg/kg sorafenib via oral gavage for 2 weeks (n = 9) were subject to DCE-MRI and CEUS 2 weeks after tumor implantation - right before treatment initiation - and also after treatment completion - right before tumor harvest...
November 19, 2018: Magnetic Resonance Imaging
An Tang, Amit G Singal, Donald G Mitchell, Elizabeth M Hecht, Kathryn J Fowler, Laura Kulik, Neehar D Parikh, Yuko Kono, Claude B Sirlin
The Liver Imaging Reporting And Data System (LI-RADS) was created with the support of the American College of Radiology (ACR) to standardize the acquisition, interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). A comprehensive and rigorous system developed by radiologists, hepatologists, pathologists, and surgeons, LI-RADS addresses a wide range of imaging contexts. Currently, 4 algorithms are available publicly on the ACR website: ultrasound for HCC surveillance, computed tomography and magnetic resonance imaging for HCC diagnosis and tumor staging, contrast-enhanced ultrasound for HCC diagnosis, and computed tomography/magnetic resonance imaging for treatment response assessment...
October 13, 2018: Clinical Gastroenterology and Hepatology
Seung Kak Shin, Duck Joo Choi, Ju Hyun Kim, Yun Soo Kim, Oh Sang Kwon
Contrast-enhanced ultrasound (CEUS) is highly accurate in depicting the vascularity of liver nodules. The aim of this study was to verify the characteristics of CEUS in distinguishing small (≤3 cm) hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC).A total of 65 patients with a liver nodule (HCC, n = 58; ICC, n = 7) smaller than 3 cm who underwent liver CEUS and pathologic confirmation were retrospectively reviewed. CEUS findings were compared with histopathologic and clinical data...
October 2018: Medicine (Baltimore)
Yong Zhan, Fubo Zhou, Xiaoling Yu, Fei Luo, Fangyi Liu, Ping Liang, Zhigang Cheng, Zhiyu Han, Jie Yu
PURPOSE: Previous studies have reported that parameters of dynamic contrast-enhanced ultrasound (DCE-US) could predict prognosis of hepatocellular carcinoma (HCC) patients after antiangiogenic therapies. In this study, we aimed to investigate the correlation of DCE-US parameters and the prognosis of HCC patients after microwave ablation (MWA). MATERIALS AND METHODS: Between June 2012 and January 2018, a total of 35 HCC patients who received MWA with a curative intent were enrolled...
October 9, 2018: International Journal of Hyperthermia
Chansik An, Do Young Kim, Jin-Young Choi, Kwang Hyub Han, Yun Ho Roh, Myeong-Jin Kim
BACKGROUND: Biannual ultrasound (US)-with or without alpha-fetoprotein (AFP)-is recommended by current guidelines for the surveillance of hepatocellular carcinoma (HCC). However, the inadequate sensitivity of US has been a concern. Magnetic resonance imaging (MRI) is known to have high sensitivity in detecting hepatic malignancies, even without contrast enhancement. The purpose of our study is to compare US with noncontrast (unenhanced) MRI for HCC surveillance of high-risk patients. METHODS/DESIGN: MIRACLE-HCC (usefulness of noncontrast MagnetIc Resonance imAging versus nonContrast ultrasonography for surveiLlancE of HepatoCellular Carcinoma) is a prospective, single-center, nonblinded, balanced-randomized, parallel-group study...
September 24, 2018: BMC Cancer
Li-Da Chen, Si-Min Ruan, Jin-Yu Liang, Zheng Yang, Shun-Li Shen, Yang Huang, Wei Li, Zhu Wang, Xiao-Yan Xie, Ming-De Lu, Ming Kuang, Wei Wang
AIM: To develop a contrast-enhanced ultrasound (CEUS) predictive model for distinguishing intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC) in high-risk patients. METHODS: This retrospective study consisted of 88 consecutive high-risk patients with ICC and 88 high-risk patients with HCC selected by propensity score matching between May 2004 and July 2016. Patients were assigned to two groups, namely, a training set and validation set, at a 1:1 ratio...
September 7, 2018: World Journal of Gastroenterology: WJG
Alina Maria Balea, Liliana Streba, Ananu Florentin Vreju, Michael Schenker, Daniela Larisa Săndulescu, Simona Bondari, Ioana Andreea Gheonea, Otilia Constantina Rogoveanu, Laurenţiu Mogoantă, Cristin Constantin Vere
Hepatocellular carcinoma (HCC) is the primary malignant tumor of the liver that is directly derived from parenchymal cells. It is usually encountered in patients already suffering from a long-established liver disease that has evolved past the stage of liver cirrhosis. It is usually associated with viral liver infections, alcohol consumption or other dietary habits that lead to liver damage. Metastases are not rare and are usually found incidentally after a period of monitoring the main liver disease. We present here a rare case of HCC metastasis found in the right gluteal region, in a hepatitis C virus-infected patient also displaying lung tumor lesions...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Ayman Alhasan, Milena Cerny, Damien Olivié, Jean-Sébastien Billiard, Catherine Bergeron, Kip Brown, Paule Bodson-Clermont, Hélène Castel, Simon Turcotte, Pierre Perreault, An Tang
PURPOSE: To evaluate the diagnostic performance of Liver Imaging Reporting and Data System (LI-RADS) v2017 major features, the impact of ancillary features, and categories on contrast-enhanced computed tomography (CECT) for the diagnosis of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: This retrospective study included 59 patients (104 observations including 72 HCCs) with clinical suspicion of HCC undergoing CECT between 2013 and 2016. Two radiologists independently assessed major and ancillary imaging features for each liver observation and assigned a LI-RADS category based on major features only and in combination with ancillary features...
August 30, 2018: Abdominal Radiology
Hsien Min Low, Jin Young Choi, Cher Heng Tan
Hepatocellular carcinoma (HCC) is a unique tumor because it is one of the few cancers which can be treated based on imaging alone. Magnetic resonance imaging (MRI) carries higher sensitivity and specificity for the diagnosis of HCC than either computed tomography (CT) or ultrasound. MRI is imaging modality of choice for the evaluation of complex liver lesions and HCC because of its inherent ability to depict cellularity, fat, and hepatocyte composition with high soft tissue contrast. The imaging features of progressed HCC are well described...
August 25, 2018: Abdominal Radiology
Wenwu Ling, Manni Wang, Xuelei Ma, Tingting Qiu, Jiawu Li, Qiang Lu, Yan Luo
To evaluate the diagnostic accuracy of liver imaging reporting and data system (LI-RADS) with contrast-enhanced ultrasound (CEUS) for patients at risk for hepatocellular carcinoma with hepatic nodules (≤2cm). We retrospectively evaluated 56 CEUS exam records of hepatic nodules (≤2cm) performed between January 2015 and July 2016 at West China hospital. Each nodule was classified into a LI-RADS-CEUS category by two radiologists according to imaging features. The ultimate CEUS categories were then compared with pathological reports and their correlation was then calculated...
2018: Journal of Cancer
Mohit Gupta, Helena Gabriel, Frank H Miller
The prognosis for hepatocellular carcinoma (HCC) is dependent on tumor stage at diagnosis, with curative treatment options more available to early-detected HCCs. Professional organizations have produced HCC screening guidelines in at-risk groups, with ultrasound the most commonly used screening tool and increased interest in MRI in specific populations. HCC may be diagnosed by imaging features alone and have been universally incorporated into management guidelines. The radiology community has standardized imaging criteria for HCC with the development of the Liver Imaging Reporting and Data System, which has expanded to incorporate computed tomography, MR, and contrast-enhanced ultrasound for diagnostic purposes...
September 2018: Gastroenterology Clinics of North America
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