Diagnostics and Staging
HCC Diagnosis with Liver-Specific MRI – Close to HistopathologyBartolozzi C. · Battaglia V. · Bozzi E.
Division of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy
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Thanks to the sensible and continuous improvements achieved, magnetic resonance imaging (MRI) can nowadays be considered the most accurate modality to image the liver. Moreover, the technique is the only one able to provide at the same time information about intracellular and vascular changes occurring in parenchymas. For these reasons, MRI plays a major role in the surveillance and follow-up of patients with cirrhosis. If a baseline MR study investigates the progressive alteration of lesion architecture, grading, stromal component, as well as intracellular content of fat, glycogen, or metal ions, thus leading to a frequent confident diagnosis of lesion nature, a dynamic study provides additional information about lesion vascular enhancement, which may represent the only clue for the differential diagnosis between premalignant and malignant lesions. In addition, the introduction of hepatobiliary contrast agents has further implemented the diagnostic confidence of the technique, permitting to explore the so-called grey area in which significant histological changes are already present without an evident arterial supply of the nodule. Although in the evaluation of liver pathologies MRI is mainly applied in the study of cirrhosis, the technique also plays a fundamental role in the assessment of other primitive liver malignancies, such as fibrolamellar carcinoma or cholangiocarcinoma. In these cases in particular, MRI is required to pose a differential diagnosis with other liver malignancies (such as metastases), and, once the nature of the neoplasm is assessed, to give an accurate locoregional staging.
© 2009 S. Karger AG, Basel
- Willatt JM, Hussain HK, Adusumilli S, et al: MRI of hepatocellular carcinoma in the cirrhotic liver: challenges and controversies. Radiology 2008;247:311–330.
- Hussain HK, Londy FJ, Francis IR, et al: Hepatic arterial phase MRI with automated bolus detection three-dimensional fast gradient-recalled echo sequence: comparison with test bolus method. Radiology 2003;226:558–566.
- Ito K: Hepatocellular carcinoma: conventional MRI findings including gadolinium-enhanced dynamic imaging. Eur J Radiol 2006;58:186–199.
- Lavelle MT, Lee VS, Rofsky NM, et al: Dynamic contrast enhanced three-dimensional MRI of the liver parenchyma: source images and angiographic reconstructions to define hepatic arterial anatomy. Radiology 2001;218:389–394.
- Bartolozzi C, Cioni D, Donati F, et al: Focal liver lesions: MRI-pathologic correlation. Eur Radiol 2001;11:1374–1388.
- Ichikawa T, Haradome H, Hachiya J, et al: Diffusion-weighted MRI with a single-shot echoplanar sequence: detection and characterization of focal hepatic lesions. Am J Roentgenol 1998;170:397–402.
- Bartolozzi C, Crocetti L, Lencioni R, et al: Biliary and reticuloendothelial impairment in hepatocarcinogenesis: the diagnostic role of tissue specific MR contrast media. Eur Radiol 2007;17:2519–2530.
- Coleman WB: Mechanisms of human hepatocarcinogenesis. Curr Mol Med 2003;3:573–588.
- Theise ND, Park YN, Kojiro M: Dysplastic nodules and hepatocarcinogenesis. Clin Liver Dis 2002;6:497–512.
- Shinmura R, Matsui O, Kobayashi S, et al: Cirrhotic nodules: association between MRI signal intensity and intranodular blood supply. Radiology 2006;237:512–519.
- Goshima S, Kanematsu M, Kondo H: Diffusion-weighted imaging of the liver: optimizing b value for the detection and characterization of benign and malignant hepatic lesions. J Magn Reson Imaging 2008;28:691–697.
- Ichikawa T, Federle MP, Grazioli L, et al: Fibrolamellar hepatocellular carcinoma: pre- and post-therapy evaluation with CT and MRI. Radiology 2000;217:145–151.
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