Fate of hypointense lesions on Gd-EOB-DTPA-enhanced magnetic resonance imaging.
ABSTRACT To investigate the natural outcome and clinical implication of hypointense lesions in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI.
Forty patients underwent Gd-EOB-DTPA-enhanced MRI for preoperative evaluation of HCC. Hypointense lesions in the hepatobiliary phase that were hypovascular 5mm of more were extracted for follow-up. We performed a longitudinal study retrospectively for these lesions regardless of whether classical HCC developed or emerged in a different area from that of the lesions being followed.
Thirty one patients displayed 130 hypointense lesions on MRI and only nine showed no hypointense lesions. In total, 17 (13.1%) of 130 hypointense lesions on MRI developed into classical HCC. The cumulative rates for these lesions to develop into classical HCC were 3.2% at 1 year, 11.1% at 2 years and 15.9% at 3 years. The total occurrence rates of classical HCC (25.8% at 1 year, 52.6% at 2 years and 76.4% at 3 years) were higher compared to those regarding only occurrence of classical HCC from hypointense lesions on MRI (10.0% at 1 year, 35.6% at 2 years and 44.6% at 3 years), although no significant difference was observed (p=0.073).
Hypointense lesions that are detected in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI have some malignant potential, although treating these lesions aggressively in patients who already have HCC may be too severe.
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ABSTRACT: Newly developed or advanced methods at ultrasonography and MR imaging provide combined anatomical and quantitative functional information regarding diffuse and focal liver diseases. Dynamic contrast-enhanced ultrasonography may improve tumor characterization and ultrasound elastography has a central role for staging liver fibrosis and an increasing role in grading portal hypertension. In clinical practice, MR imaging examinations currently include diffusion-weighted and dynamic MR imaging enhanced with extracellular or hepatobiliary contrast agents. Moreover, quantitative parameters obtained at diffusion-weighted MR imaging, dynamic contrast-enhanced MR imaging and MR elastography have the potential to further characterize diffuse and focal liver diseases by adding information about tissue cellularity, perfusion, hepatocyte transport function and visco-elasticity. The multiparametric capability of ultrasonography and more markedly of MR imaging gives the opportunity of high diagnostic performance by combining imaging biomarkers. The image acquisition and post-processing methods should be further standardized and validated in multicenter trials.Journal of Hepatology 10/2014; 62(3). DOI:10.1016/j.jhep.2014.10.014 · 10.40 Impact Factor
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