Abstract
ABSTRACTHepatocellular adenomas (HCAs) are benign tumors, of which the most serious complications are hemorrhage and malignant transformation to hepatocellular carcinoma (HCC). Among the various subtypes of HCA, the β-catenin-activated subtype (bHCA) is associated with greatest risk of malignant transformation. Magnetic resonance imaging (MRI) is an important tool to differentiate benign and malignant hepatic lesions, and preclinical experimental approaches may help to develop a method to identify MRI features associated with bHCA. HCAs are associated with various pathologies, including glycogen storage disease 1a (GSD1a). Here, we utilized a mouse model for GSD1a that develops HCA and HCC, and analyzed the mice in order to distinguish low-risk from high-risk tumors. Animals were scanned by MRI using a hepato-specific contrast agent. The mice were sacrificed after MRI and their lesions were classified using immunohistochemistry. We observed that 45% of the animals developed focal lesions, and MRI identified four different patterns after contrast administration: isointense, hyperintense and hypointense lesions, and lesions with peripheral contrast enhancement. After contrast administration, only bHCA and HCC were hypointense in T1-weighted imaging and mildly hyperintense in T2-weighted imaging. Thus, high-risk adenomas display MRI features clearly distinguishable from those exhibited by low-risk adenomas, indicating that MRI is a reliable method for early diagnosis and classification of HCA, necessary for correct patient management.
Highlights
IntroductionHepatocellular adenomas (HCAs) are benign tumors that constitute2% of all liver tumors, and their most important complications are Laboratory of Molecular Biology, Istituto Giannina Gaslini, 16147 Genova, Italy.Policlinico San Martino, 16132 Genova, Italy. ‡These authors contributed to this workDr Luigi Varesio prematurely passed away in December 2018
Hepatocellular adenomas (HCAs) are benign tumors that constitute2% of all liver tumors, and their most important complications are Laboratory of Molecular Biology, Istituto Giannina Gaslini, 16147 Genova, Italy.Department of Science of Health (DISSAL), University of Genova, 16132 Genova, Italy. 3Department of Radiology, Ospedale Policlinico San Martino, 16132 Genova, Italy. 4Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, 16132 Genova, Italy. 5Anatomic Pathology, OspedalePoliclinico San Martino, 16132 Genova, Italy. ‡These authors contributed to this workDr Luigi Varesio prematurely passed away in December 2018
We show that bHCA displays Magnetic resonance imaging (MRI) features distinguishable from those exhibited by inflammatory HCA (IHCA) or unclassified HCA (UHCA), indicating that MRI is a reliable method to identify high-risk HCA
Summary
Hepatocellular adenomas (HCAs) are benign tumors that constitute2% of all liver tumors, and their most important complications are Laboratory of Molecular Biology, Istituto Giannina Gaslini, 16147 Genova, Italy.Policlinico San Martino, 16132 Genova, Italy. ‡These authors contributed to this workDr Luigi Varesio prematurely passed away in December 2018. Hepatocellular adenomas (HCAs) are benign tumors that constitute. 2% of all liver tumors, and their most important complications are Laboratory of Molecular Biology, Istituto Giannina Gaslini, 16147 Genova, Italy. Dr Luigi Varesio prematurely passed away in December 2018. The colleagues who had the privilege to collaborate with him dedicate this paper to his memory. F.R., 0000-0002-7744-4385; L.B., 0000-0002-9606-6172; A.P., 0000-00021539-7659; A.E., 0000-0003-2949-078X License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution and reproduction in any medium provided that the original work is properly attributed
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