Abstract
In the second part of this review, we will describe the ancillary imaging features of hepatocellular carcinoma (HCC) that can be seen on standard magnetic resonance imaging (MRI) protocol, and on novel and emerging protocols such as diffusion weighted imaging and utilization of hepatocyte-specific/hepatobiliary contrast agent. We will also describe the morphologic sub-types of HCC, and give a simplified non-invasive diagnostic algorithm for HCC, followed by a brief description of the liver imaging reporting and data system (LI-RADS), and MRI assessment of tumor response following locoregional therapy.
Highlights
Resumo Na segunda parte desta revisão descreveremos os achados de imagem auxiliares para o diagnóstico de carcinoma hepatocelular (CHC) e que podem ser observados num protocolo de ressonância magnética (RM) padrão e em protocolos emergentes que incluem imagens de difusão e aplicação de contrastes hepatoespecíficos/hepatobiliares
A recent meta-analysis by Wu et al[16] found that Diffusion-weighted imaging (DWI) combined with conventional dynamic contrast-enhanced magnetic resonance imaging (MRI) performed significantly better than either DWI alone or conventional dynamic contrast-enhanced MRI alone
A recent study from Chen et al[51] evaluated the value of hypointensity on hepatobiliary phase imaging of gadoxetic acid in the 2014 version of the liver imaging reporting and data system (LI-RADS). They showed that the use of hepatobiliary phase imaging from gadoxetic acid as an additional criteria improved the sensitivity of LI-RADS to distinguish hepatocellular carcinoma (HCC) from benign hepatic lesions, while maintaining high specificity
Summary
It has been developed to provide a framework for assigning degrees of concern on imaging findings, improving communication with clinicians, and facilitating decision making and outcome monitoring[48]. This evolving comprehensive document can be accessed online at the ACR website[47]. A recent study from Chen et al[51] evaluated the value of hypointensity on hepatobiliary phase imaging of gadoxetic acid in the 2014 version of the LI-RADS They showed that the use of hepatobiliary phase imaging from gadoxetic acid as an additional criteria improved the sensitivity of LI-RADS to distinguish HCCs from benign hepatic lesions, while maintaining high specificity
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