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Characterization of the arterial enhancement pattern of focal liver lesions by multiple arterial phase magnetic resonance imaging: comparison between hepatocellular carcinoma and focal nodular hyperplasia

  • ABDOMINAL RADIOLOGY
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Abstract

Purpose

To evaluate the features of arterial enhancement pattern of focal nodular hyperplasia (FNH) and hepatocellular carcinoma (HCC) by triple-phase arterial magnetic resonance imaging (MRI).

Methods

Data were retrospectively collected from 52 consecutive patients who underwent triple-phase arterial MRI using hepatocyte-specific contrast agents (Gd-EOB-DTPA) from January 2017 to October 2017, with a MR imaging diagnosis of HCC or FNH. The images were independently assessed by two blinded readers. Contrast enhancement ratio (CER) and liver-to-lesion contrast ratio (LLCR) were calculated. The lesions were classified visually and also based on the peak of LLCR into the following groups: (1) early arterial, (2) middle arterial and (3) late arterial. Data were eventually analysed using nonparametric tests.

Results

The CER analysis showed no significant difference between HCC and FNH patients (p > 0.05). LLCRFNH were significantly higher than LLCRHCC in the early arterial (p = 0.01), but not in the middle and late arterial phases (p = 0.20 and p = 0.82, respectively). LLCRHCC presented a meaningful increase from early to middle arterial phase (p = 0.009), whereas LLCRFNH showed a decrease from middle to late arterial phase (p = 0.004). Based on the peak of LLCR, 17 (55%) FNHs were classified into early, 11 (35%) in middle and only 3 (10%) in late arterial phase groups. Similarly, 14 (34%) HCCs were categorized into early, 13 (32%) in middle and 14 (33%) in late arterial phase groups. There was a good agreement between qualitative analysis and LLCR in 85% of cases.

Conclusion

The optimal visualization of FNH has been detected in early and middle arterial phases while HCC has been best observed during middle and late arterial phases.

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Authors and Affiliations

  1. Department of Surgical Sciences, Radiology Unit, University of Turin, Via Genova 3, 10126, Turin, Italy

    Marco Gatti, Laura Bergamasco, Fatemeh Darvizeh, Stefano Rousset, Paolo Fonio & Riccardo Faletti

  2. Department of Oncology, Radiology Unit, University of Torino, Turin, Italy

    Marco Calandri & Andrea Veltri

  3. Department of Radiology, University of Brescia “Spedali Civili”, P.le Spedali Civili 1, 25123, Brescia, Italy

    Luigi Grazioli

  4. Division of Interventional Radiology, Department of Radiology, Madonna delle Grazie Hospital, 75100, Matera, Italy

    Riccardo Inchingolo

  5. School of Medicine, University of Milano-Bicocca, Milan, Italy

    Davide Ippolito

  6. Department of Diagnostic Radiology, H. S. Gerardo Monza, Via Pergolesi 33, 20900, Monza, MB, Italy

    Davide Ippolito

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  1. Marco Gatti
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  2. Marco Calandri
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  3. Laura Bergamasco
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  4. Fatemeh Darvizeh
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  10. Paolo Fonio
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Correspondence to Marco Gatti.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Gatti, M., Calandri, M., Bergamasco, L. et al. Characterization of the arterial enhancement pattern of focal liver lesions by multiple arterial phase magnetic resonance imaging: comparison between hepatocellular carcinoma and focal nodular hyperplasia. Radiol med 125, 348–355 (2020). https://doi.org/10.1007/s11547-019-01127-4

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  • DOI: https://doi.org/10.1007/s11547-019-01127-4

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