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Kim HY, Choi JY, Kim CW, Bae SH, Yoon SK, Lee YJ, Rha SE, You YK, Kim DG, Jung ES. Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging predicts the histological grade of hepatocellular carcinoma only in patients with Child-Pugh class A cirrhosis. Liver Transpl 2012; 18:850-7. [PMID: 22407909 DOI: 10.1002/lt.23426] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The aim of this study was to investigate the role of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) in predicting the histological grade of hepatocellular carcinoma (HCC) according to the hepatic function. Eighty-one consecutive patients with 122 histologically proven HCCs who underwent Gd-EOB-DTPA-enhanced MRI before resection (45 HCCs in 42 patients) or transplantation (77 HCCs in 39 patients) were analyzed retrospectively. We calculated the relative enhancement ratios (RER), which is the ratio of the relative intensity of a tumor versus the surrounding parenchyma on hepatobiliary phase images to the relative intensity on unenhanced MRI scans. We then analyzed the correlation between the RER and the tumor differentiation grade in patients with various degrees of hepatic function. The degree of tumor enhancement, which included the precontrast relative intensity ratio (RIR), the postcontrast RIR, and the RER, for well-differentiated (WD) HCCs was significantly higher than the degree of tumor enhancement for moderately differentiated and poorly differentiated (PD) HCCs (P = 0.001 and P = 0.001, respectively, for precontrast RIRs; P < 0.001 and P < 0.001, respectively, for postcontrast RIRs; and P = 0.01 and P = 0.001, respectively, for RERs). In a subgroup analysis based on liver function, the correlation between the histological grade and the enhancement ratio was demonstrated only in the group of patients with Child-Pugh class A cirrhosis. The accuracy of postcontrast RIRs for predicting WD and PD HCCs was favorable; the areas under the receiver operating characteristic curves were 0.896 [95% confidence interval (CI) = 0.817-0.974] and 0.769 (95% CI = 0.658-0.879), respectively. In conclusion, the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI may help to predict the differentiation of HCCs, especially in HCC patients with Child-Pugh class A cirrhosis before liver transplantation or resection.
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Affiliation(s)
- Hee Yeon Kim
- Department of Internal Medicine (Division of Hepatology), College of Medicine, Catholic University of Korea, Seoul, Korea
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Dhanasekaran R, Limaye A, Cabrera R. Hepatocellular carcinoma: current trends in worldwide epidemiology, risk factors, diagnosis, and therapeutics. Hepat Med 2012; 4:19-37. [PMID: 24367230 PMCID: PMC3846594 DOI: 10.2147/hmer.s16316] [Citation(s) in RCA: 153] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is a common malignancy in developing countries and its incidence is on the rise in the developing world. The epidemiology of this cancer is unique since its risk factors, including hepatitis C and B, have been clearly established. The current trends in the shifting incidence of HCC in different regions of the world can be explained partly by the changing prevalence of hepatitis. Early detection offers the only hope for curative treatment for patients with HCC, hence effective screening strategies for high-risk patients is of utmost importance. Liver transplantation and surgical resection remains the cornerstone of curative treatment. But major advances in locoregional therapies and molecular-targeted therapies for the treatment of advanced HCC have occurred recently. In this review, current trends in the worldwide epidemiology, surveillance, diagnosis, standard treatments, and the emerging therapies for HCC are discussed.
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Affiliation(s)
- Renumathy Dhanasekaran
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Alpna Limaye
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Roniel Cabrera
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Florida, Gainesville, FL, USA
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Patel M, Shariff MIF, Ladep NG, Thillainayagam AV, Thomas HC, Khan SA, Taylor-Robinson SD. Hepatocellular carcinoma: diagnostics and screening. J Eval Clin Pract 2012; 18:335-42. [PMID: 21114800 DOI: 10.1111/j.1365-2753.2010.01599.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hepatocellular carcinoma (HCC) is the commonest primary hepatic malignancy and the third most common cause of cancer-related death worldwide. Incidence remains highest in the developing world and is steadily increasing across the developed world. The majority of HCC occurs on a background of cirrhosis, principally caused by two major risk factors, chronic hepatitis B and hepatitis C infection. Current diagnostic modalities, of ultrasound and α-fetoprotein, are expensive and lack sensitivity in tumour detection. Early diagnosis is integral to improved survival rates and there have been recent advances in technology that have enabled early identification of the process of hepatocarcinogenesis. This review outlines the epidemiological trends and risk factors for HCC; diagnostic techniques and current guidelines for screening and surveillance; and newer methods of screening.
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Affiliation(s)
- Madhvi Patel
- Division of Diabetes Endocrinology and Metabolism, Department of Medicine, Imperial College London, London, UK
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A hepatoid adenocarcinoma of the stomach with liver metastasis mimicking hepatocellular carcinoma detected by F-18 FDG PET/CT imaging. Clin Nucl Med 2012; 36:1137-9. [PMID: 22064094 DOI: 10.1097/rlu.0b013e3182335ef9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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55
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Alaboudy A, Inoue T, Hatanaka K, Chung H, Hyodo T, Kumano S, Murakami T, Moustafa EFA, Kudo M. Usefulness of combination of imaging modalities in the diagnosis of hepatocellular carcinoma using Sonazoid®-enhanced ultrasound, gadolinium diethylene-triamine-pentaacetic acid-enhanced magnetic resonance imaging, and contrast-enhanced computed tomography. Oncology 2011; 81 Suppl 1:66-72. [PMID: 22212939 DOI: 10.1159/000333264] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To clarify the diagnostic ability of combining imaging methods to diagnose hepatocellular carcinoma (HCC) using Sonazoid®-enhanced ultrasound (US), gadolinium diethylene-triamine-pentaacetic acid-enhanced (Gd-EOB-DTPA) magnetic resonance imaging (MRI), and contrast-enhanced computed tomography (CECT). METHODS A total of 32 patients who underwent surgical resection for HCC were studied. Sonazoid-enhanced US, Gd-EOB-DTPA MRI, CECT, and intraoperative contrast-enhanced ultrasonography were done for all patients. The definitive diagnosis of HCC in those patients was based on histopathological confirmation. RESULTS A total of 50 histologically proven HCCs were obtained from 32 patients; their mean (± SD) age was 68.3 years ± 8.1. The mean (± SD) nodule size was 2.6 cm ± 1.9. Twenty percent were well-differentiated HCC, 64% were moderately differentiated HCC, 10% were poorly differentiated HCC, 4% were combined HCC and CCC, and 2% were HCC with severe necrosis. The overall diagnostic sensitivity of CEUS, CECT, and Gd-EOB-DTPA MRI was 72, 74, and 86%, respectively; however, there was no significant difference between the three imaging modalities in diagnosing typical HCC (p = 0.092). When combining the diagnostic ability of the different imaging modalities, the diagnostic sensitivity of Sonazoid-enhanced US and Gd-EOB-DTPA MRI was 90%, while addition of Sonazoid-enhanced US to CECT and CECT to Gd-EOB-DTPA MRI had a sensitivity of 82 and 88%, respectively. There was no significant difference between the three imaging combinations (p = 0.970). CONCLUSION Sonazoid-enhanced US and Gd-EOB-DTPA MRI can be confidently used in daily clinical practice for the management of HCC.
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Affiliation(s)
- Alshimaa Alaboudy
- Division of Gastoroenterology and Hepatology, Department of Internal Medicine, Kinki University Faculty of Medicine, Osakasayama, Japan
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Xu LH, Cai SJ, Cai GX, Peng WJ. Imaging diagnosis of colorectal liver metastases. World J Gastroenterol 2011; 17:4654-9. [PMID: 22180707 PMCID: PMC3237298 DOI: 10.3748/wjg.v17.i42.4654] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 06/15/2011] [Accepted: 06/22/2011] [Indexed: 02/06/2023] Open
Abstract
Rapid advances in imaging technology have improved the detection, characterization and staging of colorectal liver metastases. Multi-modality imaging approach is usually the more useful in diagnosis colorectal liver metastases. It is well established that hepatic resection improves the long-term prognosis of many patients with liver metastases. However, incomplete resection does not prolong survival, so knowledge of the exact extent of intra-hepatic disease is crucially important in determining patient management and outcome. The diagnosis of liver metastases relies first and totally on imaging to decide which patients may be surgical candidates. This review will discuss the imaging options and their appropriate indications. Imaging and evaluating of colorectal liver metastases (CRLM) have been performed with contrast-enhanced ultrasound, multi-detector computed tomography, magnetic resonance imaging (MRI) with extra-cellular contrast media and liver-specific contrast media MRI, and positron emission tomography/computed tomography. This review will concentrate on the imaging approach of CRLM, and also discuss certain characteristics of some liver lesions. We aim to highlight the advantages of each imaging technique, as well as underscoring potential pitfalls and limitations.
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Marshall G, Sykes A, Berry J, Jonker L. The “humble” bubble: Contrast-enhanced ultrasound. Radiography (Lond) 2011. [DOI: 10.1016/j.radi.2011.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
Focal liver lesions are a very common occurrence. The detection and differentiation of such lesions is particularly important for the management of oncology patients and is a core task for radiology. The early and conclusive detection of malignant liver processes in a cost-efficient manner and with a low radiation dose for the patient requires systematic and skillful use of the various radiological methods. This review explains the application of current radiological methods for the detection and differentiation of malignant liver lesions and the typical appearance of the most commonly found liver malignancies.
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Affiliation(s)
- T Moritz
- Univ.-Klinik für Radiodiagnostik, Allgemeines Krankenhaus, Medizinische Universität Wien, Wien, Österreich.
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Yang L, Marx H, Yen Y. Early finding of chest wall metastasis of hepatocellular carcinoma in a woman by fluorodeoxyglucose-positron emission tomography scan: a case report. J Med Case Rep 2011; 5:147. [PMID: 21489297 PMCID: PMC3089792 DOI: 10.1186/1752-1947-5-147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 04/13/2011] [Indexed: 01/18/2023] Open
Abstract
Introduction The use of fluorodeoxyglucose-positron emission tomography to evaluate well-differentiated hepatocellular carcinomas is facing critical problems. It is reported that the activity of fluorodeoxyglucose-6-phosphatase, which converts fluorodeoxyglucose-6-phosphatase to fluorodeoxyglucose, is high in normal liver cells. However, the enzyme-converting activity of glucose-6-phosphatase of well-differentiated hepatocellular carcinomas is similar to normal liver tissue. Thus, using fluorodeoxyglucose in diagnosing primary hepatocellular carcinomas is difficult. However, using fluorodeoxyglucose to detect extrahepatic metastasis of hepatocellular carcinomas is still possible. Case presentation We describe the case of a 45-year-old Chinese woman who developed a recurrent lesion in the chest wall from a previous surgically resected hepatocellular carcinoma. This recurrent lesion was detected first on the basis of a positron emission tomography scan, then on the basis of a computed tomography scan and other clinical tests. Conclusion This finding indicates that the positron emission tomography scan is a potentially reliable tool to screen for systemic metastatic disease in patients with hepatocellular carcinomas when other cross-sectional imaging tests such as computed tomography or magnetic resonance imaging are negative.
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Affiliation(s)
- Lixin Yang
- Department of Medical Oncology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA.
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60
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Geng L, Lin C, Huang B, Long XA, Dai BH, Cong WM, Yang JM. Solitary necrotic nodule of the liver: MR findings in 33 pathologically proved lesions. Eur J Radiol 2011; 81:623-9. [PMID: 21354738 DOI: 10.1016/j.ejrad.2011.01.079] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Revised: 01/03/2011] [Accepted: 01/03/2011] [Indexed: 12/14/2022]
Abstract
PURPOSE To determine characteristic magnetic resonance (MR) imaging features of solitary necrotic nodule of the liver. MATERIALS AND METHODS MR images features of thirty-two patients (17 men, 15 women; mean age, 43 years; range, 24-76 years) with pathologically proved solitary necrotic nodule of the liver were retrospectively analyzed for number, size, signal intensity features and enhancement patterns. RESULTS A total of 33 lesions were identified. The mean diameter was 2.3cm (range 1.0-4.5cm). Thirty lesions (90.9%) were 1.0-3.0cm in diameter and only 3 lesions (9.1%) were larger than 3.0cm. On T1-weighted images, solitary necrotic nodule of the liver appeared hypointense in 31 lesions (93.9%) and isointense in 2 lesions (6.1%). On T2-weighted images, 12 (36.4%) lesions were hyperintense, 15 (45.4%) were isointense or invisible and 6 (18.2%) were hypointense. After injection of gadopentetate dimeglumine, all lesions were hypointense and none of them showed enhancement. CONCLUSION Solitary necrotic nodule of the liver is usually small with the size not exceed 3.0cm in diameter. Absence of enhancement on all dynamic phase after gadopentetate dimeglumine administration may be most characteristic feature of solitary necrotic nodule of the liver on MR images, which may help discriminate this entity from metastatic liver tumors and intrahepatic cholangiocarcinoma.
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Affiliation(s)
- Li Geng
- The Department of Special Treatment, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225, Changhai Road, Shanghai 200438, China.
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Rauchfuss F, Scheuerlein H, Götz M, Dittmar Y, Voigt R, Heise M, Settmacher U. [Hepatocellular carcinoma and cholangiocarcinoma]. Chirurg 2011; 81:941-52; quiz 953. [PMID: 20827454 DOI: 10.1007/s00104-009-1864-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Hepatocellular carcinoma and cholangiocarcinoma are relatively rare tumors of the gastrointestinal tract in western Europe but their incidence has been increased in recent years. Newly diagnosed intrahepatic lesions or intrahepatic cholestasis require extensive laboratory tests and imaging studies in order to confirm the diagnosis of hepatocellular carcinoma, intrahepatic or extrahepatic cholangiocarcinoma. The treatment options range from liver resection or liver transplantation to conservative measures (in cases of non-resectable lesions). This review article aims to provide an overview on the diagnostic options and the subsequent treatment.
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Affiliation(s)
- F Rauchfuss
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Friedrich-Schiller-Universität Jena, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland.
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Fecal metabolome profiling of liver cirrhosis and hepatocellular carcinoma patients by ultra performance liquid chromatography-mass spectrometry. Anal Chim Acta 2011; 691:68-75. [PMID: 21458633 DOI: 10.1016/j.aca.2011.02.038] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 02/12/2011] [Accepted: 02/14/2011] [Indexed: 12/16/2022]
Abstract
Fecal metabolome of healthy humans and patients suffering from liver cirrhosis and hepatocellular carcinoma (HCC) were studied using ultra performance liquid chromatography coupled to quadrupole-time-of-flight mass spectrometry (UPLC/Q-TOF MS). Metabolic features detected by the method were then statistically treated using partial least squares to latent structure-discriminant analysis (PLS-DA) models to discriminate between healthy and diseased states. PLS-DA was also used to discriminate between cirrhosis and HCC stressed fecal metabolomes and to identify potential biomarkers for cirrhosis and HCC that are expressed at significantly different amounts in fecal metabolomes. Score plots of pattern recognition analysis distinguished liver cirrhosis and HCC patients from healthy humans. Based on the variable of importance in the project (VIP) values and S-plots, six metabolites were considered as potential biomarkers with a strong increase in lysophosphatidylcholines and a dramatic decrease in bile acids and bile pigments in patients with liver cirrhosis and HCC in comparison with healthy humans. Results demonstrate the potential of UPLC-MS as an efficient and convenient method that can be applied to screen fecal samples and aid in the early diagnosis of cirrhosis and hepatocellular carcinoma.
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Abstract
Technologic advancements have allowed imaging modalities to become more useful in the diagnosis of hepatobiliary and pancreatic disorders. Computed tomography scanners now use multidetector row technology with contrast-delayed imaging for quicker and more accurate imaging. Magnetic resonance imaging with cholangiopancreatography can more clearly delineate liver lesions and the biliary and pancreatic ducts, and can diagnose pathologic conditions early in their course. Newer technologies, such as single-operator cholangioscopy and endoscopic ultrasonography, have sometimes shown superiority to traditional modalities. This article addresses the literature regarding available imaging techniques in the diagnosis and treatment of common surgical hepatobiliary and pancreatic diseases.
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Abstract
The application of diagnostic imaging is of fundamental importance in the screening, diagnosis and therapy of hepatocellular carcinoma. Among the diagnostic imaging options, ultrasonography has leading role, as it is simple, non-invasive and enables real-time imaging. Screening and active follow up of patients at high risk of primary liver tumors is essential in their early detection. Screening/active follow up of patients at high risk of primary liver tumors means six monthly ultrasound examination. The diagnosis of hepatocellular carcinoma is based on the detection of its characteristic contrast enhancing dynamics, which is possible through dynamic diagnostic imaging procedures (contrast agent enhanced ultrasonography, triphasic CT, MRI). The diagnostic imaging procedure applied depends on the size of the lesions. Examination of the cirrhotic liver remains particularly difficult even with the modern diagnostic imaging procedures, especially concerning the recognition of small early stage hepatocellular carcinoma, and premalignant lesions.
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Affiliation(s)
- Zsuzsa Jakab
- Semmelweis Egyetem, Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Budapest.
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65
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Loss M, Jung E, Scherer M, Farkas S, Schlitt H. Chirurgische Therapie von Lebermetastasen. Chirurg 2010; 81:533-41. [DOI: 10.1007/s00104-010-1891-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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66
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Wong GLH, Xu HX, Xie XY. Detection Of Focal Liver Lesions In Cirrhotic Liver Using Contrast-Enhanced Ultrasound. World J Radiol 2009; 1:25-36. [PMID: 21160718 PMCID: PMC2998885 DOI: 10.4329/wjr.v1.i1.25] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 12/17/2009] [Accepted: 12/21/2009] [Indexed: 02/06/2023] Open
Abstract
Patients with liver cirrhosis are at increased risk of hepatocellular carcinoma (HCC). Conventional or baseline ultrasound (BUS) is often used as the first-line tool for HCC surveillance or detection, but the accuracy of BUS in HCC detection or differentiation from other focal liver lesions (FLLs) is limited. Contrast-enhanced ultrasound (CEUS) represents a recent revolution in the field of ultrasonography and it has become increasingly important in the detection and evaluation of FLLs. In CEUS, HCC typically exhibits arterial hyper-enhancement and portal-venous washout represented by hypo-enhanced lesions in the portal venous and late phases. The detection rate of HCC was significantly higher with CEUS compared with BUS. Even regenerative or some dysplastic nodules may exhibit arterial hyper-enhancement as they are differentiated from HCC by its iso-enhancing pattern in portal and late phases. The contrast-enhancement patterns of other different types of benign and malignant FLLs, as well as their detection rates with CEUS, were also discussed.
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Advancement in HCC imaging: diagnosis, staging and treatment efficacy assessments. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2009; 17:369-73. [DOI: 10.1007/s00534-009-0227-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2009] [Accepted: 09/01/2009] [Indexed: 12/22/2022]
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Shimofusa R, Ueda T, Kishimoto T, Nakajima M, Yoshikawa M, Kondo F, Ito H. Magnetic resonance imaging of hepatocellular carcinoma: a pictorial review of novel insights into pathophysiological features revealed by magnetic resonance imaging. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2009; 17:583-9. [DOI: 10.1007/s00534-009-0198-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2009] [Accepted: 09/01/2009] [Indexed: 12/16/2022]
Affiliation(s)
- Ryota Shimofusa
- Department of Radiology; Chiba University Hospital; 1-8-1 Inohana, Chuoh-ku Chiba 260-8670 Japan
| | - Takuya Ueda
- Department of Radiology; Chiba University Hospital; 1-8-1 Inohana, Chuoh-ku Chiba 260-8670 Japan
- Department of Radiology; Stanford University School of Medicine; 300 Pasteur Drive, Room S-072 Stanford CA 94305 USA
| | - Takashi Kishimoto
- Department of Molecular Pathology, Graduate School of Medicine; Chiba University; 1-8-1 Inohana, Chuoh-ku Chiba 260-8670 Japan
| | - Masayuki Nakajima
- Department of General Surgery, Graduate School of Medicine; Chiba University; 1-8-1 Inohana, Chuoh-ku Chiba 260-8670 Japan
| | - Masaharu Yoshikawa
- Department of Medicine and Clinical Oncology, Graduate School of Medicine; Chiba University; 1-8-1 Inohana, Chuoh-ku Chiba 260-8670 Japan
| | - Fukuo Kondo
- Department of Pathology; Teikyo University Faculty of Medicine; 2-11-1 Kaga, Itabashi-ku Tokyo 173-8605 Japan
| | - Hisao Ito
- Department of Radiology; Chiba University Hospital; 1-8-1 Inohana, Chuoh-ku Chiba 260-8670 Japan
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Shariff MIF, Cox IJ, Gomaa AI, Khan SA, Gedroyc W, Taylor-Robinson SD. Hepatocellular carcinoma: current trends in worldwide epidemiology, risk factors, diagnosis and therapeutics. Expert Rev Gastroenterol Hepatol 2009; 3:353-67. [PMID: 19673623 DOI: 10.1586/egh.09.35] [Citation(s) in RCA: 224] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death worldwide and, owing to changes in the prevalence of the two major risk factors, hepatitis B virus and hepatitis C virus, its overall incidence remains alarmingly high in the developing world and is steadily rising across most of the developed world. Early diagnosis remains the key to effective treatment and there have been recent advances in both the diagnosis and therapy of HCC, which have made important impacts on the disease. This review outlines the epidemiological trends, risk factors, diagnostic developments and novel therapeutics for HCC, both in the developing and developed world.
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Affiliation(s)
- Mohamed I F Shariff
- Liver Unit, Faculty of Medicine, Imperial College London, St Mary's Hospital, 10th Floor QEQM Building, South Wharf Road, London W2 1NY, UK.
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