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Tomihara K, Ito K, Kai K, Tanaka T, Ide T, Noshiro H. A case of intrahepatic mass-forming portal biliopathy mimicking intrahepatic cholangiocarcinoma. Clin J Gastroenterol 2024; 17:671-676. [PMID: 38642275 DOI: 10.1007/s12328-024-01971-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/03/2024] [Indexed: 04/22/2024]
Abstract
A 75-year-old man was referred to our department because of an enlarging intrahepatic mass detected on magnetic resonance imaging (MRI) follow-up for another disease. MRI showed hypointensity on T1-weighted imaging and hyperintensity on T2-weighted imaging in liver segment 4. Abdominal plain computed tomography (CT) indicated a low-density lesion with an unclear boundary, measuring approximately 4 cm × 3 cm in liver segment 4. Dynamic CT showed early rim enhancement and gradual central enhancement. Contrast-enhanced CT also showed occlusion of the portal vein in segment 4. As the possibility of intrahepatic cholangiocarcinoma could not be excluded on imaging studies, we performed laparoscopic left medial sectionectomy. Histologically, the lesion showed diminished numbers of hepatocytes with increased collagen fibers compared with normal, with no patent portal vein. We considered this lesion a reactive lesion caused by collapse of the liver parenchyma owing to localized obstruction and loss of the portal vein. This lesion was pathologically diagnosed as portal biliopathy. We experienced an extremely rare case of intrahepatic mass-forming portal biliopathy that mimicked a hepatic tumor, which was diagnosed by laparoscopic resection. Portal biliopathy rarely forms intrahepatic mass lesions and must be distinguished from a malignant hepatic tumor.
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Affiliation(s)
- Kazuki Tomihara
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
| | - Kotaro Ito
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Keita Kai
- Department of Pathology, Faculty of Medicine, Saga University, Saga, Japan
| | - Tomokazu Tanaka
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Takao Ide
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Hirokazu Noshiro
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
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2
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Yadav T, Datta D, Elhence P, Varshney V, Kumar R. Primary hepatic diffuse large B- cell lymphoma mimicking cholangiocarcinoma. EJNMMI REPORTS 2024; 8:23. [PMID: 39085728 PMCID: PMC11291803 DOI: 10.1186/s41824-024-00215-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 06/04/2024] [Indexed: 08/02/2024]
Abstract
Primary lymphoma of liver is a rare malignancy with non-specific clinical features and tumor markers. The presentation and imaging features may be indistinguishable from other hepatic malignant lesions. Pathological diagnosis is the gold standard, and early detection is essential to choose the treatment modality. Here, we share an interesting case of Primary Diffuse Large B cell lymphoma of liver and its imaging findings on Computed tomography (CT), Magnetic Resonance Imaging (MRI) and F-18 FDG PET/CT.
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Affiliation(s)
- Taruna Yadav
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Deepanksha Datta
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, India.
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, India.
| | - Poonam Elhence
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Vaibhav Varshney
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Jodhpur, India
| | - Rajesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, India
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3
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Al-Ibraheem A, Ruzzeh S, Badarneh M, Al-Adhami D, Telfah A. Beyond CT: A Case Analysis of Serial [18F]FDG PET/CT for Assessment of Necrosis and Early Recurrence in Colorectal Liver Metastases. Cureus 2023; 15:e51393. [PMID: 38292976 PMCID: PMC10826454 DOI: 10.7759/cureus.51393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2023] [Indexed: 02/01/2024] Open
Abstract
Colorectal cancer is a common malignancy, with the liver being the most frequent site of metastases. [18F] Fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) has emerged as a valuable tool in detecting and evaluating liver metastases and extrahepatic disease. Herein, we present a case of a 76-year-old male with colorectal cancer associated with lung and liver metastases. The patient received 12 chemoimmunotherapy cycles and was then put on maintenance cetuximab; serial [18F]FDG PET/CT scans were utilized to evaluate treatment response. The patient exhibited a positive response to chemoimmunotherapy, with regression of rectal disease and resolution of pulmonary metastatic nodules. Serial [18F]FDG PET/CT scans unveiled three distinct necrotic patterns. The case report advocates that [18F]FDG PET/CT plays an important role in evaluating colorectal liver metastases (CRLM) response to treatment, identifying transient necrosis, early recurrence, and emphasizing the limitations of post-treatment CT scans in identifying early CRLM recurrence. Integrating functional imaging, particularly [18F]FDG PET/CT, promises for management monitoring and surveillance of CRLM patients.
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Affiliation(s)
- Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
- School of Medicine, University of Jordan, Amman, JOR
| | - Saad Ruzzeh
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Mohannad Badarneh
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Dhuha Al-Adhami
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Ahmad Telfah
- Department of Medicine, King Hussein Cancer Center (KHCC), Amman, JOR
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Lee CW, Son HJ, Woo JY, Lee SH. Is Prone Position [ 18F]FDG PET/CT Useful in Reducing Respiratory Motion Artifacts in Evaluating Hepatic Lesions? Diagnostics (Basel) 2023; 13:2539. [PMID: 37568906 PMCID: PMC10417611 DOI: 10.3390/diagnostics13152539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Prone position is useful in reducing respiratory motion artifacts in lung nodules on 2-Deoxy-2-[18F] fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT). However, whether prone position PET/CT is useful in evaluating hepatic lesions is unknown. Thirty-five hepatic lesions from 20 consecutive patients were evaluated. The maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) of both standard supine position PET/CT and additional prone position PET/CT were evaluated. No significant difference in SUVmax (4.41 ± 2.0 vs. 4.23 ± 1.83; p = 0.240) and MTV (5.83 ± 6.69 vs. 5.95 ± 6.24; p = 0.672) was observed between supine position PET/CT and prone position PET/CT. However, SUVmax changes in prone position PET/CT varied compared with those in supine position PET/CT (median, -4%; range: -30-71%). Prone position PET/CT was helpful when [18F]FDG uptake of the hepatic lesions was located outside the liver on supine position PET/CT (n = 4, SUVmax change: median 15%; range: 7-71%) and there was more severe blurring on supine position PET/CT (n = 6, SUVmax change: median 11%; range: -3-32%). Unlike in lung nodules, prone position PET/CT is not always useful in evaluating hepatic lesions, but it may be helpful in individual cases such as hepatic dome lesions.
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Affiliation(s)
- Chung Won Lee
- Department of Radiology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea;
| | - Hye Joo Son
- Department of Nuclear Medicine, Dankook University Medical Center, Cheonan 31116, Republic of Korea;
| | - Ji Young Woo
- Department of Radiology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea;
| | - Suk Hyun Lee
- Department of Radiology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea;
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Ali HY, Mohammad SA, Ali AH, Monib AM, Shalaby MH. Can positron emission tomography–computed tomography-based three target lesions' total lesion glycolysis predict therapeutic response in Hodgkin Lymphoma? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00702-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Universally maximum standardized uptake value (SUVmax) and lactate dehydrogenase (LDH) are used as tools for response assessment in Hodgkin Lymphoma (HL) patients. Our objectives are to evaluate the predictive potential and response assessment of total lesion glycolysis (TLG) and metabolic tumor volume (MTV)—maximum three target lesions—as another alternatives and to investigate the correlation between TLG and MTV with LDH.
Results
Both initial SUVmax and TLG were significantly associated with early patient response (p value 0.03, 0.047, respectively). An optimal threshold for SUVmax and TLG less than or equal 19.52, and 158.6, respectively, correlated with better therapeutic response. Initial LDH was moderately correlated with initial values of TLG (rs = 0.4, p value 0.01), MTV (rs = 0.44, p value 0.01) and SUVmax (rs = 0.42, p value 0.01).
Conclusion
TLG in correlation with LDH can be significant prognostic factors of therapeutic response in HL. They can be used for the identification of a subset of HL patients with a better outcome.
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Xue Z, Li P, Zhang L, Lu X, Zhu G, Shen P, Ali Shah SA, Bennamoun M. Multi-Modal Co-Learning for Liver Lesion Segmentation on PET-CT Images. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:3531-3542. [PMID: 34133275 DOI: 10.1109/tmi.2021.3089702] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Liver lesion segmentation is an essential process to assist doctors in hepatocellular carcinoma diagnosis and treatment planning. Multi-modal positron emission tomography and computed tomography (PET-CT) scans are widely utilized due to their complementary feature information for this purpose. However, current methods ignore the interaction of information across the two modalities during feature extraction, omit the co-learning of the feature maps of different resolutions, and do not ensure that shallow and deep features complement each others sufficiently. In this paper, our proposed model can achieve feature interaction across multi-modal channels by sharing the down-sampling blocks between two encoding branches to eliminate misleading features. Furthermore, we combine feature maps of different resolutions to derive spatially varying fusion maps and enhance the lesions information. In addition, we introduce a similarity loss function for consistency constraint in case that predictions of separated refactoring branches for the same regions vary a lot. We evaluate our model for liver tumor segmentation using a PET-CT scans dataset, compare our method with the baseline techniques for multi-modal (multi-branches, multi-channels and cascaded networks) and then demonstrate that our method has a significantly higher accuracy ( ) than the baseline models.
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Lund M, Nadarevic T, Bjerre TA, Grønbaek H, Mortensen F, Kragh Andersen P. Contrast-enhanced ultrasound compared with computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography for diagnosing liver metastases in people with newly diagnosed colorectal cancer. Hippokratia 2020. [DOI: 10.1002/14651858.cd012388.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Martin Lund
- Department of Radiology; Randers Regional Hospital; Randers Denmark
| | - Tin Nadarevic
- Department of Radiology; Clinical Hospital Centre Rijeka; Rijeka Croatia
| | | | - Henning Grønbaek
- Medical Department V; Aarhus University Hospital; Aarhus Denmark
| | - Frank Mortensen
- Department of Surgery L; Aarhus University Hospital; Aarhus Denmark
| | - Per Kragh Andersen
- Department of Biostatistics; University of Copenhagen, Faculty of Health Sciences, Institute of Public Health; Copenhagen K Denmark
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Surasi DS, O'Malley JP, Bhambhvani P. 18F-FDG PET/CT Findings in Portal Vein Thrombosis and Liver Metastases. J Nucl Med Technol 2015; 43:229-30. [PMID: 25655342 DOI: 10.2967/jnmt.114.152777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 01/23/2015] [Indexed: 11/16/2022] Open
Abstract
(18)F-FDG PET/CT is a valuable noninvasive tool in oncologic imaging, and its application in the diagnosis of liver metastases has been very convincing. Both the sensitivity and the specificity of (18)F-FDG PET/CT are high for detecting liver metastases from various tumors including colorectal, breast, and lung. Such liver metastases are typically (18)F-FDG-avid. We present atypical (18)F-FDG PET findings in a lung cancer patient with known liver metastases and PVT.
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Affiliation(s)
- Devaki Shilpa Surasi
- Division of Molecular Imaging and Therapeutics, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Janis P O'Malley
- Division of Molecular Imaging and Therapeutics, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pradeep Bhambhvani
- Division of Molecular Imaging and Therapeutics, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
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