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Onishi Y, Ohno T, Shimizu H, Shimada K, Isoda H, Ishii T, Takai A, Nakamoto Y. Natural History of Hepatic Hemangiomas Larger Than 10 cm: Imaging Findings and Clinical Course of 22 Cases. Cureus 2023; 15:e50563. [PMID: 38226088 PMCID: PMC10788688 DOI: 10.7759/cureus.50563] [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: 12/10/2023] [Indexed: 01/17/2024] Open
Abstract
INTRODUCTION The natural history of a large hepatic hemangioma is important in determining the treatment strategy. Although several studies have assessed the natural history of hepatic hemangiomas, no study has focused on hepatic hemangiomas measuring >10 cm. The aim of this study was to assess the natural history of hepatic hemangiomas measuring >10 cm by evaluating imaging findings and clinical course. METHODS Computed tomography (CT) and magnetic resonance imaging (MRI) reports at Kyoto University Hospital, Kyoto, Japan, between January 2001 and March 2023 were retrospectively searched to find adult patients with hepatic hemangiomas >10 cm. Patients who were followed up without treatment for over six months were included. The maximum diameter of the hepatic hemangioma was compared between the baseline and the final CT or MRI. The clinical course of the patients was evaluated. RESULTS Twenty-two patients (17 women, five men; median age, 51 years) were identified. The median diameter of hepatic hemangiomas in the baseline study was 114 mm. Two patients had abdominal distention at the time of the baseline imaging, whereas the others were asymptomatic. After follow-up without treatment (the median; 95.5 months), enlargement, no change, shrinkage of hepatic hemangioma was observed in six, 11, and five patients, respectively. The median growth rate of hepatic hemangiomas was 2.5 mm/year. Two patients underwent liver resection for hepatic hemangioma, while the others were followed up without treatment. In four patients, symptoms appeared or worsened. Two patients died: one patient died from prostate cancer progression; the cause of death for the other was not confirmed. CONCLUSION Hepatic hemangiomas show a slow growth rate during follow-up, and shrinkage is occasionally observed. Some patients experience new symptoms or aggravation of symptoms; however, deaths associated with hepatic hemangiomas are uncommon.
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Affiliation(s)
- Yasuyuki Onishi
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
| | - Tsuyoshi Ohno
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
| | - Hironori Shimizu
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
| | - Kotaro Shimada
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
| | - Hiroyoshi Isoda
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
| | | | - Atsushi Takai
- Gastroenterology and Hepatology, Kyoto University, Kyoto, JPN
| | - Yuji Nakamoto
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
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Gaynor T, Sinh V, Reddipogu J. Post-traumatic rupture of hepatic haemangioma. ANZ J Surg 2023; 93:2754-2756. [PMID: 37221936 DOI: 10.1111/ans.18526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/25/2023]
Affiliation(s)
- Tessa Gaynor
- Department of Surgery, Alice Springs Hospital, Flinders University, Adelaide, South Australia, Australia
| | - Vanshika Sinh
- Department of Surgery, Alice Springs Hospital, Flinders University, Adelaide, South Australia, Australia
| | - Jonathan Reddipogu
- Department of Surgery, Alice Springs Hospital, Flinders University, Adelaide, South Australia, Australia
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Skwirczyński M, Tabor Z, Lasek J, Schneider Z, Gibała S, Kucybała I, Urbanik A, Obuchowicz R. Deep Learning Algorithm for Differentiating Patients with a Healthy Liver from Patients with Liver Lesions Based on MR Images. Cancers (Basel) 2023; 15:3142. [PMID: 37370752 DOI: 10.3390/cancers15123142] [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: 04/26/2023] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
The problems in diagnosing the state of a vital organ such as the liver are complex and remain unresolved. These problems are underscored by frequently published studies on this issue. At the same time, demand for imaging diagnostics, preferably using a method that can detect the disease at the earliest possible stage, is constantly increasing. In this paper, we present liver diseases in the context of diagnosis, diagnostic problems, and possible elimination. We discuss the dataset and methods and present the stages of the pipeline we developed, leading to multiclass segmentation of the liver in multiparametric MR image into lesions and normal tissue. Finally, based on the processing results, each case is classified as either a healthy liver or a liver with lesions. For the training set, the AUC ROC is 0.925 (standard error 0.013 and a p-value less than 0.001), and for the test set, the AUC ROC is 0.852 (standard error 0.039 and a p-value less than 0.001). Further refinements to the proposed pipeline are also discussed. The proposed approach could be used in the detection of focal lesions in the liver and the description of liver tumors. Practical application of the developed multi-class segmentation method represents a key step toward standardizing the medical evaluation of focal lesions in the liver.
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Affiliation(s)
- Maciej Skwirczyński
- Faculty of Mathematics and Computer Science, Jagiellonian University, 30-348 Krakow, Poland
| | - Zbisław Tabor
- Faculty of Electrical Engineering, Automatics, Computer Science, and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland
| | - Julia Lasek
- Faculty of Geology, Geophysics, and Environmental Protection, AGH University of Science and Technology, 30-059 Krakow, Poland
| | - Zofia Schneider
- Faculty of Geology, Geophysics, and Environmental Protection, AGH University of Science and Technology, 30-059 Krakow, Poland
| | | | - Iwona Kucybała
- Department of Diagnostic Imaging, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Andrzej Urbanik
- Department of Diagnostic Imaging, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Rafał Obuchowicz
- Department of Diagnostic Imaging, Jagiellonian University Medical College, 31-501 Krakow, Poland
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Alhyari A, Görg C, Alakhras R, Dietrich CF, Trenker C, Safai Zadeh E. HCC or Something Else? Frequency of Various Benign and Malignant Etiologies in Cirrhotic Patients with Newly Detected Focal Liver Lesions in Relation to Different Clinical and Sonographic Parameters. Diagnostics (Basel) 2022; 12:diagnostics12092079. [PMID: 36140481 PMCID: PMC9497913 DOI: 10.3390/diagnostics12092079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aims: To investigate the frequency of different benign and malignant focal liver lesions (FLLs) in relation to clinical and sonographic features among patients with liver cirrhosis (LC) and newly detected FLLs. Methods: This study was a retrospective analysis of 225 cirrhotic patients with newly detected FLLs who underwent hepatic ultrasound (US) examinations at our university hospital from 2011 to 2022. The diagnosis of FLLs was based on histology and/or consensus radiological criteria, in accordance with the current diagnostic guidelines. The FLLs were classified into benign (bFLLs) or malignant (mFLLs) lesions and the latter group was subclassified into HCC and non-HCC mFLLs. The frequency, clinical parameters, and sonographic features of the different groups were examined and compared. Results: Of the 225 FLLs, 154 (68.4%) were mFLLs and 71 (31.6%) bFLLs. HCC was the most frequent subcategory of FLLs (132; 58.7%). There were (22; 9.8%) non-HCC mFLLs with 11 (4.9%) metastases and 11 (4.9%) non-HCC primary liver tumors. Regenerative nodules (RNs) were the most frequent form of bFLLs (25; 11.1%), followed by simple cysts (22; 9.8%) and hemangiomas (14; 6.2%). The other bFLLs (10; 14.1%) were fat deposition/sparing (5), hematomas (2), abscesses (2), and echinococcal cysts (1). The distribution of bFLLs and HCC and non-HCC mFLLs varied significantly according to the clinical scenarios. HCC mFLLs were more frequent in males (p = 0.001), in those with no history of active non-hepatic primary malignant disease (NHPMD) (p < 0.001), in those with a hepatitis B or C etiology of LC (p = 0.002), when located in the right lobe (p = 0.008), and when portal vein thrombosis was present (p = 0.03). Conclusion: In cirrhotic patients with newly detected FLLs, the non-HCC etiology was more frequently diagnosed in lesions that were located in the left lobe, in females, and in patients with a history of active NHPMD. Thus, the lower frequency of HCC in the abovementioned groups demonstrated that a cautious implementation of the current consensus radiological criteria would be required for these groups, particularly in patients with an active NHPMD, given the fact that the consensus criteria were not validated in these populations. A more active diagnostic approach may ultimately be needed for these patients. Large prospective studies are needed to validate these findings.
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Affiliation(s)
- Amjad Alhyari
- Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany
- Interdisciplinary Centre of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany
- Correspondence: ; Tel.: +49-6421-58-61538
| | - Christian Görg
- Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany
- Interdisciplinary Centre of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Raed Alakhras
- Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Christoph Frank Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Bern, Beau Site, Salem und Permanence, 3013 Bern, Switzerland
| | - Corrina Trenker
- Interdisciplinary Centre of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany
- Haematology, Oncology and Immunology, University Hospital Giessen and Marburg, Philipps University Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Ehsan Safai Zadeh
- Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany
- Interdisciplinary Centre of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany
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