[Multiparametric magnetic resonance imaging for hepatocellular carcinoma, part 1 : Morphology and dynamic perfusion imaging in primary diagnostics and treatment monitoring]

Radiology plays a key role in the diagnosis and monitoring of hepatocellular carcinoma (HCC). Ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) are used to identify HCC lesions. Multiparametric MRI provides detailed insights into the tumor biology through the analysis of morphology, perfusion and diffusion. In this way preoperative decisions can be optimized. The guidelines recommend using contrast-enhanced MRI or ultrasound for the diagnosis of HCC. The preferred method is MRI due to its superiority in the detection of small lesions The treatment response is evaluated using modified response evaluation criteria for solid tumors (RECIST) and the European Association for the Study of the Liver (EASL) criteria. The use of multiparametric MRI in conjunction with the liver imaging reporting and data system (LI-RADS) plays overall a central role in the precise diagnosis and monitoring of the treatment of HCC.

Effect of magnetic resonance imaging in liver metastases

This letter to the editor is a commentary on a study titled "Liver metastases: The role of magnetic resonance imaging." Exploring a noninvasive imaging evaluation system for the biological behavior of hepatocellular carcinoma (HCC) is the key to achieving precise diagnosis and treatment and improving prognosis. This review summarizes the role of magnetic resonance imaging in the detection and evaluation of liver metastases, describes its main imaging features, and focuses on the added value of the latest imaging tools (such as T1 weighted in phase imaging, T1 weighted out of phase imaging; diffusion-weighted imaging, T2 weighted imaging). In this study, I investigated the necessity and benefits of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid for HCC diagnostic testing and prognostic evaluation.

Effect of magnetic resonance imaging in liver metastases

This letter to the editor is a commentary on a study titled "Liver metastases: The role of magnetic resonance imaging." Exploring a noninvasive imaging evaluation system for the biological behavior of hepatocellular carcinoma (HCC) is the key to achieving precise diagnosis and treatment and improving prognosis. This review summarizes the role of magnetic resonance imaging in the detection and evaluation of liver metastases, describes its main imaging features, and focuses on the added value of the latest imaging tools (such as T1 weighted in phase imaging, T1 weighted out of phase imaging; diffusion-weighted imaging, T2 weighted imaging). In this study, I investigated the necessity and benefits of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid for HCC diagnostic testing and prognostic evaluation.

Liver-specific gadoxetic acid-enhanced magnetic resonance for focal lesion evaluation

Gadolinium-enhanced magnetic resonance for the evaluation of hepatic lesions is increasingly being used in clinical practice, especially in patients with suspicious focal lesions, whether benign or malignant. In regard to hepatocellular carcinoma, the diagnostic performance of magnetic resonance through the «conventional» protocols and multi-detector computerized tomography consisting of multiphase evaluation with intravenous contrast, largely depends on the size of the lesion. They are more reliable in lesions>2cm. However, in lesions measuring 1-2cm, establishing the definitive diagnosis is a real challenge, with sensitivity values of 45-65%, but generally with excellent specificity (>95%). Furthermore, if the lesion has a diameter<1cm, diagnosis is usually unreliable. In these last 2 settings, the complementary use of liver-specific contrast agents can be advantageous. The aim of our article was to review the current evidence on the usefulness of this new non-invasive diagnostic method in hepatic lesions.