Abdominal Radiology

, Volume 43, Issue 5, pp 1143–1151 | Cite as

MRI for hepatocellular carcinoma: a primer for magnetic resonance imaging interpretation

  • Tina Sanghvi
  • James Boyum
  • Ben Spilseth
  • Robben Schat
  • Heather Estby
  • Andrew Taylor
Pictorial essay
  • 280 Downloads

Abstract

Hepatocellular carcinoma is among the most prevalent solid organ cancers, and, unlike many cancers, may be diagnosed non-invasively by imaging criteria [1] with the preferred modality recently shifting from multiphasic computed tomography (MDCT) to magnetic resonance imaging (MRI). The purpose of this article is to help facilitate radiologists and radiology trainees in the transition to MRI by providing a step-wise approach to exam interpretation to improve the MRI detection of HCC. A methodical, consistent approach to navigating a HCC screening MRI exam, in conjunction with the LI-RADS framework for characterization, should lead to improved HCC detection and diagnosis.

Keywords

Magnetic resonance imaging MRI protocol Liver imaging Hepatocellular carcinoma 

Notes

Compliance with ethical standards

Conflicts of interest

None of the authors have any potential conflicts of interest to disclose.

IRB approval was not required and for this type of study informed consent is not required.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

References

  1. 1.
    Llovet JM, Ducreux M, Lencioni R, et al. (2012) EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. European Association for Study of Liver; European Organisation for Research and Treatment of Cancer. Eur J Cancer 48(5):599–641. doi: 10.1016/j.ejca.2011.12.021 CrossRefGoogle Scholar
  2. 2.
    Vauthey JN, Dixon E, Abdalla EK, et al. (2010) Pretreatment assessment of hepatocellular carcinoma: expert consensus statement. Hpb 12(5):289–299CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Lee YJ, Lee JM, Lee JS, et al. (2015) Hepatocellular carcinoma: diagnostic performance of multidetector CT and MR imaging-A systematic review and meta-analysis. Radiology 275:97–109CrossRefPubMedGoogle Scholar
  4. 4.
    Sirlin CB, Hussain HK, Jonas E, et al. (2014) Consensus report from the 6th International forum for liver MRI using gadoxetic acid. J Magn Reson Imaging 40(3):516–529CrossRefPubMedGoogle Scholar
  5. 5.
    Rostambeigi N, Taylor AJ, Golzarian J, et al. (2016) Effect of MRI versus MDCT on Milan criteria scores and liver transplantation eligibility. AJR 206:726–733CrossRefPubMedGoogle Scholar
  6. 6.
    Llovet JM, Bustamante J, Castells A, et al. (1999) Natural history of untreated nonsurgical hepatocellular carcinoma (Rationale for the design and evaluation of therapeutic trials). Hepatology 29:62–67CrossRefPubMedGoogle Scholar
  7. 7.
    Danatoa J, Fracncab M, Candeláriaa I, Caseiro-Alvesa P (2017) Liver MRI: from basic protocol to advanced techniques. Eur J Radiol 93:30–39CrossRefGoogle Scholar
  8. 8.
  9. 9.
    Ikram , et al. (2017) Multiple arterial phase MRI of arterial hypervascular hepatic lesions: improved arterial phase capture and lesion enhancement. Abdom Radiol 42:870–876CrossRefGoogle Scholar
  10. 10.
    Hanna RF, Diego AA, Kased N, et al. (2008) Cirrhosis-associated hepatocellular nodules: correlation of histopathologic and MR imaging features. RadioGraphics 28:747–769CrossRefPubMedGoogle Scholar
  11. 11.
    Rosenkrantz AB, Lee L, Matza BW, Kim S (2012) Infiltrative hepatocellular carcinoma: comparison of MRI sequences for lesion conspicuity. Clin Radiol 67:105–111CrossRefGoogle Scholar
  12. 12.
    Foley WD, Mallisee TA, Honhenwalter MD, et al. (2000) Multiphase hepatic CT with a multirow detector CT scanner. AJR 175:679–685CrossRefPubMedGoogle Scholar
  13. 13.
    Wald C, Russo MW, Heimbach JK, et al. (2013) New OPTN/UNOS policy for liver transplant allocation: standardization of Liver Imaging, diagnosis, classification, and reporting of hepatocellular carcinoma. Radiology 266:376–382CrossRefPubMedGoogle Scholar
  14. 14.
    Goncalves Neto JA, Altun E, Vaidean G, et al. (2009) Early contrast enhancement of the liver: exact description of subphases using MRI. Magn Reson Imaging 27(6):792–800CrossRefPubMedGoogle Scholar
  15. 15.
    Choi J-Y, Lee J-M, Sirlin CB (2014) CT and MR imaging diagnosis and staging of hepatocellular carcinoma. Part II. Extracellular agents, hepatobiliary agents, and ancillary imaging features. Radiology 273:30–50CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Huang B, Wu L, Lu X-Y, et al. (2016) Small intrahepatic cholangiocarcinoma and hepatocellular carcinoma in cirrhotic livers may share similar enhancement patterns at multiphase dynamic MR imaging. Radiology 281:150–157CrossRefPubMedGoogle Scholar
  17. 17.
    Parikh T, Drew SJ, Lee VS, et al. (2008) Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology 246:812–822CrossRefPubMedGoogle Scholar
  18. 18.
    Taouli B, Koh D-M (2010) Diffusion-weighted MR Imaging of the Liver. Radiology 254:47–66CrossRefPubMedGoogle Scholar
  19. 19.
    Vandecaveye V, De Keyzer F, Verslype C, et al. (2009) Diffusion-weighted MRI provides additional value to conventional dynamic contrast-enhanced MRI for detection of hepatocellular carcinoma. Eur Radiol 19:2456–2466CrossRefPubMedGoogle Scholar
  20. 20.
    Yu J-S, Chung J-J, Kim Jh, Kim KW (2007) Fat-containing nodules in the cirrhotic liver: chemical shift MRI features and clinical implications. AJR 188:1009–1016CrossRefPubMedGoogle Scholar
  21. 21.
    Kutami R, Nakashima Y, Nakashima O, Shiota K, Kojiro M (2000) Pathomorphologic study on the mechanism of fatty change in small hepatocellular carcinoma of humans. J Hepatol 33(2):282–289CrossRefPubMedGoogle Scholar
  22. 22.
    International Consensus Group for Hepatocellular Neoplasia (2009) Pathologic diagnosis of early hepatocellular carcinoma: a report of the international consensus group for hepatocellular neoplasia. Hepatology 49(2):658–664CrossRefGoogle Scholar
  23. 23.
    Choi JY, Lee JM, Sirlin CB (2014) CT and MR imaging diagnosis and staging of hepatocellular carcinoma. Part I. Development, growth, and spread: key pathologic and imaging aspects. Radiology 272:635–654CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Prasad SR, Wang H, Humberto R, et al. (2005) Fat-containing lesions of the liver: radiologic- pathologic correlation. RadioGraphics 25:321–331CrossRefPubMedGoogle Scholar
  25. 25.
    Kadoya M, Matsui O, Takashima T, Nonomura A (1992) Hepatocellular carcinoma: correlation of MR imaging and histopathologic findings. Radiology 183(3):819–825CrossRefPubMedGoogle Scholar
  26. 26.
    Matsui O, Kadoya M, Kameyama T, et al. (1989) Adenomatous hyperplastic nodules in the cirrhotic liver: differentiation from hepatocellular carcinoma with MR imaging. Radiology 173(1):123–126CrossRefPubMedGoogle Scholar
  27. 27.
    Willatt JM, Hussain HK, Adusumilli S, Marrero JA (2008) MR, imaging of hepatocellular Carcinoma in the cirrhotic liver: challenges and controversies1. Radiology 247:311–330CrossRefPubMedGoogle Scholar
  28. 28.
    Davenport MS, Viglianti BL, Al-Hawary MM, et al. (2013) Comparison of acute transient dyspnea after intravenous administration of gadoxetate disodium and gadobenate dimeglumine: effect on arterial phase image quality. Radiology 266:452–461CrossRefPubMedGoogle Scholar
  29. 29.
    Neri E, Bali MA, Ba-Ssalamah A, et al. (2016) ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents. Eur Radiol 26:921–931CrossRefPubMedGoogle Scholar
  30. 30.
    Merkle EM, Zech CJ, Bartolozzi C, et al. (2016) Consensus report from the 7th International Forum for Liver Magnetic Resonance Imaging. Eur Radiol 26:674–682CrossRefPubMedGoogle Scholar
  31. 31.
    Bashir MR, Rajan RT, Davenport MS, et al. (2013) Hepatocellular carcinoma in a North American population: does hepatobiliary MR imaging with Gd-EOB-DTPA improve sensitivity and confidence for diagnosis? JMRI 37:398–406CrossRefPubMedGoogle Scholar
  32. 32.
    Danatoa J, Fracncab M, Candeláriaa I, Caseiro-Alvesa P (2017) Liver MRI: from basic protocol to advanced techniques. Eur J Radiol 93:30–39CrossRefGoogle Scholar
  33. 33.
    Narita M, Hatano E, Arizono S, et al. (2009) Expression of OATP1B3 determines uptake of Gd-EOB-DTPA in hepatocellular carcinoma. J Gastroenterol 44(7):793–798CrossRefPubMedGoogle Scholar
  34. 34.
    Suh YJ, Kim MJ, Choi JY, et al. (2011) Differentiation of hepatic hyperintense lesions seen on gadoxetic acid-enhanced hepatobiliary phase MRI. AJR 197(1):W44–W52CrossRefPubMedGoogle Scholar
  35. 35.
    Bashir MR (2014) Magnetic resonance contrast agents for liver imaging. Magn Reson Imaging Clin N Am 22:283–293CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Tina Sanghvi
    • 1
  • James Boyum
    • 1
    • 2
  • Ben Spilseth
    • 1
  • Robben Schat
    • 1
  • Heather Estby
    • 1
  • Andrew Taylor
    • 1
  1. 1.University of Minnesota Medical CenterMinneapolisUSA
  2. 2.Mayo ClinicRochesterUSA

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