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Venous invasion by hepatic tumors: imaging appearance and implications for management

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Abstract

Venous invasion by hepatic tumors most commonly occurs with hepatocellular carcinoma and is associated with worse patient prognosis. Imaging plays an important role in the diagnosis of tumor thrombus in the liver. Moreover, differentiating between bland and tumor thrombus in the liver has important diagnostic, staging, therapeutic, and prognostic implications and may require a multimodal imaging approach including ultrasound, computed tomography, and/or magnetic resonance imaging. Treatment of hepatic malignancies with associated tumor thrombus is dependent on tumor type, disease extent within the liver, liver hemodynamics, and underlying liver function. Treatment of such tumors may involve surgical, locoregional and/or systemic therapies. The current review will focus on the imaging characteristics of venous invasion by hepatic tumors. The imaging findings most useful for differentiating hepatic venous tumor thrombus and bland thrombus will be highlighted and demonstrated with imaging examples. Imaging findings with implications for subsequent patient management will be described.

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Correspondence to Scott M. Thompson.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This retrospective image review study was approved by the institutional review board with a waiver of informed consent for retrospective image analysis.

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Thompson, S.M., Wells, M.L., Andrews, J.C. et al. Venous invasion by hepatic tumors: imaging appearance and implications for management. Abdom Radiol 43, 1947–1967 (2018). https://doi.org/10.1007/s00261-017-1298-x

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