Pathological variants of hepatocellular carcinoma on MRI: emphasis on histopathologic correlation

Abstract

Hepatocellular carcinoma (HCC) is a unique tumor because it is one of the few cancers which can be treated based on imaging alone. Magnetic resonance imaging (MRI) carries higher sensitivity and specificity for the diagnosis of HCC than either computed tomography (CT) or ultrasound. MRI is imaging modality of choice for the evaluation of complex liver lesions and HCC because of its inherent ability to depict cellularity, fat, and hepatocyte composition with high soft tissue contrast. The imaging features of progressed HCC are well described. However, many HCC tumors do not demonstrate classical imaging features, posing a diagnostic dilemma to radiologists. Some of these can be attributed to variations in tumor biology and histology, which result in radiological features that differ from the typical progressed HCC. This pictorial review seeks to demonstrate the appearance of different variants of HCC on MRI imaging, in relation to their histopathologic features.

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Acknowledgements

The authors would like to thank Dr Cora CHAU, Dr Bernard HO, Dr Yong Howe HO, and Dr Chin Fong WONG from the Department of Pathology, Tan Tock Seng Hospital for their contributions.

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Correspondence to Cher Heng Tan.

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Low, H.M., Choi, J.Y. & Tan, C.H. Pathological variants of hepatocellular carcinoma on MRI: emphasis on histopathologic correlation. Abdom Radiol 44, 493–508 (2019). https://doi.org/10.1007/s00261-018-1749-z

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Keywords

  • Hepatocellular carcinoma
  • Atypical
  • MRI
  • Histopathology