Skip to main content

Advertisement

SpringerLink
Log in

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

  • Pictorial essay
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  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

    Article  Google Scholar 

  2. Vauthey JN, Dixon E, Abdalla EK, et al. (2010) Pretreatment assessment of hepatocellular carcinoma: expert consensus statement. Hpb 12(5):289–299

    Article  PubMed  PubMed Central  Google Scholar 

  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 275:97–109

    Article  PubMed  Google Scholar 

  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):516–529

    Article  PubMed  Google Scholar 

  5. Rostambeigi N, Taylor AJ, Golzarian J, et al. (2016) Effect of MRI versus MDCT on Milan criteria scores and liver transplantation eligibility. AJR 206:726–733

    Article  PubMed  Google Scholar 

  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 29:62–67

    Article  CAS  PubMed  Google Scholar 

  7. Danatoa J, Fracncab M, Candeláriaa I, Caseiro-Alvesa P (2017) Liver MRI: from basic protocol to advanced techniques. Eur J Radiol 93:30–39

    Article  Google Scholar 

  8. LI-RADS v2014: www.acr.org/Quality-Safety/Resources/LIRADS

  9. Ikram , et al. (2017) Multiple arterial phase MRI of arterial hypervascular hepatic lesions: improved arterial phase capture and lesion enhancement. Abdom Radiol 42:870–876

    Article  Google Scholar 

  10. Hanna RF, Diego AA, Kased N, et al. (2008) Cirrhosis-associated hepatocellular nodules: correlation of histopathologic and MR imaging features. RadioGraphics 28:747–769

    Article  PubMed  Google Scholar 

  11. Rosenkrantz AB, Lee L, Matza BW, Kim S (2012) Infiltrative hepatocellular carcinoma: comparison of MRI sequences for lesion conspicuity. Clin Radiol 67:105–111

    Article  Google Scholar 

  12. Foley WD, Mallisee TA, Honhenwalter MD, et al. (2000) Multiphase hepatic CT with a multirow detector CT scanner. AJR 175:679–685

    Article  CAS  PubMed  Google Scholar 

  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 266:376–382

    Article  PubMed  Google Scholar 

  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):792–800

    Article  PubMed  Google Scholar 

  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 273:30–50

    Article  PubMed  PubMed Central  Google Scholar 

  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 281:150–157

    Article  PubMed  Google Scholar 

  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 246:812–822

    Article  PubMed  Google Scholar 

  18. Taouli B, Koh D-M (2010) Diffusion-weighted MR Imaging of the Liver. Radiology 254:47–66

    Article  PubMed  Google Scholar 

  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 19:2456–2466

    Article  PubMed  Google Scholar 

  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 188:1009–1016

    Article  PubMed  Google Scholar 

  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):282–289

    Article  CAS  PubMed  Google Scholar 

  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):658–664

    Article  Google Scholar 

  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 272:635–654

    Article  PubMed  PubMed Central  Google Scholar 

  24. Prasad SR, Wang H, Humberto R, et al. (2005) Fat-containing lesions of the liver: radiologic- pathologic correlation. RadioGraphics 25:321–331

    Article  PubMed  Google Scholar 

  25. Kadoya M, Matsui O, Takashima T, Nonomura A (1992) Hepatocellular carcinoma: correlation of MR imaging and histopathologic findings. Radiology 183(3):819–825

    Article  CAS  PubMed  Google Scholar 

  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):123–126

    Article  CAS  PubMed  Google Scholar 

  27. Willatt JM, Hussain HK, Adusumilli S, Marrero JA (2008) MR, imaging of hepatocellular Carcinoma in the cirrhotic liver: challenges and controversies1. Radiology 247:311–330

    Article  PubMed  Google Scholar 

  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 266:452–461

    Article  PubMed  Google Scholar 

  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 26:921–931

    Article  CAS  PubMed  Google Scholar 

  30. Merkle EM, Zech CJ, Bartolozzi C, et al. (2016) Consensus report from the 7th International Forum for Liver Magnetic Resonance Imaging. Eur Radiol 26:674–682

    Article  PubMed  Google Scholar 

  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 37:398–406

    Article  PubMed  Google Scholar 

  32. Danatoa J, Fracncab M, Candeláriaa I, Caseiro-Alvesa P (2017) Liver MRI: from basic protocol to advanced techniques. Eur J Radiol 93:30–39

    Article  Google Scholar 

  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):793–798

    Article  CAS  PubMed  Google Scholar 

  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–W52

    Article  PubMed  Google Scholar 

  35. Bashir MR (2014) Magnetic resonance contrast agents for liver imaging. Magn Reson Imaging Clin N Am 22:283–293

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. James Boyum

    Present address: Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

Authors and Affiliations

  1. University of Minnesota Medical Center, 420 Delaware St SE, Minneapolis, MN, 55455, USA

    Tina Sanghvi, James Boyum, Ben Spilseth, Robben Schat, Heather Estby & Andrew Taylor

Authors
  1. Tina Sanghvi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James Boyum
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ben Spilseth
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robben Schat
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Heather Estby
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Andrew Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tina Sanghvi.

Ethics declarations

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.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sanghvi, T., Boyum, J., Spilseth, B. et al. MRI for hepatocellular carcinoma: a primer for magnetic resonance imaging interpretation. Abdom Radiol 43, 1143–1151 (2018). https://doi.org/10.1007/s00261-017-1280-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-017-1280-7

Keywords

Search

Navigation