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Radiological Evaluation of Patients with Liver Tumors

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Liver Radioembolization with 90Y Microspheres

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

For a successful radioembolization, a proper planning of the procedure is necessary—ensuring that the indication for the treatment is correct and helping to deliver the therapy substance to the right places in the liver finally. One cornerstone for such a treatment plan is the radiological evaluation of patients scheduled for radioembolization. The aim of imaging has to be an accurate assessment of number, size, and localization of malignant liver lesions. Moreover, benign differential diagnoses of different liver lesions have to be considered. Depending on the logistics within the hospital and the clinical background, several modalities can be selected for imaging patients with liver tumors. These imaging modalities will be described in this chapter and their respective advantages and limitations will be analyzed.

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References

  • Albrecht T, Hoffmann CW, Schmitz SA et al (2001) Phase-inversion sonography during the liver-specific late phase of contrast enhancement: improved detection of liver metastases. AJR Am J Roentgenol 176:1191–1198

    Article  CAS  PubMed  Google Scholar 

  • Augui J, Vignaux O, Argaud C et al (2002) Liver: T2-weighted MR imaging with breath-hold fast-recovery optimized fast spin-echo compared with breath-hold half-Fourier and non-breath-hold respiratory-triggered fast spin-echo pulse sequences. Radiology 223:853–859

    Article  PubMed  Google Scholar 

  • Baron RL (1994) Understanding and optimizing use of contrast material for CT of the liver. AJR Am J Roentgenol 163:323–331

    Article  CAS  PubMed  Google Scholar 

  • Bartolozzi C, Lencioni R, Caramella D, Palla A, Bassi AM, Di Candio G (1996) Small hepatocellular carcinoma. Detection with US, CT, MR imaging, DSA, and Lipiodol-CT. Acta Radiol 37:69–74

    CAS  PubMed  Google Scholar 

  • Bartolozzi C, Donati F, Cioni D et al (2004) Detection of colorectal liver metastases: a prospective multicenter trial comparing unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT. Eur Radiol 14:14–20

    Article  PubMed  Google Scholar 

  • Bartolozzi C, Crocetti L, Lencioni R, Cioni D, Della Pina C, Campani D (2007) Biliary and reticuloendothelial impairment in hepatocarcinogenesis: the diagnostic role of tissue-specific MR contrast media. Eur Radiol 17:2519–2530

    Article  PubMed  Google Scholar 

  • Bluemke DA, Sahani D, Amendola M et al (2005) Efficacy and safety of MR imaging with liver-specific contrast agent: US multicenter phase III study. Radiology 237:89–98

    Article  PubMed  Google Scholar 

  • Brink JA (2003) Contrast optimization and scan timing for single and multidetector-row computed tomography. Eur J Radiol [Suppl 1] 27:3–8

    Article  Google Scholar 

  • Bruix J, Sherman M (2011) Management of hepatocellular carcinoma: an update. Hepatology 53:1020–1022

    Article  PubMed Central  PubMed  Google Scholar 

  • Burrel M, Llovet JM, Ayuso C et al (2003) MRI angiography is superior to helical CT for detection of HCC prior to liver transplantation: an explant correlation. Hepatology 38:1034–1042

    Article  PubMed  Google Scholar 

  • Carlson SK, Johnson CD, Bender CE, Welch TJ (2000) CT of focal nodular hyperplasia of the liver. AJR Am J Roentgenol 174:705–712

    Article  CAS  PubMed  Google Scholar 

  • Choi JY, Kim MJ, Park YN et al (2011) Gadoxetate disodium-enhanced hepatobiliary phase MRI of hepatocellular carcinoma: correlation with histological characteristics. AJR Am J Roentgenol 197:399–405

    Article  PubMed  Google Scholar 

  • Danet IM, Semelka RC, Leonardou P et al (2003) Spectrum of MRI appearances of untreated metastases of the liver. AJR Am J Roentgenol 181:809–817

    Article  PubMed  Google Scholar 

  • de Ledinghen V, Laharie D, Lecesne R et al (2002) Detection of nodules in liver cirrhosis: spiral computed tomography or magnetic resonance imaging? A prospective study of 88 nodules in 34 patients. Eur J Gastroenterol Hepatol 14:159–165

    Article  PubMed  Google Scholar 

  • Del Frate C, Bazzocchi M, Mortele KJ et al (2002) Detection of liver metastases: comparison of gadobenate dimeglumine-enhanced and ferumoxides-enhanced MR imaging examinations. Radiology 225:766–772

    Article  PubMed  Google Scholar 

  • Golfieri R, Coppola F, Fusco F et al (2007) Malignant progression of a small HCC nodule: hypovascular ‘early HCC’ converted to hypervascular ‘small HCC’ within 6 months. Dig Liver Dis 39:883–890

    Article  CAS  PubMed  Google Scholar 

  • Grazioli L, Federle MP, Brancatelli G, Ichikawa T, Olivetti L, Blachar A (2001) Hepatic adenomas: imaging and pathologic findings. RadioGraphics 21:877–894

    Article  CAS  PubMed  Google Scholar 

  • Grazioli L, Bondioni MP, Haradome H et al (2012) Hepatocellular adenoma and focal nodular hyperplasia: value of gadoxetic acid-enhanced MR imaging in differential diagnosis. Radiology 262:520–529

    Article  PubMed  Google Scholar 

  • Guan YS, Zheng XH, Zhou XP et al (2004) Multidetector CT in evaluating blood supply of hepatocellular carcinoma after transcatheter arterial chemoembolization. World J Gastroenterol 10:2127–2129

    PubMed  Google Scholar 

  • Haider MA, Amitai MM, Rappaport DC et al (2002) Multi-detector row helical CT in preoperative assessment of small (< or = 1.5 cm) liver metastases: is thinner collimation better? Radiology 225:137–142

    Article  PubMed  Google Scholar 

  • Harvey CJ, Albrecht T (2001) Ultrasound of focal liver lesions. Eur Radiol 11:1578–1593

    Article  CAS  PubMed  Google Scholar 

  • Huppertz A, Balzer T, Blakeborough A et al (2004) Improved detection of focal liver lesions at MR imaging: multicenter comparison of gadoxetic acid-enhanced MR images with intraoperative findings. Radiology 230:266–275

    Article  PubMed  Google Scholar 

  • Huppertz A, Haraida S, Kraus A, Zech CJ et al (2005) Enhancement of focal liver lesions at gadoxetic acid-enhanced MR imaging: correlation with histopathologic findings and spiral CT–initial observations. Radiology 234:468–478

    Article  PubMed  Google Scholar 

  • Hwang GJ, Kim M-J, Yoo HS, Lee JT (1997) Nodular hepatocellular carcinoma: detection with arterial-, portal- and delayed-phase images at spiral CT. Radiology 202:383–388

    CAS  PubMed  Google Scholar 

  • Kanematsu M, Kondo H, Goshima S, Tsuge Y, Watanabe H (2008) Magnetic resonance imaging of hepatocellular carcinoma. Oncology 75(Suppl 1):65–71

    Article  PubMed  Google Scholar 

  • Kang BK, Lim JH, Kim SH et al (2003) Preoperative depiction of hepatocellular carcinoma: ferumoxides-enhanced MR imaging versus triple-phase helical CT. Radiology 226:79–85

    Article  PubMed  Google Scholar 

  • Katayama M, Masui T, Kobayashi S et al (2001) Fat-suppressed T2-weighted MRI of the liver: comparison of respiratory-triggered fast spin-echo, breath-hold single-shot fast spin-echo, and breath-hold fast-recovery fast spin-echo sequences. J Magn Reson Imaging 14:439–449

    Article  CAS  PubMed  Google Scholar 

  • Kawata S, Murakami T, Kim T et al (2002) Multidetector CT: diagnostic impact of slice thickness on detection of hypervascular hepatocellular carcinoma. AJR Am J Roentgenol 179:61–66

    Article  PubMed  Google Scholar 

  • Kettritz U, Schlund JF, Wilbur K, Eisenberg LB, Semelka RC (1996) Comparison of gadolinium chelates with manganese-DPDP for liver lesion detection and characterization: preliminary results. Magn Reson Imaging 14:1185–1190

    Article  CAS  PubMed  Google Scholar 

  • Kim JI, Lee JM, Choi JY et al (2008) The value of gadobenate dimeglumine-enhanced delayed phase MR imaging for characterization of hepatocellular nodules in the cirrhotic liver. Invest Radiol 43:202–210

    Article  CAS  PubMed  Google Scholar 

  • Kondo H, Kanematsu M, Hashi H et al (1999) Preoperative detection of malignant hepatic tumors: comparison of combined methods of MR imaging with combined methods of CT. AJR Am J Roentgenol 174:947–954

    Article  Google Scholar 

  • Lee VS, Lavelle MT, Rofsky NM et al (2000) Hepatic MR imaging with a dynamic contrast-enhanced isotropic volumetric interpolated breath-hold examination: feasibility, reproducibility, and technical quality. Radiology 215:365–372

    Article  CAS  PubMed  Google Scholar 

  • Lencioni R, Donati F, Cioni D, Paolicchi A, Cicorelli A, Bartolozzi C (1998) Detection of colorectal liver metastases: prospective comparison of unenhanced and ferumoxides-enhanced magnetic resonance imaging at 1.5 T, dual-phase spiral CT, and spiral CT during arterial portography. MAGMA 7:76–87

    Article  CAS  PubMed  Google Scholar 

  • Löwenthal D, Zeile M, Lim WY et al (2011) Detection and characterisation of focal liver lesions in colorectal carcinoma patients: comparison of diffusion-weighted and Gd-EOB-DTPA enhanced MR imaging. Eur Radiol 21:832–840

    Article  PubMed  Google Scholar 

  • Matsuo M, Kanematsu M, Itoh K et al (2001) Detection of malignant hepatic tumors: comparison of gadolinium-and ferumoxide-enhanced MR imaging. AJR Am J Roentgenol 177:637–643

    Article  CAS  PubMed  Google Scholar 

  • McKenzie CA, Lim D, Ransil BJ et al (2004) Shortening MR image acquisition time for volumetric interpolated breath-hold examination with a recently developed parallel imaging reconstruction technique: clinical feasibility. Radiology 230:589–594

    Article  PubMed  Google Scholar 

  • Namkung S, Zech CJ, Helmberger T, Reiser MF, Schönberg SO (2007) Superparamagnetic iron oxide (SPIO)-enhanced liver MR imaging with ferucarbotran: efficacy for characterization of focal liver lesions. J Magn Reson Imaging 25:755–765

    Article  PubMed  Google Scholar 

  • Oudkerk M, Torres CG, Song B et al (2002) Characterization of liver lesions with mangafodipir trisodium-enhanced MR imaging: multicenter study comparing MR and dual-phase spiral CT. Radiology 223:517–524

    Article  PubMed  Google Scholar 

  • Petersein J, Spinazzi A, Giovagnoni A et al (2000) Focal liver lesions: evaluation of the efficacy of gadobenate dimeglumine in MR imaging–a multicenter phase III clinical study. Radiology 215:727–736

    Article  CAS  PubMed  Google Scholar 

  • Quaia E (2007) Microbubble ultrasound contrast agents: an update. Eur Radiol 17:1995–2008

    Article  PubMed  Google Scholar 

  • Reimer P, Jähnke N, Fiebich M et al (2000) Hepatic lesion detection and characterization: value of nonenhanced MR imaging, superparamagnetic iron oxide–enhanced MR imaging, and spiral CT—ROC analysis. Radiology 217:152–158

    Article  CAS  PubMed  Google Scholar 

  • Reinhold C, Hammers L, Taylor CR, Quedens-Case CL, Holland CK, Taylor KJ (1995) Characterization of focal hepatic lesions with duplex sonography: findings in 198 patients. AJR Am J Roentgenol 164:1131–1135

    Article  CAS  PubMed  Google Scholar 

  • Rode A, Bancel B, Douek P et al (2001) Small nodule detection in cirrhotic livers: evaluation with US, spiral CT, and MRI and correlation with pathologic examination of explanted liver. J Comput Assist Tomogr 25:327–336

    Article  CAS  PubMed  Google Scholar 

  • Rofsky NM, Lee VS, Laub G et al (1999) Abdominal MR imaging with a volumetric interpolated breath-hold examination. Radiology 212:876–884

    Article  CAS  PubMed  Google Scholar 

  • Romano S, Tortora G, Scaglione M et al (2005) MDCT imaging of post interventional liver: a pictorial essay. Eur J Radiol 53:425–432

    Article  PubMed  Google Scholar 

  • Schima W, Kulinna C, Ba-Ssalamah A, Grunberger T (2005) Multidetector computed tomography of the liver. Radiologe 45:15–23

    Article  CAS  PubMed  Google Scholar 

  • Schima W, Hammerstingl R, Catalano C et al (2006) Quadruple-phase MDCT of the liver in patients with suspected hepatocellular carcinoma: effect of contrast material flow rate. AJR Am J Roentgenol 186:1571–1579

    Article  PubMed  Google Scholar 

  • Schoellnast H, Tillich M, Deutschmann HA et al (2003) Abdominal multidetector row computed tomography. Reduction of cost and contrast material dose using saline flush. J Comput Assist Tomogr 27:847–853

    Article  PubMed  Google Scholar 

  • Semelka RC, Cance WG, Marcos HB, Mauro MA (1999) Liver metastases: comparison of current MR techniques and spiral CT during arterial portography for detection in 20 surgically staged cases. Radiology 213:86–91

    Article  CAS  PubMed  Google Scholar 

  • Semelka RC, Martin DR, Balci C, Lance T (2001) Focal liver lesions: comparison of dual-phase CT and multisequence multiplanar MR imaging including dynamic gadolinium enhancement. J Magn Reson Imaging 13:397–401

    Article  CAS  PubMed  Google Scholar 

  • Stoker J, Romijn MG, de Man RA et al (2002) Prospective comparative study of spiral computer tomography and magnetic resonance imaging for detection of hepatocellular carcinoma. Gut 51:105–107

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Takayasu K, Arii S, Matsuo N et al (2000) Comparison of CT findings with resected specimens after chemoembolization with iodized oil for hepatocellular carcinoma. AJR Am J Roentgenol 175:699–704

    Article  CAS  PubMed  Google Scholar 

  • Tanaka S, Oshikawa O, Sasaki T, Ioka T, Tsukuma H (2000) Evaluation of tissue harmonic imaging for the diagnosis of focal liver lesions. Ultrasound Med Biol 26:183–187

    Article  CAS  PubMed  Google Scholar 

  • Taouli B, Vilgrain V, Dumont E, Daire JL, Fan B, Menu Y (2003) Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. Radiology 226:71–78

    Article  PubMed  Google Scholar 

  • Valls C, Andia E, Sanchez A et al (2001) Hepatic metastases from colorectal cancer: preoperative detection and assessment of resectability with helical CT. Radiology 218:55–60

    Article  CAS  PubMed  Google Scholar 

  • Ward J, Naik KS, Guthrie JA, Wilson D, Robinson PJ (1999) Hepatic lesion detection: comparison of MR imaging after the administration of superparamagnetic iron oxide with dual-phase CT by using alternative-free response receiver operating characteristic analysis. Radiology 210:459–466

    Article  CAS  PubMed  Google Scholar 

  • Ward J, Guthrie JA, Scott DJ et al (2000) Hepatocellular carcinoma in the cirrhotic liver: double-contrast MR imaging for diagnosis. Radiology 216:154–162

    Article  CAS  PubMed  Google Scholar 

  • Weg N, Scheer MR, Gabor MP (1998) Liver lesions: improved detection with dual-detector-array CT and routine 2.5 mm thin collimation. Radiology 209:417–426

    CAS  PubMed  Google Scholar 

  • Youk JH, Lee JM, Kim CS (2004) MRI for detection of hepatocellular carcinoma: comparison of mangafodipir trisodium and gadopentetate dimeglumine contrast agents. AJR Am J Roentgenol 183:1049–1054

    Article  PubMed  Google Scholar 

  • Zech CJ, Schoenberg SO, Herrmann KA et al (2004a) Modern visualization of the liver with MRT. Current trends and future perspectives. Radiologe 44:1160–1169

    Article  CAS  PubMed  Google Scholar 

  • Zech CJ, Herrmann KA, Huber A et al (2004b) High-resolution MR-imaging of the liver with T2-weighted sequences using integrated parallel imaging: comparison of prospective motion correction and respiratory triggering. J Magn Reson Imaging 20:443–450

    Article  PubMed  Google Scholar 

  • Zech CJ, Grazioli L, Breuer J, Reiser MF, Schoenberg SO (2008a) Diagnostic performance and description of morphological features of focal nodular hyperplasia in Gd-EOB-DTPA-enhanced liver magnetic resonance imaging: results of a multicenter trial. Invest Radiol 43:504–511

    Article  PubMed  Google Scholar 

  • Zech CJ, Herrmann KA, Dietrich O, Horger W, Reiser MF, Schoenberg SO (2008b) Black-blood diffusion-weighted EPI acquisition of the liver with parallel imaging: comparison with a standard T2-weighted sequence for detection of focal liver lesions. Invest Radiol 2008(43):261–266

    Article  Google Scholar 

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Authors and Affiliations

  1. Abteilungsleiter Interventionelle Radiologie, Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel, Petersgraben 4, CH-4031, Basel , Switzerland

    Christoph J. Zech

  2. Klinikum der LMU München, Standort Grosshadern, Institut für Klinische Radiologie, Munich, Germany

    M. F. Reiser

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  1. Christoph J. Zech
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  2. M. F. Reiser
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Correspondence to Christoph J. Zech .

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Editors and Affiliations

  1. Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Spain

    José Ignacio Bilbao

  2. Institut für Klinische Radiologie, Universitätsklinikum München Klinikum Großhadern, München, Germany

    Maximilian F Reiser

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Zech, C.J., Reiser, M.F. (2013). Radiological Evaluation of Patients with Liver Tumors. In: Bilbao, J., Reiser, M. (eds) Liver Radioembolization with 90Y Microspheres. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2013_810

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  • DOI: https://doi.org/10.1007/174_2013_810

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-36472-3

  • Online ISBN: 978-3-642-36473-0

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