Errors in the Diagnosis of Hepatic Neoplasms

  • Alfonso Ragozzino
  • Onofrio Catalano
  • Paquale Paolantonio


The diagnosis of hepatic neoplasms represents a challenging issue in abdominal radiology as it requires the careful analysis of multiple clinical and imaging parameters. First of all, the radiologist should have at hand precise clinical information, such as the patient’s age, sex, clinical history, lab test results, and clinical presentation [1]. Then, findings of previous imaging tests should be accurately reviewed. This is followed by choosing the most accurate imaging modality allowing characterization of the (suspected) hepatic neoplasm. The imaging protocol, including acquisition parameters and contrast medium choice, needs to be tailored to the patient’s case. The final, and obviously important, step is the image review. Image interpretation is strongly influenced by the radiologist’s experience. It requires a systematic approach in which all imaging findings are accurately reviewed and interpreted, leading to the correct diagnosis. The latter is achieved when it has been clearly demonstrated that the lesion shows the typical findings and clinical history described in the literature. However, there will also be many cases requiring that the radiologist is aware of the limits of diagnostic imaging, as in the case of a hepatic tumor with an atypical appearance or a mismatch between the imaging findings and the clinical data.


Liver Metastasis Hepatic Neoplasm Focal Nodular Hyperplasia Perceptive Error Nodular Regenerative Hyperplasia 


  1. 1.
    Mankad K, Hoey ET, Jones JB et al (2009) Radiology errors: how we learn from our mistakes. Clin Radiol 64:988–983PubMedCrossRefGoogle Scholar
  2. 2.
    Yoshimitsu K, Honda H, Kuroiwa T et al (2001) Unusual hemodynamic and pseudolesions of the noncirrhotic liver at CT. Radiographics 21:81–96Google Scholar
  3. 3.
    Rengo M, Bellini D, De Cecco CN et al (2011) The optimal contrast media policy in CT of the liver. Acta Radiol 52:467–472PubMedCrossRefGoogle Scholar
  4. 4.
    Khalil HI, Patterson SA, Panicek DM (2005) Hepatic lesions deemed too small to characterize at CT: prevalence and importance in women with breast cancer. Radiology 235:872–878PubMedCrossRefGoogle Scholar
  5. 5.
    Martin-Benitez G, Marti-Bonmati L, Barber C et al (2011) Hepatic lipomas and steatosis: An association beyond chance. Eur J Radiol Scholar
  6. 6.
    Goodwin MD, Dobson JE, Sirlin CB et al (2011) Diagnostic challenges and pitfalls in MR imaging with Hepatocyte-spcific Constrast agent. Radiographics 31:1547–1568PubMedCrossRefGoogle Scholar
  7. 7.
    Morgan G, Superina R (1994) Congenital absence of the portal vein: two cases and a proposed classification system for portasystemic vascular anomalies. J Pediatr Surg 29:1239–1241PubMedCrossRefGoogle Scholar
  8. 8.
    Chandler TM, Heran MK, Chang SD, et al (2011) Multiple focal nodular hyperplasia lesions of the liver associated with congenital absence of the portal vein. Magnetic resonance Imaging 29:81–96CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Alfonso Ragozzino
    • 1
  • Onofrio Catalano
    • 2
  • Paquale Paolantonio
    • 3
  1. 1.Department of Radiology“Santa Maria delle Grazie” HospitalPozzuoli (NA)Italy
  2. 2.Department of Radiology, Massachussetts General HospitalHarvard Medical SchoolBostonUSA
  3. 3.Department of Radiology“San Giovanni - Addolorata” HospitalRomeItaly

Personalised recommendations