Skip to main content
SpringerLink
Log in

Imaging of Hepatic Neoplasms in Patients with Diffuse Liver Disease

  • Chapter
Contrast Agents in Liver Imaging

Part of the book series: Series in Radiology ((SERA,volume 25))

  • 58 Accesses

Abstract

Finding and identifying hepatic neoplasms in patients with diffuse liver disease is one of the most challenging tasks in diagnostic radiology. This chapter discusses the performance of contrast enhanced CT (CECT), delayed iodine CT scan (DIS), magnetic resonance imaging (MR) and ultrasound (US) in detection and characterization of focal liver lesions in patients with diffuse liver disease. First, the sensitivity and specificity of these various imaging modalities for detection of focal lesions in patients with normal liver parenchyma is summarized. In the second part, the impact of diffuse liver disease on lesion detection is outlined. Finally, future strategies for the use of contrast agents targeted to liver in patients with diffuse liver disease are outlined.

‘Imagination is more important than knowledge’ A. Einstein

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Heiken J, Weyman P, Lee J, et al. Detection of focal metastases: prospective evaluation with CT, delayed CT, CT during arterial portography, and MR imaging. Radiology. 1989; 171:47–51.

    PubMed  CAS  Google Scholar 

  2. Bernardino M. Emory experience with both CT and MRI in the detection of focal liver disease. In: Ferruci J, Stark D, ed. Liver imaging. Current trends and new techniques. Boston: Andover Medical Publisher Inc.; 1990:73–81.

    Google Scholar 

  3. Miller D, Simmons J, Chang R, et al. Hepatic metastases: comparison of three CT contrast enhancement methods. Radiology. 1987;165:785–90.

    PubMed  CAS  Google Scholar 

  4. Sitzman J, Coleman J, Pitt H, et al. Preoperative assessment of malignant hepatic tumors. Am J Surg. 1990;159:137–43.

    Article  Google Scholar 

  5. Wernecke K, Rummeny E, Bongartz G, et al. Detection of hepatic masses in patients with carcinoma: comparative sensitivities of sonography, CT, and MR imaging. Am J Roentgenol. 1991;157:731–6

    CAS  Google Scholar 

  6. Freeny P, Ryan J. Preoperative hepatic imaging for lesion detection using bolus dynamic CT, CT angiography, delayed iodine CT, and MR. Presented at the 76th Assembly and Annual Meeting of the RSNA, Chicago, IL. November 25–30, 1990.

    Google Scholar 

  7. Arai K, Matsui O, Takashima T, et al. Focal spared areas in fatty liver caused by regional decreased portal flow. Am J Roentgenol. 1988;151:300–2.

    CAS  Google Scholar 

  8. Marchai G, Tschibwabwa-Tuma E, Verbeken E, et al. ’skip areas’ in hepatic steatosis: a sonographic-angiographic study. Gastrointest Radiol. 1989;11:151–7.

    Article  Google Scholar 

  9. Pierkarski J, Goldberg HI, Royal SA, et al. Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease. Radiology. 1980; 137:727.

    Google Scholar 

  10. Lewis E, Bernardino ME, Barnes PA, et al. The fatty liver: pitfalls in the CT and angiographic evaluation of metastatic disease. J Comput Assist Tomogr. 1983;7:235–241.

    Article  PubMed  CAS  Google Scholar 

  11. Yoshikawa J, Matsui O, Takashima T, et al. Focal fatty change of the liver adjacent to the falciform ligament: CT and sonographic findings in 5 surgically confirmed cases. Am J Roentgenol. 1987;149:491–4.

    CAS  Google Scholar 

  12. Berland LL. Focal areas of decreased echogenicity in the liver at the porta hepatis. J Ultrasound Med. 1986; 5:157–9.

    PubMed  CAS  Google Scholar 

  13. Goldberg HI, Margulis AR, Moss AA, et al. Imaging of the liver, gallbladder, spleen, pancreas, peritoneal cavity, and alimentary tube. In: James TL, Margulis AR, eds. Biomedical magnetic resonance, Chap 24. San Francisco: University of California; 1984.

    Google Scholar 

  14. Mitchell DM, Kim I, Chang TS, et al. Chemical shift phase difference and suppression magnetic resonance imaging techniques in animals, phantoms and humans: fatty liver. Invest Radiol. 1991;26:1041–52.

    Article  PubMed  CAS  Google Scholar 

  15. Itai Y, Ohtomo K, Kokubo T, et al. CT and MR imaging of fatty tumors of the liver. J. Comput Assist Tomogr. 1987; 11:253–7.

    Article  PubMed  CAS  Google Scholar 

  16. Ebara M, Watanabe S, Kita K, et al. MR imaging of small hepatocellular carcinoma: effect of intratumoral copper content on signal intensity. Radiology. 1991;180:617–21.

    PubMed  CAS  Google Scholar 

  17. Caturelli E, Costarelli L, Giordano M, et al. Hypoechoic lesions in fatty liver: quantitative study by histomorphology. Gastroenterology. 1991; 100:1678–82.

    PubMed  CAS  Google Scholar 

  18. Popper H. Pathologic aspects of cirrhosis: a review. Am J Pathol. 1977;87:228–64.

    PubMed  CAS  Google Scholar 

  19. Torres WE, Whitmire LF, McClees KG, Bernardino ME. Computed tomography of hepatic morphologic changes in cirrhosis of the liver. J Comput Assist Tomogr. 1986;10:47.

    Article  PubMed  CAS  Google Scholar 

  20. Marti-Bonmati L, Talens A, del Olmo J, et al. Chronic hepatitis and cirrhosis: evaluation by means of MR imaging with histologic correlation. Radiology. 1993;188:37–43.

    PubMed  CAS  Google Scholar 

  21. Elizondo G, Weissleder R, Stark D, et al. Hepatic cirrhosis and hepatitis: MR imaging with superparamagnetic iron oxide. Radiology. 1990;174:797–801.

    PubMed  CAS  Google Scholar 

  22. Stark D, Bass NM, Moss AA, et al. Nuclear magnetic imaging of experimentally induced liver disease. Radiology. 1983; 148:743.

    PubMed  CAS  Google Scholar 

  23. Hess CF, Schmiedl U, Kölbel G, Knecht R, Kurtz B. US diagnosis of liver cirrhosis: ROC analysis of multidimensional caudate lobe indices. Radiology. 1989;171:349–51.

    PubMed  CAS  Google Scholar 

  24. Goyal AK, Pokharna DS, Sharma SK. Ultrasonic diagnosis of cirrhosis. Reference to quantitave measurements of hepatic dimensions. Gastrointest Radiol. 1990;15:32–4.

    CAS  Google Scholar 

  25. Harbin WP, Robert NJ, Ferruci JT, Diagnosis of cirrhosis based on regional changes in hepatic morphology. A radiological analysis. Radiology. 1980; 135:273.

    PubMed  CAS  Google Scholar 

  26. Lelio AD, Cestari C, Lomazzi A, Beretta L. Cirrhosis: Diagnosis with sonographic study of the liver surface. Radiology. 1989;172:389–92.

    PubMed  Google Scholar 

  27. Ladenheim JA, Luba G, Yao F, et al. Limitations of liver surface US in the diagnosis of cirrhosis. Radiology. 1992; 185:21–4.

    PubMed  CAS  Google Scholar 

  28. Anthony PP, Ishak KG, Nayak NC, Poulsen HE, Scheuer PJ, Sobin LH. The morphology of cirrhosis. Recommendations on definition, nomenclature, and classification by a working group sponsored by the World Health Organization. J Clin Pathol. 1978;31:273–414.

    Article  Google Scholar 

  29. Ohtomo K, Baron RL, Dodd GD, et al. Confluent hepatic fibrosis in advanced cirrhosis: diagnostic appearance on hepatic CT scans. Radiology. 1993;188:31–37.

    PubMed  CAS  Google Scholar 

  30. Furuya K, Nakamura M, Yamamoto Y, et al. Macroregenerative nodule of the liver: a clinicopathologic study of 345 autopsy cases of chronic liver disease. Cancer. 1988;61:99–105.

    Article  PubMed  CAS  Google Scholar 

  31. Wada K, Kondo F, Kondo Y. Large regenerative nodules and dysplastic nodules in cirrhotic livers: a histopathologic study. Hepatology. 1988;8:1684–8.

    Article  PubMed  CAS  Google Scholar 

  32. Giorgio A, Francica G, Stefano G, et al. Sonographic recognition of intraparenchymal regenerating nodules using high frequency transducers in patients with cirrhosis. J Ultrasound Med. 1991;10:355–9.

    PubMed  CAS  Google Scholar 

  33. Ohtomo K, Itai Y, Ohtomo Y, et al. Regenerating nodules of liver cirrhosis: MR imaging with pathologic correlation. Am J Roentgenol. 1990;154:505–7.

    CAS  Google Scholar 

  34. Terada T, Nakanuma Y. Iron-negative foci in siderotic macroregenerative nodules in human cirrhotic liver. Arch Pathol Lab Med. 1989;113:916–20.

    PubMed  CAS  Google Scholar 

  35. Terada T, Nakanuma Y, Hoso M, et al. Fatty macroregenerative nodule in nonsteatotic liver cirrhosis: a morphologic study. Virchows Arch. 1989;415:131–6.

    Article  CAS  Google Scholar 

  36. Matsui O, Kadoya M, Kameyama T, et al. Adenomatous hyperplastic nodules in the cirrhotic liver: differentiation from hepatocellular carcinoma with MR imaging. Radiology. 1989;173:123–6.

    PubMed  CAS  Google Scholar 

  37. Muramatsu Y, Nawano S, Takayasu K, et al. The diagnosis of small hepatocellular carcinoma: MR imaging. Radiology. 1991;181:209–13.

    PubMed  CAS  Google Scholar 

  38. Mano I, Yoshida H, Nakabayashi K et al. Fast spin echo imaging with suspended respiration: gadolinium enhanced MR imaging of liver tumours. J Comput Assist Tomogr. 1987;11:73–80.

    Article  PubMed  CAS  Google Scholar 

  39. Schmiedl U, Koelbel G, Hess CF, Kurtz B. Dynamic sequential MR imaging of focal liver lesions using Gd-DTPA: Initial experience in 20 patients. J Comput Assist Tomogr. 1990;4:600–7.

    Article  Google Scholar 

  40. Matsui O, Takashima T, Kadoya M, et al. Liver metastases from colorectal cancers: detection with CT during arterial portography. Radiology. 1987;165:65–9.

    PubMed  CAS  Google Scholar 

  41. Dodd GD, Miller WJ, Baron RL, Skolnick ML, Campbell WL. Detection of malignant tumors in end-stage cirrhotic livers: efficacy of sonography as a screening technique. Am J Roentgenol. 1992;159:727–33.

    Google Scholar 

  42. Miller WJ, Federle MP, Campbell WL. Diagnosis and staging of hepatocellular carcinoma: comparison of CT and sonography in 36 liver transplantation patients. Am J Roentgenol 1991;157:303–6.

    CAS  Google Scholar 

  43. Chezmar JL, Nelson RC, Malko JA, Bernardino ME. Hepatic iron overload: diagnosis and quantification by noninvasive imaging. Gastrointest Radiol. 1990;15:27–31.

    Article  PubMed  CAS  Google Scholar 

  44. Seltzer SE, Janoff AS, Blau M, et al. Biodistribution and imaging characteristics of iotrolan-carrying interdigitation-fusion vesicles. Invest Radiol. 1991;26:S169–71.

    Article  PubMed  Google Scholar 

  45. Miller DL, Rosenbaum RC, Sugarbaker PH, et al. Detection of hepatic metastases: comparison of EOE-13 computed tomography and scintigraphy. Am J Roentgenol. 1983;141:931–5.

    CAS  Google Scholar 

  46. Schuhmann-Giampieri G, Schmidt-Willich H, Press WR, Negishi C, Weinmann HJ, Speck U, Preclinical evaluation of Gd-EOB-DTPA as a contrast agent in MR imaging of the hepatobiliary system. Radiology. 1992;183:59–64.

    PubMed  CAS  Google Scholar 

  47. Hamm B, Vogl TJ, Branding G, et al. Focal liver lesions: MR imaging with Mn-DPDP—initial clinical results in 40 patients. Radiology. 1992;183:53–8.

    Google Scholar 

  48. Rofsky NM, Weinreb JC, Bernardino ME, et al. Hepatocellular tumors: characterization with Mn-DPDP enhanced MR imaging. Radiology. 1993;188:53–9.

    PubMed  CAS  Google Scholar 

  49. Pavone P, Patrizio P, Buoni C, et al. Comparison of Gd-BOPTA with Gd-DTPA in MR imaging of rat liver. Radiology. 1990;176:61–4.

    PubMed  CAS  Google Scholar 

  50. Hoener B-A, Tzika A, Engelstad B, et al. Hepatic transport of the magnetic resonance imaging contrast agent Fe(III)-N-(3-phenylglutaryl) desferrioxamine B. Mag Res Med. 1991; 17:509–15.

    Article  CAS  Google Scholar 

  51. Fretz CJ, Stark DD, Metz CE, at al. Detection of hepatic metastases: comparison of contrast enhanced CT, unen-hanced MR imaging, and iron oxide enhanced MR imaging. Am J Roentgenol. 1990;155:763–70.

    CAS  Google Scholar 

  52. El Mouaaouy A, Becker HD, Schlief R, Kuhlo C, Portas C. Rat liver model for testing intraoperative echo contrast sonography. Surg Endosc. 1990;4:114–7.

    Article  PubMed  Google Scholar 

  53. Nomura Y, Matsuda Y, Yabuuchi I, et al. Hepatocellular carcinoma in adenomatous hyperplasia: detection with contrast-enhanced US with carbon dioxide microbubbles. Radiology. 1993;187:353–6.

    PubMed  CAS  Google Scholar 

  54. Schlief R, Ultrasound contrast agents. Curr Opin Radiol. 1991;3:198–207.

    PubMed  CAS  Google Scholar 

  55. Satterfield R, Tarter M, Schumacher J, et al. Comparison of perfluorocarbons as ultrasound contrast agents. Invest Radiol. 1993;28:325–31.

    Article  PubMed  CAS  Google Scholar 

  56. Nelson RC, Chezmar JL, Sugarbaker PH, Bernardino ME. Hepatic tumors: comparison of CT during arterial portography, delayed CT, and MR imaging for preoperative evaluation. Radiology. 1989:172:27–34.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. Udo P. Schmiedl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Patrick C. Freeny
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Clinical Development Diagnostics, Magnetic Resonance and Ultrasound Contrast Media, Schering AG, Berlin, Germany

    T. Balzer  & H.-P. Niendorf  & 

  2. Department of Radiology, Charité Hospital, Humboldt University, Schumannstr. 20/21, D-10098, Berlin, Germany

    B. Hamm

Rights and permissions

Reprints and permissions

Copyright information

© 1995 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Schmiedl, U.P., Freeny, P.C. (1995). Imaging of Hepatic Neoplasms in Patients with Diffuse Liver Disease. In: Balzer, T., Hamm, B., Niendorf, HP. (eds) Contrast Agents in Liver Imaging. Series in Radiology, vol 25. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-0477-7_4

Download citation

  • DOI: https://doi.org/10.1007/978-94-011-0477-7_4

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-4213-0

  • Online ISBN: 978-94-011-0477-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation