Do Risk Factors for HCC Impact the Association of CT/MRI LIRADS Major Features With HCC? An Individual Participant Data Meta-Analysis.

Guidelines suggest the Liver Imaging Reporting and Data System (LI-RADS) may not be applicable for some populations at risk for hepatocellular carcinoma (HCC). However, data assessing the association of HCC risk factors with LI-RADS major features are lacking. To evaluate whether the association between HCC risk factors and each CT/MRI LI-RADS major feature differs among individuals at-risk for HCC.

Feasibility and performance of spin-echo EPI MR elastography at 3 Tesla for staging hepatic fibrosis in the presence of hepatic iron overload.

Purpose: To assess the feasibility and performance of MR elastography (MRE) for quantifying liver fibrosis in patients with and without hepatic iron overload.

Methods: This retrospective single-center study analyzed 139 patients who underwent liver MRI at 3 Tesla including MRE (2D spin-echo EPI sequence) and R2* mapping for liver iron content (LIC) estimation. MRE feasibility and diagnostic performance between patients with normal and elevated LIC were compared.

Individual Participant Data Meta-Analysis of LR-5 in LI-RADS Version 2018 versus Revised LI-RADS for Hepatocellular Carcinoma Diagnosis.

Background A simplification of the Liver Imaging Reporting and Data System (LI-RADS) version 2018 (v2018), revised LI-RADS (rLI-RADS), has been proposed for imaging-based diagnosis of hepatocellular carcinoma (HCC). Single-site data suggest that rLI-RADS category 5 (rLR-5) improves sensitivity while maintaining positive predictive value (PPV) of the LI-RADS v2018 category 5 (LR-5), which indicates definite HCC. Purpose To compare the diagnostic performance of LI-RADS v2018 and rLI-RADS in a multicenter data set of patients at risk for HCC by performing an individual patient data meta-analysis.

Prediction of benzimidazole therapy duration with PET/CT in inoperable patients with alveolar echinococcosis.

Alveolar echinococcosis is a rare parasitic disease, most frequently affecting the liver, as a slow-growing tumor-like lesion. If inoperable, long-term benzimidazole therapy is required, which is associated with high healthcare costs and occasionally with increased morbidity. The aim of our study was to determine the role F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in staging of patients with alveolar echinococcosis and to identify quantitative imaging parameters related to patient outcome and/or duration of benzimidazole therapy.

Follow-up PET/CT of alveolar echinococcosis: Comparison of metabolic activity and immunodiagnostic testing.

Purpose: To investigate the potential role of follow-up 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in therapy control of inoperable patients with alveolar echinococcosis.

Materials And Methods: In this single-center retrospective cohort study, 48 PET/CT of 16 patients with confirmed alveolar echinococcosis were analysed. FDG-uptake of the most active echinococcosis manifestation was measured (i.

Quantitative and qualitative evaluation of liver metastases with intraprocedural cone beam CT prior to transarterial radioembolization as a predictor of treatment response.

Purpose: To investigate, by quantitative and qualitative enhancement measurements, the correlation between tumor enhancement on cone beam computed tomography (CBCT) images and treatment response at 6 months in patients undergoing transarterial radioembolization (TARE) for liver metastases.

Materials And Methods: 36 patients (56% male; median age 62.5 years) with 104 metastases were retrospectively included.

CT/MRI and CEUS LI-RADS Major Features Association with Hepatocellular Carcinoma: Individual Patient Data Meta-Analysis.

Background The Liver Imaging Reporting and Data System (LI-RADS) assigns a risk category for hepatocellular carcinoma (HCC) to imaging observations. Establishing the contributions of major features can inform the diagnostic algorithm. Purpose To perform a systematic review and individual patient data meta-analysis to establish the probability of HCC for each LI-RADS major feature using CT/MRI and contrast-enhanced US (CEUS) LI-RADS in patients at high risk for HCC.

Can magnetic resonance imaging radiomics of the pancreas predict postoperative pancreatic fistula?

Objectives: To evaluate whether a magnetic resonance imaging (MRI) radiomics-based machine learning classifier can predict postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) and to compare its performance to T1 signal intensity ratio (T1 SIratio).

Methods: Sixty-two patients who underwent 3 T MRI before PD between 2008 and 2018 were retrospectively analyzed. POPF was graded and split into clinically relevant POPF (CR-POPF) vs.

Multimodal treatment strategies for colorectal liver metastases.

Colorectal cancer is the third most common cancer worldwide. Half of CRC patients develop liver metastases during the course of the disease, with a 5-year survival rate close to zero in the absence of therapy. Surgical resection remains the only possible curative option, and current guidelines recommend adjuvant chemotherapy, resulting in a 5-year survival rate exceeding 50%.

Diagnostic accuracy of texture analysis and machine learning for quantification of liver fibrosis in MRI: correlation with MR elastography and histopathology.

Objectives: To compare the diagnostic accuracy of texture analysis (TA)-derived parameters combined with machine learning (ML) of non-contrast-enhanced T1w and T2w fat-saturated (fs) images with MR elastography (MRE) for liver fibrosis quantification.

Methods: In this IRB-approved prospective study, liver MRIs of participants with suspected chronic liver disease who underwent liver biopsy between August 2015 and May 2018 were analyzed. Two readers blinded to clinical and histopathological findings performed TA.

Does quantitative assessment of arterial phase hyperenhancement and washout improve LI-RADS v2018-based classification of liver lesions?

Objectives: To compare interreader agreement and diagnostic accuracy of LI-RADS v2018 categorization using quantitative versus qualitative MRI assessment of arterial phase hyperenhancement (APHE) and washout (WO) of focal liver lesions.

Methods: Sixty patients (19 female; mean age, 56 years) at risk for HCC with 71 liver lesions (28 HCCs, 43 benign) who underwent contrast-enhanced MRI were included in this retrospective study. Four blinded radiologists independently assigned a qualitative LI-RADS score per lesion.

Diffusion tensor imaging of the abdominal organs: Influence of oriented intravoxel flow compartments.

Water flow in partially oriented intravoxel compartments mimics an anisotropic fast-diffusion regime, which contributes to the signal attenuation in diffusion-weighted images. In the abdominal organs, this flow may reflect physiological fluid movements (eg, tubular urine flow in kidneys, or bile flow through the liver) and have a clinical relevance. This study investigated the influence of anisotropic intravoxel water flow on diffusion tensor imaging (DTI) of the abdominal organs.

Preoperative Evaluation of Pancreatic Fibrosis and Lipomatosis: Correlation of Magnetic Resonance Findings With Histology Using Magnetization Transfer Imaging and Multigradient Echo Magnetic Resonance Imaging.

Objectives: The purpose of this study was to evaluate the diagnostic performance of magnetization transfer (MT) imaging and multigradient echo magnetic resonance imaging (MRI) to quantify pancreatic fibrosis and lipomatosis in patients before pancreatoduodenectomy for postoperative risk stratification with histopathology as the reference standard.

Materials And Methods: Twenty-four patients (age, 68 ± 8 years, 16 males) prospectively underwent quantitative MT imaging using a 2-dimensional gradient echo sequence with and without MT prepulse and multigradient echo imaging on a 3 T MRI 1 day before pancreatoduodenectomy due to adenocarcinoma of the pancreatic head region (n = 20), neuroendocrine tumor (n = 3), or intraductal papillary mucinous neoplasm (n = 1). Magnetization transfer ratio (MTR) and proton density fat fraction (PDFF) were measured in pancreatic tail (PT) and at the resection margin (RM).

Dynamic MRI of the pelvic floor: comparison of performance in supine vs left lateral body position.

Objective:: To investigate the performance of MR-defecography (MRD) in lateral body position as an alternative to supine position.

Methods:: 22 consecutive patients (16 females; mean age 51 ± 19.4) with obstructed defecation and 20 healthy volunteers (11 females; mean age 33.

How to define pathologic pelvic floor descent in MR defecography during defecation?

Objectives: To assess the extents of pelvic floor descent both during the maximal straining phase and the defecation phase in healthy volunteers and in patients with pelvic floor disorders, studied with MR defecography (MRD), and to define specific threshold values for pelvic floor descent during the defecation phase.

Material And Methods: Twenty-two patients (mean age 51 ± 19.4) with obstructed defecation and 20 healthy volunteers (mean age 33.

Performance of an Automated Versus a Manual Whole-Body Magnetic Resonance Imaging Workflow.

Objectives: The aim of this study was to evaluate the performance of an automated workflow for whole-body magnetic resonance imaging (WB-MRI), which reduces user interaction compared with the manual WB-MRI workflow.

Materials And Methods: This prospective study was approved by the local ethics committee. Twenty patients underwent WB-MRI for myopathy evaluation on a 3 T MRI scanner.

Intravoxel Incoherent Motion Analysis of Abdominal Organs: Application of Simultaneous Multislice Acquisition.

Purpose: The aim of this study was to systematically evaluate the accuracy of quantitative intravoxel incoherent motion (IVIM) analysis of the upper abdomen applying simultaneous multislice (SMS) diffusion-weighted imaging (DWI) to reduce acquisition time.

Materials And Methods: Diffusion-weighted imaging of parenchymal abdominal organs was performed in 8 healthy volunteers at 3 T using a standard DWI sequence (acceleration factor 1 [AF1]) and an SMS-accelerated echo planar imaging sequence with acceleration factors 2 and 3 (AF2/AF3). Intravoxel incoherent motion analysis was performed with a multistep algorithm for true diffusion coefficient (Dt), pseudodiffusion coefficient (D*), and fraction of perfusion (Fp) measured for the liver, kidney cortex and medulla, pancreas, spleen, and erector spinae muscle.

The 3D Pelvic Inclination Correction System (PICS): A universally applicable coordinate system for isovolumetric imaging measurements, tested in women with pelvic organ prolapse (POP).

In pelvic organ prolapse (POP), the organs are pushed downward along the lines of gravity, so measurements along this longitudinal body axis are desirable. We propose a universally applicable 3D coordinate system that corrects for changes in pelvic inclination and that allows the localization of any point in the pelvis at rest or under dynamic conditions on magnetic resonance images (MRI) of pelvic floor disorders in a scanner- and software independent manner. The proposed 3D coordinate system called 3D Pelvic Inclination Correction System (PICS) is constructed utilizing four bony landmark points, with the origin set at the inferior pubic point, and three additional points at the sacrum (sacrococcygeal joint) and both ischial spines, which are clearly visible on MRI images.

Simultaneous multi-slice echo planar diffusion weighted imaging of the liver and the pancreas: Optimization of signal-to-noise ratio and acquisition time and application to intravoxel incoherent motion analysis.

Purpose: To optimize and test a diffusion-weighted imaging (DWI) echo-planar imaging (EPI) sequence with simultaneous multi-slice (SMS) excitation in the liver and pancreas regarding acquisition time (TA), number of slices, signal-to-noise ratio (SNR), image quality (IQ), apparent diffusion coefficient (ADC) quantitation accuracy, and feasibility of intravoxel incoherent motion (IVIM) analysis.

Materials And Methods: Ten healthy volunteers underwent DWI of the upper abdomen at 3T. A SMS DWI sequence with CAIPIRINHA unaliasing technique (acceleration factors 2/3, denoted AF2/3) was compared to standard DWI-EPI (AF1).

Adoption of Splenic Enhancement to Time and Trigger the Late Hepatic Arterial Phase During MDCT of the Liver: Proof of Concept and Clinical Feasibility.

Objective: The purpose of this study was to prospectively investigate the clinical feasibility of adopting splenic enhancement for timing and triggering the acquisition of late hepatic arterial phase images during multiphasic liver MDCT for assessment of hypervascular tumors.

Subjects And Methods: Forty-eight patients (33 men, 15 women; median age, 59 years; chronic liver disease, 23 patients; portal venous hypertension, 17 patients) with a total of 81 hypervascular liver tumors underwent liver MDCT by random assignment to one of two scanning protocols. Scanning delay for the late hepatic arterial phase was determined by assessment of time-to-peak splenic enhancement (splenic-triggering protocol) or aortic enhancement (aortic-triggering protocol).

Reliability, Validity, and Reader Acceptance of LI-RADS-An In-depth Analysis.

Rationale And Objectives: This study aimed to analyze interreader agreement and diagnostic accuracy of Liver Imaging Reporting and Data System (LI-RADS) in comparison to a nonstandardized 5-point scale and to assess reader acceptance of LI-RADS for clinical routine.

Materials And Methods: Eighty-four consecutive patients at risk for hepatocellular carcinoma who underwent liver magnetic resonance imaging were included in this Health Insurance Portability and Accountability Act-compliant retrospective study. Four readers rated the likelihood of hepatocellular carcinoma for 104 liver observations using LI-RADS criteria and a 5-point Likert scale (LIKERT) based on subjective impression in two separate reading sessions.

Liver-fat and liver-function indices derived from Gd-EOB-DTPA-enhanced liver MRI for prediction of future liver remnant growth after portal vein occlusion.

Objectives: To evaluate the use of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI)-derived fat- and liver function-measurements for prediction of future liver remnant (FLR) growth after portal vein occlusion (PVO) in patients scheduled for major liver resection.

Methods: Forty-five patients (age, 59 ± 13.9 y) who underwent Gd-EOB-DTPA-enhanced liver MRI within 24 ± 18 days prior to PVO were included in this study.