Background: Focal nodular hyperplasia (FNH)-like lesions are hyperplastic formations in patients with micronodular cirrhosis and a history of alcohol abuse. Although pathologically similar to hepatocellular carcinoma (HCC) lesions, they are benign. As such, it is important to develop methods to distinguish between FNH-like lesions and HCC.
Aim: To evaluate diagnostically differential radiological findings between FNH-like lesions and HCC.
Methods: We studied pathologically confirmed FNH-like lesions in 13 patients with alcoholic cirrhosis [10 men and 3 women; mean age: 54.5 ± 12.5 (33-72) years] who were negative for hepatitis-B surface antigen and hepatitis-C virus antibody and underwent dynamic computed tomography (CT) and magnetic resonance imaging (MRI), including superparamagnetic iron oxide (SPIO) and/or gadoxetic acid-enhanced MRI. Seven patients also underwent angiography-assisted CT.
Results: The evaluated lesion features included arterial enhancement pattern, washout appearance (low density compared with that of surrounding liver parenchyma), signal intensity on T1-weighted image (T1WI) and T2-weighted image (T2WI), central scar presence, chemical shift on in- and out-of-phase images, and uptake pattern on gadoxetic acid-enhanced MRI hepatobiliary phase and SPIO-enhanced MRI. Eleven patients had multiple small lesions (< 1.5 cm). Radiological features of FNH-like lesions included hypervascularity despite small lesions, lack of "corona-like" enhancement in the late phase on CT during hepatic angiography (CTHA), high-intensity on T1WI, slightly high- or iso-intensity on T2WI, no signal decrease in out-of-phase images, and complete SPIO uptake or incomplete/partial uptake of gadoxetic acid. Pathologically, similar to HCC, FNH-like lesions showed many unpaired arteries and sinusoidal capillarization.
Conclusion: Overall, the present study showed that FNH-like lesions have unique radiological findings useful for differential diagnosis. Specifically, SPIO- and/or gadoxetic acid-enhanced MRI and CTHA features might facilitate differential diagnosis of FNH-like lesions and HCC.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684202 | PMC |
| http://dx.doi.org/10.3748/wjg.v31.i2.98031 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Imaging characteristics of hypervascular focal nodular hyperplasia-like lesions in patients with chronic alcoholic liver disease.
World J Gastroenterol
January 2025
Department of Radiology, Kindai University, Faculty of Medicine, Osakasayama 589-8511, Osaka, Japan.
Background: Focal nodular hyperplasia (FNH)-like lesions are hyperplastic formations in patients with micronodular cirrhosis and a history of alcohol abuse. Although pathologically similar to hepatocellular carcinoma (HCC) lesions, they are benign. As such, it is important to develop methods to distinguish between FNH-like lesions and HCC.
View Article and Find Full Text PDFMRI findings of newly present benign focal hepatic observations following chemotherapy: distinct features in early- and late-term follow-up.
Eur Radiol
November 2024
Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
Objective: To evaluate gadoxetic acid-enhanced (Gd-EOB-DTPA) MRI features of newly detected benign focal hepatic observations after chemotherapy.
Methods: In this retrospective single-center case-control study, we enrolled a cohort of 43 cancer patients with 93 newly detected benign focal hepatic observations after chemotherapy between January 2010 and December 2020. We evaluated several parameters including the delay of occurrence after chemotherapy, imaging features, and imaging follow-up.
Role of gadoxetic acid-enhanced MRI in the differential diagnosis of chemotherapy-induced focal nodular hyperplasia-like lesions and liver metastases in patients with colorectal cancer.
Abdom Radiol (NY)
September 2024
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Article Synopsis
- The study investigates how gadoxetic acid-enhanced MRI can help identify and differentiate focal nodular hyperplasia (FNH)-like lesions from liver metastases in colorectal cancer patients who underwent chemotherapy.
- A total of 30 patients were analyzed, revealing statistically significant differences in MRI characteristics between FNH-like lesions and liver metastases, with three distinct enhancement patterns observed in FNH-like lesions.
- Follow-up results showed varying outcomes for FNH-like lesions after chemotherapy, with most remaining stable, some growing, and a few reducing or disappearing.
Congestive Hepatopathy: Pathophysiology, Workup, and Imaging Findings with Pathologic Correlation.
Radiographics
May 2024
From the Department of Radiology, Division of Body Imaging, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (M.F., A. Kamaya); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.E.); Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A. Kielar, M.S.); Department of Radiology, University of Chicago, Chicago, Ill (C.H.); Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (J.R.D.); Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY (N.H.); Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pa (M.M.); Department of Radiology, Naval Medical Center San Diego, San Diego, Calif (R.M.); and Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill (A.A.B.).
Liver congestion is increasingly encountered in clinical practice and presents diagnostic pitfalls of which radiologists must be aware. The complex altered hemodynamics associated with liver congestion leads to diffuse parenchymal changes and the development of benign and malignant nodules. Distinguishing commonly encountered benign hypervascular lesions, such as focal nodular hyperplasia (FNH)-like nodules, from hepatocellular carcinoma (HCC) can be challenging due to overlapping imaging features.
View Article and Find Full Text PDFFocal nodular hyperplasia-like nodules arising in the setting of hepatic vascular disorders with portosystemic shunting show β-catenin activation.
Hum Pathol
December 2023
Department of Pathology, University of California, San Francisco, San Francisco, CA, 94143, USA.
Article Synopsis
- Hepatocellular nodules can occur due to chronic liver vascular disorders, especially with conditions like portosystemic shunts (e.g., Abernethy malformation and post-Fontan procedure).
- These nodules vary widely in type, including benign forms (like regenerative nodules and focal nodular hyperplasia) as well as malignant ones (like hepatocellular carcinoma), complicating their classification based on appearance.
- A study of liver resections from patients with such vascular diseases revealed numerous nodule types, including FNH-like nodules that displayed unusual characteristics suggesting they could be neoplastic, highlighting the need for further diagnostic testing to assess cancer risk.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!