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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The value of imaging modalities in abdominal malignancies is discussed. Ultrasound is the first method to perform in hepatic tumors--HCC and liver metastases--, followed by CT and/or MRI. CT and ERCP are the diagnostic procedures of choice in pancreatic cancer. MRI is inferior to bolus-enhanced CT. CT and MRI are still equal in colorectal cancers for differentiating between scar and local recurrence after abdominal-perineal amputation.
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PMID:[Imaging procedures in abdominal tumors]. 198 36

Either CT or MRI can be used as a primary screening test for liver masses in a patient with a known or suspected malignancy. A number of variations in techniques are available for both CT and MRI, and combinations of these techniques are often required to increase the detectability rate for hepatic lesions. Whether CT or MRI is chosen as an initial screening technique depends upon the particular patient and the institution. After a liver lesion has been identified, attempts should be made to obtain a specific diagnosis. Certain liver masses may have a specific CT appearance, especially when they are calcified. With some benign lesions a specific diagnosis is possible using imaging techniques, and in these instances CT and a supplemental radionuclide study may be of complimentary value. These include cavernous hemangioma, focal fatty liver, and focal nodular hyperplasia. Another group of lesions have a CT or an MRI appearance that is suggestive for a specific diagnosis, but may require confirmation with a biopsy or other tests. These include hepatoma, which may present as a mass with portal vein thrombosis, hepatic adenoma, which may appear as a mass with central hemorrhage, focal nodular hyperplasia may occur as a mass with a central stellate scar (on CT), or a cavernous hemangioma, which fulfills specific CT or MRI criteria. A final group of lesions consists of masses without a characteristic or suggestive CT or MRI appearance. These lesions will require biopsy for final diagnosis.
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PMID:Imaging primary and metastatic cancer of the liver. 201 95

Transcatheter arterial embolization therapy was performed in fifteen patients with hypervascular metastatic bone and soft-tissue tumors (7 from renal carcinoma, 5 from hepatocellular carcinoma, and one each from breast, thyroid, and cholangiocarcinoma). Sites of metastasis were spine (7), pelvis (5), skull (2), paraspine (2), chest wall (1), and thigh (1). Five patients had not responded to previous radiation therapy and hyperthermia. Embolization of feeding arteries was performed superselectively with long tapered catheters or coaxial microcatheters. Emulsion of Lipiodol and anticancer agent, polyvinyl alcohol sponge, gelatin sponge, and microcoils were used as embolic materials in various combinations. Relief of pain was experienced in 14 of 15 patients. Two patients were operated following embolization with minimal blood loss. Change in tumor size was evaluated by CT or MRI in ten patients. Reduction of tumor size were more than 50% in five patients, from 25% to 50% in two, and no change in three patients. Especially, patients embolized with microcatheter and microcoils showed excellent long-term results. No serious complications were seen. In conclusion, superselective arterial embolization therapy with coaxial microcatheter and microcoils was proved to be an useful treatment for hypervascular metastatic bone and soft-tissue tumors.
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PMID:[Arterial embolization therapy for metastatic bone and soft-tissue tumors with microcatheter and microcoils]. 204 1

This study denotes that MRI is a valid imaging modality in the differential diagnosis of mass lesions in the liver. From the different prolongation of T2 relaxation time, it is possible to differentiate benign and malignant liver masses. Cavernous hemangioma and cyst present high signal intensity on heavily T2 weighted images whereas hepatoma and liver metastasis show moderate signal intensity. Quantitative study, including T2 value calculation and tumor mass/liver ratio, is a complementary measure for the differential diagnosis of liver mass lesions. Active and passive maneuvers to restrict the abdominal respiration for the preparation of patients before MR scanning are simple and effective approaches to reduce the respiratory motion artifacts.
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PMID:Magnetic resonance imaging (MRI) in 100 cases of mass lesions in the liver. 217 56

Reported is the case of a patient who underwent surgical resection of a brain metastasis from a hepatocellular carcinoma. The 62-year-old male was admitted to hospital because of headaches and a left hemiparesis. Six years earlier he had undergone transcatheter arterial embolization for a hepatocellular carcinoma. Further, one year ago the lower lobe of his right lung had been resected because of a pulmonary metastasis from the same tumor. A neurological examination on admission revealed disorientation, dressing apraxia, and a left hemiparesis. A CT scan revealed two highly dense masses with peripheral low dense areas in the right temporoparietal region, which were heterogenously enhanced with a contrast medium. Right carotid angiogram showed tumor stains in the same region. Also, a magnetic resonance T1 weighted image showed highly intense masses, and a T2 weighted image showed low intensity masses with prominent brain edema. Thus, a right fronto-temporo-parietal craniotomy was performed, and the two masses were removed. Histological examination revealed hepatocellular carcinoma. The postoperative course was uneventful, and the left hemiparesis improved gradually, enabling the patient to walk without assistance. A brain metastasis from a hepatocellular carcinoma has been rarely reported in the literature since the survival period is very short due to rapid disease progression at the primary site, so that most reports have been based on postmortem examination. The MRI, CT, and the angiographic findings are included in this report.
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PMID:[A case of brain metastasis from hepatocellular carcinoma]. 217 72

A case of hepatocellular carcinoma in idiopathic hemochromatosis is discussed to illustrate the possible advantages of MR imaging. Since hepatic iron overload provides a natural source of paramagnetic contrast enhancement MRI should performed in preference to other investigative procedures to detect small and curative resectable hepatocellular carcinomas in patients with hemochromatosis.
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PMID:[Magnetic resonance tomography in hepatocellular carcinoma and idiopathic hemochromatosis]. 217 39

47 patients with liver tumours (haemangioma, focal nodular hyperplasia, hepatocellular carcinoma) underwent MRI of the liver before and after i.v. injection of 0.2 ml./kg. gadolinium-DTPA in addition to other imaging methods. The demarcation of focal nodular hyperplasia is not influenced by use of the contrast agent as it almost behaves like surrounding normal liver tissue, thus only indirectly facilitating its identification. With regard to liver haemangiomas that show the most intensive uptake of gadolinium-DTPA, the contrast enhanced image does not reach the contrast and sensitivity of a native T2-weighted SE image, especially in cases of small haemangiomas. The contrast agent is helpful, however, in the recognition of large cavernous haemangiomas that are partially fibrotic or thrombotic. Emphasis is given to the contrast agent in hepatomas: gadolinium-DTPA presents a pattern of uptake and distribution frequently found in hepatocellular carcinoma providing additional information on the delineation of internal tumour details.
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PMID:[Differentiation of focal liver lesions using contrast-enhanced MRT]. 253 80

Characteristics and advantages of MRI (magnetic resonance imaging) in the diagnosis of cancer are represented using hepatic diseases as examples. MRI can detect as small as 10 mm lesion of hepatic tumor (less than 5 mm in favorite conditions) despite far longer acquisition time compared with CT. Although the prolongation of T1 (longitudinal relaxation time) and T2 (transverse relaxation time) is generally noted in cancer, the liver is the sole organ where in vivo measurement of T2 makes it possible to differentiate primary malignant tumor (hepatocellular carcinoma) from the most common benign tumor (cavernous hemangioma). Gd-DTPA, the clinically used contrast material on MRI, is as useful as iodine contrast material on dynamic CT for differentiation among hepatic tumors, and is safely administered in larger dose. Proton spectroscopic imaging can distinguish the signals of proton from water and fat, and can detect the presence of fat more specifically. Intravoxel incoherent motion imaging is a new technique to demonstrate diffusion (Brownish movement) and perfusion (blood flow in capillary) in the voxel as image, and has possibility to reveal the vascularity of tumor without contrast material. MRS (magnetic resonance spectroscopy) has been obtainable in vivo under the guidance of proton MRI. The pattern of 31P-MRS is essentially nonspecific but phosphorous compounds rapidly change in proportion after effective treatment against cancer. Therefore, 31P-MRS is useful in the early and noninvasive evaluation of anticancer treatment. Finally the so-called Fossel effect (widths of methyl and methylene of lipoprotein on 1H-MRS of plasma becomes narrow in patients with cancer) and critical paper against Fossel are discussed.
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PMID:[MRI and MRS in the diagnosis of cancer]. 253 87

Three cases of hepatocellular carcinoma with remarkable fatty metamorphosis were reported. When we encounter lipomatous tumor with liver cirrhosis on CT and MRI, further examination is necessary because of its high possibility of hepatocellular carcinoma.
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PMID:[Three cases of hepatocellular carcinoma with remarkable fatty metamorphosis]. 255 96

In seven primary liver cancers (HCC 5, CCC 1, mixed 1), MR images (0.35 Tesla super-conducting) were compared with macroscopic appearances, and relaxation times (T1 and T2) with microscopic characteristics. MRI was able to reveal the gross appearance of five nodular lesions, but did not reveal one diffuse HCC and one nodular HCC with marked extracapsular extension. T2-weighted SE images could not demonstrate fibrous capsules around the tumor in four nodular HCCs. The T1 and T2 values of the tumors were longer than those of the surrounding liver parenchyma, and the T1 elongation corresponded roughly to the degree of necrosis and fibrosis within the tumors.
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PMID:Magnetic resonance imaging (MRI) of primary liver cancer--MRI-pathologic correlation. 299 80


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