Financial Disclosure

Size: px
Start display at page:

Download "Financial Disclosure"

Transcription

1 Benign Liver Masses Adil Abdalla, MBBS Creighton University-CHI Health August 25, 2018 Financial Disclosure Nothing to disclose Financial Disclosure 1

2 Objectives To assess patients with benign liver tumors To recognize the key radiologic findings To understand indications of intervention Case: A 41 yr old woman who is undergoing an US scan for infertility evaluation is noted to have a 3cm hyperechoic mass in the Lt lobe of the liver. She is otherwise well and has no risk factor or physical exam findings to suggest chronic liver disease. LFTs and AFP levels are normal. What is the most appropriate next step in the care of this patient? 1. Hepatic artery embolization. 2. Contrast-enhanced MRI. 3. No further treatment or testing. 4. Radiology-guided biopsy of the mass 5. Surgical resection of the mass 2

3 Primary Liver Lesions Liver lesions Cyst Abscess Neoplasm Malignant tumors Benign tumors Differential Diagnosis of Liver Mass? Is it an incidentaloma? Clinical circumstances -Age. -Sex. -OCP. -Chronic liver disease. -Travel -Extrahepatic malignancies. Imaging characteristics: -Modality. -Numbers, size, features 3

4 You have a liver mass!!! Having an answer: -Benign Vs malignant? -Primary Vs metastatic? Avoid extensive testing. Avoid unnecessary biopsy or surgery. Are the symptoms connected to the presence of a liver mass? Incidentalomas: Most Often Benign Benign lesion are common: Incidence 7-9 % Autopsy up to 20% of population Concerns of benign masses: Difficulty to differentiate form malignancy. Few have the potential for complications Important to recognize the features of the common benign liver tumors. 4

5 Benign Liver Masses Hepatocellular: Adenoma Focal nodular hyperplasia Nodular regenerative hyperplasia Regenerating nodules Mesenchymal: Hemangioma Angiolipoma Leiomyoma Infantile Hemangioendothelioma Benign Tumors Cholangiocellular: Bile duct adenoma Biliary cystadenoma Others: Hamartoma Teratoma Pancreatic rest Adrenal rest Adapted from Bahirwani et al, Aliment pharmacol Ther 2008 Benign Liver Masses Hemangioma 55% FNH 21% Adenoma 19% Others 5% Modified from 5

6 Accuracy of US, CT, MRI and Angiography in evaluating liver masses Accuracy Specificity Positive predictive value Negative predictive value Benign lesions 98.7% 100% 100% 98.6% HCC 99.6% 98.9% 99.3% 100% Metastatic lesion 99.1% 98.8% 96.9% 100% Torzilli et al, hepatology 1999 Hemangioma From: Tumors of the Liver and Intrahepatic Bile Ducts by Ishak 6

7 Hemangioma Most common benign tumor of the liver. Prevalence 3-20%. Size 1 20 cm Female: Male = 3-6:1, age Possible hormonal influence Arise from endothelial lining, well demarcated capsule. Symptoms very rare. Bleeding: exceedingly rare even with large lesions. No malignant transformation. Gandolfi et al, Gut 1991 Bahirwani et al, Aliment Pharmacol Ther 2008 Choi et la, J Clin gatroentrol Hemangioma, Radiological Findings US: Well demarcated hyperechoic mass. Unenhanced CT: Hypo-attenuated mass. Contrast-enhanced CT: Sequential opacification (peripheral to centripetal fill-in). Jay Heiken, Cancer Imaging 2007 Choi et al, J Clin Gatroentrol

8 MRI T1: early enhanced MRI T2: high intensity MRI T1: delayed enhanced Jay Heiken, Cancer Imaging 2007 Choi et al, J Clin Gatroentrol 2005 Hemangioma, Treatment Stop, leave it alone. If treatment is needed (extremely rare): -Enucleation. -Resection. -Embolization. -Hepatic irradiation. -Transplantation. Nghiem et al, AJR Am J Roentgenol Bahirwani et al, Aliment Pharmacol Ther 2008 Choi et al, J Clin Gatroentrol

9 Focal Nodular Hyperplasia From: Tumors of the Liver and Intrahepatic Bile Ducts by Ishak Focal Nodular Hyperplasia Second most common benign tumor of the liver. Prevalence 2.5-8%. Mainly in women, 3 rd -4 th decades. Female: Male = 8:1 Size: mostly 3-5 cm, near the surface. Asymptomatic (only ~10% with symptoms). Bahirwani et al, Aliment Pharmacol Ther 2008 Choi et al, J Clin Gatroentrol

10 Focal Nodular Hyperplasia, cont. Pathogenesis: focal congenital malformation of the hepatic vasculature. -Increase local blood flow. -Hyperplasia. No clear association with OCP (may accelerate growth). Complications: -Bleeding: extremely rare. -No malignant potential. Geders et al, Hepatology 1995 Shortell et al, Surg Gynecol Obstet Fukukura et al, J Hepatol 1998 FNH CT Pre: Homogenous and isoattenuating Arterial: Bright with hypodense central scarring Portal venous phase Characteristic (not present): radiating hypodense fibrous bands and septa that arise from the scar, seen in delayed films Delay phase Bahirwani et al, Aliment Pharmacol Ther

11 FNH MRI: Unenhanced T1: isointense, hypointense central scar T2: mass isointense, scar hyperintense Gadolinium-enhanced: mass enhancement, hypointense scar and fibrous septa Delayed postcontrast: mass isointense, scar hyperintense Jay Heiken, Cancer Imaging 2007 Focal Nodular Hyperplasia, Treatment: Asymptomatic patients, clear diagnosis: -No further treatment is necessary. -Close F/U during pregnancy. Symptomatic Patients: -Surgical resection. -Transarterial embolization. Choi et al, J Clin Gatroentrol

12 Hepatic Adenoma (HA) From: Tumors of the Liver and Intrahepatic Bile Ducts by Ishak Hepatic Adenoma (HA) Mostly in femals (>30 years), F: M=4:1 Mostly solitary, well circumscribed, round, uncapsulated (or pseudocapsule). Symptomatic in ~25-50% of patients. Annual incidence: -No OCP: per million -> 5 years OCP: per million Sherlock S, Gut 1975 Rooks et al, JAMA 1979 Bahirwani et al, Aliment Pharmacol Ther

13 Etiologic Factors and Diseases Associated with Adenoma Shrinks when OCP stopped From: Tumors of the Liver and Intrahepatic Bile Ducts by Ishak Hepatic Adenoma, Histology Proliferation of hepatocytes No portal tract or bile ductules. 13

14 Hepatic Adenoma, Potential for Serious Complications > 5 cm: -Rupture, malignancy. Increasing size: -Rupture, malignancy. If not decrease when OCP stopped -Malignancy. Risk of malignant transformation~ 10%. Mortele et al, Clin Liver Dis Bahirwani et al, Aliment Pharmacol Ther 2008 Choi et al, J Clin Gatroentrol 2005 Adenoma, US and CT US: variable and nonspecific: -Hypoechoic: simple -Hyperechoic: fat, hemorrhage -Mixed-echoic: fat, hemorrhage and necrosis. CT: heterogeneous due to fat, hemorrhage, and necrosis. -Contrast CT: enhancement, but less than FNH. -Portal phase: isodense. 14

15 Adenoma, MRI with Gadobenate Dimeglumine Arterial, hyperenhancement Venous, isoenhancement Delayed hepatobiliary Roberts, Mayo GI Board Review, 3 rd Ed Do We Need To Get Beta Catenin Staining for Adenoma? Normal (negative) Staining Positive Staining 15

16 Hepatic Adenoma, Treatment If < 5cm, stop OCP and F/U US. If has potential risk of complications or causing symptoms: -Surgical enucleation -Resection -Transplantaion -Arterial embolization. Grazioli et al, Radiographics 2001 Terkivatan et al, Arch Surg 2001 Choi et al, J Clin Gatroentrol 2005 Adenoma: Multiple Lesion Multiple Hepatic Adenomas Liver Adenomatosis (>10) Females > males Female =male Prolonged OCP GSD Normal LFT No OCP No GSD Possible high AP, GGT Treatment: -Stop any OCP, no pregnancy, US q 6 months. -Liver transplant: if risk factors present. Choi et al, J Clin Gatroentrol

17 Benign Masses with Atypical Imaging Features Technetium-99m labeled RBC scintigraphy: defect in the early scan, prolonged and persistent uptake on delay scans diagnostic for hemangioma. Scintigraphy with 99m TC-sulfur-colloid: high uptake by FNH, low or absent in adenoma. MRI with Gadobenate Dimeglumine (Gd-GOPA): FNH enhances on delayed scans, adenoma does not. Jay Heiken, Cancer Imaging 2007 Bahirwani et al, Aliment Pharmacol Ther 2008 Grazioli et al, Radiology 2005 Choi et al, J Clin Gatroentrol 2005 When Do We Need Liver Biopsy? Only in equivocal cases in which all imaging modalities fail to establish a firm diagnosis. Issues with biopsies: -Cost -Morbidity -Mortality -Seeding -Non-diagnostic 17

18 Algorithm, Liver Mass, Asymptomatic patient LFTs, viral serology, AFP, CBC Normal, nonspecific LFTs Abnormal Cystic US Solid Evaluation R/O HCC, met Simple cystic structure Yes No Dynamic CT or MRI Observe Further evaluation Modified from Choi et al, J Clin Gatroentrol 2005 Algorithm, Liver Mass, Asymptomatic patient Dynamic CT or MRI Characteristic imaging of hemangioma Yes No Observe Central scar on CT or MRI Yes No 99mTc scintigraphy Probable adenoma Characteristic increased uptake No Biopsy Yes Focal nodular hyperplasia Observe Resection Biopsy Modified from Choi et al, J Clin Gatroentrol

19 Conclusion Hemangioma: Peripheral to centripetal fill-in. FNH: Central scar. Adenoma: Sometimes difficult to diagnose. Risk for complications. Most patients die with a benign liver lesion rather than from it Case #1: A 41 yr old woman who is undergoing an US scan for infertility evaluation is noted to have a 3cm hyperechoic mass in the Lt lobe of the liver. She is otherwise well and has no risk factor or physical exam findings to suggest chronic liver disease. LFTs and AFP levels are normal. What is the most appropriate next step in the care of this patient? 1. Hepatic artery embolization. 2. Contrast-enhanced MRI. 3. No further treatment or testing. 4. Radiology-guided biopsy of the mass 5. Surgical resection of the mass 19

20 Case #2: A 35 yr old male bodybuilder was seen by PCP for RUQ fullness and dyspepsia. US showed a 6 cm hepatic lesion. He does not have any liver disease and basic labs are normal. MRI ordered by GI demonstrated a large, sub-capsular, homogeneously-enhancing mass in segment 2. Biopsy of the lesion confirmed a hepatic adenoma. Your recommendation would be? 1. Repeat imaging in 6 months. 2. Refer to UNMC for liver transplant evaluation. 3. No further treatment or testing. 4. Refer for surgical resection. 20

Evaluation of Liver Mass Lesions. American College of Gastroenterology 2013 Regional Postgraduate Course

Evaluation of Liver Mass Lesions. American College of Gastroenterology 2013 Regional Postgraduate Course Evaluation of Liver Mass Lesions American College of Gastroenterology 2013 Regional Postgraduate Course Lewis R. Roberts, MB ChB, PhD Division of Gastroenterology and Hepatology Mayo Clinic College of

More information

Workup of a Solid Liver Lesion

Workup of a Solid Liver Lesion Workup of a Solid Liver Lesion Joseph B. Cofer MD FACS Chief Quality Officer Erlanger Health System Affiliate Professor of Surgery UTHSC-Chattanooga I have no financial or other relationships with any

More information

CT & MRI of Benign Liver Neoplasms Srinivasa R Prasad

CT & MRI of Benign Liver Neoplasms Srinivasa R Prasad CT & MRI of Benign Liver Neoplasms Srinivasa R Prasad No financial disclosures Acknowledgements Many thanks to Drs. Heiken, Narra & Menias (MIR) Dr. Sahani (MGH) for sharing images Benign Liver Tumors:

More information

Liver Tumors. Prof. Dr. Ahmed El - Samongy

Liver Tumors. Prof. Dr. Ahmed El - Samongy Liver Tumors Prof. Dr. Ahmed El - Samongy Objective 1. Identify the most important features of common benign liver tumors 2. Know the risk factors, diagnosis, and management of hepatocellular carcinoma

More information

Malignant Focal Liver Lesions

Malignant Focal Liver Lesions Malignant Focal Liver Lesions Other Than HCC Pablo R. Ros, MD, MPH, PhD Departments of Radiology and Pathology University Hospitals Cleveland Medical Center Case Western Reserve University Pablo.Ros@UHhospitals.org

More information

Jesse Civan, M.D. Medical Director, Jefferson Liver Tumor Center

Jesse Civan, M.D. Medical Director, Jefferson Liver Tumor Center Liver Tumors Jesse Civan, M.D. Medical Director, Jefferson Liver Tumor Center Differential Diagnosis Malignant Metastatic from non-hepatic primary Hepatocellular carcinoma Cholangiocarcinoma Biliary cystcarcinoma

More information

ACG Clinical Guideline: Diagnosis and Management of Focal Liver Lesions

ACG Clinical Guideline: Diagnosis and Management of Focal Liver Lesions ACG Clinical Guideline: Diagnosis and Management of Focal Liver Lesions Jorge A. Marrero, MD, 1 Joseph Ahn, MD, FACG, 2 K. Rajender Reddy, MD, FACG 3 1 University of Texas at Southwestern, Dallas, Texas,

More information

CTA/MRA of Pediatric Hepatic Masses Radiology-Pathology Correlation

CTA/MRA of Pediatric Hepatic Masses Radiology-Pathology Correlation Acta Radiológica Portuguesa, Vol.XVIII, nº70, pág. 41-50, Abr.-Jun., 2006 CTA/MRA of Pediatric Hepatic Masses Radiology-Pathology Correlation Marilyn J. Siegel Mallinckrodt Institute of Radiology, Washington

More information

HEPATOCYTE SPECIFIC CONTRAST MEDIA: WHERE DO WE STAND?

HEPATOCYTE SPECIFIC CONTRAST MEDIA: WHERE DO WE STAND? HEPATOCYTE SPECIFIC CONTRAST MEDIA: WHERE DO WE STAND? Andrew T. Trout, MD @AndrewTroutMD Disclosures No relevant disclosures Outline Review of hepatocyte specific contrast media Review of hepatocellular

More information

Approach to Liver Lesions. Anjana A. Pillai, MD Associate Professor of Medicine Director, Liver Tumor Clinic The University of Chicago Medical Center

Approach to Liver Lesions. Anjana A. Pillai, MD Associate Professor of Medicine Director, Liver Tumor Clinic The University of Chicago Medical Center Approach to Liver Lesions Anjana A. Pillai, MD Associate Professor of Medicine Director, Liver Tumor Clinic The University of Chicago Medical Center Objectives Identify common clinical features and imaging

More information

Essentials of Clinical MR, 2 nd edition. 65. Benign Hepatic Masses

Essentials of Clinical MR, 2 nd edition. 65. Benign Hepatic Masses 65. Benign Hepatic Masses Pulse sequences acquired for abdominal MRI typically consist of fast acquisition schemes such as single-shot turbo spin echo (i.e. HASTE) and gradient echo schemes such as FLASH

More information

Radiology of hepatobiliary diseases

Radiology of hepatobiliary diseases GI cycle - Lecture 14 436 Teams Radiology of hepatobiliary diseases Objectives 1. To Interpret plan x-ray radiograph of abdomen with common pathologies. 2. To know the common pathologies presentation.

More information

Interesting Cases from Liver Tumor Board. Jeffrey C. Weinreb, M.D.,FACR Yale University School of Medicine

Interesting Cases from Liver Tumor Board. Jeffrey C. Weinreb, M.D.,FACR Yale University School of Medicine Interesting Cases from Liver Tumor Board Jeffrey C. Weinreb, M.D.,FACR Yale University School of Medicine jeffrey.weinreb@yale.edu Common Liver Diseases Hemangioma Cyst FNH Focal Fat/Sparing THID Non-Cirrhotic

More information

MRI OF FOCAL LESIONS IN

MRI OF FOCAL LESIONS IN Introduction MRI OF FOCAL LESIONS IN THE NON-CIRRHOTIC LIVER Ivan Pedrosa M.D. Ph.D. Associate Professor of Radiology and Advanced Imaging Research Center University of Texas Southwestern. Dallas, TX Incidental

More information

HEPATO-BILIARY IMAGING

HEPATO-BILIARY IMAGING HEPATO-BILIARY IMAGING BY MAMDOUH MAHFOUZ MD PROF.OF RADIOLOGY CAIRO UNIVERSITY mamdouh.m5@gmail.com www.ssregypt.com CT ABDOMEN Indications Patient preparation Patient position Scanogram Fasting 4-6 hours

More information

Enhancements in Hepatobiliary Imaging:

Enhancements in Hepatobiliary Imaging: Enhancements in Hepatobiliary Imaging: S. Channual 1, MD; A. Pahwa 2, MD; S. Raman 1, MD. 1 UCLA Medical Center, Department of Radiologic Sciences 2 Olive-View UCLA Medical Center, Department of Radiology

More information

The Focal Hepatic Lesion: Radiologic Assessment

The Focal Hepatic Lesion: Radiologic Assessment The Focal Hepatic Lesion: Radiologic Assessment Kevin Kuo, Harvard Medical School Year III Our Patient: PS 67 y/o female w/ long history of alcohol use Drinking since age 18, up to one bottle of wine/day

More information

Interesting case. Vikas Kundra, M.D., Ph.D. October Vikas Kundra, M.D., Ph.D.

Interesting case. Vikas Kundra, M.D., Ph.D. October Vikas Kundra, M.D., Ph.D. Interesting case October 2012 Disclosure Information Vikas Kundra, M.D, Ph.D. I have no financial relationships to disclose. I WILL NOT include discussion of investigational or off-label use of a product

More information

Benign liver tumors : Diagnosis and management

Benign liver tumors : Diagnosis and management 4th International Hepatology Conference 2016 HEPATOLOGY SOCIETY, DHAKA, BANGLADESH Benign liver tumors : Diagnosis and management Pr Laurence Chiche Hepato biliary surgery and transplantation Bordeaux,

More information

Complete Summary GUIDELINE TITLE. Liver lesion characterization. BIBLIOGRAPHIC SOURCE(S)

Complete Summary GUIDELINE TITLE. Liver lesion characterization. BIBLIOGRAPHIC SOURCE(S) Complete Summary GUIDELINE TITLE Liver lesion characterization. BIBLIOGRAPHIC SOURCE(S) Foley WD, Bree RL, Gay SB, Glick SN, Heiken JP, Huprich JE, Levine MS, Ros PR, Rosen MP, Shuman WP, Greene FL, Rockey

More information

Pitfalls in the diagnosis of well-differentiated hepatocellular lesions

Pitfalls in the diagnosis of well-differentiated hepatocellular lesions 2013 Colorado Society of Pathology Pitfalls in the diagnosis of well-differentiated hepatocellular lesions Sanjay Kakar, MD University of California, San Francisco Outline Hepatocellular adenoma: new WHO

More information

Hepatobiliary and Pancreatic Malignancies

Hepatobiliary and Pancreatic Malignancies Hepatobiliary and Pancreatic Malignancies Gareth Eeson MD MSc FRCSC Surgical Oncologist and General Surgeon Kelowna General Hospital Interior Health Consultant, Surgical Oncology BC Cancer Agency Centre

More information

Diagnostic Challenges and Pitfalls in MR Imaging with Hepatocyte-specific

Diagnostic Challenges and Pitfalls in MR Imaging with Hepatocyte-specific Note: This copy is for your personal non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. ABDOMINAL AND GASTROINTESTINAL

More information

Radiological Reasoning: Incidentally Discovered Liver Mass

Radiological Reasoning: Incidentally Discovered Liver Mass AJR Integrative Imaging LIFELONG LEARNING FOR RADIOLOGY This Radiological Reasoning article is available for SAM credit and CME credits when completed with the additional educational material provided

More information

Acknowledgements. Update of Focal Liver Lesions Goals. Focal Liver Lesions. Imaging Choices For Liver Lesions. Focal Liver Lesions

Acknowledgements. Update of Focal Liver Lesions Goals. Focal Liver Lesions. Imaging Choices For Liver Lesions. Focal Liver Lesions Acknowledgements Update of Focal Liver Lesions 2012 Giles Boland Massachusetts General Hospital Harvard Medical School No disclosures Dushyant Sahani Mukesh Harisinghani Goals Focal liver lesions Imaging

More information

Large Nonmalignant Hepatic Mass and Role of Pediatric Interventional Radiology

Large Nonmalignant Hepatic Mass and Role of Pediatric Interventional Radiology Originally Posted: December 18, 2014 Large Nonmalignant Hepatic Mass and Role of Pediatric Interventional Radiology Resident(s): Kushal R Parikh, MD Attending(s): Jonathan R Dillman, MD and Ranjith Vellody,

More information

Hepatocellular carcinoma Cholangiocarcinoma. Jewels of hepatobiliary cancer imaging : what to look for? Imaging characteristics of HCC.

Hepatocellular carcinoma Cholangiocarcinoma. Jewels of hepatobiliary cancer imaging : what to look for? Imaging characteristics of HCC. Outline : Imaging Jewels Jewels of hepatobiliary cancer imaging : what to look for? Hepatocellular carcinoma Cholangiocarcinoma Surachate Siripongsakun, M.D. Chulabhorn Cancer Center Imaging characteristics

More information

Recently role of non-invasive diagnostics methods

Recently role of non-invasive diagnostics methods CERTAIN ASPECTS OF NLS-DIAGNOSTICS OF LIVER FOCAL PATHOLOGY A.Y. Shvack, V.I. Nesterov, N.L. Ogluzdina This article contains information about NLS-graphy application in diagnostics of liver focal affections:

More information

Chief Complain. Liver lesion found in routine health check 41 days ago

Chief Complain. Liver lesion found in routine health check 41 days ago Chief Complain Liver lesion found in routine health check 41 days ago Present Illness On 2005-7-26 at 台北署立醫院 he underwent a health check for the first time. Abdominal US showed suspicious of a 6*5 cm hepatoma,

More information

Liver Cancer (Hepatocellular Carcinoma or HCC) Overview

Liver Cancer (Hepatocellular Carcinoma or HCC) Overview Liver Cancer (Hepatocellular Carcinoma or HCC) Overview Recent advances in liver cancer care seek to address the rising incidence of liver cancer, which has steadily increased over the past three decades.

More information

Lewis R. Roberts, MB, ChB, PhD, FACG

Lewis R. Roberts, MB, ChB, PhD, FACG 2B: Hot Topics in Liver Disease Evaluation of Liver Mass Lesions Lewis R. Roberts, MB, ChB, PhD, FACG Clinical Classification of Liver Mass Lesions It is helpful to subclassify lesions into three clinical

More information

HCC and mass effect. Hepatocellular cancer: what if the AFP is rising but no lesion seen on imaging? What you need to know about AFP.

HCC and mass effect. Hepatocellular cancer: what if the AFP is rising but no lesion seen on imaging? What you need to know about AFP. Hepatocellular cancer: what if the AFP is rising but no lesion seen on imaging? Arun J Sanyal M.B.B.S., M.D. Charles Caravati Professor of Medicine Virginia Commonwealth University Imaging features used

More information

Liver nodules mimicking metastatic disease

Liver nodules mimicking metastatic disease Liver nodules mimicking metastatic disease Poster No.: C-1703 Congress: ECR 2011 Type: Educational Exhibit Authors: F. Vandenbroucke, B. Ilsen, B. Op de Beeck, J. de Mey ; 1 1 2 2 3 2 3 Brussels/BE, Brussel/BE,

More information

Alice Fung, MD Oregon Health and Science University

Alice Fung, MD Oregon Health and Science University Alice Fung, MD Oregon Health and Science University Disclosure Comments The speaker Alice Fung, MD Has relevant financial relationships to disclose. Received honorarium from (Guerbet). This individual

More information

Innovations in HCC Imaging: MDCT/MRI

Innovations in HCC Imaging: MDCT/MRI Innovations in HCC Imaging: MDCT/MRI Anthony E. Cheng, M.D. Cardinal MRI Center Cardinal Santos Medical Center, Wilson Street, San Juan Innovations in HCC Imaging: Goals/Objectives MDCT/MRI Learn the diagnostic

More information

Primary Hepatic Undifferentiated Pleomorphic Sarcoma: CT and angiographic findings in two cases

Primary Hepatic Undifferentiated Pleomorphic Sarcoma: CT and angiographic findings in two cases J Radiol Sci 2013; 38: 15-19 Primary Hepatic Undifferentiated Pleomorphic Sarcoma: CT and angiographic findings in two cases Jan-Wen Ku Ying-Chi Tseng Kuo-Luon Kung Hsien-Chang Shen Yen-Lin Huang Chi-Jen

More information

Objectives. HCC Incidence and Mortality. Disclosure Statement HCC. Imaging of Hepatocellular Carcinoma. Treatment of Hepatocellular Carcinoma

Objectives. HCC Incidence and Mortality. Disclosure Statement HCC. Imaging of Hepatocellular Carcinoma. Treatment of Hepatocellular Carcinoma Imaging of Hepatocellular Carcinoma and the use of LI RADS Treatment of Hepatocellular Carcinoma Aaron D. Anderson, D.O. AOCR April 2015 Objectives Show how the use of LI RADS can simplify the diagnosis

More information

CT 101 :Pancreas and Spleen

CT 101 :Pancreas and Spleen CT 101 :Pancreas and Spleen Shikha Khullar,, MD, MPH Division of Radiology University of South Alabama The Pancreas Normal Pancreas 3 Phase Pancreatic CT Non contrast Arterial phase : 30-35 35 second

More information

Diagnostic Studies Then. It s important to be able to distinguish. Diagnostic Studies Now

Diagnostic Studies Then. It s important to be able to distinguish. Diagnostic Studies Now Jonathan S. Fisher, MD, FACS It s important to be able to distinguish Diagnostic Studies Then Diagnostic Studies Then History Biopsy Diagnostic Studies Now History Biopsy Serum markers (AFP, CA19 9, CEA)

More information

Imaging of liver and pancreas

Imaging of liver and pancreas Imaging of liver and pancreas.. Disease of the liver Focal liver disease Diffusion liver disease Focal liver disease Benign Cyst Abscess Hemangioma FNH Hepatic adenoma HCC Malignant Fibrolamellar carcinoma

More information

LIVER IMAGING TIPS IN VARIOUS MODALITIES. M.Vlychou, MD, PhD Assoc. Professor of Radiology University of Thessaly

LIVER IMAGING TIPS IN VARIOUS MODALITIES. M.Vlychou, MD, PhD Assoc. Professor of Radiology University of Thessaly LIVER IMAGING TIPS IN VARIOUS MODALITIES M.Vlychou, MD, PhD Assoc. Professor of Radiology University of Thessaly Hepatocellular carcinoma is a common malignancy for which prevention, screening, diagnosis,

More information

State of the Art Imaging for Hepatic Malignancy: My Assignment

State of the Art Imaging for Hepatic Malignancy: My Assignment State of the Art Imaging for Hepatic Malignancy: My Assignment CT vs MR vs MRCP Which one to choose for HCC vs Cholangiocarcinoma What special protocols to use for liver tumors Role of PET and Duplex US

More information

Liver Cancer And Tumours

Liver Cancer And Tumours Liver Cancer And Tumours What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood from all parts of the body, cancer cells from elsewhere can

More information

Biologic and Clinical Features of Benign Solid and Cystic Lesions of the Liver

Biologic and Clinical Features of Benign Solid and Cystic Lesions of the Liver CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2011;9:547 562 STATE OF THE ART Biologic and Clinical Features of Benign Solid and Cystic Lesions of the Liver OREN SHAKED,* EVAN S. SIEGELMAN, KIM OLTHOFF, and

More information

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,350 108,000 1.7 M Open access books available International authors and editors Downloads Our

More information

Paradoxical uptake of Gd-EOB-DTPA of focal hepatic nodule in the hepatobiliary phase

Paradoxical uptake of Gd-EOB-DTPA of focal hepatic nodule in the hepatobiliary phase Paradoxical uptake of Gd-EOB-DTPA of focal hepatic nodule in the hepatobiliary phase Poster No.: C-1869 Congress: ECR 2011 Type: Educational Exhibit Authors: S. M. Ha, C. Lee, K. A. Kim, J. Lee, Y.-S.

More information

Gastrointestinal tract

Gastrointestinal tract Gastrointestinal tract Colloidal liver-spleen imaging Presented by: Jehad Felemban Introduction: To obtain better anatomic display of liver and spleen architecture, we use (CT Ultrasound). (Radionuclide

More information

Vascular Imaging in the Pediatric Abdomen. Jonathan Swanson, MD

Vascular Imaging in the Pediatric Abdomen. Jonathan Swanson, MD Vascular Imaging in the Pediatric Abdomen Jonathan Swanson, MD Goals and Objectives To understand the imaging approach, appearance, and clinical manifestations of the common pediatric abdominal vascular

More information

Evangelos Chartampilas Bioclinic Hospital Thessaloniki, Greece

Evangelos Chartampilas Bioclinic Hospital Thessaloniki, Greece Evangelos Chartampilas Bioclinic Hospital Thessaloniki, Greece Hepatospecificcontrast agents Gadobenate dimeglumine (Multihance) Gadoxeticacid (Primovist) 3-5% liver uptake 50% liver uptake Hepatobiliary

More information

X-Ray Corner. Imaging Approach to Cystic Liver Lesions. Pantongrag-Brown L. Solitary cystic liver lesions. Hepatic simple cyst (Figure 1)

X-Ray Corner. Imaging Approach to Cystic Liver Lesions. Pantongrag-Brown L. Solitary cystic liver lesions. Hepatic simple cyst (Figure 1) THAI J 136 Imaging Approach to Cystic Liver Lesions GASTROENTEROL 2013 X-Ray Corner Imaging Approach to Cystic Liver Lesions Pantongrag-Brown L Cystic liver lesions are common findings in daily practice

More information

RICCARDO LENCIONI,CLOTILDE DELLA PINA, LAURA CROCETTI,DANIA CIONI. Chapter 1

RICCARDO LENCIONI,CLOTILDE DELLA PINA, LAURA CROCETTI,DANIA CIONI. Chapter 1 RICCARDO LENCIONI,CLOTILDE DELLA PINA, LAURA CROCETTI,DANIA CIONI Chapter 1 Impact of European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on the Use of Contrast

More information

PATHOLOGY OF LIVER TUMORS

PATHOLOGY OF LIVER TUMORS PATHOLOGY OF LIVER TUMORS Pathobasic, 31.05.2016 WHO Classification Approach to a Liver Mass Lesion in a patient with chronic liver disease? Lesion in a patient without chronic liver disease? Malignant

More information

Liver surgery, acute GI tract bleeding

Liver surgery, acute GI tract bleeding Semmelweis University, Faculty of Medicine, 1 st Department of Surgery Liver surgery, acute GI tract bleeding Oszkár HAHN M.D. LIVER CYST US, CT, MRI Parasite (ELISA, eosinophil, anaphylaxy) Echinococcus

More information

Pediatric Hepatobiliary, Pancreatic & Splenic US

Pediatric Hepatobiliary, Pancreatic & Splenic US Pediatric Hepatobiliary, Pancreatic & Splenic US Susan J. Back, MD Department of Radiology, The Children s Hospital of Philadelphia No Disclosures Objectives Normal Abnormal: cases and US advances Objectives

More information

Contrast Enhanced Ultrasound of Parenchymal Masses in Children

Contrast Enhanced Ultrasound of Parenchymal Masses in Children Contrast Enhanced Ultrasound of Parenchymal Masses in Children Sue C Kaste, DO On behalf of Beth McCarville, MD St. Jude Children s Research Hospital Memphis, TN Overview Share St. Jude experience with

More information

Liver Lesions: How to Evaluate?

Liver Lesions: How to Evaluate? Liver Lesions: How to Evaluate? Disclosures Consulting: BMS, Bayer, BTG, Eisai Laura Kulik MD Professor of Medicine, Surgery and Interventional Radiology Northwestern University Finberg School of Medicine

More information

IT 의료융합 1 차임상세미나 복부질환초음파 이재영

IT 의료융합 1 차임상세미나 복부질환초음파 이재영 IT 의료융합 1 차임상세미나 2013-4-3 복부질환초음파 이재영 나는오늘누구를위하여 종을울리나? 전통적의료 의사 공학설계자 의사 최첨단진단장비들 USG, CT, MRI 환자 환자 현대의료 사용자중심의사고 US in the Abdomen Detection DDx Look Behavior Response by external stimuli Guiding Tool

More information

Chief Complaint. Retroperitoneal cystic mass incidentally found at health examination center.

Chief Complaint. Retroperitoneal cystic mass incidentally found at health examination center. Personal Information Age: 34 y/o Sex: female Past history: major systemic medical history(-) surgical history(-), family history(-) Denied food or drug allergy Chief Complaint Retroperitoneal cystic mass

More information

Primary Hepatic Neoplasms. estimated 560,000 new cases per year. There is tremendous regional variation in incidence of

Primary Hepatic Neoplasms. estimated 560,000 new cases per year. There is tremendous regional variation in incidence of Primary Hepatic Neoplasms Hepatocellular Carcinoma Incidence and Epidemiology Worldwide, hepatocellular carcinoma is the 3 rd most common causes of cancer death with an estimated 560,000 new cases per

More information

The Diagnosis of Hypovascular Hepatic Lesions Showing Hypo-intensity in the Hepatobiliary Phase of Gd-EOB- DTPA-enhanced MR Imaging in High-risk

The Diagnosis of Hypovascular Hepatic Lesions Showing Hypo-intensity in the Hepatobiliary Phase of Gd-EOB- DTPA-enhanced MR Imaging in High-risk 2013 67 4 239 244 The Diagnosis of Hypovascular Hepatic Lesions Showing Hypo-intensity in the Hepatobiliary Phase of Gd-EOB- DTPA-enhanced MR Imaging in High-risk Patients for Hepatocellular Carcinoma

More information

ADRENAL LESIONS 10/09/2012. Adrenal + lesion. Introduction. Common causes. Anatomy. Financial disclosure. Dr. Boraiah Sreeharsha. Nothing to declare

ADRENAL LESIONS 10/09/2012. Adrenal + lesion. Introduction. Common causes. Anatomy. Financial disclosure. Dr. Boraiah Sreeharsha. Nothing to declare ADRENAL LESIONS Financial disclosure Nothing to declare Dr. Boraiah Sreeharsha MBBS;FRCR;FRCPSC Introduction Adrenal + lesion Adrenal lesions are common 9% of the population Increase in the detection rate

More information

Hepatobiliary Contrast Agents for Liver MRI

Hepatobiliary Contrast Agents for Liver MRI Hepatobiliary Contrast Agents for Liver MRI Scott B. Reeder, MD, PhD International Society for Magnetic Resonance in Medicine Sociedad Mexicana de Radiologia e Imagen (SMRI) Mexico City June 4, 2014 Department

More information

Cystic Disease of the Liver Work Up and Management. Louis Ferrari MD, PGY 3 6/9/16 SUNY Downstate Medical Center

Cystic Disease of the Liver Work Up and Management. Louis Ferrari MD, PGY 3 6/9/16 SUNY Downstate Medical Center Cystic Disease of the Liver Work Up and Management Louis Ferrari MD, PGY 3 6/9/16 SUNY Downstate Medical Center The Case 73F presents to clinic after diagnostic laparoscopy at OSH. Known liver mass for

More information

Imaging features of benign hepatic lesions at US and CT imaging: a pictorial review.

Imaging features of benign hepatic lesions at US and CT imaging: a pictorial review. Imaging features of benign hepatic lesions at US and CT imaging: a pictorial review. Poster No.: C-1557 Congress: ECR 2016 Type: Educational Exhibit Authors: M. Barros, L. A. Ferreira, P. B. Oliveira,

More information

Role of imaging in RCC. Ultrasonography. Solid lesion. Cystic RCC. Solid RCC 31/08/60. From Diagnosis to Treatment: the Radiologist Perspective

Role of imaging in RCC. Ultrasonography. Solid lesion. Cystic RCC. Solid RCC 31/08/60. From Diagnosis to Treatment: the Radiologist Perspective Role of imaging in RCC From Diagnosis to Treatment: the Radiologist Perspective Diagnosis Staging Follow up Imaging modalities Limitations and pitfalls Duangkamon Prapruttam, MD Department of Therapeutic

More information

Cystic lesions of the liver

Cystic lesions of the liver Cystic lesions of the liver Poster No.: C-0408 Congress: ECR 2014 Type: Educational Exhibit Authors: E. Rosado, J. Pereira, S. El Bouchaibi, M. A. A. Bali ; 1 1 2 2 3 3 4 4 Amadora/PT, Lisboa/PT, Bruxelles/BE,

More information

Detection and Characterization of Hepatocellular Carcinoma by Imaging

Detection and Characterization of Hepatocellular Carcinoma by Imaging CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2005;3:S136 S140 Detection and Characterization of Hepatocellular Carcinoma by Imaging OSAMU MATSUI Department of Imaging Diagnosis and Interventional Radiology,

More information

Neoplasms of the Canine, Feline and Lemur Liver:

Neoplasms of the Canine, Feline and Lemur Liver: Neoplasms of the Canine, Feline and Lemur Liver: Classification and Prognosis Annual Seminar of the French Society of Veterinary Pathology John M. Cullen VMD PhD DACVP North Carolina State University Primary

More information

Review of Hepatobiliary Contrast Agents: Current Applications and Challenges

Review of Hepatobiliary Contrast Agents: Current Applications and Challenges REVIEW Review of Hepatobiliary Contrast Agents: Current Applications and Challenges Alex Frydrychowicz, M.D.*, The group of hepatobiliary contrast agents comprises two gadolinium-based contrast agents

More information

Resident Teaching Conference:

Resident Teaching Conference: Resident Teaching Conference: Evaluation of the Dreaded Liver Mass May 6, 2011 Sunil Geevarghese, MD, HS 00 Matt Landman, MD Anatomy Overview Couinaud anatomy Resection nomenclature Functional Assessment

More information

Liver Specific MRI using Gd-EOB-DTPA Disodium (Primovist) Effects Change in Management of Indeterminate Liver Lesions.

Liver Specific MRI using Gd-EOB-DTPA Disodium (Primovist) Effects Change in Management of Indeterminate Liver Lesions. Liver Specific MRI using Gd-EOB-DTPA Disodium (Primovist) Effects Change in Management of Indeterminate Liver Lesions. Poster No.: C-1751 Congress: ECR 2012 Type: Authors: Keywords: DOI: Educational Exhibit

More information

Renal masses - the role of diagnostic imaging

Renal masses - the role of diagnostic imaging Renal masses - the role of diagnostic imaging Poster No.: C-2471 Congress: ECR 2015 Type: Educational Exhibit Authors: V. Rai#; Bjelovar/HR Keywords: Cysts, Cancer, Structured reporting, Ultrasound, MR,

More information

Liver imaging takes a step forward with Ingenia

Liver imaging takes a step forward with Ingenia Publication for the Philips MRI Community ISSUE 49 2013 / 2 Liver imaging takes a step forward with Ingenia Lyon South Hospital strives to move from several studies first CT, then MR or PET to using just

More information

Pediatric Retroperitoneal Masses Radiologic-Pathologic Correlation

Pediatric Retroperitoneal Masses Radiologic-Pathologic Correlation Acta Radiológica Portuguesa, Vol.XVIII, nº 70, pág. 61-70, Abr.-Jun., 2006 Pediatric Retroperitoneal Masses Radiologic-Pathologic Correlation Marilyn J. Siegel Mallinckrodt Institute of Radiology, Washington

More information

With the widespread use of hepatic imaging, liver masses

With the widespread use of hepatic imaging, liver masses 2B: Liver Assessment of the Liver Mass: What Do You Need to Know? With the widespread use of hepatic imaging, liver masses are detected either unexpectedly or in the course of screening for liver cancer

More information

The Contribution of Contrast Enhanced Ultrasound for the characterization of benign liver lesions in clinical practice a monocentric experience

The Contribution of Contrast Enhanced Ultrasound for the characterization of benign liver lesions in clinical practice a monocentric experience Original papers Med Ultrason 2012, Vol. 14, no. 4, 283-287 The Contribution of Contrast Enhanced Ultrasound for the characterization of benign liver lesions in clinical practice a monocentric experience

More information

U ltrasonography (US) is reported to be the primary

U ltrasonography (US) is reported to be the primary 401 LIVER Improved characterisation of histologically proven liver tumours by contrast enhanced ultrasonography during the portal venous and specific late phase of SHU 508A C F Dietrich, A Ignee, J Trojan,

More information

Rare primary liver tumors - MRI pictorial review

Rare primary liver tumors - MRI pictorial review Rare primary liver tumors - MRI pictorial review Poster No.: C-2293 Congress: ECR 2017 Type: Educational Exhibit Authors: R. Lameiras, J. Cruz, J. Felício Costa, F. D. Figueiredo, A. 1 1 1 1 2 1 1 1 2

More information

Hepatocellular Adenomas: Genetics & Imaging Update 2017

Hepatocellular Adenomas: Genetics & Imaging Update 2017 No financial disclosures Hepatocellular Adenomas: Genetics & Imaging Update 2017 Srinivasa Prasad MD The UT MD Anderson Cancer Center Aims & Objectives To provide a current update on genetics & molecular

More information

Imaging Features of Sclerosed Hemangioma

Imaging Features of Sclerosed Hemangioma Sclerosed Hemangioma Abdominal Imaging Clinical Observations Deirdre J. Doyle 1 Korosh Khalili 1 Maha Guindi 2 Mostafa Atri 3 Doyle DJ, Khalili K, Guindi M, Atri M Keywords: abdominal imaging, CT, liver,

More information

Traumatic and Non Traumatic Adrenal Emergencies

Traumatic and Non Traumatic Adrenal Emergencies Traumatic and Non Traumatic Adrenal Emergencies Michael N. Patlas, MD, FRCPC (1), Christine O. Menias, MD (2), Douglas S. Katz, MD, FACR (3), Ania Z. Kielar, MD, FRCPC (4), Alla M. Rozenblit, MD (5), Jorge

More information

Modern liver imaging techniques - A new era in liver ultrasound

Modern liver imaging techniques - A new era in liver ultrasound Modern liver imaging techniques - A new era in liver ultrasound Yuko Kono, M.D., Ph.D. Clinical Professor Departments of Medicine and Radiology University of California, San Diego San Diego, USA How to

More information

ADRENAL MR: PEARLS AND PITFALLS

ADRENAL MR: PEARLS AND PITFALLS ADRENAL MR: PEARLS AND PITFALLS Frank Miller, M.D. Lee F. Rogers MD Professor of Medical Education Chief, Body Imaging Section and Fellowship Medical Director, MR Imaging Professor of Radiology Northwestern

More information

CLINICAL MANAGEMENT. Asymptomatic Liver Mass. Clinical Case. Background

CLINICAL MANAGEMENT. Asymptomatic Liver Mass. Clinical Case. Background GASTROENTEROLOGY 2006;131:619 623 CLINICAL MANAGEMENT Loren Laine, Section Editor Asymptomatic Liver Mass ROBERT S. BROWN, Jr Department of Medicine and Department of Surgery, Columbia University College

More information

Liver Tumors. Patient Education. Treatment options 8 4A. About the Liver. Surgical Specialties

Liver Tumors. Patient Education. Treatment options 8 4A. About the Liver. Surgical Specialties Patient Education Treatment options This handout describes different kinds of tumors that form in the liver and how they are treated. About the Liver Your liver is the largest organ in your abdomen. It

More information

Normal Sonographic Anatomy

Normal Sonographic Anatomy hapter 2:The Liver DUNSTAN ABRAHAM Normal Sonographic Anatomy Homogeneous, echogenic texture (Figure 2-1) Measures approximately 15 cm in length and 10 12.5 cm anterior to posterior; measurement taken

More information

Hepatocellular Carcinoma: Diagnosis and Management

Hepatocellular Carcinoma: Diagnosis and Management Hepatocellular Carcinoma: Diagnosis and Management Nizar A. Mukhtar, MD Co-director, SMC Liver Tumor Board April 30, 2016 1 Objectives Review screening/surveillance guidelines Discuss diagnostic algorithm

More information

Intrahepatic Sarcomatoid Cholangiocarcinoma with Portal Vein Thrombosis: A Case Report 1

Intrahepatic Sarcomatoid Cholangiocarcinoma with Portal Vein Thrombosis: A Case Report 1 Intrahepatic Sarcomatoid Cholangiocarcinoma with Portal Vein Thrombosis: A Case Report 1 Jae-Hoon Lim, M.D., Jin Woong Kim, M.D., Suk Hee Heo, M.D., Yong Yeon Jeong, M.D., Heoung Keun Kang, M.D. A 53-year-old

More information

Brief History. Identification : Past History : HTN without regular treatment.

Brief History. Identification : Past History : HTN without regular treatment. Brief History Identification : Name : 陳 x - Admission : 94/10/06 Gender : male Age : 75 y/o Chief Complaint : Urinary difficulty for months. Past History : HTN without regular treatment. Brief History

More information

Embolization of benign hepatics tumours. When, How and Why?

Embolization of benign hepatics tumours. When, How and Why? Embolization of benign hepatics tumours. When, How and Why? Poster No.: C-1116 Congress: ECR 2015 Type: Educational Exhibit Authors: M. D. Ferrer-Puchol, C. La Parra Casado, R. Ramiro, R. Sala, 1 1 1 1

More information

Invited Re vie W. Analytical histopathological diagnosis of small hepatocellular nodules in chronic liver diseases

Invited Re vie W. Analytical histopathological diagnosis of small hepatocellular nodules in chronic liver diseases Histol Histopathol (1 998) 13: 1077-1 087 http://www.ehu.es/histoi-histopathol Histology and Histopathology Invited Re vie W Analytical histopathological diagnosis of small hepatocellular nodules in chronic

More information

Hepatic Adenoma and Focal Nodular Hyperplasia: Diagnosis and Criteria for Treatment

Hepatic Adenoma and Focal Nodular Hyperplasia: Diagnosis and Criteria for Treatment Hepatic Adenoma and Focal Nodular Hyperplasia: Diagnosis and Criteria for Treatment Luciano De Carlis,* Vincenzo Pirotta,* GianFranco Rondinara,* Cosimo V. Sansalone,* Giovanni Colella,* Giuseppe Maione,*

More information

5/17/2013. Pancreatic Cancer. Postgraduate Course in General Surgery CASE 1: CASE 1: Overview. Case presentation. Differential diagnosis

5/17/2013. Pancreatic Cancer. Postgraduate Course in General Surgery CASE 1: CASE 1: Overview. Case presentation. Differential diagnosis Overview Case presentation Postgraduate Course in General Surgery Differential diagnosis Diagnosis and therapy Eric K. Nakakura Koloa, HI March 26, 2013 Outcomes CASE 1: CASE 1: A 78-year-old man developed

More information

Common and unusual CT and MRI manifestations of pancreatic adenocarcinoma: a pictorial review

Common and unusual CT and MRI manifestations of pancreatic adenocarcinoma: a pictorial review Review Article Common and unusual CT and MRI manifestations of pancreatic adenocarcinoma: a pictorial review Min-Jie Yang, Su Li, Yong-Guang Liu, Na Jiao, Jing-Shan Gong Department of Radiology, Shenzhen

More information

Abdominal MRI Techniques in Pediatric Oncology

Abdominal MRI Techniques in Pediatric Oncology Abdominal MRI Techniques in Pediatric Oncology Jonathan R. Dillman, M.D. Assistant Professor Departments of Radiology & Urology Section of Pediatric Radiology C.S. Mott Children s Hospital Disclosures

More information

The Frequency and Significance of Small (15 mm) Hepatic Lesions Detected by CT

The Frequency and Significance of Small (15 mm) Hepatic Lesions Detected by CT 535 Elizabeth C. Jones1 Judith L. Chezmar Rendon C. Nelson Michael E. Bernardino Received July 22, 1991 ; accepted after revision October 16, 1991. Presented atthe annual meeting ofthe American Aoentgen

More information

US LI-RADS v2017 CORE

US LI-RADS v2017 CORE US LI-RADS v2017 CORE Screening or surveillance US in patient at high risk for HCC US category US-1 US-2 US-3 Negative Subthreshold Positive Category Concept Definition US-1 Negative US-2 Subthreshold

More information

Sclerosing angiomatoid nodular transformation (SANT) of the spleen: a case report with FDG-PET findings and literature review

Sclerosing angiomatoid nodular transformation (SANT) of the spleen: a case report with FDG-PET findings and literature review Case Report Sclerosing angiomatoid nodular transformation (SANT) of the spleen: a case report with FDG-PET findings and literature review Acta Radiologica Open 5(8) 1 6! The Foundation Acta Radiologica

More information

Differentiation of hepatocellular adenoma and focal nodular hyperplasia using 18 F-fluorocholine PET/CT

Differentiation of hepatocellular adenoma and focal nodular hyperplasia using 18 F-fluorocholine PET/CT Eur J Nucl Med Mol Imaging (2011) 38:436 440 DOI 10.1007/s00259-010-1584-0 SHORT COMMUNICATION Differentiation of hepatocellular adenoma and focal nodular hyperplasia using 18 F-fluorocholine PET/CT Jacomina

More information