Hepatocellular cancer (HCC) is the second cancer death cause in the world. Its identification and correct characterization are very important because it’s a virtually curable pathology in early stage. Several american and european guidelines (AASLD [1], EASL-EORTC [2], ESMO-ESDO [3]) for HCC management exist and they agree about the use of multiphasic Computed Tomography (CT) or extracellular contrast medium dinamic Magnetic Resonance Imaging (MRI) as second level methodicals to better characterize a focal hepatic lesion discovered by Ultrasonography (US) in a cirrhotic patient. The only...

We enrolled the first 26 consecutive cirrhotic patients (mean age: 63,4 years) that previously had undergone a multiphasic CT (Revolution CT or Optima 660, Ge Healthcare) examination showing a focal hepatic lesion suspicious for HCC. CT protocol included basal study and arterial, portal and late phase scan after intravenous injection of iodine contrast medium (Iomeron 400). After one month patients underwent a Gd-EOB-DTPA (Primovist) MRI (Achieva 1,5 Tesla, Philips). T1- (in- and out-of phase), T2-, dynamic multipashic T1- (with fat suppression) and diffusion (DWI) weighted...

CT recognized 63 nodules: 11 HCC (17%), 39 atypical lesions (group 1) (62%) and 13 lesions (21%) not ascribable to HCC. 25 CT atypical lesions (64%) were classified in MRI as typical (64%) or atypical (groups 2A 28% -2B 8%) HCC; 10% continued to be evaluated as lesions of uncertain diagnosis. All lesions on category 2A and 2B were confirmed by histology. 95% of lesions characterized as typical HCC in MRI was hypointense in hepatobiliary phase. Average dimension of nodules with atypical vascularization pattern, in...

Gd-EOB-DTPA MRI has the potential to give best performances concerning detection and classification of focal hepatic lesions, particularly those with atypical aspect, providing a more correct diagnostic-therapeutic characterization [6]. This is due to its multiparametric data, furnished by DWI and mainly by hepatobiliary phase sequence that has best correlation with presence of HCC (95% of accuracy in our research). According to our study, a dimensional cut-off (15 mm) could be used to differentiate smaller lesions, that have more probability to be atypical and strictly need...

1. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology 2011; 53: 1020–22. 2. European Association for the Study of the Liver, European Organisation for Research and treatment of Cancer. EASL–EORTC Clinical Practice Guidelines: management of hepatocellular carcinoma. J. Hepatol. 2012; 56: 908–43. 3. Verslype C, Rosmorduc O, Rougier P; ESMO Guidelines Working Group. Hepatocellular carcinoma: ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012 Oct;23 Suppl 7:vii41-8. 4. Ye F, Liu J, Ouyang H. Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid...