Keywords:
Abdomen, Liver, CT, MR, Surgery, Diagnostic procedure, Transplantation
Authors:
G. Besutti, A. Pecchi, M. De Santis, G. Tarantino, F. Di Benedetto, P. Torricelli; Modena/IT
DOI:
10.1594/ecr2013/B-0237
Purpose
Liver Transplantation (LT) is the preferred treatment for selected patients with hepatocellular carcinoma (HCC).
However,
even after the introduction of selection criteria such as Milan Criteria (1),
HCC recurrence rate after LT has been estimated to be 8-15% (2,3).
Many investigators have reported on the spectrum of imaging findings and recurrence patterns of HCC after LT (2-4),
distinguishing different patterns on the basis of recurrence location (2) or timing (4).
The majority of tumor burden in recurrent HCC is typically in extrahepatic locations (2) and the average time for recurrence ranges between 1 and 2 years after LT (4).
To our knowledge,
the issue of possible variations in imaging and histopathological characteristics between the primary and the recurrent HCC,
particularly referring to the enhancement pattern and to the differentiation degree,
have never been investigated.
Recently,
some studies have compared dynamic MDCT and MRI findings with histopathological differentiation degree,
showing a correlation between higher histopathological grade and hypervascular enhancement pattern (5).
The aim of this study was to describe the patterns and imaging features of HCC recurrence after LT and to evaluate the variations in imaging and histopathological characteristics between the primary and the recurrent HCC,
particularly elucidating whether differentiation degree variations may justify enhancement pattern changes.