Evidence map›Paper›PMID 38900280›Full record

ArticleEuropean radiology2024

Lesions hyper- to isointense to surrounding liver in the hepatobiliary phase of gadoxetic acid-enhanced MRI.

Alicia Furumaya, François E J A Willemssen, Razvan L Miclea, Martijn P D Haring, Robbert J de Haas, Shirin Feshtali, Inge J S Vanhooymissen, Daniel Bos, Robert A de Man, Jan N M Ijzermans and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Potential to Avoid Invasive Procedures for Atypical Focal Nodular Hyperplasia (FNH) and FNH-like Lesions Based on MR Findings.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2026
    Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Alicia Furumaya *Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. a.furumaya@amsterdamumc.nl.ORCID http://orcid.org/0000-0001-5897-0438
François E J A Willemssen *Department of Radiology and Nuclear Medicine, Erasmus MC, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Razvan L MicleaDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht University, Maastricht, The Netherlands.
Martijn P D HaringDepartment of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Robbert J de HaasDepartment of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Shirin FeshtaliDepartment of Radiology, Leiden UMC, Leiden University, Leiden, The Netherlands.
Inge J S VanhooymissenCancer Center Amsterdam, Amsterdam, The Netherlands.
Daniel BosDepartment of Radiology and Nuclear Medicine, Erasmus MC, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Robert A de ManDepartment of Gastroenterology and Hepatology, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands.
Jan N M IjzermansDepartment of Surgery, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands.
Joris I ErdmannDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Joanne VerheijCancer Center Amsterdam, Amsterdam, The Netherlands.
Michail C DoukasDepartment of Pathology, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands.
Otto M van DeldenCancer Center Amsterdam, Amsterdam, The Netherlands.
Maarten G J ThomeerDepartment of Radiology and Nuclear Medicine, Erasmus MC, Erasmus University Rotterdam, Rotterdam, The Netherlands.

Funding

Amsterdam University Medical Centers MD/PhD scholarship
6 · The paper itself

Abstract

objectivesHyper- or isointensity in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI has high specificity for focal nodular hyperplasia (FNH) but may be present in hepatocellular adenoma and carcinoma (HCA/HCC). This study aimed to identify imaging characteristics differentiating FNH and HCA/HCC. MATERIALS AND

methodsThis multicenter retrospective cohort study included patients with pathology-proven FNH or HCA/HCC, hyper-/isointense in the HBP of gadoxetic acid-enhanced MRI between 2010 and 2020. Diagnostic performance of imaging characteristics for the differentiation between FNH and HCA/HCC were reported. Univariable analyses, multivariable logistic regression analyses, and classification and regression tree (CART) analyses were conducted. Sensitivity analyses evaluated imaging characteristics of B-catenin-activated HCA.

resultsIn total, 124 patients (mean age 40 years, standard deviation 10 years, 108 female) with 128 hyper-/isointense lesions were included. Pathology diagnoses were FNH and HCA/HCC in 64 lesions (50%) and HCA/HCC in 64 lesions (50%). Imaging characteristics observed exclusively in HCA/HCC were raster and atoll fingerprint patterns in the HBP, sinusoidal dilatation on T2-w, hemosiderin, T1-w in-phase hyperintensity, venous washout, and nodule-in-nodule partification in the HBP and T2-w. Multivariable logistic regression and CART additionally found a T2-w scar indicating FNH, less than 50% fat, and a spherical contour indicating HCA/HCC. In our selected cohort, 14/48 (29%) of HCA were B-catenin activated, most (13/14) showed extensive hyper-/isointensity, and some had a T2-w scar (4/14, 29%).

conclusionIf the aforementioned characteristics typical for HCA/HCC are encountered in lesions extensively hyper- to isointense, further investigation may be warranted to exclude B-catenin-activated HCA. CLINICAL RELEVANCE: Hyper- or isointensity in the HBP of gadoxetic acid-enhanced MRI is specific for FNH, but HCA/HCC can also exhibit this feature. Therefore, we described imaging patterns to differentiate these entities. KEY POINTS: FNH and HCA/HCC have similar HBP intensities but have different malignant potentials. Six imaging patterns exclusive to HCA/HCC were identified in this lesion population. These features in liver lesions hyper- to isointense in the HBP warrant further evaluation.

Indexed as

Carcinoma, HepatocellularContrast MediaFocal Nodular HyperplasiaGadolinium DTPALiver NeoplasmsMagnetic Resonance ImagingAdenoma, Liver CellAdultDiagnosis, DifferentialFemaleHumansLiverMaleMiddle AgedRetrospective StudiesSensitivity and SpecificityContrast MediaGadolinium DTPAgadolinium ethoxybenzyl DTPAFocal nodular hyperplasiaGadolinium DTPAHepatocellular carcinomaLiver cell adenomaMagnetic resonance imaging

Identifiers

PMID38900280
PMCPMC11557620

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