Journal of Liver Cancer

Original Article

Diagnostic Performance of Diffusion-weighted Imaging for Hepatic Neuroendocrine Tumor: Comparison with Combined Diffusion-weighted Imaging and Contrast-enhanced Magnetic Resonance Imaging: Suk Ki Jang, Jung Hoon Kim, Mi Hye Yu, Joon Koo Han; J Liver Cancer. 2016;16(2):92-100. Published online September 30, 2016; DOI: https://doi.org/10.17998/jlc.16.2.92

Abstract PDF: Background/Aims
To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for hepatic neuroendocrine tumors (NET) compared with combined DWI and contrastenhanced magnetic resonance imaging (MRI) .
Methods
Fifteen patients with hepatic NET (n=128) underwent enhanced MRI and DWI with multiple-b values. We analyzed three different sets: Precontrast set; DWI set (added DWI); combined set (added enhanced image). Two reviewers rated possibility of NET using a 5-point scale for each image set. Their diagnostic performance was compared using Jackknife alternative free-response ROC (JAFROC).
Results
Diagnostic performance was better on the combined set (figure of merit [FOM]=0.852, 0.761) than the precontrast set (FOM=0.427, 0.572, P<0.05) and the DWI set (FOM=0.682, 0.620, P<0.05). However, DWI improved performance compared with precontrast set without statistical difference. In small NETs (<1 cm), all sets showed low sensitivity (10.7-65.9%) with high specificity (95.4-100%). Interobserver agreement was moderate in all image sets (k=0.521 to 0.589).
Conclusions
Combined DWI and enhanced MRI were more useful for detecting NET. Although statistically insignficant, there was a trend in improved diagnostic performance with DWI.

Case Report

A Case of Small HCC: Chang Hyeon Seock, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Young-Hwa Chung, Yung Sang Lee; Journal of the Korean Liver Cancer Study Group. 2012;12(1):28-31. Published online February 28, 2012

Abstract PDF: According to AASLD practice guideline, nodules that are smaller than 1 cm should be followed with ultrasound at intervals from 3-6 months and nodules larger than 1 cm found on ultrasound screening of a cirrhotic liver should be investigated further with either 4-phase multidetector CT scan or dynamic contrast enhanced MRI. If the appearances are typical of HCC, the lesion should be treated as HCC. We experienced a patient who has a hepatic nodule smaller than 1 cm and followed AASLD guideline and performed radiofrequency ablation for hepatocellularcarcinoma after 13 months later. MRI helped to diagnose hepatic nodule as a hepatocellularcarcinoma during surveillance.

Review Articles

Radiological Evaluation of Treatment Response of Hepatocellular Carcinoma: Yong Moon Shin; Journal of the Korean Liver Cancer Study Group. 2011;11(1):12-17. Published online February 28, 2011

Abstract PDF: For hepatocelluar carcinoma(HCC), there are several treatment options such as transcatheter arterial chemoembolization (TACE), radiofrequency ablation (RFA), and radiation therapy. It is essential to be familiar with the radiologic findings to know whether the residual or recurrent tumor exist after treatment. But, radiological image findings show complex responses according to the initial tumor morphology and treatment methods. One purpose of this article is to discuss the guidelines to evaluate the tumor response of HCC after treatment. And the other purpose is to evaluate the imaging features of HCC after various treatment
methods
and to reveal the limitations of each imaging technique in evaluating the therapeutic effect on HCC.

Hypervascular hepatic nodules which needs to be differentiated from hepatocellular carcinoma: Mi-Suk Park, Ki Whang Kim; Journal of the Korean Liver Cancer Study Group. 2007;7(1):1-7. Published online June 30, 2007

Abstract PDF: The frequency of hepatic nodular lesion detection has increased due to recent advances in imaging diagnostic techniques. There are many hypervascular hepatic nodules which need to be differentiated from hepatocellular carcinoma. Of these lesions, hepatic adenoma, focal nodular hyperplasia, nodular regenerative hyperplasia, and focal nodular hyperplasia-like nodules will be described in this review article. All of them are hypervascular and so it is needed to differentiate hepatocellular carcinoma.

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