Aims and objectives
Hepatocellular carcinoma (HCC)is second most common cause for cancer related deaths worldwide. 1,2 HCC can be diagnosed non-invasivelyby theircharacteristic enhancement features on contrast enhanced dynamic computed tomography (CT) or magnetic resonance imaging (MRI) according to EASL,
AASLD and LIRADs criteria 3 . Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in both Europe and USA and linked to epidemic of obesity and metabolic syndrome. 3,4...
Methods and materials
This is an institutional review board (IRB) approved,
HIPPA-compliant retrospective study with waiver of informed consent. Patient selection: We reviewed our institutional pathology and imaging database between January 2006 and December 2016 for patients with HCC and hepatic steatosis. Inclusion criteria: HCC confirmed on pathology. Hepatic steatosis confirmed on pathology or at MRI (hepatic fat signal fraction >5%) performed within 6 months of HCC confirmation Triphasic CT obtained within 6...
Clinical characteristics: Mean age 63.3 years (range 43-80). Gender Female,
number (%) Male,
number (%) 14 (33.3) 28 (66.7) BMI (mean ± SD),
kg/m2 31.4±8.5 Obesity,
number (%) 25 (59.5) Diabetes,
number (%) 28 (66.7) Total Cholesterol (mean ± SD),
mg/dL 153±41 (range: 36 to 229) Triglycerides (mean ± SD),
mg/dL 136±53 (range: 54 to 237) Histology findings: Tumor Size (mean±SD) 4.3±3.0 cm Tumor Grade Well Well-Moderate Moderate Moderately-Poor Poor Number (%) 15 (35.7) 5 (11.9) 17 (40.5) 2...
HCCs in NAFLD on CT A significant proportion occur innon-cirrhotic liver May not demonstrate major features defined in EASL especially washout. Delayed phase imaging important for assessment of washout in these patients Inter-reader agreement is fair to very goof for major HCC features except for capsule The lack of washout may be relatedto the hepatic steatosis in the backgroundliver parenchyma and mildto moderate degree of fibrosis.
This reuslts in an hyperenhanced appearance of the HCC....
This work was performed at Departments of Radiology and Pathology,
Mayo Clinic College of Medicine,
USA Ishan Garg,
MBBS- Research Trainee Scott M.
Thompson,MD- Radiology Resident Eric C.
MD-Abdominal RadiologyFellow Shannon P.
MD- ConsultantAbdominal Radiologist Ashish Khandelwal,
MD- ConsultantAbdominal Radiologist Candice A.
MD- ConsultantAbdominal Radiologist Taofic Mounajjed,
MD - Consultant Hepatobiliary Pathologist Sudhakar...
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