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Topic
AI, Machine Learning, Radiomics, Liver - Focal Liver Lesions, Liver - Other, Oncology
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Vernuccio, Palermo, IT","photo":""},"playlist":[{"name":"","source":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/1034_1p.mp4","source_path":"s3:\/\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/1034_1p.mp4","cover":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/7819F5B7.jpg","data":[],"tracks":[],"chapters":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/1034_1p.vtt","thumbnails":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/1034_1p-thumbnails.vtt"}]},{"name":"SS 13.4 - Stereotactic body radiation therapy for HCC: multiparametric MRI to evaluate response to treatment and progression-free survival","mode":"playlist","public":true,"info":{"id":839,"presentation":"SS 13.4 - Stereotactic body radiation therapy for HCC: multiparametric MRI to evaluate response to treatment and progression-free survival","session":"SS 13 - Focal liver tumours: diagnosis and intervention","presenter":"R. Faletti, Turin, IT","photo":""},"playlist":[{"name":"","source":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/839_1p.mp4","source_path":"s3:\/\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/839_1p.mp4","cover":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/4C01CBCC.jpg","data":[],"tracks":[],"chapters":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/839_1p.vtt","thumbnails":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/839_1p-thumbnails.vtt"}]},{"name":"SS 13.7 - Public availability of trial results assessing transarterial chemoembolisation for treating HCC","mode":"playlist","public":true,"info":{"id":511,"presentation":"SS 13.7 - Public availability of trial results assessing transarterial chemoembolisation for treating HCC","session":"SS 13 - Focal liver tumours: diagnosis and intervention","presenter":"J. 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Perrot, Clichy, FR","photo":""},"playlist":[{"name":"","source":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/516_1p.mp4","source_path":"s3:\/\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/516_1p.mp4","cover":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/4E297A56.jpg","data":[],"tracks":[],"chapters":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/516_1p.vtt","thumbnails":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/516_1p-thumbnails.vtt"}]},{"name":"SS 13.10 - Hepatobiliary MR contrast agents are useful to diagnose HCC in patients with Budd-Chiari syndrome","mode":"playlist","public":true,"info":{"id":515,"presentation":"SS 13.10 - Hepatobiliary MR contrast agents are useful to diagnose HCC in patients with Budd-Chiari syndrome","session":"SS 13 - Focal liver tumours: diagnosis and intervention","presenter":"M. Ronot, Clichy, FR","photo":""},"playlist":[{"name":"","source":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/515_1p.mp4","source_path":"s3:\/\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/515_1p.mp4","cover":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/C0A67DB5.jpg","data":[],"tracks":[],"chapters":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/515_1p.vtt","thumbnails":"https:\/\/s3.eu-central-1.amazonaws.com\/eu-cslide-prod-recordings\/esgar2020\/81\/v\/515_1p-thumbnails.vtt"}]}]
{"type":2,"code":"8E32WM02p"}
[session]
[presentation]
[presenter]
SS 13.2 - B-mode US is more accurate than contrast-enhanced US for the subtyping of hepatocellular adenomas
Presentation Number
SS 13.2
Channel
On-demand channel 4
Purpose
To compare the features of hepatocellular adenoma subtypes (HCAs) in B-mode and contrast-enhanced US (CEUS).
Material and methods
Thirty-four patients (31 women (91%), median age 43.5 years [27-67]) with 45 pathologically proven and subtyped HCAs (including 29 inflammatory HCAs (I-HCA) and 15 HNF1-α-inactivated HCAs (H-HCA)) who underwent CEUS were included. The features of HCA on B-mode and CEUS were independently reviewed by two radiologists and compared between HCA subtypes.
Results
I-HCAs were either hypoechoic (23/29, 79%) or isoechoic (4/29, 14%) with B-mode and 12 (41.4%) were heterogeneous. All H-HCAs except one demonstrated homogeneous hyperechogenicity (93%) (p=0.001). Moderate or marked liver steatosis was only observed in I-HCAs (12/29, 41%) (p=0.001). Arterial hyperenhancement was observed on CEUS in 27/29 (93%) I-HCAs and in 14/15 (93%) H-HCAs (p=0.98). Washout was present in 6/29 (21%) I-HCAs and 1/15 (7%) H-HCAs (p=0.27). A total of 23/29 (79%) I-HCAs and 15/15 (100%) HCAs were homogeneous on portal and delayed phase acquisitions (p=0.04). The positive predictive value for identifying an H-HCA was 100% when the lesion was homogeneous and hyperechoic on B-mode, and the negative predictive value was 100% if neither of these two features was present in a liver with obvious steatosis.
Conclusion
Most CEUS features, especially enhancement patterns, do not significantly differ between HCAs. CEUS does not seem to provide additional information from B-mode US. The combination of B-mode lesion hyperechogenicity, homogeneity and the absence of obvious liver steatosis is useful to distinguish H-HCAs from I-HCAs.
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[session]
[presentation]
[presenter]
SS 13.3 - Gadoxetic acid-enhanced MRI findings of hepatocellular adenomas in glycogen storage disease type 1
Presentation Number
SS 13.3
Channel
On-demand channel 4
Purpose
To investigate the gadoxetic acid-enhanced MRI findings of hepatocellular adenomas (HCAs) in patients with glycogen storage disease type 1 (GSD1).
Material and methods
All consecutive GSD1 patients with HCAs studied with gadoxetic acid-enhanced MRI were retrospectively included. Qualitative MRI analysis of the HCAs in the various sequences and contrast phases was performed.
Results
Eight consecutive GSD1 patients (mean age 26.6 years ± 7.6; 4 men, 4 women) with 47 seven HCAs (mean size 1.2 cm ± 0.9) were included. Seven of 8 patients (87.5%) had multiple lesions (range 2-16). Of the 47 HCAs, 5 (11%) showed a pseudocapsule, 9 (19%) fat content, 31(66%) hyperintensity on T2-weighted images, but lack of atoll sign, and 26 (55%) hyperintensity on T1-weighted images. Of note, peripheral rim distribution of fat was demonstrated in 2 HCAs. Arterial enhancement was documented in 42 (89%) of 47 HCAs (weak in 35 [83%] of 42), a portal venous washout in 6 (13%), lesion contrast retention in the hepatobiliary phase in 11 (23%), and perilesional contrast retention in the hepatobiliary phase in 16 (34%). HCAs <1 cm (28 of 47) were more homogeneous than HCAs ≥1 cm (19 of 47) in almost all sequences and contrast phases. A peripheral rim of contrast retention was documented in 6 (21%) of 28 HCAs <1 cm and in 10 (53%) of the 19 HCAs ≥1 cm.
Conclusion
HCAs in GSD 1 may show different MRI features compared to the general population, including anomalous fat distribution, lack of atoll sign, and weak arterial enhancement.
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[session]
[presentation]
[presenter]
SS 13.4 - Stereotactic body radiation therapy for HCC: multiparametric MRI to evaluate response to treatment and progression-free survival
Presentation Number
SS 13.4
Channel
On-demand channel 4
Purpose
To outline the role of multiparametric MR (mpMR) in the assessment of HCC response to stereotactic body radiation therapy (SBRT).
Material and methods
Twenty-six patients (19M and 7 F; average age 63.7 y.o.) were retrospectively enrolled for a total of 42 lesions. MpMR was performed with 1.5 T scanner and gadoxetic acid. Images were evaluated by two different readers. The continuous variables were subjected to the Shapiro-Wilk normality test; Wilcoxon test was used for the comparison between paired variables, while the Mann-Whitney test was used for the independent variables; progression-free survival (PFS) was evaluated by Kaplan-Meier curves.
Results
Comparison between pre-SBRT and post-SBRT shows different significant features at 1st mpMR: arterial tissue enhancement (18.9 vs 8.4 mm; p < 0.0001), diameter (20.3 vs 16.5 mm; p < 0.0001), T2w intensity (21 vs 8 lesions; p 0.006), DWI intensity (26 vs 8 lesions; p < 0.0001) and ADC value (1.0 vs 1.4; p < 0.0001). The only feature significantly changed at 2nd mpMR was diameter (16.5 vs 12.4 mm; p 0.008). According to mRECIST at 1st mpMR were found 2 cases of infield progression (5%) and 9 cases of outfield progression (21%). The Kaplan-Meier curve demonstrates a progressive reduction in the PFS, which reaches a plateau around 24 months.
Conclusion
The role of SBRT for the treatment of HCC is still not clearly defined. MpMR can provide early indications of treatment efficacy, in particular through DWI. SBRT is a valid alternative to other locoregional therapies, demonstrating excellent performance in terms of local disease control.
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[session]
[presentation]
[presenter]
SS 13.7 - Public availability of trial results assessing transarterial chemoembolisation for treating HCC
Presentation Number
SS 13.7
Channel
On-demand channel 4
Purpose
To evaluate to what extent the results of registered randomized controlled trials (RCTs) assessing transarterial chemoembolization (TACE) for the treatment of HCC are publicly available.
Material and methods
We searched the Cochrane Central Register of Controlled Trials, the International Clinical Trials Registry Platform and primary registries for RCTs assessing TACE for the treatment of HCC, registered between January 2008 and August 2018, that had exceeded their completion date by more than one year. We searched PubMed, EMBASE and Google Scholar for a publication as well as the registry for results. The main outcomes were the availability of results, and the time to the first availability of results (i.e., posted on the registry or published). Secondary outcomes were the proportion of results publicly available at 12, 24 and 36 months after completion.
Results
Among 68 identified RCTs (11,751 participants), 26 had publicly available results (38%, i.e. 42% of participants). Results of 25 RCTs (37%) were published, with only three with results posted on the registry, and two with both published and posted results. The median (Q1-Q3) time from completion to the first public availability of results was 19 months (12-35). The cumulative percentage of RCTs with results available, either posted on the registry or published, was 10% (95% CI, 3% to 17%) at 12 months after completion of the RCTs, and 29% (95% CI, 17% to 39%) at 36 months.
Conclusion
Despite the ethical commitments and societal expectations for disclosure of results, the availability of results of RCTs on TACE for HCC is very limited.
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[session]
[presentation]
[presenter]
SS 13.9 - Liver surface nodularity: a novel predictor of post-hepatectomy liver failure in patients with colorectal liver metastases following chemotherapy
Presentation Number
SS 13.9
Channel
On-demand channel 4
Purpose
To (i) evaluate the relationship between liver surface nodularity (LSN) and chemotherapy-associated liver injury (CALI) in patients undergoing hepatectomy for colorectal liver metastases (CLM), and (ii) assess the relationship between LSN and postoperative liver failure (PHLF).
Material and methods
This is a single-center retrospective analysis of all patients with preoperative CT scans within 6 weeks before surgery and who were undergoing chemotherapy followed by hepatectomy for CLM between 2010 and 2017. LSN was determined on CT. The association between LSN, CALI and clinically relevant PHLF (i.e. ≥ grade B) was analyzed and optimal cut-off values were determined by ROC curve analysis. Multivariate analysis and propensity score matching analysis were performed to determine the influence of LSN on PHLF ≥ grade B.
Results
A total of 26 patients (10%) developed PHLF≥grade B. The mean LSN was 2.25 (1.51-3.34). On univariate analysis, LSN was associated with a higher rate of PHLF≥grade B (p<0.001). The optimal LSN cut‐off value for detecting PHLF≥grade B was 2.5 (sensitivity, 57.7%; specificity, 77.0%, accuracy 75%, p<0.001). Among chemotherapy-related variables, LSN≥2.5 was significantly associated with prolonged chemotherapy (>6 cycles, p=0.018), but not with CALI. After propensity score matching, LSN remained significantly associated with an increased risk of PHLF≥grade B (p=0.006). Multivariate analysis identified LSN≥2.5 (OR: 4.554; 95%CI:1.986-10.754; p=0.004) as the best preoperative predictor of PHLF≥grade B in patients undergoing major hepatectomy.
Conclusion
LSN is an independent surrogate of clinically relevant PHLF in patients who undergo chemotherapy followed by hepatectomy for CLM and may provide a valuable additional tool in the preoperative assessment of these patients.
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[session]
[presentation]
[presenter]
SS 13.10 - Hepatobiliary MR contrast agents are useful to diagnose HCC in patients with Budd-Chiari syndrome
Presentation Number
SS 13.10
Channel
On-demand channel 4
Purpose
To evaluate hepatobiliary phase (HBP) images for the discrimination between benign and malignant lesions in patients with Budd-Chiari syndrome (BCS).
Material and methods
The study included all patients admitted to our institution with a diagnosis of BCS and focal liver lesions on hepatobiliary contrast agent-enhanced MRI (HBCA-MRI) from 2000 to 2019. MR images were reviewed by two radiologists blinded to the diagnosis of the lesions. Patient and lesion characteristics were recorded, with a focus on the appearance on HBP. Lesions were compared using Chi-square, Fisher, Student's t or Mann-Whitney tests.
Results
26 patients (mean 35±11 yr [range 13-65], 21 women [81%]) with 99 benign liver lesions and 12 HCC were analyzed. Patients with HCC were significantly older than those with benign lesions (mean 50±10 vs. 33±9 yr, p =.003), with higher alpha-fetoprotein (AFP) levels (3/4 [75%] vs. 1/22 [5%] with AFP>15ng/mL, p<0.001). Homogeneous lesion signal hypointensity on HBP was depicted in 14 lesions, including 12/12 (100%) HCC and 2/99 (2%) benign lesions (p<0.001). The majority of benign liver lesions showed either peripheral (n=52/99 [53%]) or homogeneous hyperintensity (n=23/99 [23%]) on HBP. Lesions with signal hypointensity on HBP in patients with an AFP serum level >15 ng/mL were all found to be HCCs.
Conclusion
The majority of benign lesions showed homogeneous or peripheral hyperintensity on HBP while all HCCs showed homogeneous signal hypointensity. HBP images are helpful for the differentiation between benign lesions and HCCs and outperform other sequences. They should systematically be acquired for the characterization of focal lesions in patients with BCS.
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[session]
[presentation]
[presenter]
