Poster Author of 1 e-Poster
SE-102 - Pretext staging for hepatoblastoma according to MRI
Author of 1 Presentation
SE-102 - Pretext staging for hepatoblastoma according to MRI
Abstract
Purpose
Identify the basic anatomical and topographic criteria for hepatoblastoma staging according to the PRETEXT staging, to evaluate diagnostic significance of MRI in preoperative quantitative and qualitative assessment of hepatic parenchyma
Material and methods
MRI was performed in 68 patients with hepatoblastoma (average age 3.1 years) on a 1.5T system for evaluation volume and tumor spread. Study protocol included images in the mode T1 and T2 WI, DWI, MRСP and IV contrast enhancement.
Results
Hepatoblastoma were detected on MRI as solid lesions affecting larger part of liver, often rendered as multifocal lesions, with signs of hypervascularization in arterial and venous phases, with signs of decay in central sections. PRETEXT system was used for tumor staging. In PRETEXT I group (n = 3, 4,4%) two patients underwent left lateral sectionectomy and one – right hemihepatectomy. In PRETEXT II group (n = 26, 38,2%) nine patients underwent right hemihepatectomy, three – left hemihepatectomy, two - left lateral sectionectomy (POSTEXT I), twelve - extended right hemihepatectomy. In PRETEXT III group (n = 21, 30,8%) 20 patients underwent extended hemihepatectomy, one patient – mesohepatectomy. In one case two-stage surgery with extended right hemihepatectomy was performed due to insufficient future liver remnant. In PRETEXT IV group (n = 18, 26,4%) 9 patients underwent bilobar resection, and 9 - living donor liver transplantation
Conclusion
Comparison of hepatoblastoma imaging showed high accuracy in determining the stage of PRETEXT/POSTEXT. MRI with contrast enhancement allows to reliably the quantitative and qualitative assessment of hepatic parenchyma, especially in planning of extended liver resection.