PMID- 36169546
OWN - NLM
STAT- MEDLINE
DCOM- 20230324
LR  - 20230524
IS  - 1546-3141 (Electronic)
IS  - 0361-803X (Linking)
VI  - 220
IP  - 4
DP  - 2023 Apr
TI  - Hepatocellular Adenoma Subtypes Based on 2017 Classification System: Exploratory 
      Study of Gadoxetate Disodium-Enhanced MRI Features With Proposal of a Diagnostic 
      Algorithm.
PG  - 539-550
LID - 10.2214/AJR.22.28233 [doi]
AB  - BACKGROUND. The classification of hepatocellular adenomas (HCAs) was updated in 
      2017 on the basis of genetic and molecular analysis. OBJECTIVE. The purpose of 
      this article was to evaluate features on gadoxetate disodium-enhanced MRI of HCA 
      subtypes on the basis of the 2017 classification and to propose a diagnostic 
      algorithm for determining subtype using these features. METHODS. This 
      retrospective study included 56 patients (49 women, seven men; mean age, 37 +/- 13 
      [SD] years) with histologically confirmed HCA evaluated by gadoxetate 
      disodium-enhanced MRI from January 2010 to January 2021. Subtypes were 
      reclassified using 2017 criteria: hepatocyte nuclear factor-1alpha mutated HCA 
      (HHCA), inflammatory HCA (IHCA), beta-catenin exon 3 activated HCA (beta-HCA), mixed 
      inflammatory and beta-HCA (beta-IHCA), sonic hedgehog HCA (shHCA), and unclassified HCA 
      (UHCA). Qualitative MRI features were assessed. Liver-to-lesion contrast 
      enhancement ratios (LLCERs) were measured. Subtypes were compared, and a 
      diagnostic algorithm was proposed. RESULTS. The analysis included 65 HCAs: 16 
      HHCAs, 31 IHCAs, six beta-HCA, four beta-IHCA, five shHCA, and three UHCAs. HHCAs 
      showed homogeneous diffuse intralesional steatosis in 94%, whereas all other HCAs 
      showed this finding in 0% (p < .001). IHCAs showed the "atoll" sign in 58%, 
      whereas all other HCAs showed this finding in 12% (p < .001). IHCAs showed 
      moderate T2 hyperintensity in 52%, whereas all other HCAs showed this finding in 
      12% (p < .001). The beta-HCAs and beta-IHCAs occurred in men in 63%, whereas all other 
      HCAs occurred in men in 4% (p < .001). The beta-HCAs and beta-IHCAs had a mean size of 
      10.1 +/- 6.8 cm, whereas all other HCAs had a mean size of 5.1 +/- 2.9 cm (p = .03). 
      The beta-HCAs and beta-IHCAs showed fluid components in 60%, whereas all other HCAs 
      showed this finding in 5% (p < .001). Hepatobiliary phase iso- or hyperintensity 
      was observed in 80% of beta-HCAs and beta-IHCAs versus 5% of all other HCAs (p < .001). 
      Hepatobiliary phase LLCER was positive in nine HCAs (eight beta-HCAs and beta-IHCAs; 
      one IHCA). The shHCA and UHCA did not show distinguishing features. The proposed 
      diagnostic algorithm had accuracy of 98% for HHCAs, 83% for IHCAs, and 95% for 
      beta-HCAs or beta-IHCAs. CONCLUSION. Findings on gadoxetate disodium-enhanced MRI, 
      including hepatobiliary phase characteristics, were associated with HCA subtypes 
      using the 2017 classification. CLINICAL IMPACT. The algorithm identified common 
      HCA subtypes with high accuracy, including those with beta-catenin exon 3 mutations.
FAU - Tse, Justin R
AU  - Tse JR
AD  - Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, 
      Rm H-1307, Stanford, CA 94305.
FAU - Felker, Ely R
AU  - Felker ER
AD  - Department of Radiological Sciences, University of California, Los Angeles David 
      Geffen School of Medicine, Los Angeles, CA.
FAU - Cao, Jennie J
AU  - Cao JJ
AD  - Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, 
      Rm H-1307, Stanford, CA 94305.
FAU - Naini, Bita V
AU  - Naini BV
AD  - Department of Pathology, University of California, Los Angeles David Geffen 
      School of Medicine, Los Angeles, CA.
FAU - Liang, Tie
AU  - Liang T
AD  - Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, 
      Rm H-1307, Stanford, CA 94305.
FAU - Lu, David S K
AU  - Lu DSK
AD  - Department of Radiological Sciences, University of California, Los Angeles David 
      Geffen School of Medicine, Los Angeles, CA.
FAU - Raman, Steven S
AU  - Raman SS
AD  - Department of Radiological Sciences, University of California, Los Angeles David 
      Geffen School of Medicine, Los Angeles, CA.
LA  - eng
PT  - Journal Article
DEP - 20220928
PL  - United States
TA  - AJR Am J Roentgenol
JT  - AJR. American journal of roentgenology
JID - 7708173
RN  - 0 (gadolinium ethoxybenzyl DTPA)
RN  - 0 (beta Catenin)
RN  - 0 (Contrast Media)
RN  - 0 (Hedgehog Proteins)
SB  - IM
CIN - AJR Am J Roentgenol. 2022 Oct 12;:. PMID: 36222489
EIN - AJR Am J Roentgenol. 2023 Jun;220(6):910. PMID: 37224086
MH  - Male
MH  - Humans
MH  - Female
MH  - Young Adult
MH  - Adult
MH  - Middle Aged
MH  - *Adenoma, Liver Cell/diagnostic imaging
MH  - *Liver Neoplasms/diagnostic imaging
MH  - *Carcinoma, Hepatocellular/pathology
MH  - beta Catenin
MH  - Retrospective Studies
MH  - Contrast Media
MH  - Hedgehog Proteins
MH  - Magnetic Resonance Imaging/methods
OTO - NOTNLM
OT  - gadoxetate disodium
OT  - hepatocellular adenoma
OT  - beta-catenin mutation
EDAT- 2022/09/29 06:00
MHDA- 2023/03/25 06:00
CRDT- 2022/09/28 10:08
PHST- 2022/09/29 06:00 [pubmed]
PHST- 2023/03/25 06:00 [medline]
PHST- 2022/09/28 10:08 [entrez]
AID - 10.2214/AJR.22.28233 [doi]
PST - ppublish
SO  - AJR Am J Roentgenol. 2023 Apr;220(4):539-550. doi: 10.2214/AJR.22.28233. Epub 
      2022 Sep 28.