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Diagnostics
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Advanced Radiological Diagnostics in Hepatocellular Carcinoma and Cirrhosis
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Advanced Radiological Diagnostics in Hepatocellular Carcinoma and Cirrhosis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 August 2024) | Viewed by 3628

Special Issue Editor

Prof. Dr. Masahiro Okada

E-Mail Website
Guest Editor
Department of Radiology, Nihon University School of Medicine, Tokyo 173-8610, Japan
Interests: hepatocellular carcinoma; histological grade; diagnosis; liver imaging

Special Issue Information

Dear Colleagues,

Hepatocellular carcinoma (HCC) has contrast hyper-enhancement in the arterial phase and hypo-enhancement in the portal or delayed phase. The diagnosis of HCC has been improved by capturing these patterns of enhancement via contrast-enhanced ultrasonography (CEUS), dynamic multi-detector computer tomography (CT) and contrast-enhanced magnetic resonance (MR) with Gd-DTPA/Gd-EOB-DTPA. CEUS is useful for detecting hypervascular HCCs not detected in B-mode and for diagnosing the histological grade of HCCs. In addition, fusion imaging combined with CEUS can be used to guide the needle puncture and determine the efficacy of ablation therapy for early-stage HCCs, while Gd-EOB-DTPA-enhanced MRI allows for the detection of early-stage HCCs. Dual-energy CT represents a new CT technology that increases the conspicuity of hypervascular lesions by using the low-voltage setting.

The assessment of liver fibrosis by imaging is increasing the attention around clinical management. MR elastography is a noninvasive MR imaging technique that allows for noninvasive detection and stratification of liver fibrosis. Ultrasound elastography techniques using different excitation methods also have been used to investigate liver stiffness measurements. Noninvasive imaging with MR elastography and US elastography may replace liver biopsy in the evaluation of liver fibrosis. The aim of this Special Issue is to clarify the new advantages of HCC and liver fibrosis imaging.

Prof. Dr. Masahiro Okada
Guest Editor

Manuscript Submission Information

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Keywords

  • hepatocellular carcinoma
  • contrast-enhanced ultrasonography
  • contrast-enhanced magnetic resonance
  • Gd-EOB-DTPA
  • MR elastography
  • dual-energy CT

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Published Papers (3 papers)

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Research

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14 pages, 4919 KiB  
Article
Artificial Intelligence and Image Analysis-Assisted Diagnosis for Fibrosis Stage of Metabolic Dysfunction-Associated Steatotic Liver Disease Using Ultrasonography: A Pilot Study
by Itsuki Fujii, Naoki Matsumoto, Masahiro Ogawa, Aya Konishi, Masahiro Kaneko, Yukinobu Watanabe, Ryota Masuzaki, Hirofumi Kogure, Norihiro Koizumi and Masahiko Sugitani
Diagnostics 2024, 14(22), 2585; https://doi.org/10.3390/diagnostics14222585 - 18 Nov 2024
Viewed by 547
Abstract
Background/Objectives: Elastography increased the diagnostic accuracy of liver fibrosis. However, several challenges persist, including the widespread utilization of equipment, difficulties in measuring certain cases, and the influence of viscosity factors. A rough surface and a blunted hepatic margin have long been acknowledged as [...] Read more.
Background/Objectives: Elastography increased the diagnostic accuracy of liver fibrosis. However, several challenges persist, including the widespread utilization of equipment, difficulties in measuring certain cases, and the influence of viscosity factors. A rough surface and a blunted hepatic margin have long been acknowledged as valuable characteristics indicative of hepatic fibrosis. The objective of this study was to conduct an image analysis and quantitative assessment of the contour of the sagittal section of the left lobe of the liver. Methods: Between February and October 2020, 486 consecutive outpatients underwent ultrasound examinations at our hospital. A total of 214 images were manually annotated by delineating the liver contour to create annotation images. U-Net was employed for liver segmentation, with the dataset divided into training (n = 128), testing (n = 42), and validation (n = 44) subsets. Additionally, 43 Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) cases with pathology data from between 2015 and 2020 were included. Segmentation was performed using the program developed in the first step. Subsequently, shape analysis was conducted using ImageJ. Results: Liver segmentation exhibited high accuracy, as indicated by Dice loss of 0.044, Intersection over Union of 0.935, and an F score of 0.966. The accuracy of the classification of the liver surface as smooth or rough via ResNet 50 was 84.6%. Image analysis showed MinFeret and Minor correlated with liver fibrosis stage (p = 0.046, 0.036, respectively). Sensitivity, specificity, and AUROC of Minor for ≥F3 were 0.571, 0.862, and 0.722, respectively, and F4 were 1, 0.600, and 0.825, respectively. Conclusion: Deep learning segmentation of the sagittal cross-sectional contour of the left lobe of the liver demonstrated commendable accuracy. The roughness of the liver surface was correctly judged by artificial intelligence. Image analysis showed the thickness of the left lobe inversely correlated with liver fibrosis stage. Full article
(This article belongs to the Special Issue Advanced Radiological Diagnostics in Hepatocellular Carcinoma and Cirrhosis)
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13 pages, 2315 KiB  
Article
Comparison between Intravoxel Incoherent Motion and Splenic Volumetry to Predict Hepatic Fibrosis Staging in Preoperative Patients
by Takayuki Arakane, Masahiro Okada, Yujiro Nakazawa, Kenichiro Tago, Hiroki Yoshikawa, Mariko Mizuno, Hayato Abe, Tokio Higaki, Yukiyasu Okamura and Tadatoshi Takayama
Diagnostics 2023, 13(20), 3200; https://doi.org/10.3390/diagnostics13203200 - 13 Oct 2023
Viewed by 1128
Abstract
Intravoxel incoherent motion (IVIM) and splenic volumetry (SV) for hepatic fibrosis (HF) prediction have been reported to be effective. Our purpose is to compare the HF prediction of IVIM and SV in 67 patients with pathologically staged HF. SV was divided by body [...] Read more.
Intravoxel incoherent motion (IVIM) and splenic volumetry (SV) for hepatic fibrosis (HF) prediction have been reported to be effective. Our purpose is to compare the HF prediction of IVIM and SV in 67 patients with pathologically staged HF. SV was divided by body surface area (BSA). IVIM indices, such as slow diffusion-coefficient related to molecular diffusion (D), fast diffusion-coefficient related to perfusion in microvessels (D*), apparent diffusion-coefficient (ADC), and perfusion related diffusion-fraction (f), were calculated by two observers (R1/R2). D (p = 0.718 for R1, p = 0.087 for R2) and D* (p = 0.513, p = 0.708, respectively) showed a poor correlation with HF. ADC (p = 0.034, p = 0.528, respectively) and f (p < 0.001, p = 0.007, respectively) decreased as HF progressed, whereas SV/BSA increased (p = 0.015 for R1). The AUCs of SV/BSA (0.649–0.698 for R1) were higher than those of f (0.575–0.683 for R1 + R2) for severe HF (≥F3–4 and ≥F4), although AUCs of f (0.705–0.790 for R1 + R2) were higher than those of SV/BSA (0.628 for R1) for mild or no HF (≤F0–1). No significant differences to identify HF were observed between IVIM and SV/BSA. SV/BSA allows a higher estimation for evaluating severe HF than IVIM. IVIM is more suitable than SV/BSA for the assessment of mild or no HF. Full article
(This article belongs to the Special Issue Advanced Radiological Diagnostics in Hepatocellular Carcinoma and Cirrhosis)
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Other

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9 pages, 5436 KiB  
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Noninvasive Visualization of Tumor Blood Vessels within Hepatocellular Carcinoma by Application of Superb Microvascular Imaging to Contrast-Enhanced Ultrasonography
by Yu Ota, Kazunobu Aso, Hideki Yokoo and Mikihiro Fujiya
Diagnostics 2024, 14(7), 678; https://doi.org/10.3390/diagnostics14070678 - 23 Mar 2024
Viewed by 1310
Abstract
The combination or sequential use of systemic therapies, such as lenvatinib and locoregional therapies, can improve the curability rate of hepatocellular carcinoma. This is based on the notion that lenvatinib remodels abnormal tumor vessels into normal vessels, potentially enhancing the efficacy of locoregional [...] Read more.
The combination or sequential use of systemic therapies, such as lenvatinib and locoregional therapies, can improve the curability rate of hepatocellular carcinoma. This is based on the notion that lenvatinib remodels abnormal tumor vessels into normal vessels, potentially enhancing the efficacy of locoregional therapies. In this case report, we achieved noninvasive visualization of tumor blood vessels by applying superb microvascular imaging (SMI) to contrast-enhanced ultrasonography (CEUS). A man in his 80s with a borderline resectable hepatocellular carcinoma received preoperative therapy using lenvatinib. The patient achieved a complete response after lenvatinib therapy, underwent hepatectomy, and maintained a cancer-free status. CEUS and SMI revealed a decrease in tumor blood vessels at 1 week after lenvatinib administration and a decrease in tumor perfusion at 2 weeks. Although CEUS alone is adequate for noninvasive real-time evaluation of tumor perfusion, it is not sufficient to achieve accurate assessments of tumor blood vessels. We performed a noninvasive time-course evaluation of vascular normalization after lenvatinib administration by applying SMI. The evaluation of vascular normalization with lenvatinib therapy using CEUS and SMI can support the decision to proceed to conversion therapies. Full article
(This article belongs to the Special Issue Advanced Radiological Diagnostics in Hepatocellular Carcinoma and Cirrhosis)
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