Bone metastases of hepatocellular carcinoma: Appearance on MRI using a standard abdominal protocol

Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, António P. Matos, Ersan Altun, Richard C. Semelka

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE. The purpose of this study is to describe the MRI features of hepatocellular carcinoma (HCC) bone metastases. MATERIALS AND METHODS. Thirty-three consecutive patients were included. Two radiologists performed qualitative and quantitative analysis. The coordinator searched for clinical and epidemiologic features related to patients and their primary liver tumors. Earlier MRI studies were also reviewed to determine whether bone metastases were already present and prospectively identified. Descriptive statistics and the Lin concordance correlation coefficient were used. RESULTS. Chronic hepatitis C virus infection was the most common cause of liver disease (20/32; 62.5%), and diffuse and multifocal HCC were the most frequent types of liver HCCs (28/33; 84.8%). Most lesions were located at the spine (109/155; 70.3%), with high signal intensity on fat-suppressed T1-weighted (54/62; 87.1%) and T2-weighted (53/62; 85.5%) images. Bone metastases were predominantly nodular (48/62; 77.4%), confined to the vertebral body (40/60; 66.7%), and best visualized at the arterial phase (40/62; 64.5%). The ring pattern of enhancement was present in 23 of 62 lesions, and the remaining lesions showed diffuse enhancement. Thirty-five of 62 (56.4%) bone metastases showed arterial peak of enhancement. In 13 of 33 (39.9%) patients, bone metastases were not prospectively reported. CONCLUSION. Most patients with bone metastases had chronic hepatitis C virus infection and diffuse or multifocal HCC. Metastases are most commonly appreciated as hypervascular focal moderately intensely enhancing nodular masses on the hepatic arterial dominant phase images, with concomitant moderately high signal intensity on fat-suppressed T1- and T2-weighted images.

LanguageEnglish (US)
Pages1003-1012
Number of pages10
JournalAmerican Journal of Roentgenology
Volume206
Issue number5
DOIs
StatePublished - May 1 2016

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Hepatocellular Carcinoma
Neoplasm Metastasis
Bone and Bones
Chronic Hepatitis C
Virus Diseases
Hepacivirus
Liver
Fats
Liver Diseases
Spine
Neoplasms

Keywords

  • Bone metastases
  • Diffuse hepatocellular carcinoma
  • Hepatocellular carcinoma
  • MRI
  • Spine

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Bone metastases of hepatocellular carcinoma : Appearance on MRI using a standard abdominal protocol. / Velloni, Fernanda; Ramalho, Miguel; AlObaidy, Mamdoh; Matos, António P.; Altun, Ersan; Semelka, Richard C.

In: American Journal of Roentgenology, Vol. 206, No. 5, 01.05.2016, p. 1003-1012.

Research output: Contribution to journalArticle

Velloni, Fernanda ; Ramalho, Miguel ; AlObaidy, Mamdoh ; Matos, António P. ; Altun, Ersan ; Semelka, Richard C. / Bone metastases of hepatocellular carcinoma : Appearance on MRI using a standard abdominal protocol. In: American Journal of Roentgenology. 2016 ; Vol. 206, No. 5. pp. 1003-1012.
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abstract = "OBJECTIVE. The purpose of this study is to describe the MRI features of hepatocellular carcinoma (HCC) bone metastases. MATERIALS AND METHODS. Thirty-three consecutive patients were included. Two radiologists performed qualitative and quantitative analysis. The coordinator searched for clinical and epidemiologic features related to patients and their primary liver tumors. Earlier MRI studies were also reviewed to determine whether bone metastases were already present and prospectively identified. Descriptive statistics and the Lin concordance correlation coefficient were used. RESULTS. Chronic hepatitis C virus infection was the most common cause of liver disease (20/32; 62.5{\%}), and diffuse and multifocal HCC were the most frequent types of liver HCCs (28/33; 84.8{\%}). Most lesions were located at the spine (109/155; 70.3{\%}), with high signal intensity on fat-suppressed T1-weighted (54/62; 87.1{\%}) and T2-weighted (53/62; 85.5{\%}) images. Bone metastases were predominantly nodular (48/62; 77.4{\%}), confined to the vertebral body (40/60; 66.7{\%}), and best visualized at the arterial phase (40/62; 64.5{\%}). The ring pattern of enhancement was present in 23 of 62 lesions, and the remaining lesions showed diffuse enhancement. Thirty-five of 62 (56.4{\%}) bone metastases showed arterial peak of enhancement. In 13 of 33 (39.9{\%}) patients, bone metastases were not prospectively reported. CONCLUSION. Most patients with bone metastases had chronic hepatitis C virus infection and diffuse or multifocal HCC. Metastases are most commonly appreciated as hypervascular focal moderately intensely enhancing nodular masses on the hepatic arterial dominant phase images, with concomitant moderately high signal intensity on fat-suppressed T1- and T2-weighted images.",
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T1 - Bone metastases of hepatocellular carcinoma

T2 - American Journal of Roentgenology

AU - Velloni, Fernanda

AU - Ramalho, Miguel

AU - AlObaidy, Mamdoh

AU - Matos, António P.

AU - Altun, Ersan

AU - Semelka, Richard C.

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N2 - OBJECTIVE. The purpose of this study is to describe the MRI features of hepatocellular carcinoma (HCC) bone metastases. MATERIALS AND METHODS. Thirty-three consecutive patients were included. Two radiologists performed qualitative and quantitative analysis. The coordinator searched for clinical and epidemiologic features related to patients and their primary liver tumors. Earlier MRI studies were also reviewed to determine whether bone metastases were already present and prospectively identified. Descriptive statistics and the Lin concordance correlation coefficient were used. RESULTS. Chronic hepatitis C virus infection was the most common cause of liver disease (20/32; 62.5%), and diffuse and multifocal HCC were the most frequent types of liver HCCs (28/33; 84.8%). Most lesions were located at the spine (109/155; 70.3%), with high signal intensity on fat-suppressed T1-weighted (54/62; 87.1%) and T2-weighted (53/62; 85.5%) images. Bone metastases were predominantly nodular (48/62; 77.4%), confined to the vertebral body (40/60; 66.7%), and best visualized at the arterial phase (40/62; 64.5%). The ring pattern of enhancement was present in 23 of 62 lesions, and the remaining lesions showed diffuse enhancement. Thirty-five of 62 (56.4%) bone metastases showed arterial peak of enhancement. In 13 of 33 (39.9%) patients, bone metastases were not prospectively reported. CONCLUSION. Most patients with bone metastases had chronic hepatitis C virus infection and diffuse or multifocal HCC. Metastases are most commonly appreciated as hypervascular focal moderately intensely enhancing nodular masses on the hepatic arterial dominant phase images, with concomitant moderately high signal intensity on fat-suppressed T1- and T2-weighted images.

AB - OBJECTIVE. The purpose of this study is to describe the MRI features of hepatocellular carcinoma (HCC) bone metastases. MATERIALS AND METHODS. Thirty-three consecutive patients were included. Two radiologists performed qualitative and quantitative analysis. The coordinator searched for clinical and epidemiologic features related to patients and their primary liver tumors. Earlier MRI studies were also reviewed to determine whether bone metastases were already present and prospectively identified. Descriptive statistics and the Lin concordance correlation coefficient were used. RESULTS. Chronic hepatitis C virus infection was the most common cause of liver disease (20/32; 62.5%), and diffuse and multifocal HCC were the most frequent types of liver HCCs (28/33; 84.8%). Most lesions were located at the spine (109/155; 70.3%), with high signal intensity on fat-suppressed T1-weighted (54/62; 87.1%) and T2-weighted (53/62; 85.5%) images. Bone metastases were predominantly nodular (48/62; 77.4%), confined to the vertebral body (40/60; 66.7%), and best visualized at the arterial phase (40/62; 64.5%). The ring pattern of enhancement was present in 23 of 62 lesions, and the remaining lesions showed diffuse enhancement. Thirty-five of 62 (56.4%) bone metastases showed arterial peak of enhancement. In 13 of 33 (39.9%) patients, bone metastases were not prospectively reported. CONCLUSION. Most patients with bone metastases had chronic hepatitis C virus infection and diffuse or multifocal HCC. Metastases are most commonly appreciated as hypervascular focal moderately intensely enhancing nodular masses on the hepatic arterial dominant phase images, with concomitant moderately high signal intensity on fat-suppressed T1- and T2-weighted images.

KW - Bone metastases

KW - Diffuse hepatocellular carcinoma

KW - Hepatocellular carcinoma

KW - MRI

KW - Spine

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