Understanding liver carcinogenesis is key to diagnosing hepatocellular carcinoma, but the process involves equivocal nodules. Radiologists can identify precancerous pathology by using a straightforward MR checklist, said Prof. Carlo Bartolozzi, chair of radiology at the University of Pisa in Italy.
Speaking at the 2009 European Congress of Radiology's Josef Lissner honorary lecture, Bartolozzi explained that glycogen-rich cells represent a pathological sign of premalignancy that can be identified on T1-weighted imaging. Other premalignant features include iron-free nodules, impaired biliary function, and cholestasis. The signs he said to watch for are T1 and T2 shortening (glycogen content), no wash-in/wash-out on contrastenhanced imaging (no neoangiogenesis), and hyperintensity in the hepatobiliary phase (cholestasis).
“All pathological features have a corresponding imaging feature,” Bartolozzi said.
