Citation: Academic Radiology. 21(11):1455-64, 2014 Nov..Journal: Academic radiology.ISSN: 1076-6332.Full author list: Jha RC; Zanello PA; Nguyen XM; Pehlivanova M; Johnson LB; Fishbein T; Shetty K.UI/PMID: 25300723.Subject(s): *Algorithms | *Carcinoma, Hepatocellular/pa [Pathology] | Female | Humans | Image Enhancement/mt [Methods] | *Image Interpretation, Computer-Assisted/mt [Methods] | *Liver Neoplasms/pa [Pathology] | *Magnetic Resonance Imaging/mt [Methods] | Male | Middle Aged | Neoplasm Staging | Prognosis | Reproducibility of Results | Sensitivity and Specificity | Tumor BurdenInstitution(s): MedStar Health Research InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: http://dx.doi.org/10.1016/j.acra.2014.06.011 (Click here)Abbreviated citation: Acad Radiol. 21(11):1455-64, 2014 Nov.Abstract: RATIONALE AND OBJECTIVES: Current clinical practice favors imaging rather than biopsy to diagnose hepatocellular carcinoma (HCC). There is a need to better understand tumor biology and aggressiveness of HCC. Our goal is to investigate magnetic resonance imaging (MRI) features of HCC that are associated with faster growth rates (GRs).Abstract: MATERIALS AND METHODS: After approval from institutional review board, a retrospective evaluation was performed of pre-liver transplant patients. Fifty-two patients who developed a >2 cm HCC on serial imaging were included in the study group, with a total of 60 HCCs seen. Precursor foci were identified on serial MRIs before the specific diagnostic features of >2 cm HCC could be made, and GRs and MRI features, including signal on T1- and T2-weighted images (WI), the presence of intralesional steatosis on chemical shift imaging, and enhancement pattern were analyzed. GRs were correlated with imaging features.Abstract: RESULTS: The average GR of precursor lesions to >2 cm HCC was determined to be 0.23 cm/mo (standard deviation [SD], 0.32), with a doubling time of 5.26 months (SD, 5.44). The presence of increased signal intensity (SI) on T2-WI was associated with significantly higher growth (P = .0002), whereas increased intensity on T1-WI at the initial study was associated with a significantly lower GR (P = .0162). Furthermore, lesions with hypervascular enhancement with washout pattern had significantly higher GR (P = .0164). There is no evidence of differences in GRs seen in lesions with steatosis.Abstract: CONCLUSIONS: Small precursor lesions with increased SI on T2-WI and a washout pattern of enhancement are associated with faster GRs, which may suggest more aggressive tumor biology. These features may be helpful in patient management and surveillance for HCC.Copyright � 2014 AUR. Published by Elsevier Inc. All rights reserved.