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Gadolinium-Enhanced MRI for Tumor Surveillance Before Liver Transplantation: Center-Based Experience

¹ Department of Radiology, Emory University Hospital, Emory Clinic, Bldg. A, Ste. AT-627, 1365 Clifton Rd., Atlanta, GA 30322.
² Department of Pathology, Emory University Hospital, Atlanta, GA.
³ Department of Surgery, Division of Transplantation, Emory University Hospital, Atlanta, GA.
⁴ Division of Digestive Diseases, Liver Transplant Center, Emory University Hospital, Atlanta, GA.
⁵ Department Gastroenterology, Emory University Hospital, Atlanta, GA.

View larger version (112K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —58-year-old man with hepatitis C, cirrhosis, and 1.9-cm hepatocellular carcinoma in segment VI of liver. Unenhanced T1-weighted MR image shows lesion of low signal intensity (arrow).

View larger version (113K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —58-year-old man with hepatitis C, cirrhosis, and 1.9-cm hepatocellular carcinoma in segment VI of liver. Arterial phase MR image shows lesion with marked enhancement (arrow).

View larger version (114K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —58-year-old man with hepatitis C, cirrhosis, and 1.9-cm hepatocellular carcinoma in segment VI of liver. Venous phase image shows contrast washout with rim enhancement (arrow).

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —58-year-old man with hepatitis C, cirrhosis, and 1.9-cm hepatocellular carcinoma in segment VI of liver. Delayed phase MR image shows contrast washout with rim enhancement (arrow).

View larger version (172K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1E —58-year-old man with hepatitis C, cirrhosis, and 1.9-cm hepatocellular carcinoma in segment VI of liver. Histopathologic photograph shows malignant hepatocytes growing in solid pattern. (H and E)

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —63-year-old man with hepatitis B, cirrhosis, and 2.3-cm hepatocellular carcinoma at border of segments V and VIII. Unenhanced T1-weighted MR image shows high signal intensity of lesion (arrow).

View larger version (124K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —63-year-old man with hepatitis B, cirrhosis, and 2.3-cm hepatocellular carcinoma at border of segments V and VIII. Arterial phase MR image shows high signal intensity of lesion (arrow). Contrast enhancement is difficult to appreciate because of intrinsic high T1-weighted signal intensity within lesion.

View larger version (128K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —63-year-old man with hepatitis B, cirrhosis, and 2.3-cm hepatocellular carcinoma at border of segments V and VIII. Venous (C) and delayed (D) phase contrast-enhanced MR images show contrast washout and rim enhancement (arrow), which are features of hepatocellular carcinoma.

View larger version (114K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —63-year-old man with hepatitis B, cirrhosis, and 2.3-cm hepatocellular carcinoma at border of segments V and VIII. Venous (C) and delayed (D) phase contrast-enhanced MR images show contrast washout and rim enhancement (arrow), which are features of hepatocellular carcinoma.

View larger version (72K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2E —63-year-old man with hepatitis B, cirrhosis, and 2.3-cm hepatocellular carcinoma at border of segments V and VIII. Photograph of gross pathologic specimen shows round bile-stained subcapsular nodule (arrow) and surrounding cirrhotic liver parenchyma.

View larger version (108K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —57-year-old man with hepatitis C, cirrhosis, and 1.3-cm-diameter lesion resembling hepatocellular carcinoma on border of segments IVa and VIII. No hepatocellular carcinoma or other tumor was identified at pathologic examination. Unenhanced T1-weighted image shows lesion is inconspicuous.

View larger version (111K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —57-year-old man with hepatitis C, cirrhosis, and 1.3-cm-diameter lesion resembling hepatocellular carcinoma on border of segments IVa and VIII. No hepatocellular carcinoma or other tumor was identified at pathologic examination. Arterial phase MR image shows enhancement (arrow).

View larger version (110K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —57-year-old man with hepatitis C, cirrhosis, and 1.3-cm-diameter lesion resembling hepatocellular carcinoma on border of segments IVa and VIII. No hepatocellular carcinoma or other tumor was identified at pathologic examination. Venous phase MR image shows contrast washout and rim enhancement (arrow).

View larger version (116K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —57-year-old man with hepatitis C, cirrhosis, and 1.3-cm-diameter lesion resembling hepatocellular carcinoma on border of segments IVa and VIII. No hepatocellular carcinoma or other tumor was identified at pathologic examination. Delayed phase MR image shows contrast washout and rim enhancement (arrow).

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