Document Detail


Hepatocellular adenomas: accuracy of magnetic resonance imaging and liver biopsy in subtype classification.
MedLine Citation:
PMID:  21480324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hepatocellular adenomas (HCAs) are divided into genotype/phenotype subgroups associated with different evolutive profiles. Therefore, recognition of subtype is of clinical importance in patient management. Magnetic resonance imaging (MRI) is considered the most informative imaging modality and liver biopsy a key diagnostic tool whose role in HCA subtyping has never been extensively studied. The purpose of our study was to evaluate the diagnostic performance of MRI and liver biopsy with and without immunohistochemistry and to assess the interobserver agreement for MR classification in a consecutive series of resected HCAs. Forty-seven HCAs with preoperative MRI and biopsy were retrospectively included. MRI data were reviewed independently by two abdominal radiologists blind to the pathological results and classification. Subtyping of HCAs on liver biopsy was made blindly to clinical, biological, and imaging data and to final classification. Routine histological analysis was based on morphological criteria and immunohistochemistry was systematically performed when enough tissue was available. Final subtyping of HCA was based on the examination of the surgical specimen. Radiologists correctly classified HCAs in 85%. The interobserver kappa correlation coefficient was 0.86. Routine histological analysis led to 76.6% of correct classification and 81.6% when immunophenotypical characteristics were available. The additional value of immunophenotypical markers is best in HCAs containing steatosis. Agreement between MRI findings and routine histological analysis was observed in 74.5%, leading to a likelihood ratio of subtype diagnosis higher than 20. CONCLUSION: MRI and biopsy analysis are two efficient methods in subtyping HCAs and their association increases the diagnosis confidence. Interobserver variability in MRI criteria is very low.
Authors:
Maxime Ronot; Stephane Bahrami; Julien Calderaro; Dominique-Charles Valla; Pierre Bedossa; Jacques Belghiti; Jacques Belghti; Valérie Vilgrain; Valérie Paradis
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  53     ISSN:  1527-3350     ISO Abbreviation:  Hepatology     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-11     Completed Date:  2011-06-14     Revised Date:  2012-02-01    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1182-91     Citation Subset:  IM    
Copyright Information:
2011 American Association for the Study of Liver Diseases.
Affiliation:
Department of Radiology, Hôpital Beaujon Clichy, France; INSERM U773, centre de recherche biomédicale Bichat-Beaujon, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adenoma, Liver Cell / classification*,  pathology
Adolescent
Adult
Aged
Biopsy
Female
Humans
Liver / pathology*
Liver Neoplasms / classification*,  pathology
Magnetic Resonance Imaging / methods
Male
Middle Aged
Observer Variation
Retrospective Studies
Comments/Corrections
Erratum In:
Hepatology. 2011 Sep 2;54(3):1114
Note: Belghti, Jacques [corrected to Belghiti, Jacques]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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