What is the accuracy of MRI for the evaluation of fibrolamellar hepatocellular carcinoma?

Updated: Sep 05, 2019
  • Author: W Ross Stevens, MD; Chief Editor: John Karani, MBBS, FRCR  more...
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MRI is sensitive in the detection of intrahepatic masses of fibrolamellar carcinoma, and the modality may be slightly more sensitive than CT scanning in depicting multiple recurrent intrahepatic lesions. Although metastatic lymphadenopathy can be seen on MRI scans, CT scanning is probably more useful for detecting distant metastases, particularly in the lungs. CT scanning is also relatively less expensive than MRI; therefore, CT scanning is most appropriate for initial imaging and follow-up in most patients.

MRI is most useful in the characterization of indeterminate masses seen on CT scans. Often, MRI features of tumors can help confirm a suggested diagnosis of fibrolamellar carcinoma, or they can exclude the possibility of other entities such, as FNH or HCC.

As with CT scanning, MRI is not entirely specific for fibrolamellar carcinoma, and other liver lesions (eg, adenoma, HCC, FNH) can occasionally mimic the appearance of fibrolamellar carcinoma. For instance, the hyperintense scar that is usually associated with FNH has been reported in at least one patient with fibrolamellar carcinoma.

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