Hepatocyte-specific contrast-enhanced MRI findings of focal nodular hyperplasia-like nodules in the liver following chemotherapy in pediatric cancer patients

Diagn Interv Radiol. 2020 Jul;26(4):370-376. doi: 10.5152/dir.2019.19398.

Abstract

Purpose: We aimed to assess the MRI findings and follow-up of multiple focal nodular hyperplasia (FNH)- like lesions in pediatric cancer patients diagnosed by imaging findings.

Methods: We retrospectively analyzed clinical data and MRI examinations of 16 pediatric patients, who had been scanned using gadoxetate disodium (n=13) and gadobenate dimeglumine (n=3). Hepatic nodules were reviewed according to their number, size, contour, T1- and T2-weighted signal intensities, arterial, portal, delayed and hepatobiliary phase enhancement patterns. Follow-up images were evaluated for nodule size, number, and appearance.

Results: All 16 patients received chemotherapy in due course. Time interval between the initial diagnosis of cancer and detection of the hepatic nodule was 2-14 years. Three patients had a single lesion, 13 patients had multiple nodules. The median size of the largest nodules was 19.5 mm (range, 8-41 mm). Among 16 patients that received hepatocyte-specific agents, FNH-like nodules appeared hyperintense in 11 and isointense in 5 on the hepatobiliary phase. During follow-up, increased number and size of the nodules were seen in 4 patients. The nodules showed growth between 6-15 mm.

Conclusion: Liver MRI using hepatocyte-specific agents is a significant imaging method for the diagnosis of FNH-like lesions, which can occur in a variety of diseases. Lesions can increase in size and number in pediatric patients.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Contrast Media / administration & dosage
  • Drug Therapy / methods
  • Female
  • Focal Nodular Hyperplasia / diagnostic imaging*
  • Follow-Up Studies
  • Gadolinium DTPA / administration & dosage
  • Gadolinium DTPA / pharmacokinetics
  • Hepatocytes / metabolism
  • Hepatocytes / pathology
  • Humans
  • Image Enhancement / methods
  • Infant
  • Liver / blood supply
  • Liver / diagnostic imaging*
  • Liver / pathology
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / drug therapy
  • Magnetic Resonance Imaging / methods*
  • Male
  • Meglumine / administration & dosage
  • Meglumine / analogs & derivatives
  • Meglumine / pharmacokinetics
  • Organometallic Compounds / administration & dosage
  • Organometallic Compounds / pharmacokinetics
  • Retrospective Studies

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadolinium ethoxybenzyl DTPA
  • gadobenic acid
  • Meglumine
  • Gadolinium DTPA