caa a22 4500 605493030 CHVBK 20210128100518.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0433-9 doi (NATIONALLICENCE)springer-10.1007/s00261-015-0433-9 Biphenotypic hepatic tumors: imaging findings and review of literature [Elektronische Daten] [Michael Wells, Sudhakar Venkatesh, Vishal Chandan, Jeff Fidler, Joel Fletcher, Geoffrey Johnson, David Hough, Lewis Roberts] Purpose: To describe imaging findings in biphenotypic hepatic tumors (BPT) and a proposal for new imaging classification based on contrast-enhanced imaging. Methods: Retrospective review of CT, MRI, PET/CT, and ultrasound findings in 39 patients with histologically confirmed BPT was performed. Tumor markers including AFP, L3 fraction, CA 19.9, CA 125, and CEA were recorded. Based on the dynamic enhancement features, BPT were categorized into 4 enhancement patterns (Types 1-4). Enhancement patterns were correlated with other imaging findings and tumor markers. Imaging features and tumor markers that were not consistent with diagnosis of hepatocellular carcinoma or intrahepatic cholangiocarcinoma based on enhancement pattern were considered discordant findings. Results: Enhancement patterns in 29 patients (CT/MR) included 23 Type 2 (continuous peripheral rim of late arterial hyperenhancement with washout or fade in portal venous and/or delayed phases, ±delayed central enhancement) and 2 of each Types 1, 2, and 3. Discordant imaging findings were present in two patients with Type 2 pattern and in one patient with Type 1 pattern. Both AFP and CA 19.9 were elevated in 15 of 33 of patients. Tumor markers AFP and CA 19.9 were discordant in 17 of 21 patients with Type 2 pattern, two of two patients with Type 3 pattern. Most BPTs were markedly PET avid with average SUV max of 8.2. Most frequent ultrasound appearance is peripheral hypoechogenicity and central hyperechogenicity. Conclusions: BPT most commonly present with imaging features similar to cholangiocarcinoma or metastases. BPT can be suggested when imaging findings or tumor markers are discordant with the most likely diagnosis based on enhancement pattern. Springer Science+Business Media New York, 2015 Biphenotypic hepatic tumor nationallicence Computed tomography (CT) nationallicence Magnetic resonance imaging (MRI) nationallicence Ultrasound (US) nationallicence Positron emission tomography (PET) nationallicence Wells Michael Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut Venkatesh Sudhakar Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut Chandan Vishal Department of Pathology, Mayo Clinic, Rochester, MN, USA aut Fidler Jeff Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut Fletcher Joel Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut Johnson Geoffrey Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut Hough David Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut Roberts Lewis Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2293-2305 0942-8925 40:7<2293 2015 40 261 https://doi.org/10.1007/s00261-015-0433-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0433-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wells Michael Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Venkatesh Sudhakar Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Chandan Vishal Department of Pathology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Fidler Jeff Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Fletcher Joel Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Johnson Geoffrey Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Hough David Department of Radiology, College of Medicine, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Roberts Lewis Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2293-2305 0942-8925 40:7<2293 2015 40 261