Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

Background: Hepatocellular carcinoma (HCC) is the fifth most frequent cancer on the world. Fat accumulation within hepatocytes is known as hepatic steatosis. In recent years, research has found that people with non- alcoholic fatty liver disease have a higher chance of developing HCC. The LI-RADS® (Liver Imaging Reporting and Data System) was created to facilitate consistent reporting of imaging findings in patients at risk of HCC. The purpose of this study was to see how hepatic fat fraction affected the LI-RADS major HCC features on MRI. Methods: This study comprised 92 patients who underwent a liver MRI with MRI findings consistent with HCC (LIRADS V). Readers assessed hepatic parenchyma characteristics as well as MRI HCC features including: major HCC features, ancillary features favoring malignancy and ancillary features favoring HCC in particular. Hepatic fat signal fraction was calculated using the formula: fat fraction = [(SIP-SOP) / 2*SIP)]. We categorize the patients into two groups: 1) HCC with hepatic steatosis group (Hepatic FS fraction {u2265} 5% at MRI). 2) HCC with no hepatic steatosis group: (Hepatic FS fraction > 5% at MRI). Results: All HCC (92/92; 100%) showed arterial phase hyperenhancement (APHE), however, it was found that there was a significant association between hepatic steatosis and late APHE. Encapsulation was observed in 51 HCC (55.4 %); in hepatic steatosis patients 17 HCC (37.8 %) displayed enhancing capsule, compared to 34 HCC (72.3 %) in patients with no hepatic steatosis.The HCC size ranged from 11 - 200 mm (Mean ± SD = 42.2 ± 51.8) in the hepatic steatosis group, however in patients with negative hepatic steatosis the size ranged from 13 - 205 (Mean ± SD = 62.9 ± 54.5)

Issued also as CD