Imaging Modalities for Focal Nodular Hyperplasia and Hepatocellular Adenoma

Background/Aims: There are several imaging modalities available for the detection of focal liver lesions. Differentiation between focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) is important because of the consequences for management. However, differentiation based on imaging alone still shows limitations. Methods: We reviewed the literature for typical features of FNH and HCA on radiologic and nuclear imaging with emphasis on differentiation of both lesions. Results: Seven articles describe the performance of an imaging modality for the differentiation between FNH and HCA. Limitations of these studies are the small sample size and/or the lack of comparison with the ‘gold standard’, i.e. histological diagnosis. No studies are available that compare the accuracy of several imaging modalities in the differentiation of FNH and HCA. Conventional ultrasound (US) is not useful in the differentiation because of the non-specific features. On contrast-enhanced US, the arterial filling direction of FNH is centrifugal and centripetal in case of HCA. The parenchymal enhancement of FNH is sustained in the portal venous and delayed phases, but shows Published online: April 1, 2010 S.S.K.S. Phoa, MD, PhD Department of Radiology, Academic Medical Center Meibergdreef 9, NL–1105 AZ Amsterdam (The Netherlands) Tel. +31 20 566 9111, E-Mail s.s.phoa @ amc.uva.nl © 2010 S. Karger AG, Basel 0253–4886/10/0271–0046$26.00/0 Accessible online at: www.karger.com/dsu D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /8 /2 01 7 7: 06 :0 6 P M