Minimally Invasive Image-Guided Procedures for Benign Liver Lesions

Abstract

As access to affordable high-resolution medical imaging has improved, so too has the identification of benign hepatic lesions. Advanced imaging techniques and applications often allow characterization of these lesions so as to differentiate benign and malignant lesions without the need for biopsy. Patients with benign liver lesions are usually asymptomatic; however, a palliative intervention may be indicated if a benign liver lesion is symptomatic. This article reviews the characteristic imaging features of benign liver lesions, the indications for minimally invasive intervention, and the specific procedures for minimally invasive, nonsurgical intervention, and the procedural expectations, effectiveness, and periprocedural care.

Keywords

hemangioma - focal nodular hyperplasia - hepatic adenoma

Publikationsverlauf

Eingereicht: 14. Juni 2022

Angenommen: 14. Dezember 2022

Artikel online veröffentlicht:
05. Mai 2023

• References

• 1 Adnan A, Sheth RA. Image-guided percutaneous biopsy of the liver. Tech Vasc Interv Radiol 2021; 24 (04) 100773
• 2 Midia M, Odedra D, Shuster A, Midia R, Muir J. Predictors of bleeding complications following percutaneous image-guided liver biopsy: a scoping review. Diagn Interv Radiol 2019; 25 (01) 71-80
• 3 Honar N, Jooya P, Haghighat M. et al. Complications of blind versus ultrasound-guided percutaneous liver biopsy in children. Arab J Gastroenterol 2015; 16 (3-4): 90-93
• 4 Fioole B, Kokke M, van Hillegersberg R, Rinkes IH. Adequate symptom relief justifies hepatic resection for benign disease. BMC Surg 2005; 5: 7
• 5 Koffron AJ, Auffenberg G, Kung R, Abecassis M. Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg 2007; 246 (03) 385-392 , discussion 392–394
• 6 Bean WJ, Rodan BA. Hepatic cysts: treatment with alcohol. AJR Am J Roentgenol 1985; 144 (02) 237-241
• 7 Andersson R, Jeppsson B, Lunderquist A, Bengmark S. Alcohol sclerotherapy of non-parasitic cysts of the liver. Br J Surg 1989; 76 (03) 254-255
• 8 vanSonnenberg E, Wroblicka JT, D'Agostino HB. et al. Symptomatic hepatic cysts: percutaneous drainage and sclerosis. Radiology 1994; 190 (02) 387-392
• 9 Kairaluoma MI, Leinonen A, Ståhlberg M, Päivänsalo M, Kiviniemi H, Siniluoto T. Percutaneous aspiration and alcohol sclerotherapy for symptomatic hepatic cysts. An alternative to surgical intervention. Ann Surg 1989; 210 (02) 208-215
• 10 Simonetti G, Profili S, Sergiacomi GL, Meloni GB, Orlacchio A. Percutaneous treatment of hepatic cysts by aspiration and sclerotherapy. Cardiovasc Intervent Radiol 1993; 16 (02) 81-84
• 11 Montorsi M, Torzilli G, Fumagalli U. et al. Percutaneous alcohol sclerotherapy of simple hepatic cysts. Results from a multicentre survey in Italy. HPB Surg 1994; 8 (02) 89-94
• 12 Tikkakoski T, Mäkelä JT, Leinonen S. et al. Treatment of symptomatic congenital hepatic cysts with single-session percutaneous drainage and ethanol sclerosis: technique and outcome. J Vasc Interv Radiol 1996; 7 (02) 235-239
• 13 Larssen TB, Rosendahl K, Horn A, Jensen DK, Rørvik J. Single-session alcohol sclerotherapy in symptomatic benign hepatic cysts performed with a time of exposure to alcohol of 10 min: initial results. Eur Radiol 2003; 13 (12) 2627-2632
• 14 Iannuccilli JD, Dupuy DE. How to set up a successful tumor ablation practice. Tech Vasc Interv Radiol 2013; 16 (04) 201-208
• 15 Knavel EM, Brace CL. Tumor ablation: common modalities and general practices. Tech Vasc Interv Radiol 2013; 16 (04) 192-200
• 16 Cheng D, Amin P, Ha TV. Percutaneous sclerotherapy of cystic lesions. Semin Intervent Radiol 2012; 29 (04) 295-300
• 17 Wu S, Gao R, Yin T. et al. Complications of radiofrequency ablation for hepatic hemangioma: a multicenter retrospective analysis on 291 cases. Front Oncol 2021; 11: 706619
• 18 Lai EC, Wong J. Symptomatic nonparasitic cysts of the liver. World J Surg 1990; 14 (04) 452-456
• 19 Pitale A, Bohra AK, Diamond T. Management of symptomatic liver cysts. Ulster Med J 2002; 71 (02) 106-110
• 20 Mavilia MG, Pakala T, Molina M, Wu GY. Differentiating cystic liver lesions: a review of imaging modalities, diagnosis and management. J Clin Transl Hepatol 2018; 6 (02) 208-216
• 21 Kim JY, Kim SH, Eun HW. et al. Differentiation between biliary cystic neoplasms and simple cysts of the liver: accuracy of CT. AJR Am J Roentgenol 2010; 195 (05) 1142-1148
• 22 Aoki T, Kato T, Yasuda D. et al. Cyst wall resection and ablation by hand-assisted laparoscopic surgery combined with argon plasma coagulator for huge hepatic cysts. Int Surg 2007; 92 (06) 361-366
• 23 Kwon AH, Matsui Y, Inui H, Imamura A, Kamiyama Y. Laparoscopic treatment using an argon beam coagulator for nonparasitic liver cysts. Am J Surg 2003; 185 (03) 273-277
• 24 Wahba R, Kleinert R, Prenzel K, Bangard C, Hölscher AH, Stippel DL. Laparoscopic deroofing of nonparasitic liver cysts with or without greater omentum flap. Surg Laparosc Endosc Percutan Tech 2011; 21 (01) 54-58
• 25 Moorthy K, Mihssin N, Houghton PW. The management of simple hepatic cysts: sclerotherapy or laparoscopic fenestration. Ann R Coll Surg Engl 2001; 83 (06) 409-414
• 26 Furumaya A, van Rosmalen BV, de Graeff JJ. et al; Dutch Benign Liver Tumor Group. Systematic review on percutaneous aspiration and sclerotherapy versus surgery in symptomatic simple hepatic cysts. HPB (Oxford) 2021; 23 (01) 11-24
• 27 Halvorsen RA, Korobkin M, Foster WL, Silverman PM, Thompson WM. The variable CT appearance of hepatic abscesses. AJR Am J Roentgenol 1984; 142 (05) 941-946
• 28 Lissandrin R, Tamarozzi F, Mariconti M, Manciulli T, Brunetti E, Vola A. Watch and wait approach for inactive echinococcal cyst of the liver: an update. Am J Trop Med Hyg 2018; 99 (02) 375-379
• 29 Kuo SH, Lee YT, Li CR. et al. Mortality in Emergency Department Sepsis score as a prognostic indicator in patients with pyogenic liver abscess. Am J Emerg Med 2013; 31 (06) 916-921
• 30 Lardière-Deguelte S, Ragot E, Amroun K. et al. Hepatic abscess: diagnosis and management. J Visc Surg 2015; 152 (04) 231-243
• 31 Stojkovic M, Rosenberger K, Kauczor HU, Junghanss T, Hosch W. Diagnosing and staging of cystic echinococcosis: How do CT and MRI perform in comparison to ultrasound?. PLoS Negl Trop Dis 2012; 6 (10) e1880
• 32 Richter J, Lindner AK, Geisel D. et al. Treatment of a giant hepatic echinococcal cyst with percutaneous drainage and in vivo assessment of the protoscolicidal effect of praziquantel. Clin J Gastroenterol 2021; 14 (03) 888-892
• 33 Toro A, Mahfouz AE, Ardiri A. et al. What is changing in indications and treatment of hepatic hemangiomas. A review. Ann Hepatol 2014; 13 (04) 327-339
• 34 Yoon SS, Charny CK, Fong Y. et al. Diagnosis, management, and outcomes of 115 patients with hepatic hemangioma. J Am Coll Surg 2003; 197 (03) 392-402
• 35 Vilgrain V, Zappa M, Hakimé A, Sibert A, Vullierme MP. [Liver imaging: pitfalls, pseudolesions and pseudotumors]. J Radiol 2007; 88 (7-8, Pt 2): 1104-1120
• 36 Kuefner MA, Brand M, Ehrlich J, Braga L, Uder M, Semelka RC. Effect of antioxidants on X-ray-induced γ-H2AX foci in human blood lymphocytes: preliminary observations. Radiology 2012; 264 (01) 59-67
• 37 Concejero AM, Chen CL, Chen TY, Eng HL, Kuo FY. Giant cavernous hemangioma of the liver with coagulopathy: adult Kasabach-Merritt syndrome. Surgery 2009; 145 (02) 245-247
• 38 Belghiti J, Cauchy F, Paradis V, Vilgrain V. Diagnosis and management of solid benign liver lesions. Nat Rev Gastroenterol Hepatol 2014; 11 (12) 737-749
• 39 Anderson SW, Kruskal JB, Kane RA. Benign hepatic tumors and iatrogenic pseudotumors. Radiographics 2009; 29 (01) 211-229
• 40 Brodsky RI, Friedman AC, Maurer AH, Radecki PD, Caroline DF. Hepatic cavernous hemangioma: diagnosis with ^99mTc-labeled red cells and single-photon emission CT. AJR Am J Roentgenol 1987; 148 (01) 125-129
• 41 Bajenaru N, Balaban V, Săvulescu F, Campeanu I, Patrascu T. Hepatic hemangioma -review-. J Med Life 2015; 8 (Spec Issue): 4-11
• 42 Donati M, Stavrou GA, Donati A, Oldhafer KJ. The risk of spontaneous rupture of liver hemangiomas: a critical review of the literature. J Hepatobiliary Pancreat Sci 2011; 18 (06) 797-805
• 43 Bailey J, Di Carlo S, Blackwell J, Gomez D. Same day arterial embolisation followed by hepatic resection for treatment of giant haemangioma. BMJ Case Rep 2016; 2016: bcr2015213259
• 44 Igarashi G, Mikami K, Sawada N. et al. Interventional treatment for giant hepatic hemangioma accompanied by arterio-portal shunt with ascites. Intern Med 2018; 57 (19) 2847-2851
• 45 Zhou JX, Huang JW, Wu H, Zeng Y. Successful liver resection in a giant hemangioma with intestinal obstruction after embolization. World J Gastroenterol 2013; 19 (19) 2974-2978
• 46 Akhlaghpoor S, Torkian P, Golzarian J. Transarterial bleomycin-lipiodol embolization (B/LE) for symptomatic giant hepatic hemangioma. Cardiovasc Intervent Radiol 2018; 41 (11) 1674-1682
• 47 Gao J, Ji JS, Ding XM. et al. Laparoscopic radiofrequency ablation for large subcapsular hepatic hemangiomas: technical and clinical outcomes. PLoS One 2016; 11 (02) e0149755
• 48 Gao J, Fan RF, Yang JY. et al. Radiofrequency ablation for hepatic hemangiomas: a consensus from a Chinese panel of experts. World J Gastroenterol 2017; 23 (39) 7077-7086
• 49 Zhang X, Yan L, Li B. et al. Comparison of laparoscopic radiofrequency ablation versus open resection in the treatment of symptomatic-enlarging hepatic hemangiomas: a prospective study. Surg Endosc 2016; 30 (02) 756-763
• 50 Nat L, Poantă LI. Focal nodular hyperplasia (FNH). Rom J Intern Med 2014; 52 (01) 45-49
• 51 Kapp N, Curtis KM. Hormonal contraceptive use among women with liver tumors: a systematic review. Contraception 2009; 80 (04) 387-390
• 52 Vogl TJ, Own A, Hammerstingl R, Reichel P, Balzer JO. Transarterial embolization as a therapeutic option for focal nodular hyperplasia in four patients. Eur Radiol 2006; 16 (03) 670-675
• 53 Myers L, Ahn J. Focal nodular hyperplasia and hepatic adenoma: evaluation and management. Clin Liver Dis 2020; 24 (03) 389-403
• 54 Vidili G, Piscaglia F, Ainora ME. et al. Focal nodular hyperplasia: new findings at Doppler ultrasonography. Eur Rev Med Pharmacol Sci 2020; 24 (23) 12288-12295
• 55 Birn J, Williams TR, Croteau D, Schwartz S, Sturza S, Getzen T. Transarterial embolization of symptomatic focal nodular hyperplasia. J Vasc Interv Radiol 2013; 24 (11) 1647-1655
• 56 Zhang G, Wang M, Duan F. et al. Transarterial embolization with bleomycin for symptomatic hepatic focal nodular hyperplasia. Diagn Interv Radiol 2017; 23 (01) 66-70
• 57 Virgilio E, Cavallini M. Managing focal nodular hyperplasia of the liver: surgery or minimally-invasive approaches? A review of the preferable treatment options. Anticancer Res 2018; 38 (01) 33-36
• 58 Faria SC, Iyer RB, Rashid A, Whitman GJ. Hepatic adenoma. AJR Am J Roentgenol 2004; 182 (06) 1520
• 59 Reddy SK, Kishnani PS, Sullivan JA. et al. Resection of hepatocellular adenoma in patients with glycogen storage disease type Ia. J Hepatol 2007; 47 (05) 658-663
• 60 Martin NM, Abu Dayyeh BK, Chung RT. Anabolic steroid abuse causing recurrent hepatic adenomas and hemorrhage. World J Gastroenterol 2008; 14 (28) 4573-4575
• 61 Brancatelli G, Federle MP, Vullierme MP, Lagalla R, Midiri M, Vilgrain V. CT and MR imaging evaluation of hepatic adenoma. J Comput Assist Tomogr 2006; 30 (05) 745-750
• 62 van Rosmalen BV, de Graeff JJ, van der Poel MJ. et al; Dutch Benign Liver Tumour Group. Impact of open and minimally invasive resection of symptomatic solid benign liver tumours on symptoms and quality of life: a systematic review. HPB (Oxford) 2019; 21 (09) 1119-1130
• 63 Agrawal S, Agarwal S, Arnason T, Saini S, Belghiti J. Management of hepatocellular adenoma: recent advances. Clin Gastroenterol Hepatol 2015; 13 (07) 1221-1230
• 64 Krinsky G. Terminology of hepatocellular nodules in cirrhosis: plea for consistency. Radiology 2002; 224 (03) 638
• 65 Brancatelli G, Baron RL, Peterson MS, Marsh W. Helical CT screening for hepatocellular carcinoma in patients with cirrhosis: frequency and causes of false-positive interpretation. AJR Am J Roentgenol 2003; 180 (04) 1007-1014
• 66 Choi BI. Hepatocarcinogenesis in liver cirrhosis: imaging diagnosis. J Korean Med Sci 1998; 13 (02) 103-116
• 67 Krinsky GA, Lee VS, Nguyen MT. et al. Siderotic nodules at MR imaging: regenerative or dysplastic?. J Comput Assist Tomogr 2000; 24 (05) 773-776
• 68 Krinsky GA, Lee VS, Theise ND. et al. Hepatocellular carcinoma and dysplastic nodules in patients with cirrhosis: prospective diagnosis with MR imaging and explantation correlation. Radiology 2001; 219 (02) 445-454
• 69 Chernyak V, Fowler KJ, Kamaya A. et al. Liver imaging reporting and data system (LI-RADS) version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology 2018; 289 (03) 816-830
• 70 Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, Kamath PS. Liver cirrhosis. Lancet 2021; 398 (10308): 1359-1376
• 71 Cartier V, Crouan A, Esvan M. et al; CHIC Group. Suspicious liver nodule in chronic liver disease: usefulness of a second biopsy. Diagn Interv Imaging 2018; 99 7-8 493-499
• 72 Seow J, McGill M, Wang W, Smith P, Goodwin M. Imaging hepatic angiomyolipomas: key features and avoiding errors. Clin Radiol 2020; 75 (02) 88-99
• 73 Ren N, Qin LX, Tang ZY, Wu ZQ, Fan J. Diagnosis and treatment of hepatic angiomyolipoma in 26 cases. World J Gastroenterol 2003; 9 (08) 1856-1858
• 74 Nonomura A, Enomoto Y, Takeda M, Takano M, Morita K, Kasai T. Angiomyolipoma of the liver: a reappraisal of morphological features and delineation of new characteristic histological features from the clinicopathological findings of 55 tumours in 47 patients. Histopathology 2012; 61 (05) 863-880
• 75 Chang Z, Zhang JM, Ying JQ, Ge YP. Characteristics and treatment strategy of hepatic angiomyolipoma: a series of 94 patients collected from four institutions. J Gastrointestin Liver Dis 2011; 20 (01) 65-69
• 76 Zhou YM, Li B, Xu F. et al. Clinical features of hepatic angiomyolipoma. Hepatobiliary Pancreat Dis Int 2008; 7 (03) 284-287
• 77 Wang CP, Li HY, Wang H. et al. Hepatic angiomyolipoma mimicking hepatocellular carcinoma: magnetic resonance imaging and clinical pathological characteristics in 9 cases. Medicine (Baltimore) 2014; 93 (28) e194
• 78 Guidi G, Catalano O, Rotondo A. Spontaneous rupture of a hepatic angiomyolipoma: CT findings and literature review. Eur Radiol 1997; 7 (03) 335-337
• 79 Huber C, Treutner KH, Steinau G, Schumpelick V. Ruptured hepatic angiolipoma in tuberous sclerosis complex. Langenbecks Arch Chir 1996; 381 (01) 7-9
• 80 Kim SH, Kang TW, Lim K, Joh HS, Kang J, Sinn DH. A case of ruptured hepatic angiomyolipoma in a young male. Clin Mol Hepatol 2017; 23 (02) 179-183
• 81 Aoki H, Arata T, Morihiro T. et al. Spontaneous rupture of a hepatic angiomyolipoma: report of a case. Clin J Gastroenterol 2014; 7 (05) 429-433
• 82 Ukai K, Fuji A, Nishiwaki J. et al. Giant hepatic angiomyolipoma associated with disseminated intravascular coagulation. Intern Med 1997; 36 (03) 186-190
• 83 Kelleher T, Staunton M, Malone D, Geoghan J, Aiden McCormick P. Budd Chiari syndrome associated with angiomyolipoma of the liver. J Hepatol 2004; 40 (06) 1048-1049
• 84 Tsui WM, Colombari R, Portmann BC. et al. Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol 1999; 23 (01) 34-48
• 85 Yang CY, Ho MC, Jeng YM, Hu RH, Wu YM, Lee PH. Management of hepatic angiomyolipoma. J Gastrointest Surg 2007; 11 (04) 452-457
• 86 Yang X, Lei C, Qiu Y. et al. Selecting a suitable surgical treatment for hepatic angiomyolipoma: a retrospective analysis of 92 cases. ANZ J Surg 2018; 88 (09) E664-E669