title: Imaging Surveillance of Hypervascular Liver Lesions in Non-Cirrhotic Patients.
abstract: A consensus surveillance protocol is lacking for non-cirrhotic patients with hypervascular liver lesions presumed to represent hepatocellular adenomas. Patients with hypervascular liver lesions <5 cm not meeting criteria for focal nodular hyperplasia or hepatocellular carcinoma underwent surveillance with contrast-enhanced magnetic resonance imaging (MRI) 6, 12, and 24 months after baseline imaging. If lesions remained stable or decreased in size, then surveillance imaging was discontinued. Between 2011 and 2014, 116 patients with hypervascular liver lesions were evaluated. Seventy-nine patients were eligible for the surveillance protocol. Median follow-up was 24 months (range, 1-144 months). One patient (1 %) continued oral contraceptive pill (OCP) use and presented with hemorrhage requiring embolization 5 months after initial diagnosis. Ten patients (13 %) underwent elective embolization or surgical resection for size ≥5 cm. The remaining 68 patients (86 %) continued surveillance without hemorrhage or malignant transformation. Risk factors for requiring intervention during the surveillance period included younger age, larger lesion size, and estrogen use (all p < 0.05). Patients with hepatocellular adenomas <5 cm can safely be observed after discontinuing OCP with serial imaging 6, 12, and 24 months after diagnosis. If lesions remain stable or decrease in size, then longer-term surveillance is unlikely to identify patients at risk for complications.
authors.affiliation: Department of Surgery, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA. ys475@yahoo.com.
authors.forename: Yun Shin
authors.initials: YS
authors.lastname: Chun
authors.affiliation: Department of Radiology, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Parker
authors.affiliation: Department of Radiology, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Subbarao
authors.initials: S
authors.lastname: Inampudi
authors.affiliation: Department of Radiology, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ehrenwald
authors.affiliation: Department of Pathology, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Batts
authors.affiliation: Department of Pathology, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Burgart
authors.affiliation: Department of Radiology, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Clark W
authors.initials: CW
authors.lastname: Schumacher
authors.affiliation: Department of Radiology, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Mehling
authors.affiliation: Department of Radiology, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Bjorn I
authors.initials: BI
authors.lastname: Engstrom
authors.affiliation: Department of Surgery, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Hill
authors.affiliation: Department of Surgery, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Srinevas K
authors.initials: SK
authors.lastname: Reddy
authors.affiliation: Department of Surgery, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, 800 East 28th Street, Minneapolis, MN, 55407, USA.
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Sielaff
mesh_terms: D000236:Adenoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011159:Population Surveillance; D013997:Time Factors; D057832:Watchful Waiting; D055815:Young Adult
keywords: Focal nodular hyperplasia; Hepatocellular carcinoma; Liver cell adenoma