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Diagnostics
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Advancements on Diagnostic and Management of Liver Disease
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Advancements on Diagnostic and Management of Liver Disease

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (20 November 2022) | Viewed by 15412

Special Issue Editor

Prof. Dr. Jung-Gil Park

E-Mail Website
Guest Editor
Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Korea
Interests: non-alcoholic fatty liver disease; hepatocellular carcinoma; non-invasive diagnosis; alcohol-related liver disease; sarcopenia

Special Issue Information

Dear Colleagues,

Recent advancements in the diagnostics and management of liver disease have led to a remarkable expansion of the field of hepatology. By the development of omics and artificial intelligence technology, precision medicine is now beginning to be integrated into clinical practice. However, unmet practical needs are still present in diagnosing the various phenotypes of chronic liver disease and molecular subtypes of hepatocellular carcinoma.

In this Special Issue, original research articles, reviews, short communications, case reports and interesting images are welcome, as well as either clinical or basic research. We look forward to your contribution.

Prof. Dr. Jung-Gil Park
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (6 papers)

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Research

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12 pages, 2179 KiB  
Article
Prognostic Impact of Myosteatosis on Mortality in Hospitalized Patients with COVID-19
by Min-Kyu Kang, Yu-Rim Lee, Jeung-Eun Song, Young-Oh Kweon, Won-Young Tak, Se-Young Jang, Jung-Gil Park and Soo-Young Park
Diagnostics 2022, 12(9), 2255; https://doi.org/10.3390/diagnostics12092255 - 18 Sep 2022
Cited by 7 | Viewed by 1637
Abstract
Body composition, including sarcopenia, adipose tissue, and myosteatosis, is associated with unfavorable clinical outcomes in patients with coronavirus disease (COVID-19). However, few studies have identified the impact of body composition, including pre-existing risk factors, on COVID-19 mortality. Therefore, this study aimed to evaluate [...] Read more.
Body composition, including sarcopenia, adipose tissue, and myosteatosis, is associated with unfavorable clinical outcomes in patients with coronavirus disease (COVID-19). However, few studies have identified the impact of body composition, including pre-existing risk factors, on COVID-19 mortality. Therefore, this study aimed to evaluate the effect of body composition, including pre-existing risk factors, on mortality in hospitalized patients with COVID-19. This two-center retrospective study included 127 hospitalized patients with COVID-19 who underwent unenhanced chest computed tomography (CT) between February and April 2020. Using the cross-sectional CT images at the L2 vertebra level, we analyzed the body composition, including skeletal muscle mass, visceral to subcutaneous adipose tissue ratio (VSR), and muscle density using the Hounsfield unit (HU). Of 127 patients with COVID-19, 16 (12.6%) died. Compared with survivors, non-survivors had low muscle density (41.9 vs. 32.2 HU, p < 0.001) and high proportion of myosteatosis (4.5 vs. 62.5%, p < 0.001). Cox regression analyses revealed diabetes (hazard ratio [HR], 3.587), myosteatosis (HR, 3.667), and a high fibrosis-4 index (HR, 1.213) as significant risk factors for mortality in patients with COVID-19. Myosteatosis was associated with mortality in hospitalized patients with COVID-19, independent of pre-existing prognostic factors. Full article
(This article belongs to the Special Issue Advancements on Diagnostic and Management of Liver Disease)
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Review

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27 pages, 16380 KiB  
Review
A Narrative Review on LI-RADS Algorithm in Liver Tumors: Prospects and Pitfalls
by Federica De Muzio, Francesca Grassi, Federica Dell’Aversana, Roberta Fusco, Ginevra Danti, Federica Flammia, Giuditta Chiti, Tommaso Valeri, Andrea Agostini, Pierpaolo Palumbo, Federico Bruno, Carmen Cutolo, Roberta Grassi, Igino Simonetti, Andrea Giovagnoni, Vittorio Miele, Antonio Barile and Vincenza Granata
Diagnostics 2022, 12(7), 1655; https://doi.org/10.3390/diagnostics12071655 - 07 Jul 2022
Cited by 5 | Viewed by 3191
Abstract
Liver cancer is the sixth most detected tumor and the third leading cause of tumor death worldwide. Hepatocellular carcinoma (HCC) is the most common primary liver malignancy with specific risk factors and a targeted population. Imaging plays a major role in the management [...] Read more.
Liver cancer is the sixth most detected tumor and the third leading cause of tumor death worldwide. Hepatocellular carcinoma (HCC) is the most common primary liver malignancy with specific risk factors and a targeted population. Imaging plays a major role in the management of HCC from screening to post-therapy follow-up. In order to optimize the diagnostic-therapeutic management and using a universal report, which allows more effective communication among the multidisciplinary team, several classification systems have been proposed over time, and LI-RADS is the most utilized. Currently, LI-RADS comprises four algorithms addressing screening and surveillance, diagnosis on computed tomography (CT)/magnetic resonance imaging (MRI), diagnosis on contrast-enhanced ultrasound (CEUS) and treatment response on CT/MRI. The algorithm allows guiding the radiologist through a stepwise process of assigning a category to a liver observation, recognizing both major and ancillary features. This process allows for characterizing liver lesions and assessing treatment. In this review, we highlighted both major and ancillary features that could define HCC. The distinctive dynamic vascular pattern of arterial hyperenhancement followed by washout in the portal-venous phase is the key hallmark of HCC, with a specificity value close to 100%. However, the sensitivity value of these combined criteria is inadequate. Recent evidence has proven that liver-specific contrast could be an important tool not only in increasing sensitivity but also in diagnosis as a major criterion. Although LI-RADS emerges as an essential instrument to support the management of liver tumors, still many improvements are needed to overcome the current limitations. In particular, features that may clearly distinguish HCC from cholangiocarcinoma (CCA) and combined HCC-CCA lesions and the assessment after locoregional radiation-based therapy are still fields of research. Full article
(This article belongs to the Special Issue Advancements on Diagnostic and Management of Liver Disease)
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19 pages, 3881 KiB  
Review
Imaging Features of Post Main Hepatectomy Complications: The Radiologist Challenging
by Carmen Cutolo, Federica De Muzio, Roberta Fusco, Igino Simonetti, Andrea Belli, Renato Patrone, Francesca Grassi, Federica Dell’Aversana, Vincenzo Pilone, Antonella Petrillo, Francesco Izzo and Vincenza Granata
Diagnostics 2022, 12(6), 1323; https://doi.org/10.3390/diagnostics12061323 - 26 May 2022
Cited by 2 | Viewed by 2606
Abstract
In the recent years, the number of liver resections has seen an impressive growth. Usually, hepatic resections remain the treatment of various liver diseases, such as malignant tumors, benign tumors, hydatid disease, and abscesses. Despite technical advancements and tremendous experience in the field [...] Read more.
In the recent years, the number of liver resections has seen an impressive growth. Usually, hepatic resections remain the treatment of various liver diseases, such as malignant tumors, benign tumors, hydatid disease, and abscesses. Despite technical advancements and tremendous experience in the field of liver resection of specialized centers, there are moderately high rates of postoperative morbidity and mortality, especially in high-risk and older patient populations. Although ultrasonography is usually the first-line imaging examination for postoperative complications, Computed Tomography (CT) is the imaging tool of choice in emergency settings due to its capability to assess the whole body in a few seconds and detect all possible complications. Magnetic resonance cholangiopancreatography (MRCP) is the imaging modality of choice for delineating early postoperative bile duct injuries and ischemic cholangitis that may arise in the late postoperative phase. Moreover, both MDCT and MRCP can precisely detect tumor recurrence. Consequently, radiologists should have knowledge of these surgical procedures for better comprehension of postoperative changes and recognition of the radiological features of various postoperative complications. Full article
(This article belongs to the Special Issue Advancements on Diagnostic and Management of Liver Disease)
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15 pages, 6329 KiB  
Review
Complications after Thermal Ablation of Hepatocellular Carcinoma and Liver Metastases: Imaging Findings
by Federica De Muzio, Carmen Cutolo, Federica Dell’Aversana, Francesca Grassi, Ludovica Ravo, Marilina Ferrante, Ginevra Danti, Federica Flammia, Igino Simonetti, Pierpaolo Palumbo, Federico Bruno, Luca Pierpaoli, Roberta Fusco, Andrea Giovagnoni, Vittorio Miele, Antonio Barile and Vincenza Granata
Diagnostics 2022, 12(5), 1151; https://doi.org/10.3390/diagnostics12051151 - 05 May 2022
Cited by 10 | Viewed by 3097
Abstract
Tumour ablation is a strategy of treatment of hepatic tumours in patients with small hepatocellular carcinoma (HCC) (<3 cm) or in patients unfit for surgical resection. Moreover, tumor ablation can be used as an adjuvant therapy or may be used in association with [...] Read more.
Tumour ablation is a strategy of treatment of hepatic tumours in patients with small hepatocellular carcinoma (HCC) (<3 cm) or in patients unfit for surgical resection. Moreover, tumor ablation can be used as an adjuvant therapy or may be used in association with resection in case of patients with poor functional liver disease. These types of treatment usually could be performed percutaneously under image guidance. The most clinically verified and used ablation modalities are Radiofrequency Ablation (RFA) and microwave ablation (MWA). However, despite both of them are considered minimally invasive techniques, they could be related to post-procedural complications. The International Working Group on Image-Guided Tumor and the Society of Interventional Radiology (SIR) identified major and minor post-ablative complications. Major complications, as vascular complications, occur in 2.2% to 3.1% of cases and include all the high risk pathological conditions which could increase the level of care or result in hospital admission or substantially prolonged hospital stay (SIR classifications C–E). Minor complications, as biliary complications, occur in 5% to 8.9% and include self-limiting conditions that are considered to be of low risk for the patient’s outcome. The purpose of this review is to summarise the main pathological ultrasound (US) and Computed Tomography (CT) findings, that may arise after ablative treatment. To simplify the analysis, the pathological pictures are divided according to the site of damage into vascular, biliary and extrahepatic complications. Full article
(This article belongs to the Special Issue Advancements on Diagnostic and Management of Liver Disease)
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15 pages, 10936 KiB  
Review
Combined Hepatocellular-Cholangiocarcinoma: What the Multidisciplinary Team Should Know
by Carmen Cutolo, Federica Dell’Aversana, Roberta Fusco, Giulia Grazzini, Giuditta Chiti, Igino Simonetti, Federico Bruno, Pierpaolo Palumbo, Luca Pierpaoli, Tommaso Valeri, Francesco Izzo, Andrea Giovagnoni, Roberto Grassi, Vittorio Miele, Antonio Barile and Vincenza Granata
Diagnostics 2022, 12(4), 890; https://doi.org/10.3390/diagnostics12040890 - 02 Apr 2022
Cited by 21 | Viewed by 2677
Abstract
Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare type of primary liver malignancy. Among the risk factors, hepatitis B and hepatitis C virus infections, cirrhosis, and male gender are widely reported. The clinical appearance of cHCC-CCA is similar to that of HCC and iCCA and [...] Read more.
Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare type of primary liver malignancy. Among the risk factors, hepatitis B and hepatitis C virus infections, cirrhosis, and male gender are widely reported. The clinical appearance of cHCC-CCA is similar to that of HCC and iCCA and it is usually silent until advanced states, causing a delay of diagnosis. Diagnosis is mainly based on histology from biopsies or surgical specimens. Correct pre-surgical diagnosis during imaging studies is very problematic and is due to the heterogeneous characteristics of the lesion in imaging, with overlapping features of HCC and CCA. The predominant histological subtype within the lesion establishes the predominant imaging findings. Therefore, in this scenario, the radiological findings characteristic of HCC show an overlap with those of CCA. Since cHCC-CCAs are prevalent in patients at high risk of HCC and there is a risk that these may mimic HCC, it is currently difficult to see a non-invasive diagnosis of HCC. Surgery is the only curative treatment of HCC-CCA. The role of liver transplantation (LT) in the treatment of cHCC-CCA remains controversial, as is the role of ablative or systemic therapies in the treatment of this tumour. These lesions still remain challenging, both in diagnosis and in the treatment phase. Therefore, a pre-treatment imaging diagnosis is essential, as well as the identification of prognostic factors that could stratify the risk of recurrence and the most adequate therapy according to patient characteristics. Full article
(This article belongs to the Special Issue Advancements on Diagnostic and Management of Liver Disease)
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Other

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7 pages, 6233 KiB  
Interesting Images
A Case of Hepatic Immunoglobulin G4-Related Disease Presenting as an Inflammatory Pseudotumor and Sclerosing Cholangitis
by Se Young Jang, Young Seok Han, Sang Yub Lee, Ja Ryung Han, Young Oh Kweon, Won Young Tak, Soo Young Park, Yu Rim Lee, Hun Kyu Ryeom, Jung Guen Cha, Jihoon Hong and Yoo Na Kang
Diagnostics 2022, 12(6), 1497; https://doi.org/10.3390/diagnostics12061497 - 19 Jun 2022
Cited by 1 | Viewed by 1498
Abstract
An inflammatory pseudotumor is a benign disease characterized by tumor-like lesions consisting of inflammatory cells including plasma cells and fibrous tissue. Recently, some inflammatory pseudotumor cases proved to be a form of Immunoglobulin G4-related disease (IgG4-RD). This novel clinical entity, recognized as a [...] Read more.
An inflammatory pseudotumor is a benign disease characterized by tumor-like lesions consisting of inflammatory cells including plasma cells and fibrous tissue. Recently, some inflammatory pseudotumor cases proved to be a form of Immunoglobulin G4-related disease (IgG4-RD). This novel clinical entity, recognized as a fibroinflammatory condition, is characterized by lymphoplasmacytic infiltration with a predominance of IgG4-positive plasma cells, storiform fibrosis, and often elevated serum IgG4 concentrations. We report a case of IgG4-RD in the form of an inflammatory pseudotumor in the liver with combined sclerosing cholangitis. We recommend that for diagnosing IgG4-RD accurately, it is important to obtain adequate tissue samples and follow-up the lesion in clinical practice. Full article
(This article belongs to the Special Issue Advancements on Diagnostic and Management of Liver Disease)
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