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Special Issue "Novelties in Diagnostics and Therapeutics in Hepatology"

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A special issue of Gastroenterology Insights (ISSN 2036-7422). This special issue belongs to the section "Liver".

Deadline for manuscript submissions: 31 January 2024 | Viewed by 8336

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Dr. Giovanni Marasco

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Guest Editor

Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
Interests: liver stiffness; portal hypertension; hepatocellular carcinoma

Dr. Matteo Renzulli

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Guest Editor

Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40133 Bologna, Italy
Interests: magnetic resonance imaging; chemoembolization; radiomics; angiography
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Special Issue Information

Dear Colleagues,

Liver diseases are a globally recognized cause of morbidity and mortality. The burden of these diseases has rapidly changed over the last decade due to the introduction in clinical practice of new antiviral agents for hepatitis C virus. Therefore, hepatologists’ are now facing the burden of other pathological entities, such as metabolic-associated and hematological-associated liver diseases. A multidimensional diagnostic work-up is needed to ensure optimal management of these patients. Furthermore, novel techniques and drugs are under investigation for the treatment of advanced stages of liver disease which are complicated by portal hypertension and hepatocellular carcinoma. Within this Special Issue, we will summarize the most updated and cutting-edge research on these fields.

Dr. Giovanni Marasco
Dr. Matteo Renzulli
Guest Editors

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Keywords

portal hypertension
hepatocellular carcinoma
imaging
liver diseases

Published Papers (4 papers)

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9 pages, 2137 KiB

Open AccessArticle

Point Shear Wave Elastography and 2-Dimensional Shear Wave Elastography as a Non-Invasive Method in Differentiating Benign from Malignant Liver Lesions

Emiliya Lyubomirova Nacheva-Georgieva

Daniel Ilianov Doykov

Vladimir Nikolov Andonov

Katya Angelova Doykova

and

Silviya Bogdanova Tsvetkova

Gastroenterol. Insights 2022, 13(3), 296-304; https://doi.org/10.3390/gastroent13030030 - 10 Sep 2022

Cited by 3 | Viewed by 1795

Abstract

Non-invasive, ultrasound-based methods for visualizing and measuring tissue elasticity are becoming more and more common in routine daily practice. An accurate diagnosis of malignant and benign tumors is essential for determining the appropriate treatment. Despite the wide use of imaging techniques, the investigation for assessing the elasticity of focal liver lesions and their differentiating is still continuing. Aim: To investigate the value of point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) for the differential diagnosis of benign and malignant focal liver lesions. Materials and Methods: A total of 125 adult patients were included from the Clinic of Gastroenterology of University Hospital Kaspela, Plovdiv city, Bulgaria, in the period from January 2021 to July 2022. Participants were divided into two groups—with benign (hemangiomas) and malignant focal liver lesions (hepatocellular carcinoma). The group with benign lesions included 63 patients and the group with malignant focal liver lesions (FLLs)—62 patients. Point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) integrated in the same ultrasound machine (Esaote MyLab™ 9Exp) were performed for each lesion. Results: Malignant FLLs have significantly higher stiffness in both pSWE (2.52–4.32 m/s, 90% CI: 2.37 to 2.68, 90% CI: 4.19 to 4.55) and 2d-SWE (2.52–4.43 m/s, 90% CI: 2.31 to 2.65, 90% CI: 4.27 to 4.61). Conclusion: 2D-SWE and pSWE could provide complementary data about FLLs. They enable us to conveniently and easily obtain accurate stiffness information of FLLs. Full article

(This article belongs to the Special Issue Novelties in Diagnostics and Therapeutics in Hepatology)

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11 pages, 2710 KiB

Open AccessArticle

Radiological Features of Microvascular Invasion of Hepatocellular Carcinoma in Patients with Non-Alcoholic Fatty Liver Disease

and

Gastroenterol. Insights 2022, 13(3), 275-285; https://doi.org/10.3390/gastroent13030028 - 15 Aug 2022

Cited by 2 | Viewed by 1953

Abstract

Background: The aim of the present study was to evaluate the presence and the prognostic value of the radiological signs of microvascular invasion (MVI) of hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD). Methods: Between January 2015 and December 2017, all patients (91 patients) with de novo HCC or HCC recurrence occurring at least 2 years after the last treatment in NAFLD (36 patients) or with hepatitis C virus (HCV) liver disease (55 patients) were included. Each HCC was treated with liver resection and transplantation to obtain the anatomopathological confirmation of MVI. All patients had at least one available computed tomography (CT) scan or magnetic resonance imaging (MRI) performed no more than one month prior to the treatment. The clinical data of each patient, tumor burden (diameter, margins, two-trait predictor of venous invasion (TTPVI), and peritumoral enhancement), the recurrence rate (RR) after a 1-year follow-up, and the time to recurrence (TTR) were collected. Results: The NAFLD–HCC nodules were larger as compared to HCV–HCC (51 mm vs. 36 mm, p = 0.004) and showed a higher prevalence of TTPVI (38.9 vs. 20.0%, p = 0.058). At multivariate analysis, nodule diameter >50 mm was found to be the only independent prognostic factor of TTPVI (hazard ratio: 21.3, 95% confidence interval: 4.2–107.7, p < 0.001), and the presence of TTPVI was confirmed to be the only independent prognostic factors of recurrence (hazard ratio: 2.349, 95% confidence interval: 1.369–4.032, p = 0.002). No correlations were found between TTR and irregular tumor margins or peritumoral enhancement. Conclusion: The NAFLD–HCC patients had larger tumors at diagnosis and showed a more frequent presence of radiological signs of MVI as compared to the HCV–HCC patients. The MVI was related to a more rapid recurrence after curative treatments, demonstrating the prognostic value of this radiological diagnosis. Full article

(This article belongs to the Special Issue Novelties in Diagnostics and Therapeutics in Hepatology)

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10 pages, 295 KiB

Open AccessArticle

Correlation between the Lymphocyte-To-Monocyte Ratio (LMR) and Child–Pugh and MELD/MELDNa Scores in Vietnamese Patients with Liver Cirrhosis

and

Gastroenterol. Insights 2022, 13(2), 182-191; https://doi.org/10.3390/gastroent13020019 - 31 May 2022

Viewed by 1899

Abstract

Objectives: This study aims to determine cirrhotic patients’ clinical and laboratory characteristics, thereby examining the correlation between lymphocyte-to-monocyte ratio and Child–Pugh and MELD/MELDNa scores. Methods: A cross-sectional study with an analysis of 153 patients admitted to the Department of Gastroenterology–Clinical Hematology at Can Tho Central General Hospital. Data were collected via patient interviews and medical records. Results: The included patients were more likely to be male (66.7%) and were ≥60 years old (51.6%). Excessive alcohol consumption and hepatitis B were the dominant causes of cirrhosis (35.3% and 34.0%). The clinical and laboratory characteristics were similar to previous studies in cirrhotic patients. The mean Child score was 9.3 ± 2.1, including 9.8% of patients with Child A, 44.4% for Child B, and 45.8% for Child C. The mean MELD and MELDNa scores were 16.9 ± 7.1 and 19.4 ± 8.1, respectively. The mean lymphocyte-to-monocyte ratio (LMR) is 2.0 ± 2.2 (from 0.09 to 25.3), being negatively correlated with the other scores (Pearson correlation coefficients were −0.238; −0.211 and −0.245, respectively, all p-values < 0.01). Patients with LMR below 3.31 were more likely to be classified as Child–Pugh B and C. Conclusion: The correlation between LMR with Child–Pugh, MELD, and MELDNa scores was weak and negative. Full article

(This article belongs to the Special Issue Novelties in Diagnostics and Therapeutics in Hepatology)

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6 pages, 921 KiB

Open AccessCase Report

Hepatosplenic T-Cell Lymphoma Mimicking Acute Onset of Cholestatic Hepatitis in a Young Immunocompetent Man: A Case Report

Flavio Metelli

Riccardo Solimando

Luigina Vanessa Alemanni

Roberta Gafà

and

Giovanni Marasco

Gastroenterol. Insights 2022, 13(3), 258-263; https://doi.org/10.3390/gastroent13030026 - 09 Aug 2022

Cited by 1 | Viewed by 1955

Abstract

We herein report a case of hepatosplenic T-cell lymphoma (HSTCL) incidentally found in a 30-year-old man who came to the emergency department after an ankle trauma. At admission, laboratory tests revealed abnormal liver enzymes and pancytopenia, and imaging showed mild hepatosplenomegaly. During hospitalization, the patient’s clinical condition worsened rapidly, with a concomitant increase in cholestatic enzymes, severe jaundice, and the worsening of pancytopenia. Causes of liver injury, including many infectious diseases, were explored until the diagnosis of HSTCL was made by liver and bone marrow biopsies. Subsequently, the patient underwent six cycles of chemotherapy with a CHOP (cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone or prednisolone) regimen and one with Hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone) but, despite this aggressive treatment, died due to disease progression 2 months after diagnosis. This rare disease should be considered in the diagnostic workup of acute cholestatic hepatitis presenting with concomitant hepatosplenomegaly and cytopenia. Full article

(This article belongs to the Special Issue Novelties in Diagnostics and Therapeutics in Hepatology)

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