In recent years,the incidence and mortality rates of hepatocellular carcinoma in China have gradually become close to each other,reflecting persistent limitations in current diagnostic and therapeutic strategies.Given the close association between hepatocellular carcinoma development and the progression of precancerous lesions,the expert panel released the first edition of the Multidisciplinary Experts Consensus on Diagnosis and Treatment of Precancerous Lesions of Hepatocellular Carcinoma in 2020 and updated it in 2023,aiming to advance early-intervention strategies and improve overall patient survival rates.This article provides an in-depth interpretation of the key imaging diagnostic points outlined in the consensus,aiming to offer radiologists at all levels with a robust reference for early identification and diagnosis of hepatocellular carcinoma precancerous lesions,thereby facilitating critical support for timely patient intervention and treatment.

As a globally prevalent malignancy with high morbidity and mortality rates,hepatocellular carcinoma has demonstrated significant potential in prognostic prediction and therapeutic evaluation through its imaging manifestations.This article focuses on the potential correlations between current imaging characteristics of hepatocellular carcinoma and its prognosis,emphasizing the importance of adopting and promoting a standardized imaging terminology system.It illustrates specific examples of imaging features associated with prognosis,reviews recent research hotspots and advancements in hepatocellular carcinoma prognosis.The aim is to offer precise prognostication,diagnosis and treatment strategies for patients with hepatocellular carcinoma.

As a globally prevalent malignancy with high morbidity and mortality rates,hepatocellular carcinoma has demonstrated significant potential in prognostic prediction and therapeutic evaluation through its imaging manifestations.This article focuses on the potential correlations between current imaging characteristics of hepatocellular carcinoma and its prognosis,emphasizing the importance of adopting and promoting a standardized imaging terminology system.It illustrates specific examples of imaging features associated with prognosis,reviews recent research hotspots and advancements in hepatocellular carcinoma prognosis.The aim is to offer precise prognostication,diagnosis and treatment strategies for patients with hepatocellular carcinoma.

In recent years,the incidence and mortality rates of hepatocellular carcinoma in China have gradually become close to each other,reflecting persistent limitations in current diagnostic and therapeutic strategies.Given the close association between hepatocellular carcinoma development and the progression of precancerous lesions,the expert panel released the first edition of the Multidisciplinary Experts Consensus on Diagnosis and Treatment of Precancerous Lesions of Hepatocellular Carcinoma in 2020 and updated it in 2023,aiming to advance early-intervention strategies and improve overall patient survival rates.This article provides an in-depth interpretation of the key imaging diagnostic points outlined in the consensus,aiming to offer radiologists at all levels with a robust reference for early identification and diagnosis of hepatocellular carcinoma precancerous lesions,thereby facilitating critical support for timely patient intervention and treatment.

Objective To explore the predictive value of 3D quantitative shape features based on enhanced CT for disease-free survival(DFS)of primary gastric gastrointestinal stromal tumors(GIST)patients receiving curative resection.Methods From January 2010 to December 2016,a total of 154 patients with primary gastric GIST who received curative resection in Zhongshan Hospital,Fudan University were retrospectively collected.The conventional CT imaging features and 3D quantitative shape features of tumors were evaluated,and the influencing factors of DFS were analyzed by univariate and multivariate Cox regression.Cut-off values were extracted,and Kaplan-Meier curves were used for survival analysis.Results Maximum 3D diameter(HR=1.829,95% CI 1.389-2.408,P＜0.001)and spherical disproportion(HR=2.153,95% CI 1.474-3.146,P＜0.001)were independent risk factors for DFS in primary gastric GIST.Kaplan-Meier curves showed that patients with maximum 3D diameter＞90.5 mm and spherical disproportion＞1.5 showed shorter DFS after curative resection(P＜0.001).Conclusion Maximum 3D diameter and spherical disproportion based on preoperative enhanced CT are valuable in the diagnosis of postoperative DFS in primary gastric GIST.

Objective To observe the value of 5.0T MR susceptibility weighted imaging(SWI)for displaying cerebral small veins and detecting cerebral microbleeds(CMB).Methods Head MR examinations were prospectively performed using both 3.0T and 5.0T MR scanner in 30 stroke patients suspected caused by cerebral small vessel disease.The image quality,effect of displaying cerebral small veins and detecting CMB were compared between 3.0T and 5.0T SWI.Results The image quality scores,signal-to-noise ratios,contrast-to-noise ratios,scores of displaying deep cerebral veins and subcortical veins,the counts of detecting CMB and iron deposition on cortical surface of 5.0T SWI were all higher than those of 3.0T SWI(all P＜0.05).High consistency of CMB positions was found between 3.0T and 5.0T SWI(Kappa=1.0).Conclusion The effect of 5.0T MR SWI for displaying cerebral small veins and detecting cerebral microbleeds were better than 3.0T MR SWI,which could be used to assess stroke caused by cerebral small vascular disease.

Since the publication of guidelines for diagnosis and treatment of primary liver cancer by National Health Commission of the People's Republic of China in 2017,which were updated in 2019 and 2022.The new version of the guidelines(2024 edition)has been published,which aims to early diagnosis,treatment and improvement of survival rate for patients with hepatocellular carcinoma.Imaging is essential for early diagnosis of hepatocellular carcinoma and the new guidelines feature major changes in the imaging techniques for early diagnosis of subcentimeter hepatocellular carcinoma(diameter≤1.0 cm),which were interpretated in this article.

The incidence and mortality rates of primary liver cancer remain very high,posing a serious threat to the global public health.In Asia,the guidelines from the Korean Liver Cancer Association-National Cancer Center,the Japan Society of Hepatology,and the Chinese Guidelines for Diagnosis and Treatment of Primary Liver Cancer(2024 edition)have significant influence and provide important guidance for the diagnosis and treatment of primary liver cancer.These guidelines,based on their own national condition,background,evidence and clinical practice,exhibit both commonalities and divergences in the imaging diagnosis of liver cancer.This study aims to provide a more comprehensive and scientific reference for clinicians by comparing the specific contents of three guidelines regarding screening,surveillance,imaging diagnosis and staging of liver cancer,thereby promoting the standardized diagnosis and treatment of clinical practice in the primary liver cancer.

Objective:To compare the predictive value of parameters extracted from circular region-of-interest (ROI) with whole-liver histogram on gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced T 1 map for postoperative liver failure in patients with liver focal lesions. Methods:The data of patients who underwent Gd-EOB-DTPA-enhanced MRI for focal liver lesions in Zhongshan Hospital, Fudan University from March 2016 to March 2018 were analyzed retrospectively. Forty patients were enrolled, including 30 males and 10 females, aged (56.6±12.1) years. According to the occurrence of postoperative liver failure, forty patients were divided into liver failure group ( n=14) and control group ( n=26). The parameters extracted from circular ROIs and whole liver histogram on T 1 map before Gd-EOB-DTPA enhancement and in hepatobiliary phase (HBP) were compared between the two groups. The receiver operating characteristic (ROC) curve was used to evaluate the value of these parameters in predicting postoperative liver failure. Results:The mean, standard deviation, median and 95% quantile of T 1 HBP in histogram parameters of liver failure group were significantly higher than those of control group (all P<0.05). The three parameters extracted from circular ROIs were not effective in predicting liver failure after hepatectomy (all P>0.05). Among all the liver histogram parameters, the area under the ROC curve of the 95% quantile before T 1 enhancement for predicting postoperative liver failure was 0.702 (95% CI: 0.523-0.881), the standard deviation of T 1 HBP was 0.739 (95% CI: 0.568-0.910), and the 95% quantile of T 1 HBP was 0.721 (95% CI: 0.540-0.903). The predictive efficacy were good (all P<0.05). Among them, the predictive performance of T 1 HBP standard deviation was the best, the area under the ROC curve was 0.739, the sensitivity was 85.7%, the specificity was 57.7%, and the best threshold was 54.8 ms. Conclusions:When Gd-EOB-DTPA enhanced T 1 mapping is used to predict postoperative liver failure in patients with focal liver lesions, the whole-liver histogram analysis is superior to the conventional circular ROI-based statistical method.

Objective:To evaluate the clinical value of 5.0 T ultra-high filed MRI system in assessing intracranial arteries segments and vessel branchers.Methods:This study was a prospective study. Totally 40 consecutive healthy volunteers were recruited from Zhongshan Hospital, Fudan University from September 1, 2021 to November 30, and all participants who underwent either 3.0 T or 5.0 T time-of-flight MR angiography (TOF-MRA) in random order were divided into 3.0 T MR group and 5.0 T MR group with 20 volunteers for each group. Image quality was assessed by Likert 5 scoring systems and signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR),and score in visualization of intracranial arteries [middle cerebral artery (MCA) and its segments, anterior cerebral artery (ACA) and its segments, posterior cerebral artery (PCA) and its segments, lenticulostriate arteries (LA) and pontine artery (PA)] were assessed from 0 to 3 (≥2: good depiction of vessel segment). Quantitative indicators were compared between 2 groups using independent t test or Mann-Whitney U test. Results:Among the 40 subjects, there were 29 males and 11 females, aged 20-69 (50±12) years. SNR and CNR were both significantly higher in 5.0 T MR group than those in 3.0 T MR group (SNR: 187±9 vs 91±4, t=31.59, P<0.001; CNR: 156±7 vs 70±4, t=31.45, P<0.001), but there was no significant difference in subjective scores of image quality between the 5.0 T MR and 3.0 T MR groups [5.0 (4.0, 5.0), 5.0 (5.0, 5.0) points, respectively, Z=-1.23, P=0.218]. In the evaluation of cerebral arteries, the visualizations of the proximal and middle segments of MCA, ACA and PCA was better than those in the 3.0 T MR group, and there was no significant difference in the scores ( P>0.05), while the visualizations of proximal arteries in the 5.0 T MR group were significantly better than those in the 3.0 T MR group ( P<0.05). Furthermore, small vessel branches such as LA and PA in 5.0 T MR group were visualized better than those in 3.0 T MR group ( P<0.001). Conclusion:TOF-MRA by ultra-high filed 5.0-T provides an optimal choice in visualization of distal large arteries and small vessel branches, which could be useful for the diagnosis on cerebral vascular disease.