Lesiones Hepáticas Inespecíficas: Un Enfoque Radiológico Actualizado (2025)-WEB03-2025

Video Transcription

Video Summary

This RSNA webinar addresses the radiological evaluation and management of nonspecific, indeterminate focal liver lesions, featuring experts Dr. Guillermo Lizondo-Rioja and Dr. Fernando González. The session emphasizes using up-to-date imaging techniques, particularly liver-specific contrast agents like Gadoxetate Disodium (Eovist/Primovist), which are partially hepatocyte-specific and excreted both hepatically and renally. These agents enhance MRI sensitivity in detecting and characterizing liver lesions by differentiating functional hepatocytes from malignant or fibrotic tissue.<br /><br />Dr. Lizondo reviews the pharmacodynamics, imaging phases (arterial, portal venous, hepatobiliary), and diagnostic advantages of these agents, highlighting their role in distinguishing benign from malignant lesions. Dr. González presents clinical cases illustrating challenges in interpreting indeterminate liver lesions, stressing the importance of integrating imaging findings with clinical context and patient risk factors (e.g., history of neoplasia, liver disease). Algorithms incorporating lesion size, imaging features, and risk stratification guide decisions on follow-up, additional imaging (MRI preferred), or biopsy.<br /><br />Examples include differentiating hemangiomas, focal nodular hyperplasia, abscesses, parasitic infections, IgG4-related inflammatory pseudotumors mimicking malignancy, and atypical presentations of common benign lesions like sclerosed hemangiomas. Clinical correlation remains crucial to avoid unnecessary surgery. The discussion also covers management protocols for lesions in cirrhotic or fatty livers, referencing LI-RADS criteria.<br /><br />The panel acknowledges emerging roles of artificial intelligence, primarily supporting image reconstruction and characterization, though regulatory and validation issues persist. Contrast use in patients with metabolic syndrome or renal impairment is cautiously considered with no evidence of harm.<br /><br />Overall, the webinar underscores a multidisciplinary, evidence-based approach using advanced imaging and clinical data to improve diagnosis, guide management, and avoid overtreatment of indeterminate liver lesions.

Keywords

RSNA webinar

nonspecific liver lesions

indeterminate focal liver lesions

Gadoxetate Disodium

liver-specific contrast agents

MRI liver imaging

hepatobiliary phase

benign vs malignant liver lesions

LI-RADS criteria

artificial intelligence in radiology