Noncirrhotic Portal Hypertension: Current Concepts and Overview of Causes, Pathophysiology, and Imaging Findings.

Noncirrhotic portal hypertension (NCPH) is an uncommon but important entity caused by impaired flow dynamics in the portal venous system in the absence of advanced fibrosis. The exact prevalence of this disease is unknown since many patients with NCPH are labeled as having cryptogenic cirrhosis. Numerous disease processes performed with different mechanisms can result in this entity.

Long-term clinical outcomes and short-term treatment efficacy evaluation based on longitudinal MR elastography in patients with chronic hepatitis C virus infection.

Objectives: Magnetic resonance elastography (MRE) provides multiple quantitative biomarkers for assessing chronic liver disease. This study evaluated the prognostic value of MRE-based long-term liver stiffness (LS) changes in chronic hepatitis C virus (HCV) infection and explored short-term viscosity changes (loss modulus, LM) for monitoring responses to direct-acting antiviral treatment (DAA-Tx).

Materials And Methods: One hundred fifty-nine adults were included.

Reinterpretation of outside imaging and review at hepatobiliary tumor board: impact on diagnosis and management of patients with hepatobiliary neoplasms.

Objectives: Radiologist participation in multidisciplinary tumor board can be time-consuming and demanding, requiring substantial preparation. Anecdotally radiologist participation is felt to help identify discrepancies in previous interpretations; however, there are limited data assessing the actual impact of their tumor board review on patient management. This prospective study aims to evaluate how the reinterpretation of outside imaging and review at hepatobiliary tumor board (HBTB) affects the diagnosis and management of patients with hepatobiliary neoplasms.

MR elastography-based prediction of development of hepatocellular carcinoma in patients with chronic hepatitis B with sustained virological response.

Objectives: The goal of this study was to develop a risk score based on MR elastography (MRE) to predict hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB).

Materials And Methods: A total of 345 patients with CHB who underwent 2D/3D MRE between July 2015 and December 2018 were enrolled and then randomly assigned to training (n = 243) and validation (n = 102) cohorts. An MRE-based HCC risk score was developed for the prediction of HCC development based on a multivariable Cox model and compared with previous clinical scores.

Imaging Manifestations of Alcohol Use-associated Disorders and Diseases.

Alcohol use disorder (AUD) is a serious condition linked to multiple health issues such as nervous system damage, heart disease, alcoholic liver disease, development of cancers, fetal alcohol syndrome, mental health disorders, and injuries to self and others. AUD presents a growing problem worldwide with significant economic and health care costs. Despite its growing prevalence, AUD remains underdiagnosed, partly due to the underreporting of alcohol intake and the stigma associated with the diagnosis.

Mucinous Appendiceal Neoplasms and Pseudomyxoma Peritonei: Imaging Features and Current Therapies.

Pseudomyxoma peritonei involves the gradual accumulation of gelatinous peritoneal metastases, typically resulting from the rupture of a mucinous appendiceal neoplasm. Standard treatment often includes cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. However, recurrence is common despite optimal cytoreduction, prompting ongoing investigation into novel therapies.

Deep Learning-Based Prediction of Hepatic Decompensation in Patients With Primary Sclerosing Cholangitis With Computed Tomography.

Objective: To investigate a deep learning model for predicting hepatic decompensation using computed tomography (CT) imaging in patients with primary sclerosing cholangitis (PSC).

Patients And Methods: Retrospective cohort study involving 277 adult patients with large-duct PSC who underwent an abdominal CT scan. The portal venous phase CT images were used as input to a 3D-DenseNet121 model, which was trained using 5-fold crossvalidation to classify hepatic decompensation.

Deep learning-based uncertainty quantification for quality assurance in hepatobiliary imaging-based techniques.

Recent advances in deep learning models have transformed medical imaging analysis, particularly in radiology. This editorial outlines how uncertainty quantification through embedding-based approaches enhances diagnostic accuracy and reliability in hepatobiliary imaging, with a specific focus on oncological conditions and early detection of precancerous lesions. We explore modern architectures like the Anisotropic Hybrid Network (AHUNet), which leverages both 2D imaging and 3D volumetric data through innovative convolutional approaches.

Three-Dimensional Vector MR Elastography for Evaluating Tissue Mechanical Heterogeneity to Assess Liver Disease Progression.

Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health challenge, with evidence indicating that hepatic inflammation and fibrosis are heterogeneous processes. Purpose To measure liver mechanical property heterogeneity using MR elastography (MRE) and evaluate its potential as a biomarker for tissue inflammation and fibrosis in patients with MASLD. Materials and Methods Mechanical tissue heterogeneity in MASLD was assessed at three-dimensional vector MRE pixel-wise histogram analysis of shear stiffness and loss modulus in preclinical and clinical studies.

Deep learning analysis of MRI accurately detects early-stage perihilar cholangiocarcinoma in patients with primary sclerosing cholangitis.

Background And Aims: Among those with primary sclerosing cholangitis (PSC), perihilar cholangiocarcinoma (pCCA) is often diagnosed at a late stage and is a leading source of mortality. Detection of pCCA in PSC when curative action can be taken is challenging. Our aim was to create a deep learning model that analyzed MRI to detect early-stage pCCA and compare its diagnostic performance with expert radiologists.

Autoimmune Disorders of the Liver and Biliary Tract.

Several autoimmune diseases (primary and secondary) can affect the liver and bile ducts. While the exact cause remains unclear, early diagnosis is crucial to prevent complications. The authors' main objective is to review imaging features of various autoimmune disorders, including autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, immunoglobulin G4 (IgG4)-related diseases, and drug-induced autoimmune injury.

Population perspectives on benefits and harms of screening for metabolic dysfunction-associated steatotic liver disease.

Background And Aims: Screening for diseases can have psychological impacts, such as anxiety, and requires acceptability from the population to be effective. This study examined the perspectives on the benefits and harms of screening for metabolic dysfunction-associated steatotic liver disease (MASLD) among the general population to optimize screening practices.

Approach And Results: A survey was sent to participants enrolled between 2020 and 2024 in a prospective MASLD screening study in Olmsted County, MN.

Evaluation of prognostic scores in patients with HCC undergoing first-line immunotherapy with atezolizumab and bevacizumab.

Background & Aims: Immunotherapy with atezolizumab and bevacizumab (a + b) has improved the prognosis of patients with unresectable hepatocellular carcinoma (HCC). However, the outcome for individual patients is highly variable. This study aimed to (i) develop and validate a prognostic prediction model to estimate individual prognosis and (ii) compare it with established models.

Free-breathing hepatic 2D magnetic resonance elastography.

Purpose: To evaluate the test-retest repeatability of a rapid, free-breathing two-dimensional (2D) MR elastography (MRE) technique and to assess the reliability of the liver-stiffness measurements compared with conventional breath-hold MREs.

Methods: Fifteen and 115 participants were enrolled in the technical repeatability and measurement equivalence assessment cohorts, respectively. All participants underwent rapid free-breathing and conventional breath-hold 2D MRE (twice in repeatability cohort) on 1.

Hypointense Findings on Hepatobiliary Phase MR Images.

Hepatobiliary (HB) contrast agents are increasingly valuable diagnostic tools in MRI, offering a wider range of applications as their clinical use expands. Normal hepatocytes take up HB contrast agents, which are subsequently excreted in bile. This property creates a distinct HB phase providing valuable insights into liver function and biliary anatomy.

Differentiation between renal cell carcinoma metastases to the pancreas and pancreatic neuroendocrine tumors in patients with renal cell carcinoma on CT or MRI.

Purpose: To determine whether renal cell carcinoma metastases (RCC-Mets) to the pancreas can be differentiated from pancreatic neuroendocrine tumors (PNETs) in patients with RCC on CT or MRI at presentation.

Methods: This retrospective study included patients with biopsy-proven RCC-Mets (n = 102) or PNETs (n = 32) at diagnosis or after nephrectomy for RCC. Inter-observer agreement (Cohen kappa) was assessed in 95 patients with independent reads by two radiologists, with discrepancies resolved by consensus for final analysis.

Advanced Imaging Techniques for Assessing Fat, Iron, and Fibrosis in Chronic Liver Disease.

Imaging plays a critical role in the management of chronic liver disease (CLD) because it is a safe and painless method to assess liver health. The widely used imaging techniques include ultrasound, computed tomography and magnetic resonance imaging. These techniques allow the measurement of fat deposition, iron content, and fibrosis, replacing invasive liver biopsies in many cases.

Imaging and Nonsurgical Management of Renal Masses.

In patients with renal masses, when intervention is warranted, partial nephrectomy is preferred when feasible, especially for T1 renal masses. Thermal ablation, however, has become an accepted alternative treatment of small renal neoplasms with excellent oncologic outcomes. The National Comprehensive Cancer Network guidelines include thermal ablation as a treatment strategy for managing T1a and select T1b masses.

Computed tomography-based radiomics and body composition model for predicting hepatic decompensation.

Primary sclerosing cholangitis (PSC) is a chronic liver disease characterized by inflammation and scarring of the bile ducts, which can lead to cirrhosis and hepatic decompensation. The study aimed to explore the potential value of computational radiomics, a field that extracts quantitative features from medical images, in predicting whether or not PSC patients had hepatic decompensation. We used an in-house developed deep learning model called the body composition model, which quantifies body composition from computed tomography (CT) into four compartments: subcutaneous adipose tissue (SAT), skeletal muscle (SKM), visceral adipose tissue (VAT), and intermuscular adipose tissue (IMAT).

Benign biliary conditions with increased risk of malignant lesions.

Numerous conditions and pathologies affect the biliary system, many of which have underlying benign courses. However, these overall benign conditions can predispose the patient to malignant pathologies, often due to malignancy arising from abnormal biliary ducts (such as with cholangiocarcinoma) or due to malignancy arising from end-stage liver disease caused by the biliary condition (such as with hepatocellular carcinoma). While these malignancies can at times be obvious, some pathologies can be very difficult to detect and distinguish from the underlying benign biliary etiology.

Imaging of Ischemic Cholangiopathy Following Donation after Circulatory Death Liver Transplant.

Ischemic cholangiopathy (IC) is the leading cause of inferior long-term outcomes following donation after circulatory death (DCD) liver transplant. Biliary strictures related to IC are nonanastomotic strictures (NASs) by definition and involve the donor hepatic ducts proximal to the anastomosis, compared with postsurgical anastomotic strictures that form due to fibrotic healing. IC-related NASs can be microangiopathic with patent hepatic artery or macroangiopathic with occluded or stenotic hepatic artery.

Diffusely Infiltrative Small Bowel Disease.

Multiple infiltrative disorders can affect the small bowel, often resulting in diffuse small bowel wall thickening. These infiltrative disorders can manifest owing to various factors such as an influx of immunologic or neoplastic cells or the accumulation of substances within one or more layers of the intestinal wall. Although there can be considerable overlap in the appearances of infiltrative diseases on cross-sectional images, a comprehensive understanding of more specific ancillary imaging features and clinicopathologic correlation can substantially narrow the differential diagnosis.