Benign Liver Tumors and Imaging Techniques

Benign liver tumours, most notably hepatocellular adenoma and focal nodular hyperplasia, contribute significantly to clinical decision making in hepatology and radiology. Hepatocellular adenomas are monoclonal lesions with recognised subtypes defined by genetic and histopathological features, each carrying distinct risks of haemorrhage or malignant transformation. Focal nodular hyperplasia is a polyclonal hyperplastic response to altered perfusion, typically asymptomatic and devoid of malignant potential. Non-invasive imaging has become central to the diagnosis, characterisation and surveillance of these entities. Conventional ultrasound and computed tomography remain first-line methods for lesion detection, while multiphasic magnetic resonance imaging (MRI) with hepatobiliary contrast agents, notably gadoxetic acid, provides superior tissue contrast, functional information and subtype differentiation. Advanced post-processing approaches such as quantitative lesion-to-liver enhancement measurements, three-dimensional texture analysis and radiomic modelling have further refined diagnostic accuracy, reducing reliance on biopsy. Emerging strategies harness dynamic contrast kinetics and machine-learning algorithms to predict lesion biology and guide management, from conservative monitoring to surgical resection. Collectively, these imaging advances enable personalised care pathways, optimise resource allocation and mitigate the risks associated with invasive procedures.

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Benign Liver Tumors and Imaging Techniques publication trend

The graph below shows the total number of articles in benign liver tumors and imaging techniques across all publications each year (not limited to Nature Index journals).

Technical terms

Hepatocellular adenoma (HCA): A benign monoclonal liver neoplasm with distinct genetic subtypes and variable risk of haemorrhage or malignant change.

Focal nodular hyperplasia (FNH): A benign, polyclonal hyperplastic liver lesion characterised by central scarring and abundant arterial supply without malignant potential.

Gadoxetic acid–enhanced MRI (Gd-EOB-MRI): A magnetic resonance technique using a hepatocyte-selective contrast agent to combine dynamic vascular phases with hepatobiliary imaging.

Hepatobiliary phase (HBP): The delayed imaging phase, typically 20 minutes post-contrast, when hepatocytes take up gadoxetic acid, enhancing lesion characterisation.

Texture analysis: Computational assessment of spatial variation in image intensity to quantify lesion heterogeneity and support diagnostic classification.

References

1. Diagnostic Value of Gadoxetic Acid-Enhanced MR Imaging to Distinguish HCA and Its Subtype from FNH: A Systematic Review. International Journal of Medical Sciences (2017).
2. Hepatocellular adenomas: is there additional value in using Gd-EOB-enhanced MRI for subtype differentiation?. European Radiology (2020).
3. Spectrum of liver lesions hyperintense on hepatobiliary phase: an approach by clinical setting. Insights into Imaging (2021).
4. Focal nodular hyperplasia: hepatobiliary enhancement patterns on gadoxetic-acid contrast-enhanced MRI. Abdominal Radiology (2012).
5. HBP-enhancing hepatocellular adenomas and how to discriminate them from FNH in Gd-EOB MRI. BMC Medical Imaging (2021).
6. Current updates on the molecular genetics and magnetic resonance imaging of focal nodular hyperplasia and hepatocellular adenoma. Insights into Imaging (2015).