Hematologic Malignancies and Imaging in Hepatic Systems

Hematologic malignancies encompass a diverse group of disorders characterised by the abnormal proliferation of blood-forming cells, including lymphomas, leukaemias and plasma cell dyscrasias. Although the liver is a common site for metastatic involvement, primary hepatic manifestations—such as primary hepatic lymphoma and extramedullary infiltration by leukaemia or myeloma—remain rare and diagnostically challenging. Imaging plays a pivotal role in detection, characterisation and treatment monitoring. Ultrasonography, including contrast-enhanced techniques, provides initial assessment of focal lesions. Cross-sectional modalities—computed tomography and magnetic resonance imaging—offer detailed anatomical and functional information, with diffusion-weighted imaging improving lesion conspicuity. Positron emission tomography, often combined with computed tomography, enables metabolic quantification and whole-body staging. Advances in radiomics and molecular imaging have enhanced lesion differentiation, guiding biopsy, avoiding unnecessary intervention and optimising therapeutic strategies. Given the global burden of haematologic cancers and variable access to imaging resources, standardising protocols and integrating novel quantitative tools are crucial to improving diagnostic accuracy and patient outcomes.

Research from Nature Portfolio

Recent work has demonstrated the potential of radiomics-driven magnetic resonance imaging to distinguish hepatic lymphomatous lesions from primary liver carcinomas and metastases. Texture analysis of T2-weighted images and apparent diffusion coefficient maps achieved high sensitivity in multicentre cohorts, suggesting a non-invasive biomarker for lesion characterisation. Complementary studies have introduced immuno-PET tracers targeting B-cell markers, enabling high-resolution visualisation of hepatic involvement in non-Hodgkin lymphoma. This approach has refined staging accuracy and permitted longitudinal evaluation of therapeutic response. Furthermore, artificial intelligence algorithms applied to PET/CT have shown promise in identifying extramedullary myeloma infiltration in the liver, with deep learning models outperforming conventional interpretation in early detection of subcentimetre deposits. Collectively, these advances point to a new era of precision imaging in haematologic liver disease.

Hematologic Malignancies and Imaging in Hepatic Systems publication trend

The graph below shows the total number of articles in hematologic malignancies and imaging in hepatic systems across all publications each year (not limited to Nature Index journals).

Technical terms

Extramedullary infiltration: Dissemination of malignant haematopoietic cells into organs outside the bone marrow.

Radiomics: High-throughput extraction of quantitative features from medical images to characterise tissue heterogeneity.

Diffusion-weighted imaging (DWI): MRI technique measuring the random motion of water molecules, useful for detecting cellular density changes.

Contrast-enhanced ultrasound (CEUS): Ultrasonography following intravenous injection of microbubble agents to assess lesion vascularity.

Immuno-PET: Molecular imaging combining positron emission tomography with antibodies or fragments targeting specific cellular markers.

References

1. Multimodality Imaging of Primary Hepatic Lymphoma: A Case Report and a Literature Review. Diagnostics (2024).
2. Primary hepatic extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type. Medicine (2017).