Download PDF
Rofo 2016; 188(03): 245-252
DOI: 10.1055/s-0041-105411
Review
© Georg Thieme Verlag KG Stuttgart · New York

A Review of Scientific Topics and Literature in Abdominal Radiology in Germany – Part 2: Abdominal Parenchymal Organs

Aktuelle Schwerpunkte und Literatur der Abdominalradiologie im deutschsprachigen Raum – Teil 2: Parenchymatöse Oberbauchorgane
L. Grenacher
1   Diagnostik München – Diagnostic Imaging Center, Munich, Germany
,
M. S. Juchems
2   Diagnostic and Interventional Radiology, Konstanz Hospital, Konstanz, Germany
,
K. Holzapfel
3   Technische Universität Munich, Department of Radiology, Munich, Germany
,
S. Kinner
4   Department of Radiology, University Hospital Essen, Germany
,
T. C. Lauenstein
4   Department of Radiology, University Hospital Essen, Germany
,
J. Wessling
5   Department of Radiology, Clemens Hospital, Muenster, Germany
,
A. G. Schreyer
6   Department of Radiology, University Hospital Regensburg, Germany
› Author Affiliations
Further Information

Publication History

17 February 2015

06 July 2015

Publication Date:
01 October 2015 (online)

Also available at
   Permissions and Reprints

Abstract

The working group for abdominal and gastrointestinal diagnosis is a group of the German Radiological Society (DRG) focusing clinically and scientifically on the diagnosis and treatment of the gastrointestinal tract as well as the parenchymal abdominal organs. In this article we give an up-to-date literature review of scientific radiological topics especially covered by German radiologists. The working group experts cover the most recent relevant studies concerning liver-specific contrast media with an emphasis on a new classification system for liver adenomas. Additionally studies regarding selective internal radiotherapy (SIRT) are reviewed. For the pancreas the most important tumors are described followed by an introduction to the most recently introduced functional imaging techniques. The manuscript concludes with some remarks on recent studies and concerning chronic pancreatitis as well as autoimmune pancreatitis.

Key Points:

• Different subtypes of liver adenomas with different therapeutic consequences can be differentiated by MRI

• Most recently published studies focus on liver imaging with extracelluar liver specific contrast media as well as diffusion weighted imaging. They consider this new method having a high diagnostic potential.

• For pancreatic neoplasm diagnosis diffusion – as well as perfusion – imaging is considered as a highly promising method.

Citation Format:

• Grenacher L, Juchems MS, Holzapfel K et al. A Review of Scientific Topics and Literature in Abdominal Radiology in Germany – Part 2: Abdominal Parenchymal Organs. Fortschr Röntgenstr 2016; 188: 245 – 252

Zusammenfassung

Die AG Abdominal- und Gastrointestinaldiagnostik ist die Arbeitsgemeinschaft der Deutschen Röntgengesellschaft (DRG), die sich klinisch und wissenschaftlich auf Diagnostik und Therapie des Gastrointestinaltraktes mit allen parenchymatösen Abdominalorganen fokussiert. Im vorliegenden Artikel wird eine aktuelle Übersicht forschungsrelevanter Themengebiete vor allem der deutschsprachigen Radiologie gegeben. Die Experten der AG fassen dabei die aktuellen Studien bezüglich leberspezifischer Kontrastmittel zusammen. Ein besonderes Augenmerk wird auf die neue Einteilung der Leberadenomtypen mit ihren typischen Erscheinungsformen in der MRT gelegt. Ergänzt wird die Übersicht mit einer Zusammenfassung relevanter Publikationen zur radiologischen intraarteriellen Therapie von Lebertumoren mit Fokus auf der selektiven internen Radiotherapie (SIRT). Im Pankreas wird nach einer Übersicht der häufigsten Tumoren auf neue Entwicklungen der funktionellen Pankreasdiagnostik eingegangen. Abschließend werden die chronische Pankreatitis sowie die Autoimmunpankreatitis kurz im Spiegel der aktuellen Studienlage dargestellt.

Kernaussagen:

• Verschiedene Subtypen von Leberadenomen mit unterschiedlichen therapeutischen Konsequenzen können radiologisch MRT basiert differenziert werden.

• Extrazelluläres leberspezifisches Kontrastmittel sowie diffusionsgewichtete Bildgebung in der MRT der Leber sind stark befortschte radiologische Bildgebungsmethoden mit großem diagnostischen Potential.

• Bei Pankreasneoplasien sind funktionelle MRT Bildgebung mit Diffusion und Perfusion die aussichtsreichen neuen radiologischen Methoden.

Key words

abdomen - pancreas - CT - liver - MRI
 

  • References

  • 1 Grieser C, Steffen IG, Kramme IB et al. Gadoxetic acid enhanced MRI for differentiation of FNH and HCA: a single centre experience. Eur Radiol 2014; 24: 1339-1348
    CrossrefPubMedGoogle Scholar
  • 2 Haimerl M, Wachtler M, Platzek I et al. Added value of Gd-EOB-DTPA-enhanced Hepatobiliary phase MR imaging in evaluation of focal solid hepatic lesions. BMC medical imaging 2013; 13: 41
    CrossrefPubMedGoogle Scholar
  • 3 Haimerl M, Wachtler M, Zeman F et al. Quantitative evaluation of enhancement patterns in focal solid liver lesions with Gd-EOB-DTPA-enhanced MRI. PloS one 2014; 9: e100315
    CrossrefPubMedGoogle Scholar
  • 4 Zech CJ, Korpraphong P, Huppertz A et al. Randomized multicentre trial of gadoxetic acid-enhanced MRI versus conventional MRI or CT in the staging of colorectal cancer liver metastases. The British journal of surgery 2014; 101: 613-621
    CrossrefPubMedGoogle Scholar
  • 5 Bioulac-Sage P, Balabaud C, Zucman-Rossi J. Subtype classification of hepatocellular adenoma. Digestive surgery 2010; 27: 39-45
    CrossrefPubMedGoogle Scholar
  • 6 ESGAR 2014 Book of Abstracts. Insights into imaging. 5. 2014: 453-500
    Google Scholar
  • 7 Kinner S, Steinweg V, Maderwald S et al. Bile duct evaluation of potential living liver donors with Gd-EOB-DTPA enhanced MR cholangiography: Single-dose, double dose or half-dose contrast enhanced imaging. European journal of radiology 2014; 83: 763-767
    CrossrefPubMedGoogle Scholar
  • 8 Holzapfel K, Eiber MJ, Fingerle AA et al. Detection, classification, and characterization of focal liver lesions: Value of diffusion-weighted MR imaging, gadoxetic acid-enhanced MR imaging and the combination of both methods. Abdom Imaging 2012; 37: 74-82
    CrossrefPubMedGoogle Scholar
  • 9 Hoffmann R, Rempp H, Schraml C et al. Diffusion-weighted imaging during MR-guided radiofrequency ablation of hepatic malignancies: analysis of immediate pre- and post-ablative diffusion characteristics. Acta radiologica 2014;
    PubMedGoogle Scholar
  • 10 Beiderwellen K, Gomez B, Buchbender C et al. Depiction and characterization of liver lesions in whole body [(1)(8)F]-FDG PET/MRI. European journal of radiology 2013; 82: e669-e675
    CrossrefPubMedGoogle Scholar
  • 11 Albrecht MH, Wichmann JL, Muller C et al. Assessment of colorectal liver metastases using MRI and CT: impact of observer experience on diagnostic performance and inter-observer reproducibility with histopathological correlation. European journal of radiology 2014; 83: 1752-1758
    CrossrefPubMedGoogle Scholar
  • 12 Mitchell DG, Bruix J, Sherman M et al. LI-RADS (Liver Imaging Reporting and Data System): summary, discussion, and consensus of the LI-RADS Management Working Group and future directions. Hepatology 2015; 61: 1056-1065
    CrossrefPubMedGoogle Scholar
  • 13 Schelhorn J, Theysohn J, Ertle J et al. Selective internal radiation therapy of hepatic tumours: is coiling of the gastroduodenal artery always beneficial?. Clinical radiology 2014; 69: e216-e222
    CrossrefPubMedGoogle Scholar
  • 14 Theysohn JM, Ertle J, Muller S et al. Hepatic volume changes after lobar selective internal radiation therapy (SIRT) of hepatocellular carcinoma. Clinical radiology 2014; 69: 172-178
    CrossrefPubMedGoogle Scholar
  • 15 Schelhorn J, Ertle J, Schlaak JF et al. Selective internal radiation therapy of hepatic tumors: procedural implications of a patent hepatic falciform artery. Springerplus 2014; 3: 595
    CrossrefPubMedGoogle Scholar
  • 16 Gibbs P, Gebski V, Van Buskirk M et al. Selective Internal Radiation Therapy (SIRT) with yttrium-90 resin microspheres plus standard systemic chemotherapy regimen of FOLFOX versus FOLFOX alone as first-line treatment of non-resectable liver metastases from colorectal cancer: the SIRFLOX study. BMC Cancer 2014; 14: 897
    CrossrefPubMedGoogle Scholar
  • 17 Ricke J, Bulla K, Kolligs F et al. Safety and toxicity of radioembolization plus Sorafenib in advanced hepatocellular carcinoma: analysis of the European multicentre trial SORAMIC. Liver Int 2014;
    PubMedGoogle Scholar
  • 18 Theysohn JM, Schlaak JF, Muller S et al. Selective internal radiation therapy of hepatocellular carcinoma: potential hepatopulmonary shunt reduction after sorafenib administration. J Vasc Interv Radiol 2012; 23: 949-952
    CrossrefPubMedGoogle Scholar
  • 19 Seufferlein T, Porzner M, Becker T et al. S3-guideline exocrine pancreatic cancer. Zeitschrift fur Gastroenterologie 2013; 51: 1395-1440
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Ariyama J, Suyama M, Ogawa K et al. The detection and prognosis of small pancreatic carcinoma. International journal of pancreatology: official journal of the International Association of Pancreatology 1990; 7: 37-47
    PubMedGoogle Scholar
  • 21 Yeo CJ, Cameron JL. Prognostic factors in ductal pancreatic cancer. Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie 1998; 383: 129-133
    PubMedGoogle Scholar
  • 22 Ishikawa O, Ohigashi H, Imaoka S et al. Minute carcinoma of the pancreas measuring 1 cm or less in diameter--collective review of Japanese case reports. Hepato-gastroenterology 1999; 46: 8-15
    PubMedGoogle Scholar
  • 23 Krishna N, Tummala P, Reddy AV et al. Dilation of both pancreatic duct and the common bile duct on computed tomography and magnetic resonance imaging scans in patients with or without obstructive jaundice. Pancreas 2012; 41: 767-772
    PubMedGoogle Scholar
  • 24 Al-Hawary MM, Francis IR, Chari ST et al. Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the Society of Abdominal Radiology and the American Pancreatic Association. Radiology 2014; 270: 248-260
    CrossrefPubMedGoogle Scholar
  • 25 Gaujoux S, Brennan MF, Gonen M et al. Cystic lesions of the pancreas: changes in the presentation and management of 1424 patients at a single institution over a 15-year time period. Journal of the American College of Surgeons 2011; 212: 590-600 ; discussion -3
    CrossrefPubMedGoogle Scholar
  • 26 Valsangkar NP, Morales-Oyarvide V, Thayer SP et al. 851 resected cystic tumors of the pancreas: a 33-year experience at the Massachusetts General Hospital. Surgery 2012; 152: S4-S12
    CrossrefPubMedGoogle Scholar
  • 27 Brambs HJ, Juchems M. Radiological evaluation of intraductal papillary mucinous neoplasm. Der Chirurg Zeitschrift fur alle Gebiete der operativen Medizen 2012; 83: 116-122
    CrossrefPubMedGoogle Scholar
  • 28 Suzuki Y, Atomi Y, Sugiyama M et al. Cystic neoplasm of the pancreas: a Japanese multiinstitutional study of intraductal papillary mucinous tumor and mucinous cystic tumor. Pancreas 2004; 28: 241-246
    CrossrefPubMedGoogle Scholar
  • 29 Grenacher L, Strauß A, Bergmann F et al. Cyst features and Risk of Malignancy in Intraductal Papillary Mucinous Neoplasms of the Pancreas: Imaging and Pathology. Zeitschrift Viszeralmedizin 2015; 1
    PubMedGoogle Scholar
  • 30 Tanaka M, Fernandez-del Castillo C, Adsay V et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology 2012; 12: 183-197
    CrossrefPubMedGoogle Scholar
  • 31 Kloppel G, Luttges J. WHO-classification 2000: exocrine pancreatic tumors. Verhandlungen der Deutschen Gesellschaft fur Pathologie 2001; 85: 219-228
    PubMedGoogle Scholar
  • 32 Brambs HJ, Juchems MS. Diagnostik von Pankreastumoren. Radiologie up2date 2010; 10: 311-334
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Neumann HP, Dinkel E, Brambs H et al. Pancreatic lesions in the von Hippel-Lindau syndrome. Gastroenterology 1991; 101: 465-471
    CrossrefPubMedGoogle Scholar
  • 34 Brambs HJ, Juchems M. Radiologische Diagnostik zystischer Pankreastumoren. Viszeralmedizin 2011; 27: 205-213
    CrossrefPubMedGoogle Scholar
  • 35 Baek JH, Lee JM, Kim SH et al. Small (<or=3 cm) solid pseudopapillary tumors of the pancreas at multiphasic multidetector CT. Radiology 2010; 257: 97-106
    CrossrefPubMedGoogle Scholar
  • 36 Yu MH, Lee JY, Kim MA et al. MR imaging features of small solid pseudopapillary tumors: retrospective differentiation from other small solid pancreatic tumors. Am J Roentgenol American journal of roentgenology 2010; 195: 1324-1332
    PubMedGoogle Scholar
  • 37 Klauss M, Stiller W, Fritz F et al. Computed tomography perfusion analysis of pancreatic carcinoma. J Comput Assist Tomogr 2012; 36: 237-242
    CrossrefPubMedGoogle Scholar
  • 38 Klauss M, Stiller W, Pahn G et al. Dual-energy perfusion-CT of pancreatic adenocarcinoma. European journal of radiology 2013; 82: 208-214
    CrossrefPubMedGoogle Scholar
  • 39 Skornitzke S, Fritz F, Klauss M et al. Qualitative and quantitative evaluation of rigid and deformable motion correction algorithms using dual-energy CT images in view of application to CT perfusion measurements in abdominal organs affected by breathing motion. The British journal of radiology 2015; 88: 20140683
    CrossrefPubMedGoogle Scholar
  • 40 Bittencourt LK, Matos C, Coutinho AC et al. Diffusion-weighted magnetic resonance imaging in the upper abdomen: technical issues and clinical applications. Magn Reson Imaging Clin N Am 2011; 19: 111-131
    CrossrefPubMedGoogle Scholar
  • 41 Klauss M, Lemke A, Grunberg K et al. Intravoxel incoherent motion MRI for the differentiation between mass forming chronic pancreatitis and pancreatic carcinoma. Investigative radiology 2011; 46: 57-63
    CrossrefPubMedGoogle Scholar
  • 42 Barral M, Taouli B, Guiu B et al. Diffusion-weighted MR imaging of the pancreas: current status and recommendations. Radiology 2015; 274: 45-63
    CrossrefPubMedGoogle Scholar
  • 43 Hoffmeister A, Mayerle J, Beglinger C. Chronic Pancreatitis German Society of D, Metabolic D et al. S3-Consensus guidelines on definition, etiology, diagnosis and medical, endoscopic and surgical management of chronic pancreatitis German Society of Digestive and Metabolic Diseases (DGVS). Zeitschrift fur Gastroenterologie 2012; 50: 1176-1224
    Article in Thieme ConnectPubMedGoogle Scholar
  • 44 Schreyer AG, Jung M, Riemann JF et al. S3 guideline for chronic pancreatitis – diagnosis, classification and therapy for the radiologist. Fortschr Röntgenstr 2014; 186: 1002-1008
    Article in Thieme ConnectPubMedGoogle Scholar
  • 45 Sarner M, Cotton PB. Classification of pancreatitis. Gut 1984; 25: 756-759
    CrossrefPubMedGoogle Scholar
  • 46 Yoshida K, Toki F, Takeuchi T et al. Chronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis. Digestive diseases and sciences 1995; 40: 1561-1568
    CrossrefPubMedGoogle Scholar
  • 47 Rehnitz C, Klauss M, Singer R et al. Morphologic patterns of autoimmune pancreatitis in CT and MRI. Pancreatology 2011; 11: 240-251
    CrossrefPubMedGoogle Scholar
  • 48 Rahib L, Smith BD, Aizenberg R et al. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer research 2014; 74: 2913-2921
    CrossrefPubMedGoogle Scholar
  • 49 Strobel O, Hartwig W, Hackert T et al. Re-resection for isolated local recurrence of pancreatic cancer is feasible, safe, and associated with encouraging survival. Annals of surgical oncology 2013; 20: 964-972
    CrossrefPubMedGoogle Scholar