CT Scan unable to diagnose Liver Haemangioma vs malignant Tumours?

[jerrylimkk]

Can any kind folks help me out on this?

I had some stomach pain issues and went for an endoscopy back in Nov 2021. The doc found Gastritis but also asked me to do an ultrasound. I did and they found a mass on my liver. Doc asked me to go for a CT scan with IV contrast of the abdominal. The results came back and suggestive of a Liver Haemangioma. But due to the yellow brackets wordings in the 2nd photo comments section. The doc asked me to go for an MRI liver again to confirm whether is that liver mass indeed a Liver Haemangioma or something malignant.

I am ok to go for the MRI scan but I am worried now about will there be a big change in the results that the Liver Haemangioma diagnosis on the CT scan? I mean how accurate is a CT scan used for the diagnosis of Liver Haemangioma?

Do Radiologists often use words like "Other considerations include focal nodular hyperplasia and less likely hepatic adenoma or fibro-lameller hepatocellular carcinoma"? Meaning that there is a open question marks on what is the actual diagnosis?

[jerrylimkk]

Edited to remove the report.

[jerrylimkk in reply to jerrylimkk]

Edited to remove the report.

[AyrshireK]

Forum guidelines and the fact we arn't qualified to do so means we arn't technically allowed to comment on photographs/reports.

From a personal perspective, my hubby has various haemangioma in his liver - they were first actually seen on ultrasound with comment from reporter being "suggestive of haemangioma" which sounded a bit airy fairy to me and I asked for clarification and basically they never want to 100% commit. If they arn't totally sure then they send you for a better scan - in your case you are going for an MRI so hopefully that will reveal for sure what they have found.

Fibrolamellar cancer is very rare according to the BLT page but there are treatment options available if indeed that turned out to be the case - don't panic yourself at this stage. They have said appearance is in keeping with a haemangioma but they just want to be absolutely sure hence the follow up scan.

Best wishes,

Katie

[jerrylimkk in reply to AyrshireK]

Thanks Katie. For my case. The first scan was an ultrasound which they cannot conclude the mass is a haemangioma and therefore asking me to do the CT scan with IV constrast which is even more better than an ultrasound. I do not know the radiologist is trying to cover up himself. Seems weird to me if an experienced radiologist cannot interpret a haemangioma with CT scan.

[AyrshireK in reply to jerrylimkk]

My hubby has never had a CT scan to check his liver lumps and bumps - he has an ultrasound every 6 months because he has cirrhosis so when anything new pops up that they can't 100% commit to they have always (twice) sent him for an MRI.

I think they just want to be cautious on your diagnosis and are doing the correct thing in sending you for a more detailed scan.

Katie

[jerrylimkk in reply to AyrshireK]

Thanks Katie. I think their standards is really bad. For the ultrasound they cannot even tell what is the mass. After going for the CT, they seems like airy fairy again.

[AyrshireK in reply to jerrylimkk]

I don't think their standards are bad at all - the scans each have their own levels of clarity and accuracy and they probably thought that CT would be good enough.

I am sure you want the best and most accurate scan going but they don't immediately go there if a lower cost one will be sufficient. As it still hasn't given them 100% clarity on what your lesion is then it is absolutely the best thing to get the MRI scan done just for peace of mind.

No operator/radiographer/radiologist is going to say you are good to go unless they are convinced that you are indeed ok - obviously even then scans don't pick up everything (we've had transplant patients on here who didn't even know they had liver cancer until their old cirrhotic organ was removed and examined and previously unseen tumours discovered).

I'd be delighted that they are pulling out all the stops to get you seen & scanned appropriately (especially with the pressures our medical teams are under just now) and they'll hopefully be able to give you the all clear that you want to hear.

[jerrylimkk in reply to AyrshireK]

From what I have read. Haemangioma are pretty easy to diagnose on CT. I think the radiologist is trying to cover himself.

[Mama41]

I had an ultrasound,CT scan and MRI for my liver lesion and was diagnosed with FNH. After surgery to remove it,it was found to be Fibrolamellar (a 1 in 5 million chance).

You’re lucky that they are being through and I don’t think the radiologist is just ‘covering himself’.

MRI with contrast is the general standard of care for liver lesions.

Good luck and I hope it is just a benign hemangioma.

[jerrylimkk in reply to Mama41]

Hi Mama & @AyrshireK,

I got the MRI scan report from the same radiologist that did the CT Scan. The MRI diagnosed me with a FNH instead of Hemangioma on the CT Scan.

I could not find closure to this so I paid docpanel.com for a specialized Radiologist Dr Richard Semelka to read my MRI scans. He is very helpful and good in the interpretion of MRI scans. He also suggested that I got slight fatty liver and I will need to do more exercise.

He confidently confirmed that the mass is actually a Hemangioma instead of FHN. I google some of the liver lesion images and found his name very often in peer reviewed reports. He is also one of the top MRI Radiologist and has authored a few books that guide doctors on how to interprete scans.

amazon.com/Abdominal-Pelvic...