Exploring radiological characteristics in beta-catenin-mutated hepatocellular adenoma: a systematic review and...

Hepatocellular adenomas are rare benign liver tumors primarily affecting young women, particularly those using oral contraceptives. This systematic review and meta-analysis aimed to evaluate the radiologic features of beta-catenin mutated HCAs with a focus on enhancing diagnostic accuracy and informing management strategies. A comprehensive search of databases yielded 328 articles, with 13 meeting inclusion criteria. The analysis included 94 B-HCAs, revealing a mean size of 6.46 cm and a notable prevalence of necrosis (32.65%). Imaging characteristics demonstrated that T1-weighted MRI showed isointensity in 47% and hypointensity in 36% of lesions, while T2-weighted MRI indicated iso-mild hyperintensity in 60% and hyperintensity in 38%. In the arterial phase, 87% of lesions exhibited hyperenhancement. The presence of a central scar was noted in 47.05% of cases, while the atoll sign and intralesional hemorrhage were less common. The study found a significant tendency for malignant transformation, with 47.72% of B-HCAs evolving into malignant lesions. The findings suggest that B-HCAs may present features similar to focal nodular hyperplasia, complicating diagnosis. Given the high risk of malignancy, management strategies for B-HCAs should align with those for hepatocellular carcinoma. This review underscores the importance of comprehensive MRI evaluation and clinical context in diagnosing B-HCAs, advocating for cautious interpretation of imaging findings to guide potential biopsy decisions.