Focal "Targetoid" liver lesions on MRI: a diagnostic and practical imaging approach

Area of Science:

• Radiology
• Medical Imaging
• Hepatology

Background:

• Targetoid liver lesions display a characteristic MRI appearance due to differential signal intensity and enhancement between central and peripheral components.
• This pattern is associated with diverse conditions, including benign, malignant, infectious, inflammatory, and vascular diseases of the liver.

Purpose of the Study:

• To familiarize radiologists with the spectrum of targetoid hepatic lesions on MRI.
• To introduce a practical diagnostic algorithm integrating imaging findings and clinical context for enhanced diagnostic accuracy.

Main Methods:

• Utilizing MRI protocols including dynamic multiphase contrast-enhanced imaging (extracellular or hepatobiliary agents), T2-weighted, and diffusion-weighted sequences.
• Highlighting key imaging features such as rim arterial-phase enhancement, delayed central enhancement, T2 target appearance, diffusion restriction, and transitional/hepatobiliary phase appearances.

Main Results:

• The study outlines characteristic MRI features of targetoid liver lesions.
• A structured approach is proposed to aid in the interpretation of these complex lesions.

Conclusions:

• Implementing the proposed diagnostic algorithm enhances radiologists' confidence and precision in interpreting targetoid liver lesions.
• This systematic approach supports timely diagnosis and appropriate patient management for liver conditions presenting with a targetoid appearance.