Special Issue Liver Imaging—Part 1

A. D. Baheti

A. Eapen

Dear readers,

Welcome to this special issue of Journal of Gastrointestinal and Abdominal Radiology (JGAR). Our concepts of hepatic pathophysiology have advanced tremendously in the recent times, as for example, with the understanding of the different types of hepatic adenomas or the role of organic anion transporting polypeptides receptor for hepatobiliary contrast uptake. Hepatic imaging concepts and techniques have also made tremendous strides. In fact, a vast majority of hepatic lesions can now be diagnosed on imaging alone, be it cysts, hemangiomas, focal nodular hyperplasia, hepatocellular carcinoma, or cholangiocarcinomas. With the addition of contrast-enhanced ultrasound and hepatobiliary magnetic resonance (MR) contrast to our armory, we have got even better at problem-solving while characterizing hepatic lesions.

It was, thus, appropriate to have a series of dedicated issues focused on liver imaging, contextualizing the literature to our population. Our gratitude goes to the Editor-in-Chief for providing us with the opportunity to curate these articles. Volume 1 deals with the essentials of hepatic imaging and with noncirrhotic liver pathologies, while volume 2 focuses more on cirrhotic liver pathology. In this volume, we first begin with the basics, as Garde and Bhute discuss hepatic anatomy, variants, and imaging techniques with the help of some exquisite images.[1] Beyond lesion characterization, giving the surgeon a roadmap in terms of the segmental, vascular, and biliary anatomy is an extremely important task for the radiologist, making this article a must read. Kumar et al then comprehensively discuss an important aspect of hepatic imaging that is difficult to learn from Western textbooks given the difference in patient populations; an approach to hepatic infections in the Indian setting.[2] Do not miss their succinct table summarizing the appearance of various infections on imaging! Behera et al meticulously discuss the common benign hepatic neoplasms in the next article, including laying out few extremely useful tables and giving an algorithmic approach to solid hepatic lesions at the end.[3] We then move on from neoplasms to vascular hepatic pathologies as Augustine et al discuss an imaging approach to portal hypertension.[4] They delve deep into the topic, going beyond the “regular” imaging findings, and going into painstaking detail for each etiology of portal hypertension. This would be particularly useful not just for clinical radiologists but also for exam-going residents. We also feature an excellent prospective study by Rajesh et al, comparing the accuracy of fatty liver estimation on dual-energy computed tomography with MRI evaluation.[5]

Besides these liver-focused topics, this volume also has two other original articles. Chandramohan et al evaluate a very practical scenario faced by many radiologists reporting an MRI of a rectal mass when the pathology is unknown; should we use the rectal template for adenocarcinoma or squamous cell carcinoma, as they compare the findings in the two pathologies.[6] One of the reasons for launching the JGAR was to generate India-specific data rather than rely on data from the West or the East. Choudhury et al do precisely that as they describe ultrasound shear wave elastography of normal pancreas in adult subjects in their prospective study.[7] Juvaina et al describe a rare encounter with a spontaneously ruptured choledochal cyst in our final article of this issue.[8]

Happy reading! we are sure that once you complete reading these articles, you will eagerly await issue 2 of the special liver issue, focusing more on cirrhotic liver!

Publication History

Article published online:
13 June 2023

• References

• 1 Garde PS, Bhute RB. Liver anatomy and cross-sectional imaging techniques: a practical approach. J Gastrointestinal Abdominal Radiol 2023; 6: 87-98
• 2 Kumar A, Garg D, Gupta P. Radiological approach to liver infections. J Gastrointestinal Abdominal Radiol 2023; 6: 99-106
• 3 Behera RK, Chandola S, Goyal A, Sharma R. Benign hepatic neoplasms: an imaging review. J Gastrointestinal Abdominal Radiol 2023; 6: 107-120
• 4 Augustine A, John R, Simon B, Chandramohan A, Keshava SN, Eapen A. Imaging approach to portal hypertension. J Gastrointestinal Abdominal Radiol 2023; 6: 121-135
• 5 Rajesh S, Arunachalam VK, Periaswamy G. et al. Accuracy of evaluation of fatty liver with third-generation unenhanced dual-energy CT and MRI: prospective comparison with MR spectroscopy. J Gastrointestinal Abdominal Radiol 2023; 6: 77-86
• 6 Chandramohan A, Sathyakumar K, Augustine A. et al. MRI staging of anorectal malignancy—a reporting dilemma: is it adenocarcinoma or squamous cell carcinoma?. J Gastrointestinal Abdominal Radiol 2023; 6: 136-145
• 7 Choudhury SR, Verma M, Gupta P, Singh H, Sharma V, Kochhar R. Ultrasound shear wave elastography of normal pancreas in adult subjects. J Gastrointestinal Abdominal Radiol 2023; 6: 146-151
• 8 Juvaina P, Aleena KT, Riyaz A, Devarajan E, Ranjit P, Jyothi ER. Spontaneous rupture of choledochal cyst: a rare presentation. J Gastrointestinal Abdominal Radiol 2023; 6: 152-155