{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:57:40Z","timestamp":1777694260594,"version":"3.51.4"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,7,7]],"date-time":"2013-07-07T00:00:00Z","timestamp":1373155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Focal nodular hyperplasia (<jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content>), a benign liver tumour, has a characteristic appearance on diagnostic imaging (<jats:styled-content style=\"fixed-case\">DI<\/jats:styled-content>) and histology. The role of liver biopsy in children for the diagnosis of <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content> is unclear. This study investigates the diagnostic accuracy of <jats:styled-content style=\"fixed-case\">DI<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content> in children without comorbidities, compared to liver biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 304 consecutive patients (age &lt;18\u00a0years) with a biopsied liver mass were retrospectively ascertained (1990\u20132010). Individuals with a history of malignancy, liver disease or syndromes with increased malignancy risk were excluded. <jats:styled-content style=\"fixed-case\">DI<\/jats:styled-content> and biopsy data were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After excluding 205 cases, 99 liver masses were studied. Based on histology, the most common diagnosis was hepatoblastoma (46\/99, 44%) followed by <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content> (23\/99, 23%). The mean age at <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content> diagnosis was 11.1\u00a0\u00b1\u00a05.2\u00a0years, with female preponderance (78%), and a median follow\u2010up of 1.35\u00a0years (interquartile range 0.54, 4.20\u00a0years). 19\/23 biopsy\u2010proven <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content> met standard criteria for <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content> on <jats:styled-content style=\"fixed-case\">DI<\/jats:styled-content>. In 4\/23 cases of biopsy\u2010proven <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content>, imaging did not suggest <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content>. Two false positive cases included adenoma and fibrolamellar hepatocellular carcinoma. On review of original reports, <jats:styled-content style=\"fixed-case\">DI<\/jats:styled-content> had 82.6% sensitivity and 97.4% specificity for the diagnosis of <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content>. On blind review, the sensitivity of <jats:styled-content style=\"fixed-case\">DI<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content> diagnosis was 81.3% for <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> (13\/16), and 53.3% for <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> (8\/15).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this cohort of children with liver masses and no comorbidities, a diagnosis of <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content> by imaging was highly specific, and <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> was the most sensitive study for its diagnosis. Liver biopsy may be deferred in selected children if the <jats:styled-content style=\"fixed-case\">DI<\/jats:styled-content>, particularly <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>, is indicative of <jats:styled-content style=\"fixed-case\">FNH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12241","type":"journal-article","created":{"date-parts":[[2013,6,12]],"date-time":"2013-06-12T13:53:38Z","timestamp":1371045218000},"page":"227-234","source":"Crossref","is-referenced-by-count":24,"title":["The role of diagnostic imaging and liver biopsy in the diagnosis of focal nodular hyperplasia in children"],"prefix":"10.1111","volume":"34","author":[{"given":"Pamela L.","family":"Valentino","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition The Hospital for Sick Children (SickKids) Toronto Ontario Canada"},{"name":"Department of Paediatrics University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon C.","family":"Ling","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition The Hospital for Sick Children (SickKids) Toronto Ontario Canada"},{"name":"Department of Paediatrics University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicky L.","family":"Ng","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition The Hospital for Sick Children (SickKids) Toronto Ontario Canada"},{"name":"Department of Paediatrics University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"John","sequence":"additional","affiliation":[{"name":"Interventional Radiology and Diagnostic Imaging The Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Bonasoni","sequence":"additional","affiliation":[{"name":"Division of Pathology and Paediatric Laboratory Medicine The Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise A.","family":"Castro","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging The Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn","family":"Taylor","sequence":"additional","affiliation":[{"name":"Division of Pathology and Paediatric Laboratory Medicine The Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Govind B.","family":"Chavhan","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging The Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binita M.","family":"Kamath","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition The Hospital for Sick Children (SickKids) Toronto Ontario Canada"},{"name":"Department of Paediatrics University of Toronto Toronto Ontario 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