Differentiation of Intrahepatic Cholangiocellular Carcinoma from Hepatocellular Carcinoma in the Cirrhotic Liver Using Contrast-enhanced MR Imaging

Wengert, Georg; Baltzer, Pascal; Bickel, Hubert; Thurner, Patrick; Breitenseher, Julia; Lázár, Mathias; Pones, Matthias; Peck‐Radosavljevic, Markus; Hucke, Florian; Ba‐Ssalamah, Ahmed

doi:10.1016/j.acra.2017.06.005

Cited by 16 publications

(13 citation statements)

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“…The principal characteristics of the 32 eligible studies [ 13 , 14 , 16 , 18 – 44 ] are summarized in Table 1 . All of these studies reported the results on a per-patient basis.…”

Section: Resultsmentioning

confidence: 99%

Comparison of magnetic resonance imaging and 18-fludeoxyglucose positron emission tomography/computed tomography in the diagnostic accuracy of staging in patients with cholangiocarcinoma

Huang

Yang

et al. 2020

Medicine

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Background: Accurate clinical staging of patients with cholangiocarcinoma (CCA) has a significant impact on treatment decisions. In this study, we aimed to compare the diagnostic value of magnetic resonance imaging (MRI) and 18-fludeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for staging of CCA. Methods: We performed comprehensive systematic search in Web of Science (including MEDLINE) and Excerpta Medica Database for relevant diagnostic studies in accordance with the preferred reporting items for systematic reviews and meta-analysis statement. Based on data extracted from patient-based analysis, we calculated the pooled sensitivity and specificity with the 95% confidence intervals (CIs). In addition, the publication bias was assessed by Deek funnel plot of the asymmetry test. The potential heterogeneity was explored by threshold effect analysis and subgroup analyses. Results: Thirty-two studies with 1626 patients were included in present analysis. In T stage, the pooled sensitivity and specificity of MRI were 0.90 (95% CI 0.86–0.93), 0.84 (95% CI 0.73–0.91) respectively. The pooled sensitivity and specificity of 18 F-FDG PET/CT were 0.91 (95% CI 0.83–0.95) and 0.85 (0.64–0.95) respectively. In N stage, the pooled sensitivity and specificity of MRI were 0.64 (95% CI 0.52–0.74) and 0.69 (95% CI 0.51–0.87) respectively. The pooled sensitivity and specificity of PET/CT were 0.52 (95% CI 0.37–0.66) and 0.92 (95% CI 0.79–0.97) respectively. In M stage, the pooled sensitivity and specificity of 18 F-FDG PET/CT were 0.56 (95% CI, 0.42–0.69) and 0.95 (95% CI, 0.91–0.97) respectively. The Deek test revealed no significant publication bias. No threshold effect was identified. The subgroup analyses showed that pathological type (extrahepatic cholangiocarcinoma vs hilar cholangiocarcinoma/intrahepatic cholangiocarcinoma), country (Asia vs non-Asia) and type of MRI (1.5T vs. 3.0T) were potential causes for the heterogeneity of MRI studies and country (Asia vs non-Asia) was a potential source for 18 F-FDG PET/CT studies. Conclusion: The analysis suggested that both modalities provide reasonable diagnostic accuracy in T stage without significant differences between them. We recommend that both modalities be considered based on local availability and practice for the diagnosis of primary CCA tumors. In N stage, the diagnosis of lymph node metastasis (N) of CCA is still limited by MRI and 18 F-FDG PET/CT, due to unsatisfactory diagnostic accuracy of both. Nevertheless, 18 F-FDG PET/CT can be used to confirm lymph node metastasis while a negative result may not rule out metastasis. Furthermore, 18 F-FDG PET/CT have a low sensitivity and a high specificity for detection of distant metastas...

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“…The principal characteristics of the 32 eligible studies [ 13 , 14 , 16 , 18 – 44 ] are summarized in Table 1 . All of these studies reported the results on a per-patient basis.…”

Section: Resultsmentioning

confidence: 99%

Comparison of magnetic resonance imaging and 18-fludeoxyglucose positron emission tomography/computed tomography in the diagnostic accuracy of staging in patients with cholangiocarcinoma

Huang

Yang

et al. 2020

Medicine

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“…Prior studies have described MR imaging features characteristic of iCCA [20][21][22][23][24], collectively termed "targetoid" by the Liver Imaging Reporting And Data System (LI-RADS) [25].…”

Section: Introductionmentioning

confidence: 99%

Liver Imaging and Data System (LI-RADS) Version 2018 and Other Imaging Features in Intrahepatic Cholangiocarcinoma in Chinese Adults with vs. without Chronic Hepatitis B Viral Infection

Liang

Shao

Kuang

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

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Purpose. To describe liver imaging reporting and data system (LI-RADS) version 2018 and other MRI imaging features in intrahepatic mass-forming cholangiocarcinoma (iCCA) in Chinese adults with vs. without chronic hepatitis B viral (HBV) infection. Methods. We retrospectively enrolled 89 patients with pathologically proven iCCA after multiphase imaging performed between 2004 and 2017 at a tertiary medical center in southern China. Based on whether patients had chronic HBV, iCCA was divided into two subgroups: HBV-positive (n = 50 patients, including 9 with cirrhosis) vs. HBV-negative (n = 39 patients, including 14 with hepatolithiasis and 25 with no identifiable risk factor for iCCA; none had cirrhosis). Two independent abdominal radiologists in consensus reviewed the largest mass in each patient to assign LI-RADS v2018 features; they also scored each observation’s shape and location. Imaging features were compared using chi-square or Fisher’s exact tests. Results. Most iCCAs in HBV-positive (88% (44/50)) and HBV-negative (97% (38/39)) patients had at least one LR-M feature. Compared to iCCAs in HBV-negative patients, iCCAs in HBV-positive patients were more likely to have at least one major feature of HCC (46% (23/50) vs. 8% (3/39), P < 0.001) and more likely to be smooth (42% (21/50) vs. 10% (4/39), P = 0.001). Six of 50 (12%) iCCAs in HBV-positive patients and 1/39 (3%) iCCAs in HBV-negative patients had at least one major feature of HCC without any LR-M feature. Conclusions. In this retrospective single-center study in Chinese adults, iCCAs in HBV-positive patients were more likely to resemble HCCs than iCCAs in HBV-negative patients.

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“…CHAID algorithm has recently been recognized as a useful tool to stratify variables in clinical research. For example, CHAID analysis of radiologic lesion descriptors from magnetic resonance imaging was able to differentiate between intrahepatic cholangiocarcinoma and HCC in cirrhotic livers [23]. Also, using demographic and clinical features it was useful in predicting prognostic features of squamous cell carcinomas of the head and neck [21].…”

Section: Discussionmentioning

confidence: 99%

“…The sensitivity and specificity of the model were evaluated by binary classification analysis (Fig. 1) [17, 20-23].…”

Section: Methodsmentioning

confidence: 99%

Diagnosis of Liver Neoplasms by Computational and Statistical Image Analysis

et al. 2019

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BackgroundDistinguishing well-differentiated hepatocellular carcinoma (WD-HCC), hepatocellular adenoma (HA) and non-neoplastic liver tissue (NNLT) solely on morphology is often challenging. The purpose of this study was to evaluate the use of computational image analysis to distinguish WD-HCC, HA and NNLT.MethodsSeventy-seven cases comprising of WD-HCC (n = 26), HA (n = 23) and NNLT (n = 28) were retrieved and reviewed. A total of 485 hematoxylin and eosin (H&E) photomicrographs (× 400, 0.09 µm2) of WD-HCC (n = 183), HA (n = 173), NNLT (n = 129) and nine whole-slide scans (three of each diagnosis) were obtained, color deconvoluted and digitally transformed. Quantitative data including nuclear density, nuclear sphericity, nuclear perimeter, and nuclear eccentricity from each image were acquired. The data were analyzed by one-way analysis of variance (ANOVA) with Tukey post hoc test, followed by unsupervised and supervised (Chi-square automatic interaction detection (CHAID)) cluster analysis.ResultsUnsupervised cluster analysis identified three well defined clusters of WD-HCC, HA and NNLT. Employing the four most discriminating nuclear features, supervised analysis was performed on a training set of 383 images, and validated on the remaining 102 test images. The analysis identified WD-HCC (sensitivity 100%, specificity 98%), HA (sensitivity 71%, specificity 85%) and NNLT (sensitivity 70%, specificity 86%). An analysis of whole-slide images identified WD-HCC with sensitivity and specificity of 100%.ConclusionsWe have successfully demonstrated that computational image analysis of nuclear features can differentiate WD-HCC from non-malignant liver with high accuracy, and can be used to assist in the histopathological diagnosis of hepatocellular carcinoma.

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Differentiation of Intrahepatic Cholangiocellular Carcinoma from Hepatocellular Carcinoma in the Cirrhotic Liver Using Contrast-enhanced MR Imaging

Cited by 16 publications

References 32 publications

Comparison of magnetic resonance imaging and 18-fludeoxyglucose positron emission tomography/computed tomography in the diagnostic accuracy of staging in patients with cholangiocarcinoma

Comparison of magnetic resonance imaging and 18-fludeoxyglucose positron emission tomography/computed tomography in the diagnostic accuracy of staging in patients with cholangiocarcinoma

Liver Imaging and Data System (LI-RADS) Version 2018 and Other Imaging Features in Intrahepatic Cholangiocarcinoma in Chinese Adults with vs. without Chronic Hepatitis B Viral Infection

Diagnosis of Liver Neoplasms by Computational and Statistical Image Analysis

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