Imaging Features of Biphenotypic Primary Liver Carcinoma (Hepatocholangiocarcinoma) and the Potential to Mimic Hepatocellular Carcinoma: LI-RADS Analysis of CT and MRI Features in 61 Cases

Potretzke, Theodora A.; Tan, Benjamin; Doyle, Maria B. Majella; Brunt, Elizabeth M.; Heiken, Jay P.; Fowler, Kathryn J.

doi:10.2214/ajr.15.14997

Cited by 100 publications

(78 citation statements)

References 17 publications

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“…Nevertheless, our study revealed that mosaic architecture presented more in the cirrhosis background. Potretzke et al [10] indicated mosaic architecture as an ancillary feature favoring malignancy and HCC specifically, and the concurring more commonly seen mosaic architecture and HCC-like enhancement pattern in cirrhosis background of our study coincided with the theory to a cer- tain extent. This may be explained by the abundant fibrous stroma and segregation histopathologically which may be partly related to the disturbed blood supply and the distortion of the hepatic parenchyma under cirrhotic background.…”

Section: Discussionsupporting

confidence: 91%

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MR comparative study of combined hepatocellular-cholangiocarcinoma in normal, fibrotic, and cirrhotic livers

Sheng

Xie

et al. 2016

Abdom Radiol

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Section: Discussionsupporting

confidence: 91%

“…All lesions were hyperintense on DWI, and the marked restricted diffusion can raise suspicion for cHCC-CC, which was supported by Potretzke et al [10]. However, DWI is hampered by the low specificity, and there are substantial overlaps in the range of ADCs among cHCC-CC in normal, fibrotic, and cirrhotic livers.…”

Section: Discussionmentioning

confidence: 63%

MR comparative study of combined hepatocellular-cholangiocarcinoma in normal, fibrotic, and cirrhotic livers

Sheng

Xie

et al. 2016

Abdom Radiol

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“…The variable imaging appearance of cHCC-CC overlaps with that of both HCC and iCC, leading to frequent misdiagnosis as monophenotypic HCC or iCC [9][10][11]. While surgical resection likely confers the greatest survival benefit for eligible early stage cHCC-CC patients, post-surgical recurrence is common and most patients present with advanced disease not amenable to resection [1,12,13].…”

Section: Introductionmentioning

confidence: 99%

Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular-Cholangiocarcinoma

Chan

Sze

Poultsides

et al. 2017

Cardiovasc Intervent Radiol

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“…Hepatocholangiocarcinomas are rare primary "biphenotypic" hepatic malignancies that may show features overlapping HCC and ICC (109). Some authors suggest that the imaging features more closely resemble those of ICC and that prospective differentiation of ICC from a combined tumor can be difficult (109-111).…”

Section: Review: Li-rads Major Features For Hepatocellular Carcinoma mentioning

confidence: 99%

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

et al. 2018

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The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). It assigns category codes reflecting relative probability of HCC to imaging-detected liver observations based on major and ancillary imaging features. LI-RADS also includes imaging features suggesting malignancy other than HCC. Supported and endorsed by the American College of Radiology (ACR), the system has been developed by a committee of radiologists, hepatologists, pathologists, surgeons, lexicon experts, and ACR staff, with input from the American Association for the Study of Liver Diseases and the Organ Procurement Transplantation Network/United Network for Organ Sharing. Development of LI-RADS has been based on literature review, expert opinion, rounds of testing and iteration, and feedback from users. This article summarizes and assesses the quality of evidence supporting each LI-RADS major feature for diagnosis of HCC, as well as of the LI-RADS imaging features suggesting malignancy other than HCC. Based on the evidence, recommendations are provided for or against their continued inclusion in LI-RADS.q RSNA, 2017 Online supplemental material is available for this article.An Tang REVIEW: LI-RADS Major Features for Hepatocellular Carcinoma DiagnosisTang et al selection of five major features was based on expert opinion, the literature review was performed to ensure that imaging-based diagnostic criteria were able to achieve near-100% specificity for the noninvasive diagnosis of HCC. This review focused on the evidence supporting the inclusion of imaging features and did not attempt to gather evidence on the composition of the LI-RADS diagnostic algorithm and probability of HCC for different combinations of criteria (other than the hallmark combination of APHE and washout appearance) in the LI-RADS diagnostic table.Each subgroup was charged with developing key research questions and then critically reviewing the literature to answer research questions thematically related to its assigned topic. Search StrategyThe PICO (patient population, intervention, comparison, and outcome) format frequently used in structured reviews does not lend itself well to studies of diagnostic performance. Rather than using PICO-style questions to guide the searches, therefore, the subgroups formulated free-form questions in advance with feedback from the other subgroups. A total of 10 questions were formulated under the framework and with the understanding that their answers would inform recommendations for removing or continuing to include the corresponding LI-RADS features. After the questions were formulated, each subgroup searched the PubMed develop a standardized Liver Imaging Reporting and Data System (LI-RADS) for interpretation, reporting, and data collection of imaging studies in patients at risk for developing HCC (1). The committee was composed mainly of diagnostic radiologists, but also hepatologists, surgeons, patho...

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Imaging Features of Biphenotypic Primary Liver Carcinoma (Hepatocholangiocarcinoma) and the Potential to Mimic Hepatocellular Carcinoma: LI-RADS Analysis of CT and MRI Features in 61 Cases

Abstract: Most biphenotypic primary liver carcinomas have features of non-HCC malignancy and can be correctly categorized as such. Addition of ancillary features to major features may improve diagnostic accuracy over systems in which only major features are used.

Cited by 100 publications

References 17 publications

MR comparative study of combined hepatocellular-cholangiocarcinoma in normal, fibrotic, and cirrhotic livers

MR comparative study of combined hepatocellular-cholangiocarcinoma in normal, fibrotic, and cirrhotic livers

Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular-Cholangiocarcinoma

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

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