Prediction of the histopathologic findings of intrahepatic cholangiocarcinoma: qualitative and quantitative assessment of diffusion-weighted imaging

Lewis, Sara; Besa, Cecilia; Wagner, Mathilde; Jhaveri, Kartik; Kihira, Shingo; Zhu, Hongfa; Sadoughi, Nima; Fischer, Sandra E.; Srivastava, Amogh; Yee, Eric U.; Mortelé, Koenraad J.; Babb, James S.; Thung, Swan N.; Taouli, Bachir

doi:10.1007/s00330-017-5156-6

Cited by 38 publications

(32 citation statements)

References 35 publications

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“…Signals on DWI images were determined as a) diffusely hyperintense, b) diffusely hypointense, c) target sign, or d) isointense. The target sign was described as peripheral diffusion restriction with central isointensity/hypointensity, which is believed to represent peripheral tumor growth and central fibrosis . Dynamic patterns of enhancement (DCE) were defined as A) persistent: the enhancement remained unmodified through all three phases; B) progressive: the intensity or range of enhancement progressively increased over time, centripetal enhancement was included; C) degressive (washin without washout): decreasing hyperintensity over time without hypointensity on portal or delayed phases; D) washin with washout: intense hyperintensity during the arterial phase followed by relative hypointensity on portal or delayed phases.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, Lee et al reported that the degree of diffusion restriction in IMCC was an independent prognostic factors for overall survival . In addition, Lewis et al reported that the ADC value of IMCC was predictive of tumor grade . Therefore, we have reason to believe that DWI has more potential to assess ICC.…”

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confidence: 98%

“…17 In addition, Lewis et al reported that the ADC value of IMCC was predictive of tumor grade. 18 Therefore, we have reason to believe that DWI has more potential to assess ICC.…”

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confidence: 99%

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Mass‐forming intrahepatic cholangiocarcinoma: Can diffusion‐weighted imaging predict microvascular invasion?

Zhou

Wang

et al. 2018

Magnetic Resonance Imaging

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Background Microvascular invasion (MVI) is a risk factor influencing the survival rate of patients with mass‐forming intrahepatic cholangiocarcinoma (IMCC). Purpose To investigate whether diffusion‐weighted imaging (DWI) could be useful in predicting MVI of IMCC. Study Type Retrospective. Subjects Eighty patients with surgically resected single IMCC (21 MVI‐positive lesions and 59 MVI‐negative lesions). Field Strength/Sequence Preoperative hepatic MRI (1.5T), including T1‐ and T2‐weighted images (T1WI, T2WI), DWI, and dynamic enhancement imaging. Assessment Morphologic characteristics including contour of the lesion, biliary dilation and hepatic capsule retraction, signal features on T1WI, T2WI, and DWI, and dynamic enhancement patterns were qualitatively evaluated. The quantitative analysis was performed for the size and apparent diffusion coefficient (ADC) values. Statistical Tests Chi‐square test, Fisher's exact test, and the independent t‐test were used for univariate analysis to determine the relationships between these radiological parameters and the presence of MVI. Logistic regression analysis was used to identify the independent predictors of MVI among these radiological parameters. Receiver operating characteristic curve analysis was performed to evaluate their diagnostic performance. Results Larger tumor size (P = 0.006) and higher ADC values (P < 0.001) were positively correlated with MVI. Multivariate logistic regression analysis demonstrated that the ADC value (odds ratio, 3.099; P = 0.001) was an independent predictor for MVI of IMCC. The ADC value for MVI of IMCC showed an area under the receiver operating characteristic curve of 0.782 (optimal cutoff value was 1.59 × 10−3 mm2/s). Data Conclusion Larger tumor size was associated with MVI and higher ADC values can be a useful predictor of MVI during the preoperative evaluation of IMCC. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:315–324.

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Section: Methodsmentioning

confidence: 99%

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confidence: 98%

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Mass‐forming intrahepatic cholangiocarcinoma: Can diffusion‐weighted imaging predict microvascular invasion?

Zhou

Wang

et al. 2018

Magnetic Resonance Imaging

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“…In a study with emphasis on diffusion-weighted imaging (DWI) measured with magnetic resonance imaging (MRI), the authors demonstrated that ICCs with > 1/3 diffusion restriction had more favorable histopathologic features and better clinical outcomes compared to those with < 1/3 diffusion restriction, as less diffusion restriction is believed to correlate with more fibrous stroma [16]. With regards to the apparent diffusion coefficient (ADC) quantification, it has been suggested that the ADCmean of ICC is significantly lower than that of the adjacent liver parenchyma, and that poorly differentiated tumors demonstrated a significantly lower ADCmean than well or moderately differentiated tumors [17,18]. Lastly, it is recognized that F-18 FDG PET/CT is an important diagnostic tool in staging of ICC.…”

Section: Introductionmentioning

confidence: 99%

Outcomes assessment in intrahepatic cholangiocarcinoma using qualitative and quantitative imaging features

et al. 2020

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Background: To assess the performance of imaging features, including radiomics texture features, in predicting histopathologic tumor grade, AJCC stage, and outcomes [time to recurrence (TTR) and overall survival (OS)] in patients with intrahepatic cholangiocarcinoma (ICC). Methods: Seventy-three patients (26 M/47F, mean age 63y) with pre-operative imaging (CT, n = 37; MRI, n = 21; CT and MRI, n = 15] within 6 months of resection were included in this retrospective study. Qualitative imaging traits were assessed by 2 observers. A 3rd observer measured tumor apparent diffusion coefficient (ADC), enhancement ratios (ERs), and Haralick texture features. Blood biomarkers and imaging features were compared with histopathology (tumor grade and AJCC stage) and outcomes (TTR and OS) using log-rank, generalized Wilcoxon, Cox proportional hazards regression, and Fisher exact tests.

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“…Nevertheless, the ADC mean value of two different components was 1.19 × 10 − 3 mm 2 /s (ICC component) and 1.95 × 10 − 3 mm 2 /s (sarcomatous component), respectively. Lower mean ADC value is associated with more aggressive histopathology and poorly differentiated ICCs [ 32 ]. The ADC value indicates that the ICC component has more malignant potential than the sarcomatous component.…”

Section: Resultsmentioning

confidence: 99%

Primary intrahepatic cholangiocarcinoma with sarcomatous stroma: case report and review of the literature

et al. 2018

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BackgroundHepatic carcinosarcomas, which include both carcinomatous and sarcomatous elements, are uncommon in adults. Although carcinosarcoma in hepatocellular carcinoma is occasionally reported, carcinosarcoma in intrahepatic cholangiocarcinoma (ICC) is an extremely rare ICC variant. Few such cases have been reported in English and no large study of its clinicopathological features exists.Case presentationHere, we report a 60-year-old man with an asymptomatic hepatic B infection who developed hepatic carcinosarcoma from an otherwise normal liver. The 6.0-cm tumor was accidentally discovered by PET-CT in a cancer examination. Serum examinations showed no elevation of tumor markers. He underwent left and caudate lobectomy of the liver. The diagnosis of intrahepatic cholangiocarcinoma with sarcomatous stroma was based on thorough pathologic examination and immunohistochemical staining. The tumor exhibited adenocarcinomatous and sarcomatous components; the adenocarcinomatous element was positive for epithelial markers, the sarcomatous element was positive for mesenchymal markers, but negative for epithelial markers. The patient made an uneventful recovery after surgery. At present, 14 months after surgery, he remains well with no evidence of tumor recurrence.ConclusionsWe report an unusual case of hepatic carcinosarcoma (intrahepatic cholangiocarcinoma with sarcomatous stroma) and discuss the etiology and prognosis of this rare disease.

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Prediction of the histopathologic findings of intrahepatic cholangiocarcinoma: qualitative and quantitative assessment of diffusion-weighted imaging

Cited by 38 publications

References 35 publications

Mass‐forming intrahepatic cholangiocarcinoma: Can diffusion‐weighted imaging predict microvascular invasion?

Mass‐forming intrahepatic cholangiocarcinoma: Can diffusion‐weighted imaging predict microvascular invasion?

Outcomes assessment in intrahepatic cholangiocarcinoma using qualitative and quantitative imaging features

Primary intrahepatic cholangiocarcinoma with sarcomatous stroma: case report and review of the literature

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