Preoperative differentiation of hepatocellular carcinoma with peripheral rim-like enhancement from intrahepatic mass-forming cholangiocarcinoma on contrast-enhanced MRI

Abstract

PurposeThe present study aimed to determine the reliable imaging features to distinguish atypical hepatocellular carcinoma (HCC) with peripheral rim-like enhancement from intrahepatic mass-forming cholangiocarcinoma (IMCC) on contrast-enhanced magnetic resonance imaging (MRI).MethodsA total of 168 patients (130 male, 57.10 ± 10.53 years) pathological confirmed HCC or IMCC who underwent contrast-enhanced MRI between July 2019 and February 2022 were retrospectively included. Univariate and multivariate logistic regression analyses were used to determine independent differential factors for distinguishing HCC from IMCC, and the model was established. Bootstrap resampling 1000 times was used to verify the model, which was visualized by nomograms. The predictive performance of the model was evaluated based on discrimination, calibration, and clinical utility.ResultsRadiological capsule (OR 0.024, 95% CI: 0.006, 0.095, P<0.001), heterogeneous signal intensity (SI) on T1WI (OR 0.009, 95%CI: 0.001,0.056, P<0.001) were independent differential factors for predicting HCC over IMCC. A lobulated contour (OR 11.732, 95%CI: 2.928,47.007, P = 0.001), target sign on DP (OR 14.269, 95%CI: 2.849,82.106, P = 0.007), bile duct dilatation (OR 12.856, 95%CI: 2.013, P = 0.001) were independent differential factors for predicting IMCCs over HCCs. The independent differential factors constituted a model to distinguish atypical HCCs and IMCCs. The area under receiver operating characteristic (ROC) curve, sensitivity, and specificity values of the model were 0.964(0.940,0.987), 0.88, and 0.906, indicating that the model had an excellent differential diagnostic performance. The decision curve analysis (DCA) curve showed that the model obtained a better net clinical benefit.ConclusionThe present study identified reliable imaging features for distinguishing atypical HCCs with peripheral rim-like enhancement from IMCCs on contrast-enhanced MRI. Our findings may help radiologists provide clinicians with more accurate preoperative imaging diagnoses to select appropriate treatment options.

Extracellular volume fraction using contrast-enhanced CT is useful in differentiating intrahepatic cholangiocellular carcinoma from hepatocellular carcinoma

“…The results of the subgroup analysis suggest that fECV appears to be useful regardless of whether the patient is at risk for HCC or not. Compared to the differentiating ability using MR imaging or LI-RADS in previous articles (23,27,49), the use of fECV alone seems to have provided the comparable or slightly inferior differential ability. The present intraclass correlation coefficient analysis for fECV measurement by the two radiologists showed excellent agreement (0.82).…”

Predictive Model for Pulmonary Embolism in Pregnant and Postpartum Women: A 10-Year Retrospective Study

“…The model for predicting PE was established through the use of multivariable logistic regression analysis, which combined selected predictors from the LASSO analysis. Bootstrap resampling 1000 times 21 was used to verify the model, which was visualized by nomogram. The performance of the model was evaluated in terms of discrimination, calibration, and clinical utility, 22 discrimination was measured using the area under the receiver operating characteristic (ROC) curve (AUC), while the calibration curve analysis was used to assess the consistency between the model's predictions and actual PE occurrences.…”

Translating imaging traits of mass-forming intrahepatic cholangiocarcinoma into the clinic: From prognostic to therapeutic insights

“…Given the indispensable role of imaging in MICC management, investigators have attempted to explore non-invasive imaging biomarkers for accurate differential diagnosis as well as prediction of pathological grade and subtype. [10] , [11] , [12] Studies have also documented the potential prognostic value of radiological traits at dynamic computed tomography (CT)/magnetic resonance (MR) imaging for patients with MICC. [13] , [14] , [15] However, the progress toward clinical translation has been slower than anticipated despite extensive investigations.…”