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

Objective: To correlate qualitative and quantitative diffusion weighted imaging (DWI) characteristics of intrahepatic cholangiocarcinoma (ICC) with histopathologic tumour grade and fibrosis content.Methods: Fifty-one patients (21M/30F; mean age 61y) with ICC and MRI including DWI were included in th...

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Published in:European Radiology Vol. 28; no. 5; pp. 2047 - 2058
Main Authors: Lewis, Sara, Besa, Cecilia, Wagner, Mathilde, Jhaveri, Kartik, Kihira, Shingo, Zhu, Hongfa, Sadoughi, Nima, Fischer, Sandra, Srivastava, Amogh, Yee, Eric, Mortele, Koenraad, Babb, James, Thung, Swan, Taouli, Bachir
Format: research Journal Article
Published: Springer Nature May2018
Online Access:View this record in EBSCOhost
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      dt: May2018
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00330-017-5156-6
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        atl: Prediction of the histopathologic findings of intrahepatic cholangiocarcinoma: qualitative and quantitative assessment of diffusion-weighted imaging.
      aug:
        au:
          Lewis, Sara
          Besa, Cecilia
          Wagner, Mathilde
          Jhaveri, Kartik
          Kihira, Shingo
          Zhu, Hongfa
          Sadoughi, Nima
          Fischer, Sandra
          Srivastava, Amogh
          Yee, Eric
          Mortele, Koenraad
          Babb, James
          Thung, Swan
          Taouli, Bachir
        affil: Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
      sug:
        subj:
          Cholangiocarcinoma
          Bile Duct Neoplasms Pathology
          Magnetic Resonance Imaging Methods
          Cholangiocarcinoma Pathology
          Female
          Bile Duct Neoplasms
          ROC Curve
          Aged, 80 and Over
          Bile Ducts Pathology
          Neoplasm Grading
          Human
          Bile Ducts
          Evaluation Research
          Middle Age
          Aged
          Retrospective Design
          Sensitivity and Specificity
          Male
          Adult
          Validation Studies
          Comparative Studies
          Multicenter Studies
          Aged, 80 & over
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adult: 19-44 years
          Female
          Male
      ab: Objective: To correlate qualitative and quantitative diffusion weighted imaging (DWI) characteristics of intrahepatic cholangiocarcinoma (ICC) with histopathologic tumour grade and fibrosis content.Methods: Fifty-one patients (21M/30F; mean age 61y) with ICC and MRI including DWI were included in this IRB-approved multicentre retrospective study. Qualitative tumour features were assessed. Tumour apparent diffusion coefficient (ADC) mean, minimum, and normalized (nADCliver) values were computed. Tumour grade [well(G1), moderately(G2), or poorly differentiated(G3)] and tumour fibrosis content [minimal(1), moderate(2), or abundant(3)] were categorized pathologically. Imaging findings and ADC values were compared with pathologic measures. Utility of ADC values for predicting tumour grade was assessed using ROC analysis.Results: 51 ICCs (mean size 6.5±1.1 cm) were assessed. 33/51(64%) of ICCs demonstrated diffuse hyperintensity and 15/51(29%) demonstrated target appearance on DWI. Infiltrative morphology (p=0.02) and tumour size (p=0.04) were associated with G3. ADCmean and nADCmean of G3 (1.32±0.47x10-3 mm2/sec and 0.97±0.95) were lower than G1+G2 (1.57±0.39x10-3 mm2/sec and 1.24±0.49; p=0.03 and p=0.04). ADCmean and nADCmean were inversely correlated with tumour grade (p<0.025). No correlation was found between ADC and tumour fibrosis content. AUROC, sensitivity and specificity of nADCmean for G3 versus G1+G2 were 0.71, 89.5% and 55.5%.Conclusion: ADC quantification has reasonable accuracy for predicting ICC grade.Key Points: • ADC quantification was useful for predicting ICC tumour grade. • Infiltrative tumour morphology and size were associated with poorly differentiated ICCs. • ADC values depended more on ICC tumour grade than fibrosis content. • Ability to predict ICC tumour grade non-invasively could impact patient management.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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