Combined hepatocellular cholangiocarcinoma: LI-RADS v2017 categorisation for differential diagnosis and prognostication on gadoxetic acid-enhanced MR imaging.
Objectives: To investigate the performance of the Liver Imaging Reporting and Data System (LI-RADS) v2017 for combined hepatocellular cholangiocarcinoma (cHCC-CCA) in the differential diagnosis from hepatocellular carcinoma (HCC) and prediction of prognosis on gadoxetic acid-enhanced MRI (Gd-EOB-MRI...
| Published in: | European Radiology Vol. 29; no. 1; pp. 373 - 383 |
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| Main Authors: | , , , , , , |
| Format: | diagnostic images research tables/charts Journal Article |
| Published: |
Springer Nature
Jan2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=133531133&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 133531133 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Jan2019 vid: 29 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 133531133 133531133 NLM29955948 133531133 10.1007/s00330-018-5605-x NLM29955948 133531133 ppf: 373 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Combined hepatocellular cholangiocarcinoma: LI-RADS v2017 categorisation for differential diagnosis and prognostication on gadoxetic acid-enhanced MR imaging. aug: au: Jeon, Sun Kyung Joo, Ijin Lee, Dong Ho Lee, Sang Min Kang, Hyo-Jin Lee, Kyoung-Bun Lee, Jeong Min affil: Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Korea sug: subj: Contrast Media Pharmacodynamics Carcinoma, Hepatocellular Diagnosis Liver Neoplasms Diagnosis Magnetic Resonance Imaging Methods Prognosis Female Middle Age Male Diagnosis, Differential Psychological Tests Middle Aged: 45-64 years Female Male ab: Objectives: To investigate the performance of the Liver Imaging Reporting and Data System (LI-RADS) v2017 for combined hepatocellular cholangiocarcinoma (cHCC-CCA) in the differential diagnosis from hepatocellular carcinoma (HCC) and prediction of prognosis on gadoxetic acid-enhanced MRI (Gd-EOB-MRI).Methods: Patients at high risk of HCC with pathologically confirmed cHCC-CCAs (n = 70) and a matched control of HCCs (n = 70) who had undergone Gd-EOB-MRI were included. LI-RADS category was assigned for each lesion by two radiologists. Imaging features and surgical outcomes were compared between cHCC-CCAs of LR-M and LR-5/4 using the χ2 test or Fisher's exact test. Recurrence-free survival (RFS) was estimated using Kaplan-Meier survival curves and compared using the log-rank test.Results: cHCC-CCAs and HCCs were categorised as LR-M, LR-5/4 and LR-TIV in 61.4% (43/70), 37.1% (26/70) and 1.4% (1/70) and 10.0% (7/70), 88.6% (62/70) and 1.4% (1/70), respectively. cHCC-CCAs of LR-5/4, in comparison to LR-M, showed significantly higher frequencies of major HCC features: arterial hyperenhancement (96.2% (25/26) vs. 58.1% (25/43), p = 0.001), washout appearance (80.8% (21/26) vs. 48.8% (21/43), p = 0.011) and enhancing capsule (34.6% (9/26) vs. 11.6% (5/43), p = 0.031). After curative surgery, patients with cHCC-CCAs of LR-M showed a higher early recurrence rate (≤ 6 months) than did those with LR-5/4 (27.8% (10/36) vs. 4.8% (1/21), p = 0.041), whereas no significant difference was observed in RFS (log-rank p = 0.084).Conclusions: By using LI-RADS on Gd-EOB-MRI, a substantial proportion of cHCC-CCAs can be categorised as non-LR-M. In addition, cHCC-CCAs mimicking HCCs on imaging (LR-5/4) may indicate better surgical outcomes with regard to early recurrence than those of LR-M.Key Points: • cHCC-CCAs can be categorised as either LR-M or non-LR-M on Gd-EOB-MRI. • cHCC-CCAs of LR-5/4 frequently demonstrate major HCC imaging features. • LI-RADS categorisation may provide prognostic information after surgery in cHCC-CCAs. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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