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16-01-2024 | Hepatocellular Carcinoma | Hepatobiliary

A multi-parameter intrahepatic cholangiocarcinoma scoring system based on modified contrast-enhanced ultrasound LI-RADS M criteria for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma

Authors: Li-Fan Wang, Xin Guan, Yu-Ting Shen, Bo-Yang Zhou, Yi-Kang Sun, Xiao-Long Li, Hao-Hao Yin, Dan Lu, Xin Ye, Xin-Yuan Hu, Dao-Hui Yang, Han-Sheng Xia, Xi Wang, Qing Lu, Hong Han, Hui-Xiong Xu, Chong-Ke Zhao, China Alliance of Multi-Center Clinical Study for Ultrasound (Ultra-Chance)

Published in: Abdominal Radiology | Issue 2/2024

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Abstract

Purpose

To develop a multi-parameter intrahepatic cholangiocarcinoma (ICC) scoring system and compare its diagnostic performance with contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system M (LR-M) criteria for differentiating ICC from hepatocellular carcinoma (HCC).

Methods

This retrospective study enrolled 62 high-risk patients with ICCs and 62 high-risk patients with matched HCCs between January 2022 and December 2022 from two institutions. The CEUS LR-M criteria was modified by adjusting the early wash-out onset (within 45 s) and the marked wash-out (within 3 min). Then, a multi-parameter ICC scoring system was established based on clinical features, B-mode ultrasound features, and modified LR-M criteria.

Result

We found that elevated CA 19-9 (OR=12.647), lesion boundary (OR=11.601), peripheral rim-like arterial phase hyperenhancement (OR=23.654), early wash-out onset (OR=7.211), and marked wash-out (OR=19.605) were positive predictors of ICC, whereas elevated alpha-fetoprotein (OR=0.078) was a negative predictor. Based on these findings, an ICC scoring system was established. Compared with the modified LR-M and LR-M criteria, the ICC scoring system showed the highest area under the curve (0.911 vs. 0.831 and 0.750, both p<0.05) and specificity (0.935 vs. 0.774 and 0.565, both p<0.05). Moreover, the numbers of HCCs categorized as LR-M decreased from 27 (43.5%) to 14 (22.6%) and 4 (6.5%) using the modified LR-M criteria and ICC scoring system, respectively.

Conclusion

The modified LR-M criteria-based multi-parameter ICC scoring system had the highest specificity for diagnosing ICC and reduced the number of HCC cases diagnosed as LR-M category.

Graphical abstract

Appendix
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Literature
8.
go back to reference Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nolsøe CP, et al. (2013) Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver--update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall Med, 34(1):11-29. https://doi.org/10.1055/s-0032-1325499CrossRefPubMed Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nolsøe CP, et al. (2013) Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver--update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall Med, 34(1):11-29. https://​doi.​org/​10.​1055/​s-0032-1325499CrossRefPubMed
11.
go back to reference Kono Y, Lyshchik A, Cosgrove D, Dietrich CF, Jang HJ, Kim TK, Piscaglia F, Willmann JK, Wilson SR, Santillan C, Kambadakone A, Mitchell D, Vezeridis A, Sirlin CB. (2017) Contrast Enhanced Ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS®): the official version by the American College of Radiology (ACR). Ultraschall Med, 38(1):85-86. https://doi.org/10.1055/s-0042-124369CrossRefPubMed Kono Y, Lyshchik A, Cosgrove D, Dietrich CF, Jang HJ, Kim TK, Piscaglia F, Willmann JK, Wilson SR, Santillan C, Kambadakone A, Mitchell D, Vezeridis A, Sirlin CB. (2017) Contrast Enhanced Ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS®): the official version by the American College of Radiology (ACR). Ultraschall Med, 38(1):85-86. https://​doi.​org/​10.​1055/​s-0042-124369CrossRefPubMed
12.
go back to reference Terzi E, Iavarone M, Pompili M, Veronese L, Cabibbo G, Fraquelli M, Riccardi L, De Bonis L, Sangiovanni A, Leoni S, Zocco MA, Rossi S, Alessi N, Wilson SR, Piscaglia F. (2018) Contrast ultrasound LI-RADS LR-5 identifies hepatocellular carcinoma in cirrhosis in a multicenter restropective study of 1,006 nodules. J Hepatol, 68(3):485-492. https://doi.org/10.1016/j.jhep.2017.11.007CrossRefPubMed Terzi E, Iavarone M, Pompili M, Veronese L, Cabibbo G, Fraquelli M, Riccardi L, De Bonis L, Sangiovanni A, Leoni S, Zocco MA, Rossi S, Alessi N, Wilson SR, Piscaglia F. (2018) Contrast ultrasound LI-RADS LR-5 identifies hepatocellular carcinoma in cirrhosis in a multicenter restropective study of 1,006 nodules. J Hepatol, 68(3):485-492. https://​doi.​org/​10.​1016/​j.​jhep.​2017.​11.​007CrossRefPubMed
13.
go back to reference Li F, Li Q, Liu Y, Han J, Zheng W, Huang Y, Zheng X, Cao L, Zhou JH. (2020) Distinguishing intrahepatic cholangiocarcinoma from hepatocellular carcinoma in patients with and without risks: the evaluation of the LR-M criteria of contrast-enhanced ultrasound liver imaging reporting and data system version 2017. Eur Radiol, 30(1):461-470. https://doi.org/10.1007/s00330-019-06317-2CrossRefPubMed Li F, Li Q, Liu Y, Han J, Zheng W, Huang Y, Zheng X, Cao L, Zhou JH. (2020) Distinguishing intrahepatic cholangiocarcinoma from hepatocellular carcinoma in patients with and without risks: the evaluation of the LR-M criteria of contrast-enhanced ultrasound liver imaging reporting and data system version 2017. Eur Radiol, 30(1):461-470. https://​doi.​org/​10.​1007/​s00330-019-06317-2CrossRefPubMed
16.
22.
go back to reference Yuan MX, Li R, Zhang XH, Tang CL, Guo YL, Guo DY, Luo MK. (2016) Factors affecting the enhancement patterns of intrahepatic cholangiocarcinoma (ICC) on contrast-enhanced ultrasound (CEUS) and their pathological correlations in patients with a single lesion. Ultraschall Med, 37(6):609-618. https://doi.org/10.1055/s-0034-1399485CrossRefPubMed Yuan MX, Li R, Zhang XH, Tang CL, Guo YL, Guo DY, Luo MK. (2016) Factors affecting the enhancement patterns of intrahepatic cholangiocarcinoma (ICC) on contrast-enhanced ultrasound (CEUS) and their pathological correlations in patients with a single lesion. Ultraschall Med, 37(6):609-618. https://​doi.​org/​10.​1055/​s-0034-1399485CrossRefPubMed
24.
Metadata
Title
A multi-parameter intrahepatic cholangiocarcinoma scoring system based on modified contrast-enhanced ultrasound LI-RADS M criteria for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma
Authors
Li-Fan Wang
Xin Guan
Yu-Ting Shen
Bo-Yang Zhou
Yi-Kang Sun
Xiao-Long Li
Hao-Hao Yin
Dan Lu
Xin Ye
Xin-Yuan Hu
Dao-Hui Yang
Han-Sheng Xia
Xi Wang
Qing Lu
Hong Han
Hui-Xiong Xu
Chong-Ke Zhao
China Alliance of Multi-Center Clinical Study for Ultrasound (Ultra-Chance)
Publication date
16-01-2024
Publisher
Springer US
Published in
Abdominal Radiology / Issue 2/2024
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-023-04114-6

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