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European Radiology
Published in: European Radiology 11/2017

01-11-2017 | Hepatobiliary-Pancreas

Gadoxetic acid disodium-enhanced MR imaging of cholangiolocellular carcinoma of the liver: imaging characteristics and histopathological correlations

Authors: Hiroki Haradome, Toshiyuki Unno, Hiroyuki Morisaka, Yusuke Toda, Thomas C. Kwee, Hiroshi Kondo, Keiji Sano, Tomoaki Ichikawa, Fukuo Kondo, Masahiko Sugitani, Tadatoshi Takayama

Published in: European Radiology | Issue 11/2017

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Abstract

Objectives

To review the gadoxetic acid disodium (EOB)-enhanced magnetic resonance (MR) imaging features of cholangiolocellular carcinoma (CoCC) of the liver and compare them with those of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).

Methods

EOB-enhanced MR images of 19 patients with CoCC, 23 with ICC, and 51 with HCC were retrospectively evaluated qualitatively and quantitatively. Univariate and multivariate analyses were performed to determine the characteristic MR features of CoCC with histopathological–imaging correlation.

Results

Multivariate logistic regression analysis showed that dot-/band-shaped internal enhancement during the arterial and portal phases (P < 0.001), and larger arterial ring enhancement ratio (CoCC, 0.13 ± 0.04; ICC, 0.074 ± 0.04; P = 0.013) were significantly independently associated with CoCC in contrast to ICC, whereas several MR features including progressive enhancement during the portal and late phases (P < 0.001), target appearance in the hepatocyte phase (P = 0.004), and vessel penetration (P = 0.013) were significantly more frequently associated with CoCC than HCC. The dot-/band-like internal enhancement (78.9% of CoCCs) histopathologically corresponded to the tumour cell nest with vascular proliferations and retained Glisson's sheath structure.

Conclusions

EOB-enhanced MR features of CoCC largely differ from those of HCC but are similar to those of ICC. However, the finding of thicker arterial ring enhancement with dot-/band-like internal enhancement could help differentiate CoCC from ICC.

Key Points

• Gadoxetic acid-enhanced MR features of cholangiolocellular carcinoma (CoCC) resembled those of intrahepatic cholangiocarcinoma (ICC).
• Gadoxetic acid-enhanced MR features of CoCC largely differed from those of hepatocellular carcinoma.
• Dot-/band-like internal enhancement of CoCC may be helpful for differentiating from ICC.
• Arterial ring enhancement of CoCC was larger than that of ICC.
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Metadata
Title
Gadoxetic acid disodium-enhanced MR imaging of cholangiolocellular carcinoma of the liver: imaging characteristics and histopathological correlations
Authors
Hiroki Haradome
Toshiyuki Unno
Hiroyuki Morisaka
Yusuke Toda
Thomas C. Kwee
Hiroshi Kondo
Keiji Sano
Tomoaki Ichikawa
Fukuo Kondo
Masahiko Sugitani
Tadatoshi Takayama
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4811-2

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