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European Radiology
Published in: European Radiology 5/2018

01-05-2018 | Gastrointestinal

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

Authors: Sara Lewis, Cecilia Besa, Mathilde Wagner, Kartik Jhaveri, Shingo Kihira, Hongfa Zhu, Nima Sadoughi, Sandra Fischer, Amogh Srivastava, Eric Yee, Koenraad Mortele, James Babb, Swan Thung, Bachir Taouli

Published in: European Radiology | Issue 5/2018

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Abstract

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.
Appendix
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Metadata
Title
Prediction of the histopathologic findings of intrahepatic cholangiocarcinoma: qualitative and quantitative assessment of diffusion-weighted imaging
Authors
Sara Lewis
Cecilia Besa
Mathilde Wagner
Kartik Jhaveri
Shingo Kihira
Hongfa Zhu
Nima Sadoughi
Sandra Fischer
Amogh Srivastava
Eric Yee
Koenraad Mortele
James Babb
Swan Thung
Bachir Taouli
Publication date
01-05-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5156-6

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