Imaging of combined hepatocellular-cholangiocarcinoma in cirrhosis and risk of false diagnosis of hepatocellular carcinoma.


Journal

United European gastroenterology journal
ISSN: 2050-6406
Titre abrégé: United European Gastroenterol J
Pays: England
ID NLM: 101606807

Informations de publication

Date de publication:
02 2019
Historique:
received: 25 08 2018
accepted: 13 10 2018
entrez: 22 2 2019
pubmed: 23 2 2019
medline: 23 2 2019
Statut: ppublish

Résumé

Diagnosis of hepatocellular carcinoma can be achieved by imaging in cirrhotic patients. Combined hepatocellular-cholangiocarcinoma is a primary liver tumor and its imaging patterns have been poorly investigated. Misdiagnosis for either hepatocellular carcinoma or benign lesions can occur. We aimed to evaluate the enhancement pattern of combined hepatocellular-cholangiocarcinoma in cirrhosis with imaging techniques and to estimate the risk of misdiagnosis for hepatocellular carcinoma. All histology-confirmed combined hepatocellular-cholangiocarcinoma in cirrhosis seen in two Italian centers between 2003 and 2016, in which at least one imaging technique had been performed, was retrospectively collected. The enhancement pattern was analyzed for all available imaging modalities. A total of 37 combined hepatocellular-cholangiocarcinoma nodules were identified. Contrast-enhanced ultrasound, computed tomography, and magnetic resonance imaging had been performed in 27, 34, and 17 nodules, respectively. Contrast-enhanced ultrasound was at higher risk of misdiagnosis for pure hepatocellular carcinoma than computed tomography ( Contrast-enhanced ultrasound misdiagnosed a higher number of combined hepatocellular-cholangiocarcinoma as hepatocellular carcinoma than computed tomography and magnetic resonance imaging. However, the latter techniques were able to identify features of malignancy less often.

Sections du résumé

Background
Diagnosis of hepatocellular carcinoma can be achieved by imaging in cirrhotic patients. Combined hepatocellular-cholangiocarcinoma is a primary liver tumor and its imaging patterns have been poorly investigated. Misdiagnosis for either hepatocellular carcinoma or benign lesions can occur. We aimed to evaluate the enhancement pattern of combined hepatocellular-cholangiocarcinoma in cirrhosis with imaging techniques and to estimate the risk of misdiagnosis for hepatocellular carcinoma.
Methods
All histology-confirmed combined hepatocellular-cholangiocarcinoma in cirrhosis seen in two Italian centers between 2003 and 2016, in which at least one imaging technique had been performed, was retrospectively collected. The enhancement pattern was analyzed for all available imaging modalities.
Results
A total of 37 combined hepatocellular-cholangiocarcinoma nodules were identified. Contrast-enhanced ultrasound, computed tomography, and magnetic resonance imaging had been performed in 27, 34, and 17 nodules, respectively. Contrast-enhanced ultrasound was at higher risk of misdiagnosis for pure hepatocellular carcinoma than computed tomography (
Conclusions
Contrast-enhanced ultrasound misdiagnosed a higher number of combined hepatocellular-cholangiocarcinoma as hepatocellular carcinoma than computed tomography and magnetic resonance imaging. However, the latter techniques were able to identify features of malignancy less often.

Identifiants

pubmed: 30788118
doi: 10.1177/2050640618815378
pii: 10.1177_2050640618815378
pmc: PMC6374835
doi:

Substances chimiques

Biomarkers 0

Types de publication

Journal Article

Langues

eng

Pagination

69-77

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Auteurs

Elisabetta Sagrini (E)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Massimo Iavarone (M)

First Division of Gastroenterology, University of Milan, Milan, Italy.

Federico Stefanini (F)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Francesco Tovoli (F)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Sara Vavassori (S)

First Division of Gastroenterology, University of Milan, Milan, Italy.

Marco Maggioni (M)

First Division of Gastroenterology, University of Milan, Milan, Italy.

Matteo Renzulli (M)

Radiology Unit, S. Orsola-Malpighi Bologna Authority Hospital, Bologna, Italy.

Veronica Salvatore (V)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Horia Stefanescu (H)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Massimo Colombo (M)

First Division of Gastroenterology, University of Milan, Milan, Italy.

Luigi Bolondi (L)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Fabio Piscaglia (F)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

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