Can contrast enhanced ultrasound differentiate intrahepatic cholangiocarcinoma from hepatocellular carcinoma?

Bile Duct Neoplasms / diagnostic imaging Bile Ducts, Intrahepatic Carcinoma, Hepatocellular / diagnostic imaging Cholangiocarcinoma / diagnostic imaging Contrast Media Female Humans Liver Neoplasms / diagnostic imaging Magnetic Resonance Imaging Male Middle Aged Retrospective Studies Sensitivity and Specificity
Contrast enhanced ultrasound Diagnosis Hepatocellular carcinoma Intrahepatic cholangiocarcinoma Liver imaging reporting and data system

Journal

World journal of gastroenterology
ISSN: 2219-2840
Titre abrégé: World J Gastroenterol
Pays: United States
ID NLM: 100883448

Informations de publication

Date de publication:
21 Jul 2020
Historique:
received: 02 03 2020
revised: 09 05 2020
accepted: 04 07 2020
entrez: 11 8 2020
pubmed: 11 8 2020
medline: 11 5 2021
Statut: ppublish

Résumé

Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) differ in treatment and prognosis, warranting an effective differential diagnosis between them. The LR-M category in the contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) was set up for lesions that are malignant but not specific to HCC. However, a substantial number of HCC cases in this category elevated the diagnostic challenge. To investigate the possibility and efficacy of differentiating ICC from HCC classified in the LR-M category according to the CEUS LI-RADS. Patients with complete CEUS records together with pathologically confirmed ICC and LR-M HCC (HCC classified in the CEUS LI-RADS LR-M category) between January 2015 and October 2018 were included in this retrospective study. Each ICC was assigned a category as per the CEUS LI-RADS. The enhancement pattern, washout timing, and washout degree between the ICC and LR-M HCC were compared using the A total of 228 nodules (99 ICCs and 129 LR-M HCCs) in 228 patients were included. The mean sizes of ICC and LR-M HCC were 6.3 ± 2.8 cm and 5.5 ± 3.5 cm, respectively ( Rim APHE is a key predictor for differentiating ICC from LR-M HCC. Rim APHE plus elevated CA 19-9 and normal AFP is a strong predictor of ICC rather than LR-M HCC. Early washout and marked washout have limited value for the differentiation between the two entities.

Sections du résumé

BACKGROUND BACKGROUND
Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) differ in treatment and prognosis, warranting an effective differential diagnosis between them. The LR-M category in the contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) was set up for lesions that are malignant but not specific to HCC. However, a substantial number of HCC cases in this category elevated the diagnostic challenge.
AIM OBJECTIVE
To investigate the possibility and efficacy of differentiating ICC from HCC classified in the LR-M category according to the CEUS LI-RADS.
METHODS METHODS
Patients with complete CEUS records together with pathologically confirmed ICC and LR-M HCC (HCC classified in the CEUS LI-RADS LR-M category) between January 2015 and October 2018 were included in this retrospective study. Each ICC was assigned a category as per the CEUS LI-RADS. The enhancement pattern, washout timing, and washout degree between the ICC and LR-M HCC were compared using the
RESULTS RESULTS
A total of 228 nodules (99 ICCs and 129 LR-M HCCs) in 228 patients were included. The mean sizes of ICC and LR-M HCC were 6.3 ± 2.8 cm and 5.5 ± 3.5 cm, respectively (
CONCLUSION CONCLUSIONS
Rim APHE is a key predictor for differentiating ICC from LR-M HCC. Rim APHE plus elevated CA 19-9 and normal AFP is a strong predictor of ICC rather than LR-M HCC. Early washout and marked washout have limited value for the differentiation between the two entities.

Identifiants

DOI: 10.3748/wjg.v26.i27.3938 PMID: 32774068 PMC: PMC7385563
pubmed: 32774068
doi: 10.3748/wjg.v26.i27.3938
pmc: PMC7385563
doi:

Substances chimiques

Contrast Media 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3938-3951

Informations de copyright

©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict-of-interest statement: The authors have no financial relationships to disclose.

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Auteurs

Jia-Yan Huang (JY)

Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.

Jia-Wu Li (JW)

Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.

Wen-Wu Ling (WW)

Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.

Tao Li (T)

Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.

Yan Luo (Y)

Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.

Ji-Bin Liu (JB)

Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, United States.

Qiang Lu (Q)

Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China. luqiang@wchscu.cn.

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Classifications MeSH

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questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Tumeurs du foie › Carcinome hépatocellulaire › Can contrast enhanced ultrasound differentiate...
questionsmedicales.fr › Tumeurs › Tumeurs par type histologique › Tumeurs épithéliales épidermoïdes et glandulaires › Carcinomes › Adénocarcinome › Cholangiocarcinome › Can contrast enhanced ultrasound differentiate...
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