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European Radiology

, Volume 28, Issue 5, pp 2047–2057 | Cite as

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

  • 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
Gastrointestinal
  • 263 Downloads

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.

Keywords

Diffusion Magnetic Resonance Imaging Liver Neoplasms Cholangiocarcinoma Tumour Grading Fibrosis 

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Sara Lewis, MD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic

• multicentre study

Supplementary material

330_2017_5156_MOESM1_ESM.docx (86 kb)
ESM 1 (DOCX 85 kb)

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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Sara Lewis
    • 1
    • 2
  • Cecilia Besa
    • 2
    • 3
  • Mathilde Wagner
    • 2
    • 4
  • Kartik Jhaveri
    • 5
  • Shingo Kihira
    • 2
  • Hongfa Zhu
    • 6
  • Nima Sadoughi
    • 5
    • 7
  • Sandra Fischer
    • 8
  • Amogh Srivastava
    • 9
  • Eric Yee
    • 10
    • 11
  • Koenraad Mortele
    • 9
  • James Babb
    • 12
  • Swan Thung
    • 6
  • Bachir Taouli
    • 1
    • 2
  1. 1.Department of RadiologyIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Translational and Molecular Imaging Institute (TMII)Icahn School of Medicine at Mount SinaiNew YorkUSA
  3. 3.Department of RadiologyPontificia Universidad Católica de ChileSantiagoChile
  4. 4.Department of RadiologySorbonne Universités, UPMC, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de ParisParisFrance
  5. 5.Department of RadiologyUniversity of TorontoTorontoCanada
  6. 6.Department of PathologyIcahn School of Medicine at Mount SinaiNew YorkUSA
  7. 7.Department of RadiologyUniversity of Ottawa and The Ottawa HospitalOttawaCanada
  8. 8.Department of PathologyUniversity of TorontoOntarioCanada
  9. 9.Department of RadiologyBeth Israel Deaconess Medical Center, Harvard Medical SchoolBostonUSA
  10. 10.Department of PathologyBeth Israel Deaconess Medical Center, Harvard Medical SchoolBostonUSA
  11. 11.Department of Pathology, College of MedicineUniversity of Arkansas for Medical SciencesLittle RockUSA
  12. 12.Department of RadiologyNew York University Langone Medical CenterNew YorkUSA

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