DWI Combined With Hepatobiliary-Phase Enhanced Imaging Can Better Differentiate Cholangiocarcinoma From Atypical
Li-Hong Xing1, Li-Yong Zhuo1, Yu Zhang1
1Department of CT/MRI Room, Affiliated Hospital of Hebei University, and Key Laboratory of Cancer Radiotherapy and Chemotherapy Mechanism and Regulations, Baoding, China.
Insights
Diffusion-weighted imaging (DWI) and hepatobiliary phase (HBP) imaging improve the differentiation of intrahepatic mass-forming cholangiocarcinoma (IMCC) from liver abscesses. Combining DWI with enhanced HBP imaging offers superior sensitivity and accuracy for diagnosis.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Intrahepatic mass-forming cholangiocarcinoma (IMCC) and atypical liver abscesses present diagnostic challenges.
- Accurate differentiation is crucial for appropriate patient management and treatment.
Purpose of the Study:
- To evaluate the diagnostic value of diffusion-weighted imaging (DWI) combined with hepatobiliary phase (HBP) Gd-BOPTA enhancement.
- To differentiate IMCC from atypical liver abscesses.
Main Methods:
- Retrospective analysis of 43 IMCC and 25 atypical liver abscess cases.
- Analysis of DWI signals, contrast noise ratio (CNR) at HBP, and lesion visibility.
- Comparison of DWI, HBP imaging, and their combination.
Main Results:
- Significant differences in DWI and T2WI signal patterns were observed between IMCC and liver abscess groups.
- HBP imaging showed statistically significant differences in peripheral CNR and visibility.
- Combined DWI and enhanced HBP imaging demonstrated significantly higher sensitivity and accuracy than either modality alone.
Conclusions:
- IMCC and atypical liver abscesses exhibit distinct imaging characteristics on DWI and T2WI.
- The combination of DWI and enhanced HBP imaging is a highly sensitive and accurate method for differentiating IMCC from atypical liver abscesses.
Objective:
To investigate the value of diffusion-weighted imaging (DWI) combined with the hepatobiliary phase (HBP) Gd-BOPTA enhancement in differentiating intrahepatic mass-forming cholangiocarcinoma (IMCC) from atypical liver abscess.
Materials And Methods:
A retrospective analysis was performed on 43 patients with IMCCs (IMCC group) and 25 patients with atypical liver abscesses (liver abscess group). The DWI signal, the absolute value of the contrast noise ratio (│CNR│) at the HBP, and visibility were analyzed.
Results:
A relatively high DWI signal and a relatively high peripheral signal were presented in 29 patients (67.5%) in the IMCC group, and a relatively high DWI signal was displayed in 15 patients (60.0%) in the atypical abscess group with a relatively high peripheral signal in only one (6.7%) patient and a relatively high central signal in 14 (93.3%, 14/15). A significant (P<0.001) difference existed in the pattern of signal between the two groups of patients. On T2WI, IMCC was mainly manifested by homogeneous signal (53.5%), whereas atypical liver abscesses were mainly manifested by heterogeneous signal and relatively high central signal (32%, and 64%), with a significant difference (P<0.001) in T2WI imaging presentation between the two groups. On the HBP imaging, there was a statistically significant difference in peripheral │CNR│ (P< 0.001) and visibility between two groups. The sensitivity of the HBP imaging was significantly (P=0.002) higher than that of DWI. The sensitivity and accuracy of DWI combined with enhanced HBP imaging were significantly (P=0.002 and P<0.001) higher than those of either HBP imaging or DWI alone.
Conclusion:
Intrahepatic mass-forming cholangiocarcinoma and atypical liver abscesses exhibit different imaging signals, and combination of DWI and hepatobiliary-phase enhanced imaging has higher sensitivity and accuracy than either technique in differentiating intrahepatic mass-forming cholangiocarcinoma from atypical liver abscesses.
