Differentiating peripheral cholangiocarcinoma in stages T1N0M0 and T2N0M0 from hepatic hypovascular nodules using dynamic contrast-enhanced MRI

Shihong Li,Guangwu Lin,Yu Peng,Haizhen Qian,Huihui Jia

doi:10.1038/s41598-017-08634-2

Abstract

Because cholangiocarcinoma shows no specific clinical signs or symptoms and presents with non-specific biological and tumor markers in the early stages, MRI findings often lack typical features before this lesion becomes symptomatic and might be mistaken for other liver lesions. An evaluation of relevant radiological findings in nodular cholangiocarcinoma (≤3 cm) in stages T1N0M0 and T2N0M0 is urgently needed. In our study, we compared two groups of liver hypovascular nodules and found that a distinct margin and enhanced area/nodule size >2/3 in the delayed phase were more frequently observed in cholangiocarcinoma cases than in metastatic nodule cases in which markedly high signal intensity on T2WI was common (p < 0.05). The results also revealed that in the both the portal and delayed phases, an enhanced area/nodule size >2/3 favored cholangiocarcinoma, whereas the presence of regional markedly higher SI on T2WI favored benign nodules. Furthermore, signs of peripheral washout in the delayed phase only appeared in cholangiocarcinoma cases.

Highlights

The overall prognosis of cholangiocarcinoma is generally poor, curative resection of early stage cholangiocarcinoma may improve the chances of long-term survival[1,2,3]
Cholangiocarcinoma is a primary tumor arising from the bile duct epithelium and is the second most common primary hepatobiliary cancer after hepatocellular carcinoma
The treatment options depend on the site, extent, and stage of the cholangiocarcinoma

Summary

Introduction

The overall prognosis of cholangiocarcinoma is generally poor, curative resection of early stage cholangiocarcinoma may improve the chances of long-term survival[1,2,3]. The majority of cholangiocarcinomas present at an advanced stage; early stage cancers are incidentally diagnosed with increasing frequency. Preoperative diagnosis of early stage cholangiocarcinoma has not been studied as frequently. Cholangiocarcinoma shows no specific clinical signs or symptoms and presents with non-specific biological and tumor markers in early stages of the disease[5]. Cholangiocarcinomas have been defined as hypovascular liver tumors as well as metastatic liver tumors, especially in comparison to colorectal or breast cancers and other benign nodules[8]. An evaluation of the radiological findings in nodular cholangiocarcinoma (≤3 cm) in stages T1N0M0 and T2N0M0 has not been performed. We conducted this study to compare the diagnostic performance of nodular cholangiocarcinoma vs that of other common hypovascular hepatic lesions (≤3.0 cm)

Methods

Results

Conclusion