Abstract
Accurate preoperative differentiation of intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) in the setting of cirrhotic liver is of great clinical significance because the treatment and prognosis of these entities differ markedly. Through a retrospectively research, we sought to determine the diagnostic performances of intravoxel incoherent motion (IVIM) and diffusion weighted imaging (DWI) parameters in the differentiating of ICC and HCC. According to the results, we found that apparent diffusion coefficient (ADC) derived from mono-exponential model and true ADC (ADCslow) derived from bi-exponential model can be used to distinguish the ICC and HCC, and ADCslowentailed the higher diagnostic performance than ADC. However, pseudo-ADC (ADCfast) and perfusion fraction (f) can not be used to differentiate ICC and HCC. These results suggested that IVIM and DWI parameters can be useful in differentiating ICC and HCC and might be helpful in selecting the treatment plan and predicting prognosis.
Highlights
Intrahepatic cholangiocarcinoma (ICC), an aggressive epithelial malignancy of the bile ducts [1], is the second most common primary liver cancer worldwide, with a rising incidence [2]
Pseudo-apparent diffusion coefficient (ADC) (ADCfast) and perfusion fraction (f) can not be used to differentiate intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC). These results suggested that intravoxel incoherent motion (IVIM) and diffusion weighted imaging (DWI) parameters can be useful in differentiating ICC and HCC and might be helpful in selecting the treatment plan and predicting prognosis
Due to the common risk factor of Hepatitis-B virus (HBV) infection with hepatocellular carcinoma (HCC), ICC can be presented with cirrhosis [4, 5]
Summary
Intrahepatic cholangiocarcinoma (ICC), an aggressive epithelial malignancy of the bile ducts [1], is the second most common primary liver cancer worldwide, with a rising incidence [2]. The overall prognosis of ICC remains poor with the five-year survival rate less than 30% [3]. Due to the common risk factor of Hepatitis-B virus (HBV) infection with hepatocellular carcinoma (HCC), ICC can be presented with cirrhosis [4, 5]. Differentiation of ICC and HCC in the setting of liver cirrhosis is of great importance, because the treatment and prognosis of these entities can be quite different [6, 7]. Accurate preoperative diagnosis of ICC in patients with cirrhosis has been quite difficult by using these usual imaging because of similar imaging features compared with HCC especially in the cirrhotic liver [15]
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