Role of Intravoxel Incoherent Motion in Discriminating Hepatitis B Virus-Related Intrahepatic Mass-Forming Cholangiocarcinoma from Hepatocellular Carcinoma Based on Liver Imaging Reporting and Data System v2018.

Abstract

Backgroud: Intravoxel incoherent motion (IVIM) could be used to characterize benign and malignant hepatic lesions and predict the histological grade of hepatocellular carcinoma (HCC). To evaluate IVIM-derived parameters for differentiating between hepatitis B virus (HBV)-related intrahepatic mass-forming cholangiocarcinoma (IMCC) and HCC based on the Liver Imaging Reporting and Data System (LI-RADS) v2018. Materials and Methods: 20 IMCC patients and one-to-one matched control HCC patients were retrospectively assessed. IVIM scanning with 11 b-values (from 0 to 1500 s/mm2) was obtained using a 3.0-T magnetic resonance scanner. Apparent diffusion coefficient (ADC) and IVIM parameters, including diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f), were compared between IMCC and HCC. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performances of ADC, D, f, and D*. The LI-RADS features and a final category were also compared using LI-RADS v2018. Results: ADC and D were significantly higher in IMCC than in HCC (p = 0.012 and p = 0.007, respectively); f was significantly higher in HCC than in IMCC (p = 0.004). The area under the ROC curve values for ADC, D, and f for differentiating HBV-related IMCC from HCC were 0.724, 0.753, and 0.741, respectively. Conclusion: The majority of HBV-related IMCCs can be categorized as LR-M by using LI-RADS. However, atypical IMCCs may be classified as non-LR-M. ADC, D, and f values may be helpful in differentiating HBV-related IMCC from HCC, and similar diagnostic performances were obtained for these values.