Quantitative Assessment of Hypovascular Component in Arterial Phase to Help the Discrimination of Combined Hepatocellular-Cholangiocarcinoma and Hepatocellular Carcinoma
Xue Yang,1,* Jing Chang,2,* Ruili Li,3 Yu Qi,1 Xufen Zeng,4 Wei Wang,1 Hongjun Li1 1Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 2Department of Pathology, Beijing YouAn Hospital, Capital Medical University,...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-01-01
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| Series: | Journal of Hepatocellular Carcinoma |
| Subjects: | |
| Online Access: | https://www.dovepress.com/quantitative-assessment-of-hypovascular-component-in-arterial-phase-to-peer-reviewed-fulltext-article-JHC |
| _version_ | 1811168839964033024 |
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| author | Yang X Chang J Li R Qi Y Zeng X Wang W Li H |
| author_facet | Yang X Chang J Li R Qi Y Zeng X Wang W Li H |
| author_sort | Yang X |
| collection | DOAJ |
| description | Xue Yang,1,* Jing Chang,2,* Ruili Li,3 Yu Qi,1 Xufen Zeng,4 Wei Wang,1 Hongjun Li1 1Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 2Department of Pathology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 3Department of Radiology, Xuanwu Hospital Capital Medical University, Beijing, 100073, People’s Republic of China; 4Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongjun Li, Department of Radiology, Beijing YouAn Hospital, Capital Medical University, No. 8 Xi Tou Tiao, Youanmen Wai, Fengtai District, Beijing, 100069, People’s Republic of China, Email lihongjun00113@ccmu.edu.cnPurpose: To explore the imaging performance for discrimination of combined hepatocellular- cholangiocarcinoma (cHCC-CCA) and hepatocellular carcinoma (HCC).Methods: In total, 35 patients with cHCC-CCA and a matched control group of HCC patients (n = 35) were included retrospectively. We quantitatively evaluated the hypovascular component in tumor and qualitatively assessed LI-RADS features and other aggressive features to develop model for cHCC-CCA diagnose. Subgroup analyses were performed by tumor size and LI-RADS category.Results: cHCC-CCA frequently showed a larger proportion (≥ 50%) of hypovascular areas followed by HCC (P = 0.000). Among those patients with ≥ 50% hypovascular areas, 8 patients did not present rim enhancement in atrial phase. The LI-RADS major features were more commonly observed in HCC (82.9– 45.7%,), than cHCC-CCA (P = 0.003– 0.022). The targetoid appearances and non-smooth margin frequently appeared in cHCC-CCA (34.3– 63.9%), compared with HCC (P = 0.000– 0.023). We developed a radiologic model based on ≥ 50% hypovascular component and delayed enhancement, which presented AUC of 0.821, accuracy of 80%. We also obtained good performance by radiologic model in LR-M group and tumor size < 50mm group (AUC: 0.841 and 0.866, respectively). Combined group which included CA 19– 9 and ≥ 50% hypovascular component and delayed enhancement did not improve the distinction performance between cHCC-CCA and HCC, which presented good performance of identifying cHCC-CCA in the LR-4/5 subgroup and tumor size ≥ 50 mm subgroup (AUC: 0.717, 0.730, respectively). cHCC-CCA group presented heterogeneous dominant pathology involving 15 of HCC, 7 of intrahepatic cholangiocarcinoma (iCCA) or cholangiolocellular carcinoma (CLC), 13 of intermediate cells component. Macrotrabecular appearances were higher in cHCC-CCA than that in HCC. The proportion of Hepa-1 was significantly higher in true negative (TN) patients (29 [93.5%]) and false negative (FN) patients (10 [100%]) than in true positive (TP) patients (16 [64%]; P = 0.036).Conclusion: Quantitative assessment of hypovascular component could help the discrimination of cHCC-CCA. Macrotrabecular appearances were more exhibited in cHCC-CCA than that in HCC.Keywords: combined hepatocellular-cholangiocarcinoma, hepatocellular carcinoma, computed tomography, magnetic resonance imaging, pathologic feature, cHCC-CCA, HCC, CT |
| first_indexed | 2024-04-10T16:32:06Z |
| format | Article |
| id | doaj.art-2404149b62b146bfb30c96a06d31f3ff |
| institution | Directory Open Access Journal |
| issn | 2253-5969 |
| language | English |
| last_indexed | 2024-04-10T16:32:06Z |
| publishDate | 2023-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Hepatocellular Carcinoma |
| spelling | doaj.art-2404149b62b146bfb30c96a06d31f3ff2023-02-08T22:12:28ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692023-01-01Volume 1011312281288Quantitative Assessment of Hypovascular Component in Arterial Phase to Help the Discrimination of Combined Hepatocellular-Cholangiocarcinoma and Hepatocellular CarcinomaYang XChang JLi RQi YZeng XWang WLi HXue Yang,1,* Jing Chang,2,* Ruili Li,3 Yu Qi,1 Xufen Zeng,4 Wei Wang,1 Hongjun Li1 1Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 2Department of Pathology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 3Department of Radiology, Xuanwu Hospital Capital Medical University, Beijing, 100073, People’s Republic of China; 4Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongjun Li, Department of Radiology, Beijing YouAn Hospital, Capital Medical University, No. 8 Xi Tou Tiao, Youanmen Wai, Fengtai District, Beijing, 100069, People’s Republic of China, Email lihongjun00113@ccmu.edu.cnPurpose: To explore the imaging performance for discrimination of combined hepatocellular- cholangiocarcinoma (cHCC-CCA) and hepatocellular carcinoma (HCC).Methods: In total, 35 patients with cHCC-CCA and a matched control group of HCC patients (n = 35) were included retrospectively. We quantitatively evaluated the hypovascular component in tumor and qualitatively assessed LI-RADS features and other aggressive features to develop model for cHCC-CCA diagnose. Subgroup analyses were performed by tumor size and LI-RADS category.Results: cHCC-CCA frequently showed a larger proportion (≥ 50%) of hypovascular areas followed by HCC (P = 0.000). Among those patients with ≥ 50% hypovascular areas, 8 patients did not present rim enhancement in atrial phase. The LI-RADS major features were more commonly observed in HCC (82.9– 45.7%,), than cHCC-CCA (P = 0.003– 0.022). The targetoid appearances and non-smooth margin frequently appeared in cHCC-CCA (34.3– 63.9%), compared with HCC (P = 0.000– 0.023). We developed a radiologic model based on ≥ 50% hypovascular component and delayed enhancement, which presented AUC of 0.821, accuracy of 80%. We also obtained good performance by radiologic model in LR-M group and tumor size < 50mm group (AUC: 0.841 and 0.866, respectively). Combined group which included CA 19– 9 and ≥ 50% hypovascular component and delayed enhancement did not improve the distinction performance between cHCC-CCA and HCC, which presented good performance of identifying cHCC-CCA in the LR-4/5 subgroup and tumor size ≥ 50 mm subgroup (AUC: 0.717, 0.730, respectively). cHCC-CCA group presented heterogeneous dominant pathology involving 15 of HCC, 7 of intrahepatic cholangiocarcinoma (iCCA) or cholangiolocellular carcinoma (CLC), 13 of intermediate cells component. Macrotrabecular appearances were higher in cHCC-CCA than that in HCC. The proportion of Hepa-1 was significantly higher in true negative (TN) patients (29 [93.5%]) and false negative (FN) patients (10 [100%]) than in true positive (TP) patients (16 [64%]; P = 0.036).Conclusion: Quantitative assessment of hypovascular component could help the discrimination of cHCC-CCA. Macrotrabecular appearances were more exhibited in cHCC-CCA than that in HCC.Keywords: combined hepatocellular-cholangiocarcinoma, hepatocellular carcinoma, computed tomography, magnetic resonance imaging, pathologic feature, cHCC-CCA, HCC, CThttps://www.dovepress.com/quantitative-assessment-of-hypovascular-component-in-arterial-phase-to-peer-reviewed-fulltext-article-JHCcombined hepatocellular-cholangiocarcinomahepatocellular carcinomacomputed tomographymagnetic resonance imagingpathologic feature |
| spellingShingle | Yang X Chang J Li R Qi Y Zeng X Wang W Li H Quantitative Assessment of Hypovascular Component in Arterial Phase to Help the Discrimination of Combined Hepatocellular-Cholangiocarcinoma and Hepatocellular Carcinoma Journal of Hepatocellular Carcinoma combined hepatocellular-cholangiocarcinoma hepatocellular carcinoma computed tomography magnetic resonance imaging pathologic feature |
| title | Quantitative Assessment of Hypovascular Component in Arterial Phase to Help the Discrimination of Combined Hepatocellular-Cholangiocarcinoma and Hepatocellular Carcinoma |
| title_full | Quantitative Assessment of Hypovascular Component in Arterial Phase to Help the Discrimination of Combined Hepatocellular-Cholangiocarcinoma and Hepatocellular Carcinoma |
| title_fullStr | Quantitative Assessment of Hypovascular Component in Arterial Phase to Help the Discrimination of Combined Hepatocellular-Cholangiocarcinoma and Hepatocellular Carcinoma |
| title_full_unstemmed | Quantitative Assessment of Hypovascular Component in Arterial Phase to Help the Discrimination of Combined Hepatocellular-Cholangiocarcinoma and Hepatocellular Carcinoma |
| title_short | Quantitative Assessment of Hypovascular Component in Arterial Phase to Help the Discrimination of Combined Hepatocellular-Cholangiocarcinoma and Hepatocellular Carcinoma |
| title_sort | quantitative assessment of hypovascular component in arterial phase to help the discrimination of combined hepatocellular cholangiocarcinoma and hepatocellular carcinoma |
| topic | combined hepatocellular-cholangiocarcinoma hepatocellular carcinoma computed tomography magnetic resonance imaging pathologic feature |
| url | https://www.dovepress.com/quantitative-assessment-of-hypovascular-component-in-arterial-phase-to-peer-reviewed-fulltext-article-JHC |
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