Apparent diffusion coefficient value of mass-forming intrahepatic cholangiocarcinoma: a potential imaging biomarker for
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HEPATOBILIARY
Apparent diffusion coefficient value of mass‑forming intrahepatic cholangiocarcinoma: a potential imaging biomarker for prediction of lymph node metastasis Yang Zhou1,2 · Guofeng Zhou2,3 · Xuan Gao2 · Chen Xu4 · Xiaolin Wang2 · Pengju Xu2,3
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To compare the differences of MR features between mass-forming intrahepatic cholangiocarcinoma (IMCC) with and without lymph node metastasis (LNM) and to search for new imaging biomarkers for predicting LNM. Materials and methods The study included 91 patients with histopathologically confirmed single IMCC (20 patients with LNM and 71 patients without LNM). Findings of preoperative MR imaging including diffusion-weighted imaging (DWI) (b value 0, 500 mm2/s) were analyzed and apparent diffusion coefficient (ADC) values (b = 500 mm2/s) were calculated. Logistic regression analysis was performed to identify independent predictors of LNM. The diagnostic performance of independent predictors was assessed by receiver operating characteristic (ROC) and area under the curve (AUC) was compared. Results Larger tumor size (p = 0.001), diameter of largest lymph node (LN) > 1 cm (p 1 cm (odds ratio, 7.571; p = 0.004) were independent predictors of LNM. The AUCs for ADCIMCC value, diameter of largest LN > 1 cm,and combined method (the combination of ADCIMCC value and diameter of largest LN > 1 cm) were 0.782, 0.701,and 0.857, respectively. The AUC for combined method was significantly higher than that of diameter of largest LN > 1 cm (p = 0.033). Conclusion ADCIMCC value can be a potential imaging biomarker for predicting LNM of IMCC, especially in combination with diameter of largest LN > 1 cm. Keywords Diffusion-weighted imaging (DWI) · Lymph node metastasis (LNM) · Magnetic resonance imaging (MRI) · Mass-forming intrahepatic cholangiocarcinoma (IMCC) Abbreviations ADC Apparent diffusion coefficient AUC Area under curve DWI Diffusion-weighted imaging * Pengju Xu [email protected] 1
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
2
Shanghai Institute of Medical Imaging, Shanghai 200032, China
3
Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China
4
Department of Pathology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China
IMCC Mass-forming intrahepatic cholangiocarcinoma LN Lymph node LNM Lymph node metastasis MRI Magnetic resonance imaging ROC Receiver operating characteristic curve
Introduction Intrahepatic cholangiocarcinoma (ICC) is the second most common primary malignant liver cancer after hepatocellular carcinoma and the incidence of ICC has markedly increased in recent decades [1, 2]. The morphology of ICC is classified into three types based on macroscopic appearance: the mass–forming type, the periductal infiltrative type, and the intraductal growing type [3]. Mass-form
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