Distinguishing intrahepatic mass-forming biliary carcinomas from hepatocellular carcinoma by computed tomography and mag
- PDF / 2,966,879 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 7 Downloads / 188 Views
HEPATOBILIARY-PANCREAS
Distinguishing intrahepatic mass-forming biliary carcinomas from hepatocellular carcinoma by computed tomography and magnetic resonance imaging using the Bayesian method: a bi-center study Shintaro Ichikawa 1 & Hiroyoshi Isoda 2 & Tatsuya Shimizu 1 & Daiki Tamada 1 & Kojiro Taura 3 & Kaori Togashi 4 & Hiroshi Onishi 1 & Utaroh Motosugi 1,5 Received: 11 March 2020 / Revised: 7 April 2020 / Accepted: 20 May 2020 # European Society of Radiology 2020
Abstract Objectives To determine imaging hallmarks for distinguishing intrahepatic mass-forming biliary carcinomas (IMBCs) from hepatocellular carcinoma (HCC) and to validate their diagnostic ability using Bayesian statistics. Methods Study 1 retrospectively identified clinical and imaging hallmarks that distinguish IMBCs (n = 41) from HCC (n = 247) using computed tomography (CT) and magnetic resonance imaging (MRI). Study 2 retrospectively assessed the diagnostic ability of these hallmarks to distinguish IMBCs (n = 37) from HCC (n = 111) using Bayesian statistics with images obtained from a different institution. We also assessed the diagnostic ability of the hallmarks in the patient subgroup with high diagnostic confidence (≥ 80% of post-test probability). Two radiologists independently evaluated the imaging findings in studies 1 and 2. Results In study 1, arterial phase peritumoral parenchymal enhancement on CT/MRI, delayed enhancement on CT/MRI, diffusion-weighted imaging peripheral hyperintensity, and bile duct dilatation were hallmarks indicating IMBCs, whereas chronic liver disease, non-rim arterial phase hyperenhancement on CT/MRI, enhancing capsule on CT/MRI, and opposedphase signal drop were hallmarks indicating HCC (p = 0.001–0.04). In study 2, Bayesian statistics-based post-test probability combining all hallmark features had a diagnostic accuracy of 89.2% (132/148) in distinguishing IMBCs from HCC for both readers. In the high diagnostic confidence subgroup (n = 120 and n = 124 for readers 1 and 2, respectively), the accuracy improved (95.0% (114/120) and 93.5% (116/124) for readers 1 and 2, respectively). Conclusions Combined interpretation of CT and MRI to identify hallmark features is useful in discriminating IMBCs from HCCs. High post-test probability by Bayesian statistics allows for a more reliable non-invasive diagnosis. Key Points • Combined interpretation of CT and MRI to identify hallmark features was useful in discriminating intrahepatic mass-forming biliary carcinomas from hepatocellular carcinoma. • Bayesian method-based post-test probability combining all hallmark features determined in study 1 showed high (> 90%) sensitivity and specificity for distinguishing intrahepatic mass-forming biliary carcinomas from hepatocellular carcinoma.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-06972-w) contains supplementary material, which is available to authorized users. * Shintaro Ichikawa [email protected] 1
2
Department of Radiology, University of Yamanashi, 11
Data Loading...
