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Differences in early imaging features and pattern of progression on CT between intrahepatic biliary metastasis of colorectal origin and intrahepatic non-mass-forming cholangiocarcinoma in patients with extrabiliary malignancy

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Abstract

Purpose

To assess the differences in early imaging features and progression pattern on CT between intrahepatic biliary metastasis (IBM) and non-mass-forming cholangiocarcinoma (NMFC) in patients with extrabiliary malignancy.

Methods

This retrospective study included 35 patients who were surgically and pathologically confirmed with IBM (n = 14) or NMFC (n = 21) at the time of or after surgery for extrabiliary malignancy. Two observers evaluated the following aspects of biliary lesions on initial or follow-up CT images: location, characteristics of intrahepatic duct (IHD) dilatation, presence of duct wall thickening, and periductal infiltration lesion or periductal expansile mass.

Results

All IBMs were associated with colorectal cancer (p = 0.032). As early imaging features on CT, smooth tapered localized IHD dilatation without duct wall thickening and peripheral duct involvement were observed significantly more often in IBM, and IHD dilatation with abrupt tapering or irregularity of transition site and bile duct wall thickening were significantly more common in NMFC (all p < 0.05). Regarding progression pattern, periductal expansile mass was present only in IBM, whereas periductal infiltrative lesion was present only in NMFC (p < 0.001).

Conclusion

In the differentiation between IBM and NMFC in patients with extrabiliary malignancy, the differences in early imaging features and progression pattern of the two diseases revealed in this study would be helpful for diagnosis.

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Abbreviations

IBM:

Intrahepatic biliary metastasis

NMFC:

Non-mass-forming cholangiocarcinoma

IHD:

Intrahepatic duct

CCC:

Cholangiocarcinoma

CEA:

Carcinoembryonic antigen

CA19-9:

Carbohydrate antigen 19-9

TNM:

Tumor, node, metastases

PACS:

Picture archiving and communication system

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Acknowledgements

We appreciate Prof. Cheol Keun Park and Prof. Kee Taek Jang for their histopathologic analysis.

Funding

We declare no sources of financial support or funding received from any organization including National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI).

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Authors and Affiliations

  1. Department of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea

    Ji Hye Min

  2. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea

    Kyung Mi Jang, Dong Ik Cha, Tae Wook Kang & Seong Hyun Kim

  3. Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea

    Seo-Youn Choi

  4. Eone Pathology Laboratory, 2, Jeongdeun-ro 6beon-gil, Suji-gu, Yongin-Si, Gyeonggi-do, Korea

    Kwangseon Min

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  1. Ji Hye Min
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Corresponding author

Correspondence to Kyung Mi Jang.

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Conflict of interest

The authors (Ji Hye Min, Kyung Mi Jang, Dong Ik Cha, Tae Wook Kang, Seong Hyun Kim, Seo-Youn Choi, and Kwangseon Min) declare no conflict of interest.

Ethical approval

Research involving human participants and/or animals: Research involving human participants. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

This retrospective study was approved by our institutional review board, and the requirement for informed consent was waived.

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Min, J.H., Jang, K.M., Cha, D.I. et al. Differences in early imaging features and pattern of progression on CT between intrahepatic biliary metastasis of colorectal origin and intrahepatic non-mass-forming cholangiocarcinoma in patients with extrabiliary malignancy. Abdom Radiol 44, 1350–1360 (2019). https://doi.org/10.1007/s00261-018-1814-7

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  • DOI: https://doi.org/10.1007/s00261-018-1814-7

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