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Gadoxetic acid disodium-enhanced MR imaging of cholangiolocellular carcinoma of the liver: imaging characteristics and histopathological correlations

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Objectives

To review the gadoxetic acid disodium (EOB)-enhanced magnetic resonance (MR) imaging features of cholangiolocellular carcinoma (CoCC) of the liver and compare them with those of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).

Methods

EOB-enhanced MR images of 19 patients with CoCC, 23 with ICC, and 51 with HCC were retrospectively evaluated qualitatively and quantitatively. Univariate and multivariate analyses were performed to determine the characteristic MR features of CoCC with histopathological–imaging correlation.

Results

Multivariate logistic regression analysis showed that dot-/band-shaped internal enhancement during the arterial and portal phases (P < 0.001), and larger arterial ring enhancement ratio (CoCC, 0.13 ± 0.04; ICC, 0.074 ± 0.04; P = 0.013) were significantly independently associated with CoCC in contrast to ICC, whereas several MR features including progressive enhancement during the portal and late phases (P < 0.001), target appearance in the hepatocyte phase (P = 0.004), and vessel penetration (P = 0.013) were significantly more frequently associated with CoCC than HCC. The dot-/band-like internal enhancement (78.9% of CoCCs) histopathologically corresponded to the tumour cell nest with vascular proliferations and retained Glisson's sheath structure.

Conclusions

EOB-enhanced MR features of CoCC largely differ from those of HCC but are similar to those of ICC. However, the finding of thicker arterial ring enhancement with dot-/band-like internal enhancement could help differentiate CoCC from ICC.

Key Points

• Gadoxetic acid-enhanced MR features of cholangiolocellular carcinoma (CoCC) resembled those of intrahepatic cholangiocarcinoma (ICC).

• Gadoxetic acid-enhanced MR features of CoCC largely differed from those of hepatocellular carcinoma.

• Dot-/band-like internal enhancement of CoCC may be helpful for differentiating from ICC.

• Arterial ring enhancement of CoCC was larger than that of ICC.

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Abbreviations

cHCC-CC:

Combined hepatocellular and cholangiocarcinoma

CoCC:

Cholangiolocellular carcinoma

DW:

Diffusion-weighted

EOB:

Gadoxetic acid disodium

HCC:

Hepatocellular carcinoma

HE:

Hematoxylin and eosin

ICC:

Intrahepatic cholangiocarcinoma

LLC:

Lesion-to-liver contrast

ROI:

Region of interest

SI:

Signal intensity

WHO:

World Health Organization

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Acknowledgements

We are grateful to Kazuhito Nakayasu (Kondo Photo Process Co., Ltd.) for providing professional statistical advice.

Author information

Authors and Affiliations

  1. Department of Radiology, Nihon University School of Medicine, 30-1, Ohyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan

    Hiroki Haradome & Yusuke Toda

  2. Department of Radiology, Showa General Hospital, Koganei, Japan

    Toshiyuki Unno

  3. Department of Radiology, Saitama Medical University International Medical Center, Saitama, Japan

    Hiroyuki Morisaka & Tomoaki Ichikawa

  4. Department of Radiology, UMC Groningen, Groningen, The Netherlands

    Thomas C. Kwee

  5. Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan

    Hiroshi Kondo

  6. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan

    Keiji Sano

  7. Department of Pathology, Teikyo University Hospital, Tokyo, Japan

    Fukuo Kondo

  8. Department of Pathology, Nihon University School of Medicine, Tokyo, Japan

    Masahiko Sugitani

  9. Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan

    Tadatoshi Takayama

Authors
  1. Hiroki Haradome
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  2. Toshiyuki Unno
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  3. Hiroyuki Morisaka
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  6. Hiroshi Kondo
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  8. Tomoaki Ichikawa
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  9. Fukuo Kondo
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  11. Tadatoshi Takayama
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Corresponding author

Correspondence to Hiroki Haradome.

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Guarantor

The scientific guarantor of this publication is Tadatoshi Takayama

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

Kazuhito Nakayasu (Kondo Photo Process Co., Ltd.) kindly provided statistical advice.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Methodology

• Retrospective

• Case-control/observational study

• Multicenter study

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Haradome, H., Unno, T., Morisaka, H. et al. Gadoxetic acid disodium-enhanced MR imaging of cholangiolocellular carcinoma of the liver: imaging characteristics and histopathological correlations. Eur Radiol 27, 4461–4471 (2017). https://doi.org/10.1007/s00330-017-4811-2

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  • DOI: https://doi.org/10.1007/s00330-017-4811-2

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