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Apparent diffusion coefficient value of mass-forming intrahepatic cholangiocarcinoma: a potential imaging biomarker for prediction of lymph node metastasis

  • Hepatobiliary
  • Published:
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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 < 0.001), higher ADC value of primary IMCC lesion (ADCIMCC value) (p = 0.001), and positive CA19-9 level (p = 0.018) were correlated with LNM. Multivariate logistic regression analysis demonstrated that ADCIMCC value (odds ratio, 3.347; p = 0.001) and diameter of largest LN > 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.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under curve

DWI:

Diffusion-weighted imaging

IMCC:

Mass-forming intrahepatic cholangiocarcinoma

LN:

Lymph node

LNM:

Lymph node metastasis

MRI:

Magnetic resonance imaging

ROC:

Receiver operating characteristic curve

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Funding

This study was supported by grants from the Shanghai Municipal Key Clinical Specialty (W2019-018).

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China

    Yang Zhou

  2. Shanghai Institute of Medical Imaging, Shanghai, 200032, China

    Yang Zhou, Guofeng Zhou, Xuan Gao, Xiaolin Wang & Pengju Xu

  3. Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China

    Guofeng Zhou & Pengju Xu

  4. Department of Pathology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China

    Chen Xu

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  1. Yang Zhou
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  3. Xuan Gao
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  4. Chen Xu
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  5. Xiaolin Wang
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Correspondence to Pengju Xu.

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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. This study does not contain any studies with animals performed by any of the authors. For this type of study formal consent is not required.

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The institutional review board approved this study and waived informed consent because of retrospective study.

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Zhou, Y., Zhou, G., Gao, X. et al. Apparent diffusion coefficient value of mass-forming intrahepatic cholangiocarcinoma: a potential imaging biomarker for prediction of lymph node metastasis. Abdom Radiol 45, 3109–3118 (2020). https://doi.org/10.1007/s00261-020-02458-x

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