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Added-value of ancillary imaging features for differentiating hepatocellular carcinoma from intrahepatic mass-forming cholangiocarcinoma on Gd-BOPTA-enhanced MRI in LI-RADS M

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objective

To identify the reliable imaging features and added-value of ancillary imaging features for differentiating hepatocellular carcinoma (HCC) and intrahepatic mass-forming cholangiocarcinoma (IMCC) assigned to LI-RADS M on Gd-BOPTA-enhanced MRI.

Methods

This retrospective study included 116 liver observations assigned to LI-RADS M, including 82 HCC and 34 IMCC histologically confirmed. Before and after adding ancillary imaging features, all variables with a p-value of < 0.05 in univariable analysis were entered into a multivariable logistic regression analysis to build diagnostic model 1 and model 2 to find reliable predictors of HCC diagnosis. Receiver operating characteristic (ROC) analysis and the DeLong test were used to compare the two models.

Results

Forty-nine of 82(59.8%) HCCs had a considerably higher frequency of enhancing “capsule” compared with IMCCs (p < 0.001). Based on LI-RADS major and LR-M features and clinical-pathologic factors, an elevated AFP level (OR = 10.676, 95%CI = 2.125–4.470, p = 0.004) and enhancing “capsule” (OR = 20.558, 95%CI = 4.470–94.550, p < 0.001) were extracted as independent risk factors in Model 1. After adding ancillary imaging features, Male (OR = 23.452, 95%CI = 1.465–375.404, p = 0.026), enhancing “capsule” (OR = 13.161, 95%CI = 1.725–100.400, p = 0.013), septum (OR = 17.983, 95%CI = 1.049–308.181, p = 0.046), small-scale central HBP hyperintensity (OR = 44.386, 95%CI = 1.610–1223.484, p = 0.025) were confirmed as independent significant variables associated with HCC. Model 2 demonstrated significantly superior AUC (0.918 vs 0.845, p = 0.021) compared with Model 1. When any two or more predictors in model 2 were satisfied, sensitivity was 91.46%, and accuracy was at the top (87.93%).

Conclusion

Enhancing “capsule” was a reliable imaging feature to help identify HCC. Adding ancillary imaging features improved sensitivity and accuracy for HCC diagnosis with differentiation from IMCC in LR-M.

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Acknowledgements

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Funding

Educational Research Project for Young and Middle‐aged Teachers of Fujian Provincial Department of Education (JAT200167).

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Authors and Affiliations

  1. Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian, China

    Wanjing Zheng, Hongjie Huang, Dejun She, Meilian Xiong, Xiaodan Chen, Xiaojun Lin & Dairong Cao

  2. Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fujian, China

    Dairong Cao

  3. Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fujian, China

    Dairong Cao

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  1. Wanjing Zheng
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Zheng, W., Huang, H., She, D. et al. Added-value of ancillary imaging features for differentiating hepatocellular carcinoma from intrahepatic mass-forming cholangiocarcinoma on Gd-BOPTA-enhanced MRI in LI-RADS M. Abdom Radiol 47, 957–968 (2022). https://doi.org/10.1007/s00261-021-03380-6

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  • DOI: https://doi.org/10.1007/s00261-021-03380-6

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