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Preoperative Diagnosis of Lymph Node Metastasis of Perihilar Cholangiocarcinoma Using Diffusion-Weighted Magnetic Resonance Imaging

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

Although the prognosis of patients with resected perihilar cholangiocarcinoma (PHC) with histological lymph node metastasis (LNM) is poor, preoperative prediction of LNM is difficult. This study aimed to evaluate the diagnostic performance of diffusion-weighted magnetic resonance imaging (DWI) for LNM of PHC.

Method

Consecutive patients who underwent surgical resection of PHC between January 2012 and May 2020 were retrospectively reviewed. The lymph node (LN) area (mm2) and apparent diffusion coefficient (ADC) value ( × 10−3 mm2/s) of pericholedochal LNs were measured by DWI. The characteristics of the patients and the LNs were evaluated according to the histological presence or absence of regional LNM. Univariate and multivariate analyses were performed to identify the predictors of LNM of PHC.

Results

Of the 93 eligible patients, 49 (53%) were LNM positive and 44 (47%) were LNM negative. Although the characteristics of the patients were similar between the two groups, the mean ADC value was significantly lower in the LNM positive group than in the LNM negative group. On multivariate analysis, mean ADC value ≤1.80 × 10−3 mm2/s was independently associated with LNM of PHC (risk ratio: 12.5, 95% confidence interval: 3.05–51.4; p = 0.0004). The sensitivity, specificity and accuracy of mean ADC values ≤ 1.80 × 10−3 mm2/s for predicting LNM of PHC were 94%, 55% and 75%, respectively.

Conclusions

DWI might be useful for the preoperative diagnosis of LNM of PHC.

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Authors and Affiliations

  1. Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan

    Isamu Hosokawa MD, PhD, FACS, Katsunori Furukawa MD, PhD, Tsukasa Takayashiki MD, PhD, Satoshi Kuboki MD, PhD, Shigetsugu Takano MD, PhD & Masayuki Ohtsuka MD, PhD

  2. Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan

    Koichi Hayano MD, PhD, FACS & Hisahiro Matsubara MD, PhD

  3. Narita Hospital, International University of Health and Welfare, Chiba, Japan

    Masaru Miyazaki MD, PhD

Authors
  1. Isamu Hosokawa MD, PhD, FACS
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  2. Koichi Hayano MD, PhD, FACS
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  3. Katsunori Furukawa MD, PhD
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  4. Tsukasa Takayashiki MD, PhD
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  5. Satoshi Kuboki MD, PhD
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  6. Shigetsugu Takano MD, PhD
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  7. Hisahiro Matsubara MD, PhD
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  8. Masaru Miyazaki MD, PhD
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  9. Masayuki Ohtsuka MD, PhD
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Correspondence to Masayuki Ohtsuka MD, PhD.

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Hosokawa, I., Hayano, K., Furukawa, K. et al. Preoperative Diagnosis of Lymph Node Metastasis of Perihilar Cholangiocarcinoma Using Diffusion-Weighted Magnetic Resonance Imaging. Ann Surg Oncol 29, 5502–5510 (2022). https://doi.org/10.1245/s10434-022-11931-4

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  • DOI: https://doi.org/10.1245/s10434-022-11931-4

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