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Prediction of the histopathologic findings of intrahepatic cholangiocarcinoma: qualitative and quantitative assessment of diffusion-weighted imaging

  • Gastrointestinal
  • Published:
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Abstract

Objective

To correlate qualitative and quantitative diffusion weighted imaging (DWI) characteristics of intrahepatic cholangiocarcinoma (ICC) with histopathologic tumour grade and fibrosis content.

Methods

Fifty-one patients (21M/30F; mean age 61y) with ICC and MRI including DWI were included in this IRB-approved multicentre retrospective study. Qualitative tumour features were assessed. Tumour apparent diffusion coefficient (ADC) mean, minimum, and normalized (nADCliver) values were computed. Tumour grade [well(G1), moderately(G2), or poorly differentiated(G3)] and tumour fibrosis content [minimal(1), moderate(2), or abundant(3)] were categorized pathologically. Imaging findings and ADC values were compared with pathologic measures. Utility of ADC values for predicting tumour grade was assessed using ROC analysis.

Results

51 ICCs (mean size 6.5±1.1 cm) were assessed. 33/51(64%) of ICCs demonstrated diffuse hyperintensity and 15/51(29%) demonstrated target appearance on DWI. Infiltrative morphology (p=0.02) and tumour size (p=0.04) were associated with G3. ADCmean and nADCmean of G3 (1.32±0.47x10-3 mm2/sec and 0.97±0.95) were lower than G1+G2 (1.57±0.39x10-3 mm2/sec and 1.24±0.49; p=0.03 and p=0.04). ADCmean and nADCmean were inversely correlated with tumour grade (p<0.025). No correlation was found between ADC and tumour fibrosis content. AUROC, sensitivity and specificity of nADCmean for G3 versus G1+G2 were 0.71, 89.5% and 55.5%.

Conclusion

ADC quantification has reasonable accuracy for predicting ICC grade.

Key Points

• ADC quantification was useful for predicting ICC tumour grade.

• Infiltrative tumour morphology and size were associated with poorly differentiated ICCs.

• ADC values depended more on ICC tumour grade than fibrosis content.

• Ability to predict ICC tumour grade non-invasively could impact patient management.

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Funding

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

Author information

Authors and Affiliations

  1. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Sara Lewis & Bachir Taouli

  2. Translational and Molecular Imaging Institute (TMII), Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Sara Lewis, Cecilia Besa, Mathilde Wagner, Shingo Kihira & Bachir Taouli

  3. Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile

    Cecilia Besa

  4. Department of Radiology, Sorbonne Universités, UPMC, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France

    Mathilde Wagner

  5. Department of Radiology, University of Toronto, Toronto, Ontario, Canada

    Kartik Jhaveri & Nima Sadoughi

  6. Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Hongfa Zhu & Swan Thung

  7. Department of Radiology, University of Ottawa and The Ottawa Hospital, Ottawa, Canada

    Nima Sadoughi

  8. Department of Pathology, University of Toronto, Ontario, Canada

    Sandra Fischer

  9. Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Amogh Srivastava & Koenraad Mortele

  10. Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Eric Yee

  11. Department of Pathology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Eric Yee

  12. Department of Radiology, New York University Langone Medical Center, New York, NY, USA

    James Babb

Authors
  1. Sara Lewis
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  2. Cecilia Besa
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  3. Mathilde Wagner
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  7. Nima Sadoughi
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  8. Sandra Fischer
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  9. Amogh Srivastava
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  10. Eric Yee
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  11. Koenraad Mortele
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  12. James Babb
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  13. Swan Thung
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  14. Bachir Taouli
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Corresponding author

Correspondence to Sara Lewis.

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Guarantor

The scientific guarantor of this publication is Sara Lewis, MD.

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.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic

• multicentre study

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Lewis, S., Besa, C., Wagner, M. et al. Prediction of the histopathologic findings of intrahepatic cholangiocarcinoma: qualitative and quantitative assessment of diffusion-weighted imaging. Eur Radiol 28, 2047–2057 (2018). https://doi.org/10.1007/s00330-017-5156-6

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  • DOI: https://doi.org/10.1007/s00330-017-5156-6

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