Ijin Joo1,2, Jeong Min Lee3,4,5, Sang Min Lee1, Jeong Sub Lee1, Jin Young Park1, Joon Koo Han1,2,6. 1. Department of Radiology, Seoul National University Hospital, Seoul, Korea. 2. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. 3. Department of Radiology, Seoul National University Hospital, Seoul, Korea. jmsh@snu.ac.kr. 4. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. jmsh@snu.ac.kr. 5. Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea. jmsh@snu.ac.kr. 6. Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea.
Abstract
PURPOSE: To investigate the utility of Liver Imaging Reporting and Data System (LI-RADS) v2014 for intrahepatic mass-forming cholangiocarcinomas (IMCC) on gadoxetic acid-enhanced magnetic resonance imaging (MRI). MATERIALS AND METHODS: This retrospective study was approved by our Institutional Review Board with waiver of informed consent. Pathologically confirmed IMCCs (n = 35) and hepatocellular carcinomas (HCCs) (n = 71) in patients with chronic hepatitis B or cirrhosis who had undergone gadoxetic acid-enhanced 3.0T or 1.5T MRI were included. Three radiologists independently assigned LI-RADS categories for each IMCC or HCC. Diagnostic performances of LR-M (probable malignancy, not specific for HCC) and LR-5/5v (definitely HCC) were investigated, and imaging features were compared between IMCCs of LR-M and non-LR-M. RESULTS: In all, 88.6% (31/35), 80.0% (28/35), and 74.3% (26/35) of IMCCs and 12.7% (9/71), 22.5% (16/71), and 16.9% (12/71) of HCCs were assigned as LR-M by the three reviewers with substantial interobserver agreements (kappa = 0.664-0.741). Among IMCCs, 2.9% (1/35), 5.7% (2/35), and 11.4% (4/35) were categorized as LR-5/5v. IMCCs of non-LR-M (n = 8, using the consensus method) were significantly smaller (24.1 ± 17.4 vs. 62.8 ± 30.6 mm, P = 0.002) and showed higher frequencies of arterial hyperenhancement (75.0% (6/8) vs. 7.4% (2/27), P < 0.001) and lower frequencies of non-HCC malignancy-favoring features such as peripheral enhancement (12.5% (1/8) vs. 77.8% (21/27), P = 0.002) or the target appearance on the hepatobiliary phase (0% (0/8) vs. 81.5% (22/27), P < 0.001) than IMCCs of LR-M (n = 27). CONCLUSION: Using LI-RADS, the majority of IMCCs can be accurately categorized as LR-M on gadoxetic acid-enhanced MRI; however, caution is warranted, as some atypical IMCCs may be assigned as LR-5/5v resulting in a false-positive diagnosis of HCC. J. Magn. Reson. Imaging 2016;44:1330-1338.
PURPOSE: To investigate the utility of Liver Imaging Reporting and Data System (LI-RADS) v2014 for intrahepatic mass-forming cholangiocarcinomas (IMCC) on gadoxetic acid-enhanced magnetic resonance imaging (MRI). MATERIALS AND METHODS: This retrospective study was approved by our Institutional Review Board with waiver of informed consent. Pathologically confirmed IMCCs (n = 35) and hepatocellular carcinomas (HCCs) (n = 71) in patients with chronic hepatitis B or cirrhosis who had undergone gadoxetic acid-enhanced 3.0T or 1.5T MRI were included. Three radiologists independently assigned LI-RADS categories for each IMCC or HCC. Diagnostic performances of LR-M (probable malignancy, not specific for HCC) and LR-5/5v (definitely HCC) were investigated, and imaging features were compared between IMCCs of LR-M and non-LR-M. RESULTS: In all, 88.6% (31/35), 80.0% (28/35), and 74.3% (26/35) of IMCCs and 12.7% (9/71), 22.5% (16/71), and 16.9% (12/71) of HCCs were assigned as LR-M by the three reviewers with substantial interobserver agreements (kappa = 0.664-0.741). Among IMCCs, 2.9% (1/35), 5.7% (2/35), and 11.4% (4/35) were categorized as LR-5/5v. IMCCs of non-LR-M (n = 8, using the consensus method) were significantly smaller (24.1 ± 17.4 vs. 62.8 ± 30.6 mm, P = 0.002) and showed higher frequencies of arterial hyperenhancement (75.0% (6/8) vs. 7.4% (2/27), P < 0.001) and lower frequencies of non-HCC malignancy-favoring features such as peripheral enhancement (12.5% (1/8) vs. 77.8% (21/27), P = 0.002) or the target appearance on the hepatobiliary phase (0% (0/8) vs. 81.5% (22/27), P < 0.001) than IMCCs of LR-M (n = 27). CONCLUSION: Using LI-RADS, the majority of IMCCs can be accurately categorized as LR-M on gadoxetic acid-enhanced MRI; however, caution is warranted, as some atypical IMCCs may be assigned as LR-5/5v resulting in a false-positive diagnosis of HCC. J. Magn. Reson. Imaging 2016;44:1330-1338.
Authors: Sun Kyung Jeon; Ijin Joo; Dong Ho Lee; Sang Min Lee; Hyo-Jin Kang; Kyoung-Bun Lee; Jeong Min Lee Journal: Eur Radiol Date: 2018-06-28 Impact factor: 5.315
Authors: Daniel R Ludwig; Tyler J Fraum; Roberto Cannella; David H Ballard; Richard Tsai; Muhammad Naeem; Maverick LeBlanc; Amber Salter; Allan Tsung; Anup S Shetty; Amir A Borhani; Alessandro Furlan; Kathryn J Fowler Journal: Abdom Radiol (NY) Date: 2019-06