Extracellular volume fraction using contrast-enhanced CT is useful in differentiating intrahepatic cholangiocellular carcinoma from hepatocellular carcinoma

Frontiers in Oncology

Oncology

S. Kobayashi¹  H. Eguchi¹  S. Tahara²  K. Yano³  H. Fukui⁴  T. Honda⁴  K. Kiso⁴  H. Onishi⁴  A. Nakamoto⁴  M. Tatsumi⁴  T. Tsuboyama⁴  N. Tomiyama⁴  T. Ota⁴ 

[1] Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan;Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan;Department of Radiology, Osaka Medical and Pharmaceutical University, Osaka, Japan;Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan;

关键词: extracellular space;    carcinoma;    hepatocellular;    cholangiocarcinoma;    multidetector computed tomography;    contrast media;   

DOI  :  10.3389/fonc.2023.1214977

 received in 2023-05-01, accepted in 2023-06-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesTo evaluate whether tumor extracellular volume fraction (fECV) on contrast-enhanced computed tomography (CT) aids in the differentiation between intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC).MethodsIn this retrospective study, 113 patients with pathologically confirmed ICC (n = 39) or HCC (n = 74) who had undergone preoperative contrast-enhanced CT were enrolled. Enhancement values of the tumor (Etumor) and aorta (Eaorta) were obtained in the precontrast and equilibrium phase CT images. fECV was calculated using the following equation: fECV [%] = Etumor/Eaorta × (100 – hematocrit [%]). fECV values were compared between the ICC and HCC groups using Welch’s t-test. The diagnostic performance of fECV for differentiating ICC and HCC was assessed using receiver-operating characteristic (ROC) analysis. fECV and the CT imaging features of tumors were evaluated by two radiologists. Multivariate logistic regression analysis was performed to identify factors predicting a diagnosis of ICC.ResultsMean fECV was significantly higher in ICCs (43.8% ± 13.2%) than that in HCCs (31.6% ± 9.0%, p < 0.001). The area under the curve for differentiating ICC from HCC was 0.763 when the cutoff value of fECV was 41.5%. The multivariate analysis identified fECV (unit OR: 1.10; 95% CI: 1.01–1.21; p < 0.05), peripheral rim enhancement during the arterial phase (OR: 17.0; 95% CI: 1.29–225; p < 0.05), and absence of washout pattern (OR: 235; 95% CI: 14.03–3933; p < 0.001) as independent CT features for differentiating between the two tumor types.ConclusionsA high value of fECV, peripheral rim enhancement during the arterial phase, and absence of washout pattern were independent factors in the differentiation of ICC from HCC.

【 授权许可】

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Copyright © 2023 Honda, Onishi, Fukui, Yano, Kiso, Nakamoto, Tsuboyama, Ota, Tatsumi, Tahara, Kobayashi, Eguchi and Tomiyama