Distinguishing intrahepatic cholangiocarcinoma from hepatocellular carcinoma in patients with and without risks: the evaluation of the LR-M criteria of contrast-enhanced ultrasound liver imaging reporting and data system version 2017

Fei Li, Qing Li, Yubo Liu, Jing Han, Wei Zheng, Yini Huang, Xueyi Zheng, Longhui Cao, Jian hua Zhou

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To assess the diagnostic performance of the LR-M criteria of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System version 2017 in differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC) in patients with and without risk factors for HCC. Methods: Fifty-four ICC in patients with risks and 55 ICC in patients without risks and matched control cases of HCC with and without risks (n = 59 and n = 55, respectively) were enrolled. The enhanced features of the lesions were retrospectively analyzed according to LR-M criteria. The diagnostic performances including the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of LR-M criteria were assessed. Result: Peripheral rim-like hyperenhancement, early washout (< 45 or 60s), and marked washout did not differ between ICCs with and without risks, while all of these features were more common in ICCs than in HCCs (p < 0.05) no matter if patients were with and without risk factors. Using the LR-M criteria to differentiate ICC from HCC, the AUC, sensitivity, specificity, and accuracy were 0.92, 97.25%, 87.72%, and 92.38%, respectively. If early washout onset was adjusted to < 45 s, the specificity was significantly increased to 95.61% (p = 0.004) without losing sensitivity (96.33%, p = 0.945). The rate of HCCs misdiagnosed as ICCs would decrease from 12.3 to 4.4%. Conclusion: Although the LR-M criteria showed high sensitivity in distinguishing ICCs from HCCs in patients with and without risks, the specificity would be significantly increased after adjustments to current criteria. Key Points: • The LR-M criteria of CEUS-LI-RADS v2017 could be used for distinguishing ICC from HCC not only in patients with risk factors for HCC but also in those without risk factors. • The diagnostic performance of differentiating ICC from HCC by using the LR-M criteria showed high AUC (0.92), high sensitivity (97.25%), intermediate specificity (87.72%), and high accuracy (92.38%). • If the onset of early washout was adjusted to < 45 s, the specificity was significantly increased from 87.72 to 95.61% (p = 0.004) without losing sensitivity (p = 0.945), and the rate of HCCs misdiagnosed as ICCs would decrease from 12.3 to 4.4%.

Original languageEnglish (US)
Pages (from-to)461-470
Number of pages10
JournalEuropean Radiology
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2020

Fingerprint

Cholangiocarcinoma
Information Systems
Hepatocellular Carcinoma
Ultrasonography
Liver
Area Under Curve
Diagnostic Errors
Sensitivity and Specificity
ROC Curve

Keywords

  • Contrast media
  • Hepatocellular carcinoma
  • Intrahepatic cholangiocarcinoma
  • Ultrasonography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Distinguishing intrahepatic cholangiocarcinoma from hepatocellular carcinoma in patients with and without risks : the evaluation of the LR-M criteria of contrast-enhanced ultrasound liver imaging reporting and data system version 2017. / Li, Fei; Li, Qing; Liu, Yubo; Han, Jing; Zheng, Wei; Huang, Yini; Zheng, Xueyi; Cao, Longhui; Zhou, Jian hua.

In: European Radiology, Vol. 30, No. 1, 01.01.2020, p. 461-470.

Research output: Contribution to journalArticle

@article{cbb7fc30c6c54dcda65a27abedc7ff99,
title = "Distinguishing intrahepatic cholangiocarcinoma from hepatocellular carcinoma in patients with and without risks: the evaluation of the LR-M criteria of contrast-enhanced ultrasound liver imaging reporting and data system version 2017",
abstract = "Purpose: To assess the diagnostic performance of the LR-M criteria of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System version 2017 in differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC) in patients with and without risk factors for HCC. Methods: Fifty-four ICC in patients with risks and 55 ICC in patients without risks and matched control cases of HCC with and without risks (n = 59 and n = 55, respectively) were enrolled. The enhanced features of the lesions were retrospectively analyzed according to LR-M criteria. The diagnostic performances including the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of LR-M criteria were assessed. Result: Peripheral rim-like hyperenhancement, early washout (< 45 or 60s), and marked washout did not differ between ICCs with and without risks, while all of these features were more common in ICCs than in HCCs (p < 0.05) no matter if patients were with and without risk factors. Using the LR-M criteria to differentiate ICC from HCC, the AUC, sensitivity, specificity, and accuracy were 0.92, 97.25{\%}, 87.72{\%}, and 92.38{\%}, respectively. If early washout onset was adjusted to < 45 s, the specificity was significantly increased to 95.61{\%} (p = 0.004) without losing sensitivity (96.33{\%}, p = 0.945). The rate of HCCs misdiagnosed as ICCs would decrease from 12.3 to 4.4{\%}. Conclusion: Although the LR-M criteria showed high sensitivity in distinguishing ICCs from HCCs in patients with and without risks, the specificity would be significantly increased after adjustments to current criteria. Key Points: • The LR-M criteria of CEUS-LI-RADS v2017 could be used for distinguishing ICC from HCC not only in patients with risk factors for HCC but also in those without risk factors. • The diagnostic performance of differentiating ICC from HCC by using the LR-M criteria showed high AUC (0.92), high sensitivity (97.25{\%}), intermediate specificity (87.72{\%}), and high accuracy (92.38{\%}). • If the onset of early washout was adjusted to < 45 s, the specificity was significantly increased from 87.72 to 95.61{\%} (p = 0.004) without losing sensitivity (p = 0.945), and the rate of HCCs misdiagnosed as ICCs would decrease from 12.3 to 4.4{\%}.",
keywords = "Contrast media, Hepatocellular carcinoma, Intrahepatic cholangiocarcinoma, Ultrasonography",
author = "Fei Li and Qing Li and Yubo Liu and Jing Han and Wei Zheng and Yini Huang and Xueyi Zheng and Longhui Cao and Zhou, {Jian hua}",
year = "2020",
month = "1",
day = "1",
doi = "10.1007/s00330-019-06317-2",
language = "English (US)",
volume = "30",
pages = "461--470",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",
number = "1",

}

TY - JOUR

T1 - Distinguishing intrahepatic cholangiocarcinoma from hepatocellular carcinoma in patients with and without risks

T2 - the evaluation of the LR-M criteria of contrast-enhanced ultrasound liver imaging reporting and data system version 2017

AU - Li, Fei

AU - Li, Qing

AU - Liu, Yubo

AU - Han, Jing

AU - Zheng, Wei

AU - Huang, Yini

AU - Zheng, Xueyi

AU - Cao, Longhui

AU - Zhou, Jian hua

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Purpose: To assess the diagnostic performance of the LR-M criteria of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System version 2017 in differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC) in patients with and without risk factors for HCC. Methods: Fifty-four ICC in patients with risks and 55 ICC in patients without risks and matched control cases of HCC with and without risks (n = 59 and n = 55, respectively) were enrolled. The enhanced features of the lesions were retrospectively analyzed according to LR-M criteria. The diagnostic performances including the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of LR-M criteria were assessed. Result: Peripheral rim-like hyperenhancement, early washout (< 45 or 60s), and marked washout did not differ between ICCs with and without risks, while all of these features were more common in ICCs than in HCCs (p < 0.05) no matter if patients were with and without risk factors. Using the LR-M criteria to differentiate ICC from HCC, the AUC, sensitivity, specificity, and accuracy were 0.92, 97.25%, 87.72%, and 92.38%, respectively. If early washout onset was adjusted to < 45 s, the specificity was significantly increased to 95.61% (p = 0.004) without losing sensitivity (96.33%, p = 0.945). The rate of HCCs misdiagnosed as ICCs would decrease from 12.3 to 4.4%. Conclusion: Although the LR-M criteria showed high sensitivity in distinguishing ICCs from HCCs in patients with and without risks, the specificity would be significantly increased after adjustments to current criteria. Key Points: • The LR-M criteria of CEUS-LI-RADS v2017 could be used for distinguishing ICC from HCC not only in patients with risk factors for HCC but also in those without risk factors. • The diagnostic performance of differentiating ICC from HCC by using the LR-M criteria showed high AUC (0.92), high sensitivity (97.25%), intermediate specificity (87.72%), and high accuracy (92.38%). • If the onset of early washout was adjusted to < 45 s, the specificity was significantly increased from 87.72 to 95.61% (p = 0.004) without losing sensitivity (p = 0.945), and the rate of HCCs misdiagnosed as ICCs would decrease from 12.3 to 4.4%.

AB - Purpose: To assess the diagnostic performance of the LR-M criteria of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System version 2017 in differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC) in patients with and without risk factors for HCC. Methods: Fifty-four ICC in patients with risks and 55 ICC in patients without risks and matched control cases of HCC with and without risks (n = 59 and n = 55, respectively) were enrolled. The enhanced features of the lesions were retrospectively analyzed according to LR-M criteria. The diagnostic performances including the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of LR-M criteria were assessed. Result: Peripheral rim-like hyperenhancement, early washout (< 45 or 60s), and marked washout did not differ between ICCs with and without risks, while all of these features were more common in ICCs than in HCCs (p < 0.05) no matter if patients were with and without risk factors. Using the LR-M criteria to differentiate ICC from HCC, the AUC, sensitivity, specificity, and accuracy were 0.92, 97.25%, 87.72%, and 92.38%, respectively. If early washout onset was adjusted to < 45 s, the specificity was significantly increased to 95.61% (p = 0.004) without losing sensitivity (96.33%, p = 0.945). The rate of HCCs misdiagnosed as ICCs would decrease from 12.3 to 4.4%. Conclusion: Although the LR-M criteria showed high sensitivity in distinguishing ICCs from HCCs in patients with and without risks, the specificity would be significantly increased after adjustments to current criteria. Key Points: • The LR-M criteria of CEUS-LI-RADS v2017 could be used for distinguishing ICC from HCC not only in patients with risk factors for HCC but also in those without risk factors. • The diagnostic performance of differentiating ICC from HCC by using the LR-M criteria showed high AUC (0.92), high sensitivity (97.25%), intermediate specificity (87.72%), and high accuracy (92.38%). • If the onset of early washout was adjusted to < 45 s, the specificity was significantly increased from 87.72 to 95.61% (p = 0.004) without losing sensitivity (p = 0.945), and the rate of HCCs misdiagnosed as ICCs would decrease from 12.3 to 4.4%.

KW - Contrast media

KW - Hepatocellular carcinoma

KW - Intrahepatic cholangiocarcinoma

KW - Ultrasonography

UR - http://www.scopus.com/inward/record.url?scp=85069689231&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85069689231&partnerID=8YFLogxK

U2 - 10.1007/s00330-019-06317-2

DO - 10.1007/s00330-019-06317-2

M3 - Article

C2 - 31297632

AN - SCOPUS:85069689231

VL - 30

SP - 461

EP - 470

JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 1

ER -