Evaluation of Combined Hepatocellular-cholangiocarcinoma Using CEUS LI-RADS: Correlation with Pathological Characteristics

Overview

Journal Abdom Radiol (NY)

Publisher Springer

Specialties Gastroenterology
Radiology

Date 2024 Aug 16

PMID 39150545

Authors

Jingwen Bao

Zehua Nie

Quanwen Wang

Yanling Chen

Kun Wang

Xinjiang Liu

Affiliations

Soon will be listed here.

Abstract

Objective: To explore the factors that influence the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) classification of combined hepatocellular-cholangiocarcinoma (cHCC-ICC).

Methods: Between September 2014 to July 2020, the CEUS features of 58 patients with pathologically confirmed cHCC-ICC were retrospectively evaluated and assigned according to the CEUS LI-RADS (version 2017). The pathological characteristics of nodules categorizing as different CEUS LI-RADS categories were compared. Multivariate logistic regression analysis was conducted to explore potential factors that may influence the CEUS LI-RADS classification of cHCC-ICC.

Results: According to CEUS LI-RADS, 32.8% (19/58), 63.8% (37/58), and 3.4% (2/58) were categorized as LR-5, LR-M, and LR-TIV, respectively. There was significant difference between the LR-M and LR-5 groups with regard to the pathological grade, nodule size, and HCC/ICC-component ratio of cHCC-ICC. Multivariate logistic regression analysis identified tumor size and the relative proportions of hepatocellular carcinomas (HCC) and intrahepatic cholangiocarcinomas (ICC) components as the independent influencing factors.

Conclusion: Tumor size and the relative proportion of HCC and ICC components within the nodule had a significant impact on the CEUS LI-RADS classification of cHCC-ICC.

References

Beaufrere A, Calderaro J, Paradis V . Combined hepatocellular-cholangiocarcinoma: An update. J Hepatol. 2021; 74(5):1212-1224. DOI: 10.1016/j.jhep.2021.01.035. View

Akiba J, Nakashima O, Hattori S, Tanikawa K, Takenaka M, Nakayama M . Clinicopathologic analysis of combined hepatocellular-cholangiocarcinoma according to the latest WHO classification. Am J Surg Pathol. 2013; 37(4):496-505. DOI: 10.1097/PAS.0b013e31827332b0. View

Wakizaka K, Yokoo H, Kamiyama T, Ohira M, Kato K, Fujii Y . Clinical and pathological features of combined hepatocellular-cholangiocarcinoma compared with other liver cancers. J Gastroenterol Hepatol. 2018; 34(6):1074-1080. DOI: 10.1111/jgh.14547. View

Song P, Midorikawa Y, Nakayama H, Higaki T, Moriguchi M, Aramaki O . Patients' prognosis of intrahepatic cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma after resection. Cancer Med. 2019; 8(13):5862-5871. PMC: 6792494. DOI: 10.1002/cam4.2495. View

Chi C, Chau G, Lee R, Chen Y, Lei H, Hou M . Radiological features and outcomes of combined hepatocellular-cholangiocarcinoma in patients undergoing surgical resection. J Formos Med Assoc. 2019; 119(1 Pt 1):125-133. DOI: 10.1016/j.jfma.2019.02.012. View

Yamashita Y, Aishima S, Nakao Y, Yoshizumi T, Nagano H, Kuroki T . Clinicopathological characteristics of combined hepatocellular cholangiocarcinoma from the viewpoint of patient prognosis after hepatic resection: High rate of early recurrence and its predictors. Hepatol Res. 2020; 50(7):863-870. DOI: 10.1111/hepr.13507. View

Holzner M, Tabrizian P, Parvin-Nejad F, Fei K, Gunasekaran G, Rocha C . Resection of Mixed Hepatocellular-Cholangiocarcinoma, Hepatocellular Carcinoma, and Intrahepatic Cholangiocarcinoma. Liver Transpl. 2020; 26(7):888-898. DOI: 10.1002/lt.25786. View

Gigante E, Ronot M, Bertin C, Ciolina M, Bouattour M, Dondero F . Combining imaging and tumour biopsy improves the diagnosis of combined hepatocellular-cholangiocarcinoma. Liver Int. 2019; 39(12):2386-2396. DOI: 10.1111/liv.14261. View

Kono Y, Lyshchik A, Cosgrove D, Dietrich C, Jang H, Kim T . Contrast Enhanced Ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS®): the official version by the American College of Radiology (ACR). Ultraschall Med. 2017; 38(1):85-86. DOI: 10.1055/s-0042-124369. View

10.

Huang J, Li J, Lu Q, Luo Y, Lin L, Shi Y . Diagnostic Accuracy of CEUS LI-RADS for the Characterization of Liver Nodules 20 mm or Smaller in Patients at Risk for Hepatocellular Carcinoma. Radiology. 2019; 294(2):329-339. DOI: 10.1148/radiol.2019191086. View

11.

Li J, Yang L, Ma L, Lu Q, Luo Y . Diagnostic Accuracy of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) for Differentiating Between Hepatocellular Carcinoma and Other Hepatic Malignancies in High-Risk Patients: A Meta-Analysis. Ultraschall Med. 2020; 42(2):187-193. DOI: 10.1055/a-1309-1568. View

12.

Li F, Li Q, Liu Y, Han J, Zheng W, Huang Y . 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. Eur Radiol. 2019; 30(1):461-470. DOI: 10.1007/s00330-019-06317-2. View

13.

Yang J, Huang J, Chen X, Ling W, Luo Y, Shi Y . Combined hepatocellular-cholangiocarcinoma: can we use contrast-enhanced ultrasound Liver Imaging Reporting and Data System (LI-RADS) to predict the patient's survival?. Eur Radiol. 2021; 31(8):6397-6405. DOI: 10.1007/s00330-020-07656-1. View

14.

Guo Y, Zhou S, Zhao B, Wen L, Liu M . Ultrasound Findings and O-RADS Malignancy Risk Stratification of Ovarian Collision Tumors. J Ultrasound Med. 2021; 41(9):2325-2331. DOI: 10.1002/jum.15919. View

15.

Ye J, Xie X, Lin Y, Liu B, Wang W, Huang X . Imaging features of combined hepatocellular-cholangiocarcinoma on contrast-enhanced ultrasound: correlation with clinicopathological findings. Clin Radiol. 2017; 73(3):237-243. DOI: 10.1016/j.crad.2017.10.003. View

16.

Li R, Yang D, Tang C, Cai P, Ma K, Ding S . Combined hepatocellular carcinoma and cholangiocarcinoma (biphenotypic) tumors: clinical characteristics, imaging features of contrast-enhanced ultrasound and computed tomography. BMC Cancer. 2016; 16:158. PMC: 4768404. DOI: 10.1186/s12885-016-2156-x. View

17.

Claudon M, Dietrich C, Choi B, Cosgrove D, Kudo M, Nolsoe C . Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver - update 2012: A WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol. 2012; 39(2):187-210. DOI: 10.1016/j.ultrasmedbio.2012.09.002. View

18.

Bartolotta T, Terranova M, Gagliardo C, Taibbi A . CEUS LI-RADS: a pictorial review. Insights Imaging. 2020; 11(1):9. PMC: 7000618. DOI: 10.1186/s13244-019-0819-2. View

19.

EDMONDSON H, STEINER P . Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies. Cancer. 1954; 7(3):462-503. DOI: 10.1002/1097-0142(195405)7:3<462::aid-cncr2820070308>3.0.co;2-e. View

20.

Martins-Filho S, Paiva C, Azevedo R, Alves V . Histological Grading of Hepatocellular Carcinoma-A Systematic Review of Literature. Front Med (Lausanne). 2017; 4:193. PMC: 5701623. DOI: 10.3389/fmed.2017.00193. View