Dataset Information

Differentiating peripheral cholangiocarcinoma in stages T1N0M0 and T2N0M0 from hepatic hypovascular nodules using dynamic contrast-enhanced MRI.

ABSTRACT: Because cholangiocarcinoma shows no specific clinical signs or symptoms and presents with non-specific biological and tumor markers in the early stages, MRI findings often lack typical features before this lesion becomes symptomatic and might be mistaken for other liver lesions. An evaluation of relevant radiological findings in nodular cholangiocarcinoma (≤3 cm) in stages T1N0M0 and T2N0M0 is urgently needed. In our study, we compared two groups of liver hypovascular nodules and found that a distinct margin and enhanced area/nodule size >2/3 in the delayed phase were more frequently observed in cholangiocarcinoma cases than in metastatic nodule cases in which markedly high signal intensity on T2WI was common (p < 0.05). The results also revealed that in the both the portal and delayed phases, an enhanced area/nodule size >2/3 favored cholangiocarcinoma, whereas the presence of regional markedly higher SI on T2WI favored benign nodules. Furthermore, signs of peripheral washout in the delayed phase only appeared in cholangiocarcinoma cases.

SUBMITTER: Li S

PROVIDER: S-EPMC5556016 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Differentiating peripheral cholangiocarcinoma in stages T1N0M0 and T2N0M0 from hepatic hypovascular nodules using dynamic contrast-enhanced MRI.

Li Shihong S Qian Haizhen H Peng Yu Y Jia Huihui H Lin Guangwu G

Scientific reports 20170814 1

Because cholangiocarcinoma shows no specific clinical signs or symptoms and presents with non-specific biological and tumor markers in the early stages, MRI findings often lack typical features before this lesion becomes symptomatic and might be mistaken for other liver lesions. An evaluation of relevant radiological findings in nodular cholangiocarcinoma (≤3 cm) in stages T1N0M0 and T2N0M0 is urgently needed. In our study, we compared two groups of liver hypovascular nodules and found that a di ...[more]

PMID: 28808285

Similar Datasets

Project description:BackgroundPeripheral nodular cholangiocarcinoma (PCC) and hepatic hemangioma (HG) significantly differ in treatment strategies and prognosis. However, they can present similar imaging characteristics, making them difficult to distinguish. The distinction between PCC and atypical HG using pre-operative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) holds substantial significance.MethodsFifty-four cases of solitary hypovascular hepatic nodules (nodules ≤3 cm in diameter and enhancement not exceeding the hepatic parenchyma) confirmed pathologically were collected, including 25 cases of PCC and 29 cases of HG. The clinical and DCE-MRI features were observed, and the apparent diffusion coefficient (ADC) values were compared. The t-test or Fisher's exact test was used to compare the differences between the two groups. Receiver operating characteristic (ROC) curve analysis was performed on the diagnostic results of the two readings before and after the study by three diagnostic physicians.ResultsThe signal of PCC was more heterogeneous and could be shown as a ring hyperintensity signal on diffusion weighted imaging (DWI). The T2-weighted imaging (T2WI) signal of HG lesions showed a more homogeneous high-intense signal. The ADC value of PCC patients was lower than that of HG patients. Most of the patients in the two groups presented marginal enhancement in the arterial phase with infrequent abnormal perfusion around. The intratumoral vascular traversal signs in the PCC group showed a diagnostic significance. Among the lesions with marginal enhancement at arterial stage, the enhancement in PCC group was more likely to have annular enhancement with the main manifestation of delay reduction and nebulous or separated/astral center. On the other hand, HG tended to be more likely to have nodular enhancement in the arterial phase with delayed invariance at the margins and with no significant enhancement at the center. The area under the curves (AUC) of the three radiologists before and after the two readings were 0.645 and 0.888, respectively.ConclusionsIn the differentiation of PCC and atypical liver hemangioma, the presence of a circular hyper-intense signal in DWI, the ADC values, and the pattern and extent of enhancement of marginal and central lesions were of diagnostic significance.

Project description:ObjectiveThis study aims to investigate the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis and risk stratification of ACR TI-RADS category 4 and 5 thyroid nodules with non-hypovascular.MethodsFrom January 2016 to December 2019 in our hospital, 217 ACR TI-RADS category 4 and 5 nodules with non-hypovascular in 210 consecutive patients were included for a derivation cohort. With surgery and/or fine-needle aspiration (FNA) as a reference, conventional ultrasound (US) features and CEUS features were analyzed. Multivariate logistic regression analysis was used to screen the independent risk factors and establish a risk predictive model. Between January 2020 and March 2021, a second cohort of 100 consecutive patients with 101 nodules were included for an external validation cohort. The model was converted into a simplified risk score and was validated in the validation cohort. The area under the receiver operating characteristic curves (AUC) were used to assess the models' diagnostic performance.ResultsMicro-calcification, irregular margin, earlier wash-out, centripetal enhancement, and absence of ring enhancement were independent risk factors and strongly discriminated malignancy in the derivation cohort (AUC = 0.921, 95% CI 0.876-0.953) and the validation cohort (0.900, 0.824-0.951). There was no significant difference (P = 0.3282) between the conventional US and CEUS in differentiating malignant non-hypovascular thyroid nodules, but a combination of them (the predictive model) had better performance than the single method (all P <0.05), with a sensitivity of 87.0%, specificity of 86.2%, and accuracy of 86.6% in the derivation cohort. The risk score based on the independent risk factors divided non-hypovascular thyroid nodules into low-suspicious (0-3 points; malignancy risk <50%) and high-suspicious (4-7 points; malignancy risk ≥ 50%), the latter with nodule ≥10mm was recommended for FNA. The risk score showed a good ability of risk stratification in the validation cohort. Comparing ACR TI-RADS in screening suitable non-hypovascular nodules for FNA, the risk score could avoid 30.8% benign nodules for FNA.ConclusionsCEUS is helpful in combination with conventional US in differentiating ACR TI-RADS category 4 and 5 nodules with non-hypovascular. The risk score in this study has the potential to improve the diagnosis and risk stratification of non-hypovascular thyroid nodules.

Project description:BackgroundAlterations in the vascular microenvironment of cancer have gradually gained widespread attention in oncology research, and early qualitative diagnosis using noninvasive examination techniques is crucial in clinical practice. This study aimed to explore the value of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the assessment of vascular architecture of solid solitary pulmonary nodules (SSPNs).MethodsDCE-MRI scan images of a total of 79 patients with SSPNs from November 2021 to December 2023 were prospectively analyzed. Quantitative permeability parameters Ktrans, Kep, and Ve values of the lesions were measured, labeled immunohistochemically with CD31 microvessel density (CD31-MVD), smooth muscle actin microvessel density (SMA-MVD), and vascular endothelial growth factor (VEGF), and quantitative values of vascular architectural parameters were obtained using the image analysis software Image-J. The diagnostic efficacy of quantitative permeability parameters for the diagnosis of malignant SSPNs was analyzed by receiver operating characteristic (ROC) curves using surgical pathology findings as the gold standard for the diagnosis of malignant SSPNs. Spearman's correlation analysis was used to evaluate the relationship between quantitative permeability parameters and vascular construct parameters.ResultsThe study included 51 female patients (64.6%) with a mean age of 50.5±11.5 years. Only 21 patients (26.6%) had a smoking history, and 30 patients (38.0%) had a normal weight. Statistically significant differences were found between benign and malignant SSPNs subgroups in Ktrans and Ve values in quantitative permeability parameters, and in SMA-MVD and microvascular perfusion index (MPI) in vascular conformation parameters (P<0.05). Ktrans and Ve values showed high diagnostic value for malignant SSPNs [area under the curve (AUC), 0.813 and 0.759]. Ktrans, Kep, and Ve were significantly positively correlated with CD31-MVD, with r-values of 0.857, 0.830, and 0.798 (P<0.05); they were also significantly positively correlated with VEGF, with r-values of 0.851, 0.859, and 0.764 (P<0.05); and Ktrans and Kep were significantly negatively correlated with MPI, with r-values were -0.779 and -0.864 (P<0.05).ConclusionsThe quantitative permeability parameters of DCE-MRI correlate with some of the vascular architectural parameters, and magnetic resonance image-based quantification of pulmonary nodal vascular architecture provides a noninvasive method for the differential diagnosis of SSPNs.

Project description:Background and purposeEarly assessment of treatment response is critical in patients with glioblastomas. A combination of DTI and DSC perfusion imaging parameters was evaluated to distinguish glioblastomas with true progression from mixed response and pseudoprogression.Materials and methodsForty-one patients with glioblastomas exhibiting enhancing lesions within 6 months after completion of chemoradiation therapy were retrospectively studied. All patients underwent surgery after MR imaging and were histologically classified as having true progression (>75% tumor), mixed response (25%-75% tumor), or pseudoprogression (<25% tumor). Mean diffusivity, fractional anisotropy, linear anisotropy coefficient, planar anisotropy coefficient, spheric anisotropy coefficient, and maximum relative cerebral blood volume values were measured from the enhancing tissue. A multivariate logistic regression analysis was used to determine the best model for classification of true progression from mixed response or pseudoprogression.ResultsSignificantly elevated maximum relative cerebral blood volume, fractional anisotropy, linear anisotropy coefficient, and planar anisotropy coefficient and decreased spheric anisotropy coefficient were observed in true progression compared with pseudoprogression (P < .05). There were also significant differences in maximum relative cerebral blood volume, fractional anisotropy, planar anisotropy coefficient, and spheric anisotropy coefficient measurements between mixed response and true progression groups. The best model to distinguish true progression from non-true progression (pseudoprogression and mixed) consisted of fractional anisotropy, linear anisotropy coefficient, and maximum relative cerebral blood volume, resulting in an area under the curve of 0.905. This model also differentiated true progression from mixed response with an area under the curve of 0.901. A combination of fractional anisotropy and maximum relative cerebral blood volume differentiated pseudoprogression from nonpseudoprogression (true progression and mixed) with an area under the curve of 0.807.ConclusionsDTI and DSC perfusion imaging can improve accuracy in assessing treatment response and may aid in individualized treatment of patients with glioblastomas.

Project description:ObjectiveThe purpose of this study was to validate a kinetic assessment based on visually identified peak enhancement, which is routinely used in clinical practice, for differentiating benign from malignant lesions during fast dynamic contrast-enhanced MRI.Materials and methodsBetween January 2015 and December 2016, 90 consecutively registered patients with 105 breast lesions (40 benign, 65 malignant) underwent dynamic contrast-enhanced 1.5-T MRI that included one unenhanced and eight contrast-enhanced fast temporal resolution (10 seconds) whole-breast acquisitions. Histogram analysis was performed to measure the voxel-based enhancement of the entire lesion to obtain 90th, 75th, and 50th percentile values at each time point and to generate kinetic curves. Two observers selected visually identified peak enhancement within the lesions to generate the kinetic curves. The kinetic curves from histogram and visually identified peak enhancement analyses were fitted by means of an empiric mathematic model (EMM): ΔS(t) = A × (1 - e-αt), where A is the upper limit of signal intensity, e indicates the exponential function, and α (min-1) is the rate of increase in signal intensity. The initial slope of the kinetic curve (A × α) and the initial AUC (AUC30) were calculated. These parameters were compared between benign and malignant lesions, and results from visually identified peak enhancement analysis were compared with those from histogram analysis.ResultsBenign lesions were successfully differentiated from malignant lesions in both visually identified peak enhancement and histogram analyses (90th and 75th percentile values) on the basis of α, A × α, and AUC30 from the EMM. There was no significant difference in ROC AUC in these EMM parameters between visually identified peak enhancement and histogram analyses (p = 0.21).ConclusionKinetic assessment with visually identified peak enhancement was acceptable for differentiating benign from malignant lesions.

Dataset Information

Differentiating peripheral cholangiocarcinoma in stages T1N0M0 and T2N0M0 from hepatic hypovascular nodules using dynamic contrast-enhanced MRI.

Publications

Differentiating peripheral cholangiocarcinoma in stages T1N0M0 and T2N0M0 from hepatic hypovascular nodules using dynamic contrast-enhanced MRI.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets