Relationship between pattern of tumor enhancement and clinicopathologic characteristics in intrahepatic cholangiocarcinoma.
OBJECTIVE
Common enhancement pattern of intrahepatic cholangiocarcinoma (ICC) on computed tomography (CT) is that of hypovascular enhancement; however, in some cases, tumor shows identical enhancement in the arterial phase to that in hepatocellular carcinoma. To identify the specific characteristics of different enhancement patterns, we examined the relationship between CT enhancement pattern and clinicopathological features or postoperative prognosis.


METHODS
Subjects were 43 consecutive ICC patients who had undergone hepatectomy. Enhancement patterns were divided into two types: hypovascular or delayed enhancement (Type A), and early enhancement in the arterial phase (Type B).


RESULTS
Type A enhancement was observed in 23 patients and Type B in 20. Accompanying chronic viral hepatitis was significantly more frequent in Type B than Type A. Well-differentiated adenocarcinoma was significantly more frequent in Type B than Type A. Multiple tumors were significantly more frequent in Type A than Type B. Japanese TNM stage I and II was more frequent in patients with Type B than those with Type A. Disease-free or overall survival was significantly better in patients with Type B than those with Type A.


CONCLUSIONS
Early enhancement in the arterial phase might be a useful indicator of lower malignant potential and better survival in ICC patients.
Nanashima
Atsushi
A
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@net.nagasaki-u.ac.jp
Sumida
Yorihisa
Y
Abo
Takafumi
T
Oikawa
Masayuki
M
Murakami
Goshi
G
Takeshita
Hiroaki
H
Fukuoka
Hidetoshi
H
Hidaka
Shigekazu
S
Nagayasu
Takeshi
T
Sakamoto
Ichiro
I
Sawai
Terumitsu
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000098:blood supply / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology* / Q000601:surgery; D018281:Cholangiocarcinoma / Q000098:blood supply / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006498:Hepatectomy; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D007089:Image Enhancement; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol