title: Intratumoral artery on contrast-enhanced computed tomography imaging: differentiating intrahepatic cholangiocarcinoma from poorly differentiated hepatocellular carcinoma.
abstract: OBJECTIVE
  Differentiating intrahepatic cholangiocarcinoma (ICC) from poorly differentiated hepatocellular carcinoma (p-HCC) is often difficult, but it is important for providing appropriate treatments. The purpose of this study was to examine the features differentiating ICC from p-HCC on contrast-enhanced dynamic-computed tomography (CT).
  
  
  METHODS
  This study examined 42 patients with pathologically confirmed ICC (n = 19) or p-HCC (n = 23) for which contrast-enhanced dynamic CT data were available. CT images were analyzed for enhancement patterns during the arterial phase, washout pattern, delayed enhancement, satellite nodules, capsular retraction, lesion shape, and presence of an intratumoral hepatic artery, intratumoral hepatic vein, intratumoral portal vein, and bile duct dilation around the tumor, portal vein tumor thrombus, lobar atrophy, or lymphadenopathy.
  
  
  RESULTS
  Univariate analysis revealed the presence of rim enhancement (p = 0.037), lobulated shape (p = 0.004), intratumoral artery (p < 0.001), and bile duct dilation (p = 0.006) as parameters significantly favoring ICC, while a washout pattern significantly favored p-HCC (p < 0.001). Multivariate analysis revealed intratumoral artery as a significant, independent variable predictive of ICC (p = 0.037), and 15 ICCs (78.9%) showed this feature. Washout pattern was a significant, independent variable favoring p-HCC (p = 0.049), with 15 p-HCCs (65.2%) showing this feature.
  
  
  CONCLUSIONS
  The presence of an intratumoral artery in the arterial phase on contrast-enhanced dynamic CT was a predictable finding for ICC, and the presence of a washout pattern was a predictable finding for p-HCC, differentiating between ICC and p-HCC.
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Tsunematsu
authors.forename: Makoto
authors.initials: M
authors.lastname: Chuma
authors.forename: Toshiya
authors.initials: T
authors.lastname: Kamiyama
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Miyamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yabusaki
authors.forename: Kanako
authors.initials: K
authors.lastname: Hatanaka
authors.forename: Tomoko
authors.initials: T
authors.lastname: Mitsuhashi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kamachi
authors.forename: Hideki
authors.initials: H
authors.lastname: Yokoo
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kakisaka
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Tsuruga
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Orimo
authors.forename: Kenji
authors.initials: K
authors.lastname: Wakayama
authors.forename: Jun
authors.initials: J
authors.lastname: Ito
authors.forename: Fumiyuki
authors.initials: F
authors.lastname: Sato
authors.forename: Katsumi
authors.initials: K
authors.lastname: Terashita
authors.forename: Masato
authors.initials: M
authors.lastname: Nakai
authors.forename: Yoko
authors.initials: Y
authors.lastname: Tsukuda
authors.forename: Takuya
authors.initials: T
authors.lastname: Sho
authors.forename: Goki
authors.initials: G
authors.lastname: Suda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Morikawa
authors.forename: Mitsuteru
authors.initials: M
authors.lastname: Natsuizaka
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Koji
authors.initials: K
authors.lastname: Ogawa
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Matsuno
authors.forename: Naoya
authors.initials: N
authors.lastname: Sakamoto
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging*; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media