title: Intrahepatic mass-forming cholangiocarcinoma: enhancement pattern on Gd-BOPTA-MRI with emphasis of hepatobiliary phase.
abstract: OBJECTIVE
  To describe the Gd-BOPTA MRI findings of intrahepatic mass-forming type cholangiocarcinomas (IMCs), with emphasis on the hepatobiliary phase (HBP).
  
  
  METHODS
  We reviewed retrospectively 29 IMC patients who underwent Gd-BOPTA-MRI between June, 2004 and June, 2014. Images were acquired prior to, and after, administration of 15-20 mL of Gd-BOPTA in the dynamic phase (arterial phase, portal venous phase, and 3-5 min phase), 10-15-min late phase, and 2-3 h HBP phase.
  
  
  RESULTS
  In the dynamic phase, 27 (93%) lesions showed a peripheral rim-like enhancement in the arterial and portal venous phases, followed by progressive filling-in on the delayed images. In 14 (56%) cases, a hypointense peripheral rim was identified in the 10-15-min late phase, delineating a target pattern. In the HBP, the cholangiocarcinoma showed a diffuse, mainly central and inhomogeneous enhancement (cloud of enhancement) in 28 (96%) patients; in 23 (79%) cases, there was an association between cloud appearance and a hypointense peripheral rim, showing a target pattern.
  
  
  CONCLUSIONS
  Gd-BOPTA MRI pattern of IMC on dynamic study is similar to that of conventional extracellular agents, that is peripheral enhancement with progressive and concentric filling of contrast material on delayed phases. At 10-15 min delayed phases, IMC shows often a peripheral hypointense rim consistent with a target appearance. In the HBP, due to progressive central enhancement (cloud) and peripheral hypointense rim, an higher number of tumors show a target appearance; this pattern is not specific and would also be expected to be seen in metastases from adenocarcinoma.
authors.affiliation: Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT) - University of Pittsburgh Medical Center (UPMC), Via Ernesto Tricomi 5, 90127, Palermo, Italy. gmamone@ismett.edu.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mamone
authors.affiliation: Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT) - University of Pittsburgh Medical Center (UPMC), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Marrone
authors.affiliation: Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT) - University of Pittsburgh Medical Center (UPMC), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors.forename: Settimo
authors.initials: S
authors.lastname: Caruso
authors.affiliation: Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT) - University of Pittsburgh Medical Center (UPMC), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Carollo
authors.affiliation: Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT) - University of Pittsburgh Medical Center (UPMC), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gentile
authors.affiliation: Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT) - University of Pittsburgh Medical Center (UPMC), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Crino'
authors.affiliation: Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT) - University of Pittsburgh Medical Center (UPMC), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors.forename: Mariapina
authors.initials: M
authors.lastname: Milazzo
authors.affiliation: Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT) - University of Pittsburgh Medical Center (UPMC), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Luca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology*; D001652:Bile Ducts / Q000473:pathology; D018281:Cholangiocarcinoma / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008099:Liver; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine
keywords: Gd-BOPTA; Hepatobiliary phase (HBP); Intrahepatic mass-forming cholangiocarcinoma (IMC); Liver; MRI