European Radiology: These MRI findings in mixed hepatocellular carcinoma-cholangiocarcinoma suggest prognosis!

As a rare primary liver cancer, mixed hepatocellular carcinoma - cholangiocarcinoma (cHCC-CCA) contains both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) components .
The distinction between cHCC-CCA and HCC or CCA depends mainly on the histological composition of the tumor .
Although the imaging features of cHCC-CCA may be similar to HCC or CCA, diagnosis based on imaging alone is always challenging due to the heterogeneous features of cHCC-CCA and overlapping features with HCC and CCA .
Currently, surgical resection is the first choice for curative treatment of cHCC-CCA .

As a rare primary liver cancer, mixed hepatocellular carcinoma - cholangiocarcinoma (cHCC-CCA) contains both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) components .

The distinction between cHCC-CCA and HCC or CCA depends mainly on the histological composition of the tumor .
Although the imaging features of cHCC-CCA may be similar to HCC or CCA, diagnosis based on imaging alone is always challenging due to the heterogeneous features of cHCC-CCA and overlapping features with HCC and CCA .
Currently, surgical resection is the first choice for the diagnosis of cHCC-CCA .

It is well known that alpha-fetoprotein (AFP) and CA19-9 are the leading biomarkers for HCC and CCA
.

It has been suggested that AFP or CA19-9 can be used as independent indicators to evaluate the prognosis of patients with HCC or CCA after radical therapy

It is well known that alpha-fetoprotein (AFP) and CA19-9 are the leading biomarkers for HCC and CCA

Recently, a study published in the journal European Radiology conducted a comprehensive analysis of the relationship between the prognostic factors of RFS and OS and clinicopathological and imaging features in cHCC-CCA patients, and provided clinical recommendations for optimal treatment plan and evaluation of patient prognosis.
strong support .
 

This study included 160 patients with pathologically confirmed cHCC-CCA according to the 2019 WHO classification

A total of 160 patients were included (mean age, male and female: 55.
7 ± 10.
2 and 54.

 

Figure A 58-year-old male patient with cHCC - CCA .

An irregularly shaped tumor in the right lobe of the liver shows peripheral hyperintensity and central hypointensity on diffusion - weighted imaging ( a ) .
T1-weighted imaging (b) shows heterogeneous hypointense and hepatic capsule retraction (arrow) .

Figure A 58-year-old male patient with cHCC - CCA .
An irregularly shaped tumor in the right lobe of the liver shows peripheral hyperintensity and central hypointensity on diffusion - weighted imaging ( a ) .
T1-weighted imaging (b) shows heterogeneous hypointense and hepatic capsule retraction (arrow) .
Peripheral enhancement (arrow) and peritumoral enhancement (arrowhead) in the arterial phase on contrast- enhanced T1-weighted imaging (c), and peripheral washout (arrowhead) on the portal venous phase (d ) .
Multiple recurrences were found in this patient 15 months after surgery .
 Figure A 58-year-old male patient with cHCC - CCA .
An irregularly shaped tumor in the right lobe of the liver shows peripheral hyperintensity and central hypointensity on diffusion - weighted imaging ( a ) .
T1-weighted imaging (b) shows heterogeneous hypointense and liver capsule retracted (arrow)

The imaging features of mixed hepatocellular carcinoma-cholangiocarcinoma are complex and do not correspond exactly to AFP or CA 19-9 levels .
In addition, several features, including age, CA 19-9 >37 U/ml, perianeurysmal enhancement and delayed enhancement during the arterial phase were independent factors predicting lower recurrence-free survival .
In addition, periarterial enhancement was an independent predictor of lower overall survival in patients with mixed hepatocellular carcinoma-cholangiocarcinoma .

Original source :

Original source :

Changwu Zhou , Yi Wang , Li Ma ,et al .

Combined hepatocellular carcinoma-cholangiocarcinoma: MRI features correlated with tumor biomarkers and prognosis .
DOI : 10.
1007/s00330-021-08188-y

Changwu Zhou Yi Wang Li Ma ,et al Combined hepatocellular carcinoma-cholangiocarcinoma: MRI features correlated with tumor biomarkers and prognosis 10.
1007/s00330-021-08188-y 10.
1007/s00330-021-08188-y Leave a message here