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Radio-pathologic correlation of biphenotypic primary liver cancer (combined hepatocellular cholangiocarcinoma): changes in the 2019 WHO classification and impact on LI-RADS classification at liver MRI

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Abstract
Objectives To explain the new changes in pathologic diagnoses of biphenotypic primary liver cancer (PLC) according to the updated 2019 World Health Organization (WHO) classification and how it impacts Liver Imaging Reporting and Data System (LI-RADS) classification using gadoxetic acid-enhanced MRI (Gd-EOB-MRI). Methods We retrospectively included 209 patients with pathologically proven biphenotypic PLCs according to the 2010 WHO classification who had undergone preoperative Gd-EOB-MRI between January 2009 and December 2018. Imaging analysis including LI-RADS classification and pathologic review including the proportion of tumor components were performed. Frequencies of each diagnosis and subtype according to the 2010 and 2019 WHO classifications were compared, and changes in LI-RADS classification were evaluated. Univariable and multivariable analysis were performed to determine significant tumor component for LI-RADS classification. Results Of the 209 biphenotypic PLCs of the 2010 WHO classification, 177 (84.7%) were diagnosed as bipheonotypic PLCs, 25 (12.0%) as hepatocellular carcinomas (HCCs), and 7 (3.3%) as cholangiocarcinomas (CCAs) using the 2019 WHO classification. Of the 177 biphenotypic PLCs, LR-M, LR-4, and LR-5 were assigned in 77 (43.5%), 21 (11.9%), and 63 (35.5%), respectively. There were no significant differences in the proportion of LR-5 and LR-M categories between the WHO 2010 and 2019 classifications (p = 0.941). Proportion of HCC component was the only independent factor for LI-RADS classification (adjusted odds ratio, 1.02; p < 0.001). Conclusion According to the 2019 WHO classification, 15% of biphenotypic PLCs from the 2010 WHO classification were re-diagnosed as HCCs or CCAs, and a substantial proportion of biphenotypic PLCs of the 2019 WHO classification could be categorized as LR-4 or LR-5 on Gd-EOB-MRI.
Author(s)
강효진김혜령박양순이승수이정민정선경최상현허보연
Issued Date
2021
Type
Article
Keyword
Diagostic RadiologyHepatobiliary-PancreasImagingInernal MedicineInterventional RadiologyLiver cancerMagnetic resonance imagingMedicineMedicine &amp; Public HealthNeuroradiologyRadiologyUltrasound
DOI
10.1007/s00330-021-07984-w
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7432
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2532261286&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Radio-pathologic%20correlation%20of%20biphenotypic%20primary%20liver%20cancer%20(combined%20hepatocellular%20cholangiocarcinoma):%20changes%20in%20the%202019%20WHO%20classification%20and%20impact%20on%20LI-RADS%20classification%20at%20liver%20MRI&amp;offset=0&amp;pcAvailability=true
Publisher
EUROPEAN RADIOLOGY
Location
미국
Language
한국어
ISSN
0938-7994
Citation Volume
31
Citation Number
12
Citation Start Page
9479
Citation End Page
9488
Appears in Collections:
Medicine > Medicine
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