Prognostic prediction of apparent diffusion coefficient obtained by diffusion‐weighted MRI in mass‐forming intrahepatic cholangiocarcinoma

Abstract

BackgroundWe evaluated apparent diffusion coefficient (ADC) of diffusion‐weighted image MRI as a prognostic factor for mass‐forming intrahepatic cholangiocarcinoma (IHCC).MethodsWe enrolled 26 patients who had undergone hepatic resections for mass‐forming‐type IHCC in this study, and calculated their mean ADC, using diffusion‐weighted image MRI (b: 0, 20, 800 seconds/mm2; 1.5 T MRI). Patients were divided into the ADCHigh and the ADCLow groups at the median ADC value (n = 13 for both). We also immunohistochemically evaluated hypoxia‐inducible factor (HIF)‐1α in tumor tissue.ResultsMedian age in the ADCLow was older (P = .03), and showed significant higher rate of scirrhous tumor (P = .02). The 5‐year overall survival rate in the ADCLow group was significantly worse than in the ADCHigh group (P = .04). In multivariate analysis, hilar tumor, portal vein invasion and low ADC were independent prognostic factors (P < .05). The ADCLow group also had a higher rate of high HIF‐1α expression than the ADCHigh group (P < .05). Representative case of ADCLow group showed rich stroma and high HIF‐1α expression.ConclusionsThe ADC values in MRIs can predict IHCC prognosis, and correlated with stromal density and HIF‐1α expression.

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Prognostic Implications of Lymphocyte/C-Reactive Protein Ratio With Tumor-Infiltrating Lymphocytes in Resected Intrahepatic Cholangiocarcinoma

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