Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2020; 26(27): 3938-3951
Published online Jul 21, 2020. doi: 10.3748/wjg.v26.i27.3938
Can contrast enhanced ultrasound differentiate intrahepatic cholangiocarcinoma from hepatocellular carcinoma?
Jia-Yan Huang, Jia-Wu Li, Wen-Wu Ling, Tao Li, Yan Luo, Ji-Bin Liu, Qiang Lu
Jia-Yan Huang, Jia-Wu Li, Wen-Wu Ling, Yan Luo, Qiang Lu, Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Tao Li, Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Ji-Bin Liu, Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, United States
Author contributions: Lu Q, Luo Y, and Liu JB designed the research; Li JW and Ling WW performed the research; Huang JY, Li T, and Lu Q contributed to the analytical tools; Huang JY, Li JW, and Lu Q analyzed the data; Huang JY wrote the paper; Lu Q, Luo Y, and Liu JB revised and edited the manuscript.
Supported by National Natural Science Foundation of China, No. 81571697; Science and Technology Department of Sichuan Province, No. 2018FZ0044; 1.3.5 Project for Disciplines of Excellence, West China Hospital of Sichuan University, No. ZYJC18008.
Institutional review board statement: This study was reviewed and approved by West China Hospital of Sichuan University.
Informed consent statement: All patients gave informed consent to the study.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Qiang Lu, MD, Professor, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan Province, China.
Received: March 2, 2020
Peer-review started: March 2, 2020
First decision: April 25, 2020
Revised: May 9, 2020
Accepted: July 4, 2020
Article in press: July 4, 2020
Published online: July 21, 2020
Core Tip

Core tip: Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) differ in treatment and prognosis, warranting an effective differential diagnosis between them. The LR-M category in the contrast-enhanced ultrasound liver imaging reporting and data system was set up for lesions that are malignant but not specific to HCC. Our study demonstrated that rim arterial phase hyperenhancement (APHE) is a key predictor for differentiating ICC from LR-M HCC, whereas early washout and marked washout have limited value for differentiating them. Rim APHE plus elevated carbohydrate antigen 19-9 and normal alpha fetoprotein is a strong predictor of ICC rather than LR-M HCC.