Preoperative Diagnosis of Lymph Node Metastasis of Perihilar Cholangiocarcinoma Using Diffusion-Weighted Magnetic Resonance Imaging View Full Text


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Article Info

DATE

2022-05-31

AUTHORS

Isamu Hosokawa, Koichi Hayano, Katsunori Furukawa, Tsukasa Takayashiki, Satoshi Kuboki, Shigetsugu Takano, Hisahiro Matsubara, Masaru Miyazaki, Masayuki Ohtsuka

ABSTRACT

IntroductionAlthough the prognosis of patients with resected perihilar cholangiocarcinoma (PHC) with histological lymph node metastasis (LNM) is poor, preoperative prediction of LNM is difficult. This study aimed to evaluate the diagnostic performance of diffusion-weighted magnetic resonance imaging (DWI) for LNM of PHC.MethodConsecutive patients who underwent surgical resection of PHC between January 2012 and May 2020 were retrospectively reviewed. The lymph node (LN) area (mm2) and apparent diffusion coefficient (ADC) value ( × 10−3 mm2/s) of pericholedochal LNs were measured by DWI. The characteristics of the patients and the LNs were evaluated according to the histological presence or absence of regional LNM. Univariate and multivariate analyses were performed to identify the predictors of LNM of PHC.ResultsOf the 93 eligible patients, 49 (53%) were LNM positive and 44 (47%) were LNM negative. Although the characteristics of the patients were similar between the two groups, the mean ADC value was significantly lower in the LNM positive group than in the LNM negative group. On multivariate analysis, mean ADC value ≤1.80 × 10−3 mm2/s was independently associated with LNM of PHC (risk ratio: 12.5, 95% confidence interval: 3.05–51.4; p = 0.0004). The sensitivity, specificity and accuracy of mean ADC values ≤ 1.80 × 10−3 mm2/s for predicting LNM of PHC were 94%, 55% and 75%, respectively.ConclusionsDWI might be useful for the preoperative diagnosis of LNM of PHC. More... »

PAGES

5502-5510

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    29 schema:description IntroductionAlthough the prognosis of patients with resected perihilar cholangiocarcinoma (PHC) with histological lymph node metastasis (LNM) is poor, preoperative prediction of LNM is difficult. This study aimed to evaluate the diagnostic performance of diffusion-weighted magnetic resonance imaging (DWI) for LNM of PHC.MethodConsecutive patients who underwent surgical resection of PHC between January 2012 and May 2020 were retrospectively reviewed. The lymph node (LN) area (mm2) and apparent diffusion coefficient (ADC) value ( × 10−3 mm2/s) of pericholedochal LNs were measured by DWI. The characteristics of the patients and the LNs were evaluated according to the histological presence or absence of regional LNM. Univariate and multivariate analyses were performed to identify the predictors of LNM of PHC.ResultsOf the 93 eligible patients, 49 (53%) were LNM positive and 44 (47%) were LNM negative. Although the characteristics of the patients were similar between the two groups, the mean ADC value was significantly lower in the LNM positive group than in the LNM negative group. On multivariate analysis, mean ADC value ≤1.80 × 10−3 mm2/s was independently associated with LNM of PHC (risk ratio: 12.5, 95% confidence interval: 3.05–51.4; p = 0.0004). The sensitivity, specificity and accuracy of mean ADC values ≤ 1.80 × 10−3 mm2/s for predicting LNM of PHC were 94%, 55% and 75%, respectively.ConclusionsDWI might be useful for the preoperative diagnosis of LNM of PHC.
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    36 ConclusionsDWI
    37 Diffusion-Weighted Magnetic Resonance Imaging
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    40 LNM-positive group
    41 LNs
    42 Ln
    43 MethodConsecutive patients
    44 ResultsOf
    45 absence
    46 accuracy
    47 analysis
    48 apparent diffusion coefficient (ADC) values
    49 area
    50 characteristics
    51 cholangiocarcinoma
    52 coefficient values
    53 diagnosis
    54 diagnostic performance
    55 diffusion coefficient values
    56 diffusion-weighted magnetic resonance imaging
    57 eligible patients
    58 group
    59 histological lymph node metastasis
    60 histological presence
    61 imaging
    62 lymph node area
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    65 mean ADC value
    66 metastasis
    67 mm2/s
    68 multivariate analysis
    69 negative group
    70 node area
    71 node metastasis
    72 patients
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    74 perihilar cholangiocarcinoma
    75 positive group
    76 prediction
    77 predictors
    78 predictors of LNM
    79 preoperative diagnosis
    80 preoperative prediction
    81 presence
    82 prognosis
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    84 regional lymph node metastasis
    85 resection
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    92 schema:name Preoperative Diagnosis of Lymph Node Metastasis of Perihilar Cholangiocarcinoma Using Diffusion-Weighted Magnetic Resonance Imaging
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