Role of Intravoxel Incoherent Motion in Discriminating Hepatitis B Virus-Related Intrahepatic Mass-Forming Cholangiocarcinoma from Hepatocellular Carcinoma Based on Liver Imaging Reporting and Data System v2018.

Intravoxel incoherent motion (IVIM) could be used to characterize benign and malignant hepatic lesions and predict the histological grade of hepatocellular carcinoma (HCC). To evaluate IVIM-derived parameters for differentiating between hepatitis B virus (HBV)-related intrahepatic mass-forming cholangiocarcinoma (IMCC) and HCC based on the Liver Imaging Reporting and Data System (LI-RADS) v2018. 20 IMCC patients and one-to-one matched control HCC patients were retrospectively assessed. IVIM scanning with 11 -values (from 0 to 1500 s/mm) was obtained using a 3.0-T magnetic resonance scanner. Apparent diffusion coefficient (ADC) and IVIM parameters, including diffusion coefficient (), pseudodiffusion coefficient (*), and perfusion fraction (), were compared between IMCC and HCC. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performances of ADC, , , and *. The LI-RADS features and a final category were also compared using LI-RADS v2018. ADC and were significantly higher in IMCC than in HCC ( = 0.012 and  = 0.007, respectively); was significantly higher in HCC than in IMCC ( = 0.004). The area under the ROC curve values for ADC, , and for differentiating HBV-related IMCC from HCC were 0.724, 0.753, and 0.741, respectively. The majority of HBV-related IMCCs can be categorized as LR-M by using LI-RADS. However, atypical IMCCs may be classified as non-LR-M. ADC, , and values may be helpful in differentiating HBV-related IMCC from HCC, and similar diagnostic performances were obtained for these values.