Huang Jingcheng, Shen Dejuan, Sun Jun, Shi Jie, Dou Weiqiang, Prince Martin, Ye Jing, Luo Xianfu
Department of Radiology, Northern Jiangsu People's Hospital, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No. 98 Nantong West Road, Yangzhou 225001, China; Department of Radiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China.
Department of Radiology, Northern Jiangsu People's Hospital, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No. 98 Nantong West Road, Yangzhou 225001, China.
Magn Reson Imaging. 2025 Nov;123:110491. doi: 10.1016/j.mri.2025.110491. Epub 2025 Aug 9.
To investigate the potential of amide proton transfer-weighted (APTw) MRI in differentiating hepatocellular carcinoma (HCC) from mass-forming intrahepatic cholangiocarcinoma (MF-ICC).
76 Patients with histo-pathologically confirmed HCC or MF-ICC underwent dynamic contrast enhanced(DCE) MRI,APTw and DWI. Mean APTw and apparent diffusion coefficient (ADC) of liver tumors were measured independently by two radiologists. Five-point scale were scored with DCE images. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of APTw, ADC,DCE in differentiating HCC from MF-ICC.
The HCC group (n = 53) exhibited higher APTw values compared to the MF-ICC group (n = 23)(1.37 ± 0.99 % vs. -0.31 ± 0.79 %, P < 0.001). The ADC values of HCC were lower than those of MF-ICC (0.87 ± 0.14 mm/s vs. 1.02 ± 0.20 mm/s, P < 0.001). In differentiating HCC from MF-ICC, APTw demonstrated significantly higher diagnostic accuracy than ADC (AUC: 0.90 vs. 0.72; P < 0.001) and comparable efficacy to DCE-MRI (AUC: 0.90 vs. 0.92; P > 0.05). The optimal APTw threshold for differentiating HCC from MF-ICC was 0.04 %, with a sensitivity of 92 % and a specificity of 78 %.
APTw MRI demonstrated superior discrimination to DWI and comparable diagnostic efficacy to DCE-MRI in differentiating HCC from MF-ICC.
探讨酰胺质子转移加权（APTw）磁共振成像（MRI）在鉴别肝细胞癌（HCC）与肿块型肝内胆管癌（MF-ICC）中的应用潜力。
76例经组织病理学确诊为HCC或MF-ICC的患者接受了动态对比增强（DCE）MRI、APTw和扩散加权成像（DWI）检查。两名放射科医生独立测量肝脏肿瘤的平均APTw和表观扩散系数（ADC）。采用五点量表对DCE图像进行评分。采用受试者操作特征（ROC）曲线分析评估APTw、ADC、DCE在鉴别HCC与MF-ICC中的诊断性能。
HCC组（n = 53）的APTw值高于MF-ICC组（n = 23）（1.37±0.99% vs. -0.31±0.79%，P < 0.001）。HCC的ADC值低于MF-ICC（0.87±0.14mm²/s vs. 1.02±0.20mm²/s，P < 0.001）。在鉴别HCC与MF-ICC方面，APTw的诊断准确性显著高于ADC（曲线下面积[AUC]：0.90 vs. 0.72；P < 0.001），且与DCE-MRI的诊断效能相当（AUC：0.90 vs. 0.92；P > 0.05）。鉴别HCC与MF-ICC的最佳APTw阈值为0.04%，灵敏度为92%，特异度为78%。
在鉴别HCC与MF-ICC方面，APTw MRI显示出优于DWI的鉴别能力，且与DCE-MRI具有相当的诊断效能。
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