In a retrospective study published in Cancer Imaging, researchers identified magnetic resonance imaging (MRI) features that can differentiate confluent fibrosis (CF) from mass-forming intrahepatic cholangiocarcinoma with an infiltrative tumor margin (mICCITM), demonstrating that combining arterial phase non-enhancement or non-rim enhancement with delayed phase signal homogeneity achieved a diagnostic accuracy of 97.3% (72/74) for CF, with an area under the curve (AUC) of 0.972 (95% CI: 0.904–0.996).
The retrospective analysis evaluated 44 CF patients and 30 mICCITM patients who underwent upper abdomen MRI scans to assess lesion imaging features and measure apparent diffusion coefficient (ADC) values, noting that imaging features of CF may mimic intrahepatic cholangiocarcinoma. Hepatic capsular retraction at the site of the lesion, hepatic volume loss, the “nodular surround sign,” and liver cirrhosis were observed more frequently in CF patients than in mICCITM patients (all P < 0.005). When evaluated individually, superior diagnostic accuracy was shown by hepatic capsular retraction at 75.7% (56/74), arterial phase non-enhancement or non-rim enhancement at 79.7% (59/74), and delayed phase signal homogeneity at 94.6% (70/74).
Diagnostic performance varied across feature combinations. A sensitivity of 100.0% (44/44) for CF diagnosis was achieved when hepatic capsular retraction, arterial phase non-enhancement or non-rim enhancement, or delayed phase signal homogeneity was present. A specificity of 96.7% (29/30) was reached when hepatic capsular retraction and delayed phase signal homogeneity were present, when arterial non-enhancement or non-rim enhancement and delayed phase signal homogeneity were present, or when all three features were positive. In addition to 97.3% accuracy, the combination of arterial non-enhancement or non-rim enhancement and delayed phase signal homogeneity yielded 97.7% (43/44) sensitivity and 96.7% (29/30) specificity, whereas no significant difference was observed in lesion ADC values between CF and mICCITM (P = 0.511).
Based on these findings, the authors concluded that the combination of non-enhancement or non-rim enhancement in the arterial phase and delayed phase signal homogeneity represents potential MRI features for differentiating CF from mICCITM.
Subject of Research: MRI differentiation of confluent hepatic fibrosis and intrahepatic cholangiocarcinoma
Article Title: Differentiation of confluent hepatic fibrosis and mass forming intrahepatic cholangiocarcinoma with infltrative tumor margin (mICCITM) on MR imaging
Article References: Liu, J.-J., Sun, Z.-Q., Duan, M.-J., Chu, Q.-Q., Huang, M.-Y., Che, Y.-Y., Wang, M.-Z., Li, K.-X., & Zhang, Y. (2026). Differentiation of confluent hepatic fibrosis and mass forming intrahepatic cholangiocarcinoma with infltrative tumor margin (mICCITM) on MR imaging. Cancer Imaging. https://doi.org/10.1186/s40644-026-01147-0
Image Credits: AI Generated
DOI: 10.1186/s40644-026-01147-0
Keywords: magnetic resonance imaging, confluent hepatic fibrosis, intrahepatic cholangiocarcinoma, apparent diffusion coefficient, diagnostic accuracy, hepatic capsular retraction, delayed phase signal homogeneity, Differentiation, confluent, hepatic, fibrosis, mass
Tags: apparent diffusion coefficientconfluentconfluent hepatic fibrosisdelayed phase signal homogeneitydiagnostic accuracydifferentiationFibrosishepatichepatic capsular retractionintrahepatic cholangiocarcinomamagnetic resonance imagingmass
