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August 17, 2025Open Access

Value of intravoxel incoherent motion and diffusion kurtosis imaging to differentiate hepatocellular carcinoma and intrahepatic cholangiocarcinoma

Key Points

SADC, D, MK, and MD effectively distinguish between hepatocellular carcinoma and intrahepatic cholangiocarcinoma, enhancing diagnostic accuracy.
The sensitivity rates for distinguishing these cancers reached as high as 100%, ensuring robust evaluation methods according to tests conducted.
This study used multi-b-value diffusion weighted imaging and quantitative MRI parameters to analyze results from 58 patients with liver tumors.
Effective MRI imaging techniques can support early and accurate diagnosis of liver cancers, potentially improving patient outcomes.

Abstract

BACKGROUND The differential diagnosis between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) is crucial. The individual differences of patients increase the complexity of diagnosis. Currently, imaging diagnosis mainly relies on conventional computed tomography and magnetic resonance imaging (MRI), but few studies have investigated MRI functional imaging. This study combined MRI functional imaging including intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI), facilitating differential diagnosis. AIM To explore the differential diagnostic value of IVIM imaging and DKI in differentiating between HCC and ICC. METHODS A total of 58 patients who underwent multi-b-value diffusion weighted imaging (DWI) on a 3.0 T magnetic MRI scanner were enrolled in this study. Standard apparent diffusion coefficient (SADC), IVIM quantitative parameters, including pure diffusion coefficient (D), pseudo diffusion coefficient (Dstar), and perfusion fraction (f), as well as the DKI quantitative parameters mean diffusion coefficient (MD) and mean kurtosis coefficient (MK) were computed by multi-b DWI images. The χ 2 test was used for classified data, and a one-way analysis of variance was performed for counted data. P 0.05). The optimal cutoff levels of the total values of SADC, D, MK, MD and all associated parameters were 1.25 × 10-3 mm²/second, 1.32 × 10-3 mm²/second, 650.2 × 10-3 mm²/second, 1.41 × 10-3 mm²/second and 0.46 × 10-3 mm²/second, respectively. The sensitivity of diagnosis was 95%, 80%, 90%, 100%, and 70%, respectively, the specificity of diagnosis was 67.39%, 69.57%, 67.39%, 43.48%, and 93.48%, respectively, and the area under the ROC curve was 0.874, 0.793, 0.733, 0.757, and 0.895, respectively. CONCLUSION SADC, D, MK, and MD could be used to distinguish HCC from ICC, with the diagnostic value reaching a maximum after establishing a joint model.

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