Performance of Ultrasonography-Based Fractal Parameters in Distinguishing Hepatocellular Carcinoma From Intrahepatic Cholangiocarcinoma

To evaluate the ability of fractal parameters based on ultrasonography to distinguish between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) in patients. This retrospective study was performed to assess the performance of certain ultrasound-based parameters, including fractal dimension (FD), lacunarity (LAC), and FD combined with LAC (FL), in distinguishing HCC from ICC with liver biopsy as the gold standard, information was obtained from 204 eligible patients. Receiver operating characteristic (ROC) curve analysis was conducted, to assess the performance of these parameters in distinguishing between HCC and ICC in patients with or without CLD. The following parameters were significantly different between with and without CLD: the levels of alpha-fetoprotein, abnormal prothrombin, alanine aminotransferase, aspartic acid, total bilirubin and indirect bilirubin (<i>p</i> < .05). The AUC of FL in differentiating HCC from ICC was 0.983 and 0.854 in patients without or with CLD, which were significantly better than that of FD (non-CLD, 0.902 AUC; CLD, 0.647 AUC, <i>p</i> < .05) and LAC (non-CLD, 0.895 AUC; CLD, 0.843 AUC, <i>p</i> < .05). FL can better distinguish between HCC and ICC in patients with or without CLD than FD and LAC. FL may serve as a promising preoperative alternative for distinguishing between the two diseases.Clinical trials:Brief title: Exploration of noninvasive differential diagnosis of benign and malignant liver tumors.URL: https://register.clinicaltrials.govClinicalTrials.gov ID: NCT06524557.