Differentiation of Confluent Hepatic Fibrosis and Mass Forming Intrahepatic Cholangiocarcinoma with Infltrative Tumor Margin on MR Imaging

Motivation: There is a diagnostic challenge even for experienced radiologists for confluent fibrosis (CF) and mass forming intrahepatic cholangiocarcinoma with infltrative tumor margin (mICCITM) due to some similarities in imaging findings. Goal(s): We investigated the magnetic resonance imaging (MRI) features for CF and mICCITM. Approach: The imaging features on conventional MRI, dynamic contrast enhanced (DCE)-MRI and DWI were analyzed. Results: The MR features of the hepatic capsular retraction at the site of lesion, nonenhancement or nonrimenhancement in arterial phase, and delayed phase signal homogeneity can be useful for the diagnosis of CF, as they allow differentiation from mICCITM. Impact: The study detected several key MRI features for accurate diagnosis CF and differentiation from mICCITM, which may avoid unnecessary biopsies and overtreatment, and providing better patient care.