{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:11:55Z","timestamp":1792469515397,"version":"4.5.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To develop and validate a diagnostic scoring system to differentiate intrahepatic mass-forming cholangiocarcinoma (IMCC) from solitary colorectal liver metastasis (CRLM).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 366 patients (263 in the training cohort, 103 in the validation cohort) who underwent MRI examination with pathologically proven either IMCC or CRLM from two centers were included. Twenty-eight MRI features were collected. Univariate analyses and multivariate logistic regression analyses were performed to identify independent predictors for distinguishing IMCC from solitary CRLM. The independent predictors were weighted over based on regression coefficients to build a scoring system. The overall score distribution was divided into three groups to show the diagnostic probability of CRLM.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Six independent predictors, including hepatic capsular retraction, peripheral hepatic enhancement, vessel penetrating the tumor, upper abdominal lymphadenopathy, peripheral washout at the portal venous phase, and rim enhancement at the portal venous phase were included in the system. All predictors were assigned 1 point. At a cutoff of 3 points, AUCs for this score model were 0.948 and 0.903 with sensitivities of 96.5% and 92.0%, specificities of 84.4% and 71.7%, positive predictive values of 87.7% and 75.4%, negative predictive values of 95.4% and 90.5%, and accuracies of 90.9% and 81.6% for the training and validation cohorts, respectively. An increasing trend was shown in the diagnostic probability of CRLM among the three groups based on the score.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The established scoring system is reliable and convenient for distinguishing IMCC from solitary CRLM using six MRI features.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical relevance statement<\/jats:title>\n                <jats:p>A reliable and convenient scoring system was developed to differentiate between intrahepatic mass-forming cholangiocarcinoma from solitary colorectal liver metastasis using six MRI features.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p>\u2022 <jats:italic>Characteristic MRI features were identified to distinguish intrahepatic mass-forming cholangiocarcinoma (IMCC) from solitary colorectal liver metastasis (CRLM).<\/jats:italic><\/jats:p>\n                <jats:p>\u2022 <jats:italic>A model to distinguish IMCC from solitary CRLM was created based on 6 features, including hepatic capsular retraction, upper abdominal lymphadenopathy, peripheral washout at the portal venous phase, rim enhancement at the portal venous phase, peripheral hepatic enhancement, and vessel penetrating the tumor.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-023-09873-w","type":"journal-article","created":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T09:02:33Z","timestamp":1688202153000},"page":"8986-8998","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A convenient scoring system to distinguish intrahepatic mass-forming cholangiocarcinoma from solitary colorectal liver metastasis based on magnetic resonance imaging features"],"prefix":"10.1007","volume":"33","author":[{"given":"Keren","family":"Shen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weixing","family":"Mo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risheng","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,1]]},"reference":[{"issue":"Suppl 1","key":"9873_CR1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1111\/liv.14095","volume":"39","author":"SA Khan","year":"2019","unstructured":"Khan SA, Tavolari S, Brandi G (2019) Cholangiocarcinoma: Epidemiology and risk factors. Liver Int 39(Suppl 1):19\u201331","journal-title":"Liver Int"},{"key":"9873_CR2","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/S0140-6736(21)00153-7","volume":"397","author":"JW Valle","year":"2021","unstructured":"Valle JW, Kelley RK, Nervi B, Oh D-Y, Zhu AX (2021) Biliary tract cancer. Lancet 397:428\u2013444","journal-title":"Lancet"},{"key":"9873_CR3","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1148\/rg.293085729","volume":"29","author":"YE Chung","year":"2009","unstructured":"Chung YE, Kim MJ, Park YN et al (2009) Varying appearances of cholangiocarcinoma: radiologic-pathologic correlation. Radiographics 29:683\u2013700","journal-title":"Radiographics"},{"key":"9873_CR4","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1097\/01.sla.0000217629.94941.cf","volume":"244","author":"S Manfredi","year":"2006","unstructured":"Manfredi S, Lepage C, Hatem C, Coatmeur O, Faivre J, Bouvier AM (2006) Epidemiology and management of liver metastases from colorectal cancer. Ann Surg 244:254\u2013259","journal-title":"Ann Surg"},{"issue":"Suppl 4","key":"9873_CR5","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1093\/annonc\/mdp130","volume":"20","author":"E Van Cutsem","year":"2009","unstructured":"Van Cutsem E, Oliveira J, Group EGW (2009) Advanced colorectal cancer: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 20(Suppl 4):61\u201363","journal-title":"Ann Oncol"},{"key":"9873_CR6","doi-asserted-by":"publisher","first-page":"55368","DOI":"10.18632\/oncotarget.10552","volume":"7","author":"J de Ridder","year":"2016","unstructured":"de Ridder J, de Wilt JH, Simmer F, Overbeek L, Lemmens V, Nagtegaal I (2016) Incidence and origin of histologically confirmed liver metastases: an explorative case-study of 23,154 patients. Oncotarget 7:55368\u201355376","journal-title":"Oncotarget"},{"key":"9873_CR7","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1002\/jhbp.920","volume":"28","author":"T Beppu","year":"2021","unstructured":"Beppu T, Imai K, Honda G et al (2021) Proposal of a novel H category-based classification of colorectal liver metastases based on a Japanese nationwide survey. J Hepatobiliary Pancreat Sci 28:317\u2013326","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"9873_CR8","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1053\/j.sult.2016.08.005","volume":"37","author":"AD Karaosmanoglu","year":"2016","unstructured":"Karaosmanoglu AD, Onur MR, Ozmen MN, Akata D, Karcaaltincaba M (2016) Magnetic resonance imaging of liver metastasis. Semin Ultrasound CT MR 37:533\u2013548","journal-title":"Semin Ultrasound CT MR"},{"key":"9873_CR9","doi-asserted-by":"publisher","first-page":"468","DOI":"10.4240\/wjgs.v12.i12.468","volume":"12","author":"T Lee","year":"2020","unstructured":"Lee T, Teng TZJ, Shelat VG (2020) Carbohydrate antigen 19\u20139 - tumor marker: Past, present, and future. World J Gastrointest Surg 12:468\u2013490","journal-title":"World J Gastrointest Surg"},{"key":"9873_CR10","doi-asserted-by":"publisher","first-page":"158","DOI":"10.32074\/1591-951X-252","volume":"113","author":"S Sarcognato","year":"2021","unstructured":"Sarcognato S, Sacchi D, Fassan M et al (2021) Cholangiocarcinoma. Pathologica 113:158\u2013169","journal-title":"Pathologica"},{"key":"9873_CR11","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1016\/j.humpath.2009.10.029","volume":"41","author":"A Somoracz","year":"2010","unstructured":"Somoracz A, Tatrai P, Horvath G et al (2010) Agrin immunohistochemistry facilitates the determination of primary versus metastatic origin of liver carcinomas. Hum Pathol 41:1310\u20131319","journal-title":"Hum Pathol"},{"key":"9873_CR12","doi-asserted-by":"crossref","unstructured":"Beal EW, Cloyd JM, Pawlik TM (2020) Surgical treatment of intrahepatic cholangiocarcinoma: Current and emerging principles. J Clin Med 10:104","DOI":"10.3390\/jcm10010104"},{"key":"9873_CR13","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-021-03880-4","author":"S Acciuffi","year":"2021","unstructured":"Acciuffi S, Meyer F, Bauschke A, Croner R, Settmacher U, Altendorf-Hofmann A (2021) Solitary colorectal liver metastasis: overview of treatment strategies and role of prognostic factors. J Cancer Res Clin Oncol. https:\/\/doi.org\/10.1007\/s00432-021-03880-4","journal-title":"J Cancer Res Clin Oncol"},{"key":"9873_CR14","doi-asserted-by":"publisher","first-page":"35","DOI":"10.21037\/hbsn.2019.05.11","volume":"9","author":"B Hazhirkarzar","year":"2020","unstructured":"Hazhirkarzar B, Khoshpouri P, Shaghaghi M, Ghasabeh MA, Pawlik TM, Kamel IR (2020) Current state of the art imaging approaches for colorectal liver metastasis. Hepatobiliary Surg Nutr 9:35\u201348","journal-title":"Hepatobiliary Surg Nutr"},{"key":"9873_CR15","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1177\/0284185117695666","volume":"58","author":"JD Kovac","year":"2017","unstructured":"Kovac JD, Galun D, Duric-Stefanovic A et al (2017) Intrahepatic mass-forming cholangiocarcinoma and solitary hypovascular liver metastases: is the differential diagnosis using diffusion-weighted MRI possible? Acta Radiol 58:1417\u20131426","journal-title":"Acta Radiol"},{"key":"9873_CR16","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1016\/S0730-725X(03)00187-5","volume":"21","author":"L Braga","year":"2003","unstructured":"Braga L, Semelka RC, Danet IM, Venkataraman S, Woosley JT (2003) Liver metastases from unknown primary site: demonstration on MR images. Magn Reson Imaging 21:871\u2013877","journal-title":"Magn Reson Imaging"},{"key":"9873_CR17","doi-asserted-by":"publisher","first-page":"4461","DOI":"10.1007\/s00330-017-4811-2","volume":"27","author":"H Haradome","year":"2017","unstructured":"Haradome H, Unno T, Morisaka H et al (2017) Gadoxetic acid disodium-enhanced MR imaging of cholangiolocellular carcinoma of the liver: imaging characteristics and histopathological correlations. Eur Radiol 27:4461\u20134471","journal-title":"Eur Radiol"},{"key":"9873_CR18","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s40644-020-00318-x","volume":"20","author":"X Ma","year":"2020","unstructured":"Ma X, Liu L, Fang J et al (2020) MRI features predict microvascular invasion in intrahepatic cholangiocarcinoma. Cancer Imaging 20:40","journal-title":"Cancer Imaging"},{"key":"9873_CR19","doi-asserted-by":"publisher","first-page":"9131","DOI":"10.1007\/s00330-021-08061-y","volume":"31","author":"Q Li","year":"2021","unstructured":"Li Q, Dong F, Wang Q, Xu F, Zhang M (2021) A model comprising the blend sign and black hole sign shows good performance for predicting early intracerebral haemorrhage expansion: a comprehensive evaluation of CT features. Eur Radiol 31:9131\u20139138","journal-title":"Eur Radiol"},{"key":"9873_CR20","doi-asserted-by":"publisher","first-page":"ofz103","DOI":"10.1093\/ofid\/ofz103","volume":"6","author":"H Ben Ayed","year":"2019","unstructured":"Ben Ayed H, Koubaa M, Hammami F et al (2019) Performance of an easy and simple new scoring model in predicting multidrug-resistant Enterobacteriaceae in community-acquired urinary tract infections. Open Forum Infect Dis 6:ofz103","journal-title":"Open Forum Infect Dis"},{"key":"9873_CR21","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL et al (2021) Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71:209\u2013249","journal-title":"CA Cancer J Clin"},{"key":"9873_CR22","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21590","volume":"70","author":"RL Siegel","year":"2020","unstructured":"Siegel RL, Miller KD, Jemal A (2020) Cancer statistics, 2020. CA Cancer J Clin 70:7\u201330","journal-title":"CA Cancer J Clin"},{"key":"9873_CR23","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1148\/radiology.167.3.2834769","volume":"167","author":"PR Ros","year":"1988","unstructured":"Ros PR, Buck JL, Goodman ZD, Ros AM, Olmsted WW (1988) Intrahepatic cholangiocarcinoma: radiologic-pathologic correlation. Radiology 167:689\u2013693","journal-title":"Radiology"},{"key":"9873_CR24","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s40644-018-0142-z","volume":"18","author":"J Sammon","year":"2018","unstructured":"Sammon J, Fischer S, Menezes R et al (2018) MRI features of combined hepatocellular- cholangiocarcinoma versus mass forming intrahepatic cholangiocarcinoma. Cancer Imaging 18:8","journal-title":"Cancer Imaging"},{"key":"9873_CR25","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.611738","volume":"11","author":"H Zhang","year":"2021","unstructured":"Zhang H, Chai S, Chen L et al (2021) MRI features of hepatic sarcomatoid carcinoma different from hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Front Oncol 11:611738","journal-title":"Front Oncol"},{"key":"9873_CR26","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1007\/s13244-016-0520-7","volume":"7","author":"GX Tan","year":"2016","unstructured":"Tan GX, Miranda R, Sutherland T (2016) Causes of hepatic capsular retraction: a pictorial essay. Insights Imaging 7:831\u2013840","journal-title":"Insights Imaging"},{"key":"9873_CR27","doi-asserted-by":"publisher","first-page":"651","DOI":"10.2214\/ajr.182.3.1820651","volume":"182","author":"FM Fennessy","year":"2004","unstructured":"Fennessy FM, Mortele KJ, Kluckert T et al (2004) Hepatic capsular retraction in metastatic carcinoma of the breast occurring with increase or decrease in size of subjacent metastasis. AJR Am J Roentgenol 182:651\u2013655","journal-title":"AJR Am J Roentgenol"},{"key":"9873_CR28","doi-asserted-by":"publisher","first-page":"5992","DOI":"10.1007\/s00330-020-06972-w","volume":"30","author":"S Ichikawa","year":"2020","unstructured":"Ichikawa S, Isoda H, Shimizu T et al (2020) Distinguishing intrahepatic mass-forming biliary carcinomas from hepatocellular carcinoma by computed tomography and magnetic resonance imaging using the Bayesian method: a bi-center study. Eur Radiol 30:5992\u20136002","journal-title":"Eur Radiol"},{"key":"9873_CR29","doi-asserted-by":"publisher","first-page":"2186","DOI":"10.1053\/j.gastro.2021.02.005","volume":"160","author":"L Aldrighetti","year":"2021","unstructured":"Aldrighetti L, De Cobelli F, Colombo M (2021) Climbing the Everest of lymph nodes staging in cholangiocarcinoma: close to the peak? Gastroenterology 160:2186\u20132188","journal-title":"Gastroenterology"},{"key":"9873_CR30","doi-asserted-by":"publisher","first-page":"1993","DOI":"10.1038\/s41467-020-15886-6","volume":"11","author":"C Zhang","year":"2020","unstructured":"Zhang C, Zhang L, Xu T et al (2020) Mapping the spreading routes of lymphatic metastases in human colorectal cancer. Nat Commun 11:1993","journal-title":"Nat Commun"},{"key":"9873_CR31","doi-asserted-by":"publisher","first-page":"4213","DOI":"10.3892\/ol.2017.6656","volume":"14","author":"Y Chen","year":"2017","unstructured":"Chen Y, Pan Y, Shen KR et al (2017) Contrast-enhanced multiple-phase imaging features of intrahepatic mass-forming cholangiocarcinoma and hepatocellular carcinoma with cirrhosis: a comparative study. Oncol Lett 14:4213\u20134219","journal-title":"Oncol Lett"},{"key":"9873_CR32","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.2214\/AJR.04.1698","volume":"186","author":"JS Yu","year":"2006","unstructured":"Yu JS, Rofsky NM (2006) Hepatic metastases: perilesional enhancement on dynamic MRI. AJR Am J Roentgenol 186:1051\u20131058","journal-title":"AJR Am J Roentgenol"},{"key":"9873_CR33","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1148\/radiology.180.2.2068294","volume":"180","author":"E Outwater","year":"1991","unstructured":"Outwater E, Tomaszewski JE, Daly JM, Kressel HY (1991) Hepatic colorectal metastases: correlation of MR imaging and pathologic appearance. Radiology 180:327\u2013332","journal-title":"Radiology"},{"key":"9873_CR34","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1002\/jmri.23728","volume":"36","author":"J Hwang","year":"2012","unstructured":"Hwang J, Kim YK, Park MJ et al (2012) Differentiating combined hepatocellular and cholangiocarcinoma from mass-forming intrahepatic cholangiocarcinoma using gadoxetic acid-enhanced MRI. J Magn Reson Imaging 36:881\u2013889","journal-title":"J Magn Reson Imaging"},{"key":"9873_CR35","doi-asserted-by":"publisher","first-page":"3938","DOI":"10.3748\/wjg.v26.i27.3938","volume":"26","author":"JY Huang","year":"2020","unstructured":"Huang JY, Li JW, Ling WW et al (2020) Can contrast enhanced ultrasound differentiate intrahepatic cholangiocarcinoma from hepatocellular carcinoma? World J Gastroenterol 26:3938\u20133951","journal-title":"World J Gastroenterol"},{"key":"9873_CR36","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1097\/CM9.0000000000001474","volume":"134","author":"W Cao","year":"2021","unstructured":"Cao W, Chen HD, Yu YW, Li N, Chen WQ (2021) Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020. Chin Med J (Engl) 134:783\u2013791","journal-title":"Chin Med J (Engl)"}],"container-title":["European Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-023-09873-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00330-023-09873-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-023-09873-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T17:06:32Z","timestamp":1700759192000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00330-023-09873-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,1]]},"references-count":36,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["9873"],"URL":"https:\/\/doi.org\/10.1007\/s00330-023-09873-w","relation":{},"ISSN":["1432-1084"],"issn-type":[{"value":"1432-1084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,1]]},"assertion":[{"value":"12 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2023","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2023","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2023","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The scientific guarantor of this publication is Risheng Yu.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the institutional review board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional review board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"\u2022 retrospective\u2022 diagnostic or prognostic study\u2022multicenter study","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}