Evidence map›Paper›PMID 40844594›Full record

SynthesisAbdominal radiology (New York)2026

Diagnostic value of quantitative DWI and IVIM parameters in differentiating intrahepatic cholangiocarcinoma and hepatocellular carcinoma: a systematic review and meta-analysis.

Saeed Mohammadzadeh, Alisa Mohebbi, Mehrad Zare, Faeze Salahshour, Afshin Mohammadi

Abstract readSystematic ReviewMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Saeed MohammadzadehTehran University of Medical Sciences, Tehran, Iran, Islamic Republic of.
Alisa MohebbiTehran University of Medical Sciences, Tehran, Iran, Islamic Republic of.
Mehrad ZareTehran University of Medical Sciences, Tehran, Iran, Islamic Republic of.
Faeze SalahshourAdvanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran, Islamic Republic of.
Afshin MohammadiUrmia University of Medical Sciences, Urmia, Iran, Islamic Republic of. mohammadi.a@umsu.ac.ir.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study evaluates the diagnostic performance of quantitative diffusion-weighted imaging (DWI), including both conventional and intravoxel incoherent motion (IVIM)-derived parameters, in differentiating hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC).

methodA systematic review and meta-analysis were conducted following a pre-registered protocol ( https://osf.io/9yhrg ). Relevant studies were identified through PubMed, Web of Science, Cochrane Library, and Embase up to March 8, 2025. Quantitative DWI parameters, including apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (pseudo-D), and perfusion fraction (f), were compared between HCC and ICC using a random-effects model. Sensitivity analysis and publication bias tests were performed.

resultsTwenty-one studies encompassing 1109 HCC and 838 ICC lesions were included. Pooled ADC values did not differ significantly between HCC (1.10, 95% CI = 1.03 to 1.17) and ICC (1.16, 95% CI = 1.06 to 1.25) groups (p = 0.156). In contrast, D showed significant differentiation between HCC (0.89, 95% CI = 0.77 to 1.02) and ICC (1.04, 95% CI = 0.93 to 1.16), with p < 0.001. Moreover, the pseudo-D parameter demonstrated comparable values in ICC (53.3; 95% CI, 22.47-84.13) and HCC (49.35; 95% CI, 23.28-75.41) lesions (p = 0.912). Finally, the f parameter revealed significantly (p = 0.022) lower values for ICC (19.21, 95% CI = 12.98 to 25.44) compared to HCC (23.78, 95% CI = 14.76 to 32.8). For each parameter, we calculated pooled mean differences, standardized mean differences, percentage differences, sensitivity, specificity, and area under the curve.

conclusionWhile ADC retains clinical utility due to widespread availability, this meta-analysis establishes D as a superior biomarker over ADC for distinguishing ICC from HCC focal liver lesions. These findings support the integration of non-Gaussian DWI techniques in clinical practice for improved tumor characterization.

Indexed as

Bile Duct NeoplasmsCarcinoma, HepatocellularCholangiocarcinomaDiffusion Magnetic Resonance ImagingLiver NeoplasmsDiagnosis, DifferentialHumansSensitivity and SpecificityDiagnostic test accuracy (DTA)Diffusion-weighted imaging (DWI)Hepatocellular carcinoma (HCC)Intrahepatic cholangiocarcinoma (ICC)

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.