OBJECTIVE: To investigate the potential of amide proton transfer-weighted (APTw) MRI in differentiating hepatocellular carcinoma (HCC) from mass-forming intrahepatic cholangiocarcinoma (MF-ICC). METHODS: 76 Patients with histo-pathologically confirmed HCC or MF-ICC underwent dynamic contrast enhanced(DCE) MRI,APTw and DWI. Mean APTw and apparent diffusion coefficient (ADC) of liver tumors were measured independently by two radiologists. Five-point scale were scored with DCE images. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of APTw, ADC,DCE in differentiating HCC from MF-ICC. RESULTS: The HCC group (n = 53) exhibited higher APTw values compared to the MF-ICC group (n = 23)(1.37 ± 0.99 % vs. -0.31 ± 0.79 %, P < 0.001). The ADC values of HCC were lower than those of MF-ICC (0.87 ± 0.14 mm2/s vs. 1.02 ± 0.20 mm2/s, P < 0.001). In differentiating HCC from MF-ICC, APTw demonstrated significantly higher diagnostic accuracy than ADC (AUC: 0.90 vs. 0.72; P < 0.001) and comparable efficacy to DCE-MRI (AUC: 0.90 vs. 0.92; P > 0.05). The optimal APTw threshold for differentiating HCC from MF-ICC was 0.04 %, with a sensitivity of 92 % and a specificity of 78 %. CONCLUSION: APTw MRI demonstrated superior discrimination to DWI and comparable diagnostic efficacy to DCE-MRI in differentiating HCC from MF-ICC.
