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Clinical Staging of Mass-Forming Intrahepatic Cholangiocarcinoma: Computed Tomography Versus Magnetic Resonance Imaging

 Yeun-Yoon Kim  ;  Suk-Keu Yeom  ;  Hyejung Shin  ;  Sang Hyun Choi  ;  Hyungjin Rhee  ;  Ji Hoon Park  ;  Eun-Suk Cho  ;  Sumi Park  ;  Seung Soo Lee  ;  Mi-Suk Park 
 HEPATOLOGY COMMUNICATIONS, Vol.5(12) : 2009-2018, 2021-12 
Journal Title
Issue Date
Aged ; Bile Duct Neoplasms / diagnostic imaging* ; Bile Ducts, Intrahepatic / diagnostic imaging ; Cholangiocarcinoma / diagnostic imaging* ; Female ; Humans ; Magnetic Resonance Imaging / statistics & numerical data* ; Male ; Middle Aged ; Neoplasm Staging / methods* ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed / statistics & numerical data*
We compared the performance of computed tomography (CT) and magnetic resonance imaging (MRI) for preoperative clinical staging of mass-forming intrahepatic cholangiocarcinoma (iCCA), using the eighth American Joint Committee on Cancer (AJCC) system. This retrospective, multicenter, cohort study consecutively identified patients who underwent partial hepatectomy for mass-forming iCCA and had preoperative CT and MRI performed from January 2009 to December 2015. CT and MRI characteristics were used to determine clinical stage based on the eighth AJCC system. Performances of CT and MRI for clinical T and N staging were compared using generalized estimating equations. In 334 patients (median age, 63 years; 221 men), MRI sensitivities were significantly higher than CT sensitivities for detecting T1b or higher stages (91.0% vs. 80.5%, respectively, P < 0.001), T2 or higher stages (89.1% vs. 73.8%, respectively, P < 0.001), and T3 or T4 stage (77.8% vs. 58.0%, respectively, P < 0.001). MRI was also more sensitive at identifying multiple tumors than CT (66.7% vs. 50.0%, respectively, P = 0.026), without a significant difference in specificity (78.1% vs. 80.1%, respectively, P = 0.342). Sensitivities were comparable between CT and MRI for determination of size >5 cm (i.e., T1b for single tumor) and extrahepatic organ invasion (i.e., T4). Sensitivities of CT and MRI were not different for N stage (65.0% vs. 64.0%, respectively, P = 0.808), but the specificity of CT was significantly higher than that of MRI (80.7% vs. 72.9%, respectively, P = 0.001) when using a composite reference standard. Conclusion: MRI showed superior sensitivity to CT for diagnosing T2 and T3 stages, particularly multiple tumors. CT and MRI had comparable sensitivity for N staging, but CT provided higher specificity than MRI.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yeun-Yoon(김연윤) ORCID logo https://orcid.org/0000-0003-2018-5332
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Rhee, Hyungjin(이형진) ORCID logo https://orcid.org/0000-0001-7759-4458
Cho, Eun Suk(조은석)
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