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Preoperative magnetic resonance imaging-based prognostic model for mass-forming intrahepatic cholangiocarcinoma

Authors
 Hyungjin Rhee  ;  Sang Hyun Choi  ;  Ji Hoon Park  ;  Eun-Suk Cho  ;  Suk-Keu Yeom  ;  Sumi Park  ;  Kyunghwa Han  ;  Seung Soo Lee  ;  Mi-Suk Park 
Citation
 LIVER INTERNATIONAL, Vol.42(4) : 930-941, 2022-04 
Journal Title
LIVER INTERNATIONAL
ISSN
 1478-3223 
Issue Date
2022-04
MeSH
Bile Duct Neoplasms* / diagnostic imaging ; Bile Duct Neoplasms* / surgery ; Bile Ducts, Intrahepatic / diagnostic imaging ; Bile Ducts, Intrahepatic / pathology ; Cholangiocarcinoma* / diagnostic imaging ; Cholangiocarcinoma* / surgery ; Humans ; Magnetic Resonance Imaging ; Neoplasm Staging ; Prognosis ; Retrospective Studies
Keywords
bile duct invasion ; carbohydrate antigen 19-9 ; lymph node metastasis ; multiplicity
Abstract
Background & aims: As most staging systems for intrahepatic cholangiocarcinoma (iCCA) are based on pathological results, preoperative prognostic prediction is limited. This study aimed to develop and validate a prognostic model for the overall survival of patients with mass-forming iCCA (MF-iCCA) using preoperative magnetic resonance imaging (MRI) and clinical findings.

Methods: We enrolled a total of 316 patients who underwent preoperative MRI and surgical resection for treatment-naive MF-iCCA from six institutions, between January 2009 and December 2015. The subjects were randomly assigned to a training set (n = 208) or validation set (n = 108). The MRIs were independently reviewed by three abdominal radiologists. Using MRI and clinical findings, an MRI prognostic score was established. We compared the discrimination performance of MRI prognostic scores with those of conventional pathological staging systems.

Results: We developed an MRI prognostic score consisting of serum CA19-9 and three MRI findings (tumour multiplicity, lymph node metastasis and bile duct invasion). The MRI prognostic score demonstrated good discrimination performance in both the training set (C-index, 0.738; 95% confidence interval [CI], 0.698-0.780) and validation set (C-index, 0.605; 95% CI, 0.526-0.680). In the validation set, MRI prognostic score showed no significant difference with AJCC 8th TNM stage, MEGNA score and Nathan's stage.

Conclusions: Our MRI prognostic score for overall survival of MF-iCCA showed comparable discriminatory performance with pathological staging systems and might be used to determine an optimal treatment strategy.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/liv.15196
DOI
10.1111/liv.15196
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
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)
Han, Kyung Hwa(한경화)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189590
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