Abdominal Radiology

, Volume 44, Issue 1, pp 110–121 | Cite as

Gadoxetic acid enhanced magnetic resonance imaging for prediction of the postoperative prognosis of intrahepatic mass-forming cholangiocarcinoma

  • Sungwon Kim
  • Chansik An
  • Kyunghwa Han
  • Myeong-Jin KimEmail author



To identify imaging markers that independently predict the post-operative outcome of intrahepatic mass-forming cholangiocarcinoma (IMCC) using gadoxetate disodium-enhanced magnetic resonance imaging (MRI).


Data from 54 patients who underwent pre-operative gadoxetate disodium-enhanced MRI and curative surgery for IMCC were retrospectively evaluated. The prognostic power of various imaging and pathological features reportedly associated with recurrence-free survival (RFS) and overall survival (OS) was analyzed using Cox regression models. A model combining imaging and pathological features was developed and its performance was evaluated using the Harrell C-index and Akaike information criterion.


Capsule penetration (P = 0.016) and tumor size (P = 0.015) were independent markers for worse RFS, while capsule penetration (P = 0.012) and hepatic vein obstruction (HVO, P = 0.016) were independent markers for worse OS, respectively, in the imaging-based model. Capsule penetration was the only imaging marker identified in the combined prediction model of RFS, and the combined model showed a higher C-index and lower AIC value compared with the model based on pathological features alone.


Capsule penetration and HVO on MRI are significantly worse imaging prognostic factors for post-operative outcomes in patients with IMCC. Incorporation of capsule penetration and HVO into a surgical staging system may improve prediction of the post-operative prognosis of IMCC.


Prognostic factors Intrahepatic cholangiocarcinoma Magnetic resonance imaging Disodium gadoxetate 



Apparent diffusion coefficient


Akaike information criterion


American Joint Committee on Cancer


Arterial phase


Any vascular invasion


Bile duct invasion


Biliary obstruction


Confidence interval


Computed tomography


Diffusion-weighted images


Hepatobiliary phase


Hazard ratio


Hepatic vein obstruction


Intrahepatic mass-forming cholangiocarcinoma


Liver Cancer Study Group of Japan


Magnetic resonance imaging


Microvessel invasion


Overall survival


Portal vein obstruction


Restricted cubic splines


Recurrence-free survival


Signal intensity


Compliance with ethical standards



Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

261_2018_1727_MOESM1_ESM.pdf (336 kb)
Supplementary material 1 (PDF 336 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiology and Research Institute of Radiological Science, Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea

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