Gadoxetic acid enhanced magnetic resonance imaging for prediction of the postoperative prognosis of intrahepatic mass-forming cholangiocarcinoma
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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.
KeywordsPrognostic factors Intrahepatic cholangiocarcinoma Magnetic resonance imaging Disodium gadoxetate
Apparent diffusion coefficient
Akaike information criterion
American Joint Committee on Cancer
Any vascular invasion
Bile duct invasion
Hepatic vein obstruction
Intrahepatic mass-forming cholangiocarcinoma
Liver Cancer Study Group of Japan
Magnetic resonance imaging
Portal vein obstruction
Restricted cubic splines
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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