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Intrahepatic mass-forming cholangiocarcinoma: prognostic value of preoperative gadoxetic acid-enhanced MRI

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To assess whether gadoxetic acid-enhanced MRI could be used as a prognostic factor for intrahepatic mass-forming cholangiocarcinomas (IMCCs).

Methods

Forty-one patients with pathologically proven IMCCs who underwent preoperative gadoxetic acid-enhanced MRI were included. The signal intensity of the IMCCs on hepatobiliary phase (HBP) MRI was qualitatively analyzed by two radiologists, and categorized into intermediate or hypointense groups. Analysis of clinicopathological prognostic factors and correlations of imaging and histology were also performed. Survival time and time to recurrence (TTR) were analyzed.

Results

Of the 41 IMCCs, 23 were in the intermediate group and 18 were in the hypointense group on HBP MRI. IMCCs in the intermediate group were associated with shorter survival time (P = 0.048) and TTR (P = 0.002) than the IMCCs of the hypointense group. Only the intermediate group on HBP MRI had a significantly shorter TTR on multivariate analysis (P = 0.012). The IMCCs of the intermediate group showed a tendency for more abundant tumour fibrous stroma than those of the hypointense group (P = 0.027).

Conclusions

The enhancement of IMCCs on HBP gadoxetic acid-enhanced MRI appears to correlate with tumour aggressiveness and outcomes due to the tumour fibrous stromal component. Thus, HBP images could be a useful prognostic factor for IMCCs after surgery.

Key points

• The enhancement of IMCCs on HBP correlates with the tumour fibrous stroma.

• The enhancement of IMCCs on HBP MRI appears to correlate with prognosis.

• Gadoxetic acid-enhanced MRI is helpful for predicting prognosis of IMCCs after surgery.

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Abbreviations

IMCC:

Intrahepatic mass-forming cholangiocarcinoma

HBP:

Hepatobiliary phase

TTR:

Time to recurrence

GRE:

Gradient echo

ADC:

Apparent diffusion coefficient

SI:

Signal intensity

SNR:

Signal-to-noise ratio

CNR:

Contrast-to-noise ratio

ICG 15:

Indocyanine green 15

AFP:

Alpha-fetoprotein

CA 19-9:

Carbohydrate antigen 19-9

CEA:

Carcinoembryonic antigen

PIVKA-II:

Proteins induced by vitamin K absence or antagonist-II

AJCC:

American Joint Committee on Cancer

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Acknowledgements

The scientific guarantor of this publication is Jin-Young Choi. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study was supported by a faculty research grant of Yonsei University College of Medicine for 6-2014-0126. Ha Yan Kim kindly provided statistical advice for this manuscript. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Korea

    Jieun Koh, Yong Eun Chung, Myeong-Jin Kim & Jin-Young Choi

  2. Department of Pathology, Yonsei University, College of Medicine, Seoul, Korea

    Ji Hae Nahm & Young Nyun Park

  3. Biostatistics Collaboration Unit, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea

    Ha Yan Kim

  4. Department of General Surgery, Yonsei University, College of Medicine, Seoul, Korea

    Kyung-Sik Kim

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  1. Jieun Koh
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Correspondence to Jin-Young Choi.

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Koh, J., Chung, Y.E., Nahm, J.H. et al. Intrahepatic mass-forming cholangiocarcinoma: prognostic value of preoperative gadoxetic acid-enhanced MRI. Eur Radiol 26, 407–416 (2016). https://doi.org/10.1007/s00330-015-3846-5

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  • DOI: https://doi.org/10.1007/s00330-015-3846-5

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