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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
Article
  • 127 Downloads

Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusions

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.

Keywords

Prognostic factors Intrahepatic cholangiocarcinoma Magnetic resonance imaging Disodium gadoxetate 

Abbreviations

ADC

Apparent diffusion coefficient

AIC

Akaike information criterion

AJCC

American Joint Committee on Cancer

AP

Arterial phase

AVI

Any vascular invasion

BDI

Bile duct invasion

BO

Biliary obstruction

CI

Confidence interval

CT

Computed tomography

DWI

Diffusion-weighted images

HBP

Hepatobiliary phase

HR

Hazard ratio

HVO

Hepatic vein obstruction

IMCC

Intrahepatic mass-forming cholangiocarcinoma

LCSGJ

Liver Cancer Study Group of Japan

MRI

Magnetic resonance imaging

MVI

Microvessel invasion

OS

Overall survival

PVO

Portal vein obstruction

RCS

Restricted cubic splines

RFS

Recurrence-free survival

SI

Signal intensity

Notes

Compliance with ethical standards

Funding

Nothing.

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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