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A radiomic-based model of different contrast-enhanced CT phase for differentiate intrahepatic cholangiocarcinoma from inflammatory mass with hepatolithiasis

  • Hepatobiliary
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Background

Intrahepatic cholangiocarcinoma (ICC) is hard to distinguish from inflammatory mass (IM) complicated with hepatolithiasis in clinical practice preoperatively. This study looked to develop and confirm the radiomics models to make a distinction between ICC with hepatolithiasis from IM and to compare the results of different contrast-enhanced computed tomography (CT) phase.

Methods

The models were developed in a training cohort of 110 patients from January 2005 to June 2020. Radiomics features were extracted from both arterial phase and portal venous phase contrast-enhanced computed tomography (CT) scans. The radiomics scores based on radiomics features, were built by logistic regression after using the least absolute shrinkage and selection operator (LASSO) method. The rad-scores of two contrast -enhanced CT phases and clinical features were incorporated into a novel model. The performance of the models were determined by theirs discrimination, calibration, and clinical usefulness. The models were externally validated in 35 consecutive patients.

Results

The radiomics signature comprised two features in arterial phase (training cohort, AUC = 0.809, sensitivity 0.700, specificity 0.848, and accuracy 0.774;validation cohort, AUC = 0.790, sensitivity 0.714, specificity 0.800, and accuracy 0.757) and three related features in portal venous phase (training cohort, AUC = 0.801, sensitivity 0.800, specificity 0.717, and accuracy 0.759; validation cohort, AUC = 0.830, sensitivity 0.700, specificity 0.750, and accuracy 0.775) showed significant association with ICC in both cohorts (P < 0.05).We also developed a model only based on clinical variables (training cohort, AUC = 0.778, sensitivity 0.567, specificity 0.891, and accuracy 0.729; validation cohort, AUC = 0.788, sensitivity 0.571, specificity 0.950, and accuracy 0.761). The radiomics-based model contained rad-score of two phases and two clinical factors (CEA and CA19-9) showed the best performance (training cohort, AUC = 0.864, sensitivity 0.867, specificity 0.804, and accuracy 0.836; validation cohort, AUC = 0.843, sensitivity 0.643, specificity 0.980, and accuracy 0.821).

Conclusions

Our radiomics-based models provided a diagnostic tool for differentiate intrahepatic cholangiocarcinoma (ICC) from inflammatory mass (IM) with hepatolithiasis both in arterial phase and portal venous phase. To go a step further, the diagnostic accuracy will improved by a clinico-radiologic model.

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Abbreviations

IHL-ICC:

Intrahepatic cholangiocarcinoma (ICC) complicated by intrahepatic lithiasis (IHL)

IHL-IM:

Inflammatory mass (IM) complicated by intrahepatic lithiasis (IHL)

ICC:

Intrahepatic cholangiocarcinoma

IHL:

Intrahepatic lithiasis

IM:

Inflammatory mass

LASSO:

Least absolute shrinkage and selection operator

DCA:

Decision curve analysis

ROI:

Region of interest

OR:

Odds ratios

AUC:

Area under the curve

H–L:

Hosmer–Lemeshow

WMU:

Wenzhou Medical University

CEA:

Carcinoembryonic antigen

CA19-9:

Carbohydrate antigen 19-9

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Author notes

  1. Beihui Xue and Sunjie Wu have contributed equally.

Authors and Affiliations

  1. The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Beihui Xue, Sunjie Wu, Mingyue Zhang, Junjie Hong, Bole Liu, Nina Xu, Kun Tang & Xiangwu Zheng

  2. The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Qiqiang Zeng

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  1. Beihui Xue
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Xue, B., Wu, S., Zhang, M. et al. A radiomic-based model of different contrast-enhanced CT phase for differentiate intrahepatic cholangiocarcinoma from inflammatory mass with hepatolithiasis. Abdom Radiol 46, 3835–3844 (2021). https://doi.org/10.1007/s00261-021-03027-6

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