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Contrast-enhanced MRI could predict response of systemic therapy in advanced intrahepatic cholangiocarcinoma

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

Abstract

Objective

To investigate whether pre-treatment contrast-enhanced MRI could predict the therapeutic response of systemic treatment in advanced intrahepatic cholangiocarcinoma (ICC).

Methods

This retrospective study enrolled 61 ICC participants with contrast-enhanced MRI before combined systemic therapy. Clinical characteristics and MRI features were compared between patients with and without therapeutic response by univariate and multivariate logistic regression analyses. Then, a combined MRI-based model and the nomogram were established based on the results of the multivariate analysis. The diagnostic performances of significant findings and the combined model were evaluated and compared. The progression-free survival (PFS) rates between patients with high and low combined index values were compared.

Results

Thirty (49.18%) patients showed overall response after therapy. In multivariate analysis, tumor margin (odds ratio (OR) = 5.004, p = 0.014), T2 homogeneity (OR = 14.93, p = 0.019), and arterial peritumoral enhancement (OR = 5.076, p = 0.042) were independent predictive factors associated with therapeutic response. The C-index with the formulated nomogram incorporating the three independent imaging features was 0.828 (95% CI 0.710–0.913). Diagnostic characteristics of the combined index were superior to any single feature alone (p = 0.0007–0.0141). ICCs with high combined index values showed higher PFS rates than those with low values (χ2 = 13.306, p < 0.0001).

Conclusions

Pre-treatment contrast-enhanced MRI can be used to predict therapeutic response in advanced ICC with systemic therapy. The combination model incorporating significant MRI features achieved an improved predictive value, which may play an important role in identifying appropriate therapeutic candidates.

Key Points

• Contrast-enhanced MRI can predict response of systemic therapy in advanced ICC.

• MRI features of tumor margin, T2 homogeneity, and arterial peritumoral enhancement are related to therapeutic response.

• The combined MRI-based model may help to identify appropriate therapeutic candidates.

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Abbreviations

ADC:

Apparent diffusion coefficient

APE:

Arterial peritumoral enhancement

AUC:

Area under the curve

CI:

Confidence interval

ICC:

Intrahepatic cholangiocarcinoma

MRI:

Magnetic resonance imaging

OR:

Odds ratio

PD-1:

Programmed cell death protein 1

PFS:

Progression-free survival

RECIST:

Response Evaluation Criteria in Solid Tumors

ROI:

Region of interest

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Acknowledgements

This study was funded by the Natural Science Foundation of Fujian Province (grant number 2021D032), Shanghai Rising Stars of Medical Talent Youth Development Program (grant number SHWRS(2020)_087), the Shanghai Municipal Key Clinical Specialty (grant number shslczdzk03202), and the Clinical Research Plan of SHDC (grant number SHDC2020CR1003A). The authors thank the statistician Minzhi Lv for her support in statistical analyses in this work.

Funding

This study has received funding by the Natural Science Foundation of Fujian Province (grant number 2021D032), Shanghai Rising Stars of Medical Talent Youth Development Program (grant number SHWRS(2020)_087), the Shanghai Municipal Key Clinical Specialty (grant number shslczdzk03202), and the Clinical Research Plan of SHDC (grant number SHDC2020CR1003A).

Author information

Authors and Affiliations

  1. Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China

    Ruofan Sheng, Kaipu Jin, Shanshan Gao, Mengsu Zeng & Dong Wu

  2. Zhongshan Xiamen Hospital, Fudan University, Shanghai, China

    Ruofan Sheng

  3. Shanghai Institute of Medical Imaging, Shanghai, China

    Kaipu Jin, Shanshan Gao, Mengsu Zeng & Dong Wu

  4. Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

    Xiaoyong Huang & Guoming Shi

Authors
  1. Ruofan Sheng
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  2. Xiaoyong Huang
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  4. Shanshan Gao
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  5. Mengsu Zeng
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  6. Dong Wu
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  7. Guoming Shi
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Corresponding authors

Correspondence to Mengsu Zeng or Dong Wu.

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Guarantor

The scientific guarantor of this publication is Mengsu Zeng.

Conflict of interest

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.

Statistics and biometry

One of the authors has significant statistical expertise (Shanshan Gao). And Minzhi Lv kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained by Zhongshan Hospital, Fudan University (Approval Number: B2021-113R).

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Mengsu Zeng and Dong Wu contribute the same as corresponding authors.

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Cite this article

Sheng, R., Huang, X., Jin, K. et al. Contrast-enhanced MRI could predict response of systemic therapy in advanced intrahepatic cholangiocarcinoma. Eur Radiol 32, 5156–5165 (2022). https://doi.org/10.1007/s00330-022-08679-6

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  • DOI: https://doi.org/10.1007/s00330-022-08679-6

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