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Clinical Staging of Mass-Forming Intrahepatic Cholangiocarcinoma: Computed Tomography Versus Magnetic Resonance Imaging

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Abstract
We compared the performance of computed tomography (CT) and magnetic resonance imaging (MRI) for preoperative clinical staging of mass-forming intrahepatic cholangiocarcinoma (iCCA), using the eighth American Joint Committee on Cancer (AJCC) system. This retrospective, multicenter, cohort study consecutively identified patients who underwent partial hepatectomy for mass-forming iCCA and had preoperative CT and MRI performed from January 2009 to December 2015. CT and MRI characteristics were used to determine clinical stage based on the eighth AJCC system. Performances of CT and MRI for clinical T and N staging were compared using generalized estimating equations. In 334 patients (median age, 63 years; 221 men), MRI sensitivities were significantly higher than CT sensitivities for detecting T1b or higher stages (91.0% vs. 80.5%, respectively, P < 0.001), T2 or higher stages (89.1% vs. 73.8%, respectively, P < 0.001), and T3 or T4 stage (77.8% vs. 58.0%, respectively, P < 0.001). MRI was also more sensitive at identifying multiple tumors than CT (66.7% vs. 50.0%, respectively, P = 0.026), without a significant difference in specificity (78.1% vs. 80.1%, respectively, P = 0.342). Sensitivities were comparable between CT and MRI for determination of size >5 cm (i.e., T1b for single tumor) and extrahepatic organ invasion (i.e., T4). Sensitivities of CT and MRI were not different for N stage (65.0% vs. 64.0%, respectively, P = 0.808), but the specificity of CT was significantly higher than that of MRI (80.7% vs. 72.9%, respectively, P = 0.001) when using a composite reference standard. Conclusion: MRI showed superior sensitivity to CT for diagnosing T2 and T3 stages, particularly multiple tumors. CT and MRI had comparable sensitivity for N staging, but CT provided higher specificity than MRI.
Author(s)
김연윤박미숙박수미박지훈신혜정염석규이승수이형진조은석최상현
Issued Date
2021
Type
Article
Keyword
AgedBile Duct Neoplasms - diagnostic imagingBile DuctsIntrahepatic - diagnostic imagingCholangiocarcinomaCholangiocarcinoma - diagnostic imagingContrast agentsFemaleHumansLiver cancerLymphatic systemMagnetic resonance imagingMagnetic Resonance Imaging - statistics &amp; numerical dataMaleMetastasisMiddle agedMortalityNeoplasm Staging - methodsPatientsReproducibility of ResultsRetrospective StudiesSensitivity and SpecificityStatistical analysisSurgeryThrombosisTomographyTomographyX-Ray Computed - statistics &amp; numerical dataTumors
DOI
10.1002/hep4.1774
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7234
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_bebf443a7faf4d6286377d80bd149db6&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Clinical%20Staging%20of%20Mass-Forming%20Intrahepatic%20Cholangiocarcinoma:%20Computed%20Tomography%20Versus%20Magnetic%20Resonance%20Imaging&amp;offset=0&amp;pcAvailability=true
Publisher
Hepatology Communications
Location
미국
Language
영어
ISSN
2471-254X
Citation Volume
5
Citation Number
12
Citation Start Page
2009
Citation End Page
2018
Appears in Collections:
Medicine > Medicine
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