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European Radiology
Published in: European Radiology 8/2022

17-03-2022 | Magnetic Resonance Imaging | Hepatobiliary-Pancreas

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

Authors: Ruofan Sheng, Xiaoyong Huang, Kaipu Jin, Shanshan Gao, Mengsu Zeng, Dong Wu, Guoming Shi

Published in: European Radiology | Issue 8/2022

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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.
Literature
1.
Sirica AE, Gores GJ, Groopman JD et al (2019) Intrahepatic cholangiocarcinoma: continuing challenges and translational advances. Hepatology 69:1803–1815CrossRef
2.
Kelley RK, Bridgewater J, Gores GJ, Zhu AX (2020) Systemic therapies for intrahepatic cholangiocarcinoma. J Hepatol 72:353–363CrossRef
3.
Fiteni F, Nguyen T, Vernerey D et al (2014) Cisplatin/gemcitabine or oxaliplatin/gemcitabine in the treatment of advanced biliary tract cancer: a systematic review. Cancer Med 3:1502–1511CrossRef
4.
Jang JS, Lim HY, Hwang IG et al (2010) Gemcitabine and oxaliplatin in patients with unresectable biliary cancer including gall bladder cancer: a Korean Cancer Study Group phase II trial. Cancer Chemother Pharmacol 65:641–647CrossRef
5.
Llovet JM, Ricci S, Mazzaferro V et al (2008) Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 359:378–390CrossRef
6.
Kudo M, Finn RS, Qin S et al (2018) Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet 391:1163–1173CrossRef
7.
Ueno M, Ikeda M, Sasaki T et al (2020) Phase 2 study of lenvatinib monotherapy as second-line treatment in unresectable biliary tract cancer: primary analysis results. BMC Cancer 20:1105CrossRef
8.
El-Khoueiry AB, Sangro B, Yau T et al (2017) Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate 040): an open-label, non-comparative, phase 1/2 dose escalation and expansion trial. Lancet 389:2492–2502CrossRef
9.
Finn RS, Ryoo BY, Merle P et al (2020) Pembrolizumab as second-line therapy in patients with advanced hepatocellular carcinoma in KEYNOTE-240: a randomized, double-blind, phase III trial. J Clin Oncol 38:193–202CrossRef
10.
Ilyas FZ, Beane JD, Pawlik TM (2021) The state of immunotherapy in hepatobiliary cancers. Cells 10:2096CrossRef
11.
Lee YJ, Lee JM, Lee JS et al (2015) Hepatocellular carcinoma: diagnostic performance of multidetector CT and MR imaging-a systematic review and meta-analysis. Radiology 275:97–109CrossRef
12.
Kudo M (2020) Gd-EOB-DTPA-MRI could predict WNT/beta-catenin mutation and resistance to immune checkpoint inhibitor therapy in hepatocellular carcinoma. Liver Cancer 9:479–490CrossRef
13.
Yoon JH, Lee JM (2019) Can MRI features predict prognosis in mass-forming intrahepatic cholangiocarcinoma? Radiology 290:700–701CrossRef
14.
Pandey A, Pandey P, Ghasabeh MA et al (2018) Baseline volumetric multiparametric MRI: can it be used to predict survival in patients with unresectable intrahepatic cholangiocarcinoma undergoing transcatheter arterial chemoembolization? Radiology 289:843–853CrossRef
15.
Kim S, An C, Han K, Kim MJ (2019) Gadoxetic acid enhanced magnetic resonance imaging for prediction of the postoperative prognosis of intrahepatic mass-forming cholangiocarcinoma. Abdom Radiol (NY) 44:110–121CrossRef
16.
Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247CrossRef
17.
Bertuccio P, Malvezzi M, Carioli G et al (2019) Global trends in mortality from intrahepatic and extrahepatic cholangiocarcinoma. J Hepatol 71:104–114CrossRef
18.
Chen J, Wu Z, Xia C et al (2020) Noninvasive prediction of HCC with progenitor phenotype based on gadoxetic acid-enhanced MRI. Eur Radiol 30:1232–1242CrossRef
19.
Zhao YJ, Chen WX, Wu DS, Zhang WY, Zheng LR (2016) Differentiation of mass-forming intrahepatic cholangiocarcinoma from poorly differentiated hepatocellular carcinoma: based on the multivariate analysis of contrast-enhanced computed tomography findings. Abdom Radiol (NY) 41:978–989CrossRef
20.
Wei Y, Pei W, Qin Y, Su D, Liao H (2021) Preoperative MR imaging for predicting early recurrence of solitary hepatocellular carcinoma without microvascular invasion. Eur J Radiol 138:109663CrossRef
21.
Ahn KS, Kang KJ (2020) Molecular heterogeneity in intrahepatic cholangiocarcinoma. World J Hepatol 12:1148–1157CrossRef
22.
Braconi C, Roessler S, Kruk B, Lammert F, Krawczyk M, Andersen JB (2019) Molecular perturbations in cholangiocarcinoma: is it time for precision medicine? Liver Int 39(Suppl 1):32–42CrossRef
23.
Wang X, Wang W, Ma X et al (2020) Combined hepatocellular-cholangiocarcinoma: which preoperative clinical data and conventional MRI characteristics have value for the prediction of microvascular invasion and clinical significance? Eur Radiol 30:5337–5347CrossRef
24.
Chong HH, Yang L, Sheng RF et al (2021) Multi-scale and multi-parametric radiomics of gadoxetate disodium-enhanced MRI predicts microvascular invasion and outcome in patients with solitary hepatocellular carcinoma ≤ 5 cm. Eur Radiol 31:4824–4838CrossRef
25.
Zhao H, Hua Y, Dai T et al (2017) Development and validation of a novel predictive scoring model for microvascular invasion in patients with hepatocellular carcinoma. Eur J Radiol 88:32–40CrossRef
26.
Yang L, Gu D, Wei J et al (2019) A radiomics nomogram for preoperative prediction of microvascular invasion in hepatocellular carcinoma. Liver Cancer 8:373–386CrossRef
27.
Zhou C, Wang Y, Ma L, Qian X, Yang C, Zeng M (2021) Combined hepatocellular carcinoma-cholangiocarcinoma: MRI features correlated with tumor biomarkers and prognosis. Eur Radiol 32:78–88CrossRef
28.
King MJ, Hectors S, Lee KM et al (2020) Outcomes assessment in intrahepatic cholangiocarcinoma using qualitative and quantitative imaging features. Cancer Imaging 20:43CrossRef
Metadata
Title
Contrast-enhanced MRI could predict response of systemic therapy in advanced intrahepatic cholangiocarcinoma
Authors
Ruofan Sheng
Xiaoyong Huang
Kaipu Jin
Shanshan Gao
Mengsu Zeng
Dong Wu
Guoming Shi
Publication date
17-03-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08679-6

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