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

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 cons...

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Autores principales:	Yeun‐Yoon Kim, Suk‐Keu Yeom, Hyejung Shin, Sang Hyun Choi, Hyungjin Rhee, Ji Hoon Park, Eun‐Suk Cho, Sumi Park, Seung Soo Lee, Mi‐Suk Park
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/bebf443a7faf4d6286377d80bd149db6
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spelling	oai:doaj.org-article:bebf443a7faf4d6286377d80bd149db62021-11-30T13:39:17ZClinical Staging of Mass‐Forming Intrahepatic Cholangiocarcinoma: Computed Tomography Versus Magnetic Resonance Imaging2471-254X10.1002/hep4.1774https://doaj.org/article/bebf443a7faf4d6286377d80bd149db62021-12-01T00:00:00Zhttps://doi.org/10.1002/hep4.1774https://doaj.org/toc/2471-254XWe 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.Yeun‐Yoon KimSuk‐Keu YeomHyejung ShinSang Hyun ChoiHyungjin RheeJi Hoon ParkEun‐Suk ChoSumi ParkSeung Soo LeeMi‐Suk ParkWileyarticleDiseases of the digestive system. GastroenterologyRC799-869ENHepatology Communications, Vol 5, Iss 12, Pp 2009-2018 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 Yeun‐Yoon Kim Suk‐Keu Yeom Hyejung Shin Sang Hyun Choi Hyungjin Rhee Ji Hoon Park Eun‐Suk Cho Sumi Park Seung Soo Lee Mi‐Suk Park Clinical Staging of Mass‐Forming Intrahepatic Cholangiocarcinoma: Computed Tomography Versus Magnetic Resonance Imaging
description	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.
format	article
author	Yeun‐Yoon Kim Suk‐Keu Yeom Hyejung Shin Sang Hyun Choi Hyungjin Rhee Ji Hoon Park Eun‐Suk Cho Sumi Park Seung Soo Lee Mi‐Suk Park
author_facet	Yeun‐Yoon Kim Suk‐Keu Yeom Hyejung Shin Sang Hyun Choi Hyungjin Rhee Ji Hoon Park Eun‐Suk Cho Sumi Park Seung Soo Lee Mi‐Suk Park
author_sort	Yeun‐Yoon Kim
title	Clinical Staging of Mass‐Forming Intrahepatic Cholangiocarcinoma: Computed Tomography Versus Magnetic Resonance Imaging
title_short	Clinical Staging of Mass‐Forming Intrahepatic Cholangiocarcinoma: Computed Tomography Versus Magnetic Resonance Imaging
title_full	Clinical Staging of Mass‐Forming Intrahepatic Cholangiocarcinoma: Computed Tomography Versus Magnetic Resonance Imaging
title_fullStr	Clinical Staging of Mass‐Forming Intrahepatic Cholangiocarcinoma: Computed Tomography Versus Magnetic Resonance Imaging
title_full_unstemmed	Clinical Staging of Mass‐Forming Intrahepatic Cholangiocarcinoma: Computed Tomography Versus Magnetic Resonance Imaging
title_sort	clinical staging of mass‐forming intrahepatic cholangiocarcinoma: computed tomography versus magnetic resonance imaging
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/bebf443a7faf4d6286377d80bd149db6
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Clinical Staging of Mass‐Forming Intrahepatic Cholangiocarcinoma: Computed Tomography Versus Magnetic Resonance Imaging

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