Delayed-phase dynamic CT enhancement as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma

Yoshiki Asayama, Kengo Yoshimitsu, Hiroyuki Irie, Tsuyoshi Tajima, Akihiro Nishie, Masakazu Hirakawa, Tomohiro Nakayama, Daisuke Kakihara, Akinobu Taketomi, Shin Ichi Aishima, Hiroshi Honda

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Abstract

Purpose: To retrospectively determine whether the degree of contrast material enhancement at delayed-phase dynamic computed tomography (CT) for intrahepatic cholangiocarcinoma (ICC) is related to the patient's prognosis after surgery. Materials and Methods: Neither institutional review board approval nor informed consent was required for this retrospective evaluation. Thirty-two patients (22 men, 10 women; mean age, 60.8 years; range, 33-80 years) with mass-forming ICC underwent dynamic CT. Delayed CT images obtained 4-6 minutes after the injection of contrast material were evaluated by two radiologists. Patients were classified in consensus into one of two groups: Group 1 included those in whom more than two thirds of the tumor showed enhancement on delayed-phase scans. Group 2 included those in whom less than two thirds of the tumor showed enhancement on delayed-phase scans. The imaging findings were correlated with pathologic findings. Survival curves were drawn by using the Kaplan-Meier method, and the differences between the groups were compared with the log-rank test. Multivariate analysis was performed to clarify prognostic factors. Results: There were 13 patients in group 1 and 19 in group 2. The degree of enhancement on the delayed-phase images showed statistically significant correlation with the amount of fibrous stroma (P < .001) and the frequency of perineural invasion (P < .01). The survival rate in group 1 was significantly lower than that in group 2 (P = .016). Multivariate analysis revealed that enhancement of more than two-thirds of the ICC was a significant and independent prognostic factor. Conclusion: The degree of enhancement on delayed-phase CT scans is a useful indicator for prediction of the prognosis of patients with mass-forming ICC.

Original languageEnglish
Pages (from-to)150-155
Number of pages6
JournalRadiology
Volume238
Issue number1
DOIs
Publication statusPublished - Jan 1 2006

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Cholangiocarcinoma
Tomography
Contrast Media
Multivariate Analysis
Research Ethics Committees
Informed Consent
Neoplasms
Survival Rate
Injections
Survival

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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Delayed-phase dynamic CT enhancement as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma. / Asayama, Yoshiki; Yoshimitsu, Kengo; Irie, Hiroyuki; Tajima, Tsuyoshi; Nishie, Akihiro; Hirakawa, Masakazu; Nakayama, Tomohiro; Kakihara, Daisuke; Taketomi, Akinobu; Aishima, Shin Ichi; Honda, Hiroshi.

In: Radiology, Vol. 238, No. 1, 01.01.2006, p. 150-155.

Research output: Contribution to journalArticle

Asayama, Yoshiki ; Yoshimitsu, Kengo ; Irie, Hiroyuki ; Tajima, Tsuyoshi ; Nishie, Akihiro ; Hirakawa, Masakazu ; Nakayama, Tomohiro ; Kakihara, Daisuke ; Taketomi, Akinobu ; Aishima, Shin Ichi ; Honda, Hiroshi. / Delayed-phase dynamic CT enhancement as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma. In: Radiology. 2006 ; Vol. 238, No. 1. pp. 150-155.
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abstract = "Purpose: To retrospectively determine whether the degree of contrast material enhancement at delayed-phase dynamic computed tomography (CT) for intrahepatic cholangiocarcinoma (ICC) is related to the patient's prognosis after surgery. Materials and Methods: Neither institutional review board approval nor informed consent was required for this retrospective evaluation. Thirty-two patients (22 men, 10 women; mean age, 60.8 years; range, 33-80 years) with mass-forming ICC underwent dynamic CT. Delayed CT images obtained 4-6 minutes after the injection of contrast material were evaluated by two radiologists. Patients were classified in consensus into one of two groups: Group 1 included those in whom more than two thirds of the tumor showed enhancement on delayed-phase scans. Group 2 included those in whom less than two thirds of the tumor showed enhancement on delayed-phase scans. The imaging findings were correlated with pathologic findings. Survival curves were drawn by using the Kaplan-Meier method, and the differences between the groups were compared with the log-rank test. Multivariate analysis was performed to clarify prognostic factors. Results: There were 13 patients in group 1 and 19 in group 2. The degree of enhancement on the delayed-phase images showed statistically significant correlation with the amount of fibrous stroma (P < .001) and the frequency of perineural invasion (P < .01). The survival rate in group 1 was significantly lower than that in group 2 (P = .016). Multivariate analysis revealed that enhancement of more than two-thirds of the ICC was a significant and independent prognostic factor. Conclusion: The degree of enhancement on delayed-phase CT scans is a useful indicator for prediction of the prognosis of patients with mass-forming ICC.",
author = "Yoshiki Asayama and Kengo Yoshimitsu and Hiroyuki Irie and Tsuyoshi Tajima and Akihiro Nishie and Masakazu Hirakawa and Tomohiro Nakayama and Daisuke Kakihara and Akinobu Taketomi and Aishima, {Shin Ichi} and Hiroshi Honda",
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AU - Asayama, Yoshiki

AU - Yoshimitsu, Kengo

AU - Irie, Hiroyuki

AU - Tajima, Tsuyoshi

AU - Nishie, Akihiro

AU - Hirakawa, Masakazu

AU - Nakayama, Tomohiro

AU - Kakihara, Daisuke

AU - Taketomi, Akinobu

AU - Aishima, Shin Ichi

AU - Honda, Hiroshi

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N2 - Purpose: To retrospectively determine whether the degree of contrast material enhancement at delayed-phase dynamic computed tomography (CT) for intrahepatic cholangiocarcinoma (ICC) is related to the patient's prognosis after surgery. Materials and Methods: Neither institutional review board approval nor informed consent was required for this retrospective evaluation. Thirty-two patients (22 men, 10 women; mean age, 60.8 years; range, 33-80 years) with mass-forming ICC underwent dynamic CT. Delayed CT images obtained 4-6 minutes after the injection of contrast material were evaluated by two radiologists. Patients were classified in consensus into one of two groups: Group 1 included those in whom more than two thirds of the tumor showed enhancement on delayed-phase scans. Group 2 included those in whom less than two thirds of the tumor showed enhancement on delayed-phase scans. The imaging findings were correlated with pathologic findings. Survival curves were drawn by using the Kaplan-Meier method, and the differences between the groups were compared with the log-rank test. Multivariate analysis was performed to clarify prognostic factors. Results: There were 13 patients in group 1 and 19 in group 2. The degree of enhancement on the delayed-phase images showed statistically significant correlation with the amount of fibrous stroma (P < .001) and the frequency of perineural invasion (P < .01). The survival rate in group 1 was significantly lower than that in group 2 (P = .016). Multivariate analysis revealed that enhancement of more than two-thirds of the ICC was a significant and independent prognostic factor. Conclusion: The degree of enhancement on delayed-phase CT scans is a useful indicator for prediction of the prognosis of patients with mass-forming ICC.

AB - Purpose: To retrospectively determine whether the degree of contrast material enhancement at delayed-phase dynamic computed tomography (CT) for intrahepatic cholangiocarcinoma (ICC) is related to the patient's prognosis after surgery. Materials and Methods: Neither institutional review board approval nor informed consent was required for this retrospective evaluation. Thirty-two patients (22 men, 10 women; mean age, 60.8 years; range, 33-80 years) with mass-forming ICC underwent dynamic CT. Delayed CT images obtained 4-6 minutes after the injection of contrast material were evaluated by two radiologists. Patients were classified in consensus into one of two groups: Group 1 included those in whom more than two thirds of the tumor showed enhancement on delayed-phase scans. Group 2 included those in whom less than two thirds of the tumor showed enhancement on delayed-phase scans. The imaging findings were correlated with pathologic findings. Survival curves were drawn by using the Kaplan-Meier method, and the differences between the groups were compared with the log-rank test. Multivariate analysis was performed to clarify prognostic factors. Results: There were 13 patients in group 1 and 19 in group 2. The degree of enhancement on the delayed-phase images showed statistically significant correlation with the amount of fibrous stroma (P < .001) and the frequency of perineural invasion (P < .01). The survival rate in group 1 was significantly lower than that in group 2 (P = .016). Multivariate analysis revealed that enhancement of more than two-thirds of the ICC was a significant and independent prognostic factor. Conclusion: The degree of enhancement on delayed-phase CT scans is a useful indicator for prediction of the prognosis of patients with mass-forming ICC.

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DO - 10.1148/radiol.2381041765

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