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Modification and comparison of CT criteria in the preoperative assessment of hepatic arterial invasion by hilar cholangiocarcinoma

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objective

To compare the diagnostic performance of three CT criteria and two signs in evaluating hepatic arterial invasion by hilar cholangiocarcinoma.

Methods

In this study, we retrospectively reviewed the CT images of 85 patients with hilar cholangiocarcinoma. Modified Loyer’s, Lu’s, and Li’s standards were used to evaluate hepatic arterial invasion by hilar cholangiocarcinoma with the reference of intraoperative findings and/or the postoperative pathological diagnosis. Arterial tortuosity and contact length were also evaluated.

Results

Loyer’s, Lu’s, and Li’s standards showed sensitivities of 91.7%, 90.3%, and 72.2%, specificities of 94.0%, 94.5%, and 95.6%, and accuracies of 93.3%, 93.3%, and 89.0%, respectively, in evaluating hepatic arterial invasion by hilar cholangiocarcinoma. Loyer’s and Lu’s standards and contact length performed better than Li’s standard (P < 0.001). Arterial tortuosity performed worse than other criteria (P < 0.001). The CT criteria performed best in evaluating proper hepatic arterial invasion compared with the left and right hepatic artery. When the cut-off contact length of 6.73 mm was combined with Loyer’s standard, 4 false-negative cases could be avoided.

Conclusions

Loyer’s and Lu’s standards and the contact length performed best in evaluating hepatic arterial invasion by hilar cholangiocarcinoma on preoperative CT images, particularly in assessing the proper hepatic artery. Arterial tortuosity could serve as an important supplement. The combination of the contact length and Loyer’s standard could improve the diagnostic performance.

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Abbreviations

ROI:

Region of interest

MPR:

Multiple planar reconstruction

VR:

Volume rendering

MIP:

Maximum intensity projection

ROC:

Receiver operating characteristic

ICC:

Intraclass correlation coefficient

AUC:

Area under the ROC curve

ERCP:

Endoscopic retrograde cholangio-pancreatography

PTCD:

Percutaneous transhepatic cholangial drainage

PVE:

Portal vein embolization

CI:

Confidence interval

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Acknowledgements

The authors thank the hepatobiliary pancreatic tumor multidisciplinary team in Nanjing Drum Tower Hospital

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Author notes

  1. Kefeng Zhou, Anning Hu and Jian He have contributed equally.

Authors and Affiliations

  1. Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China

    Qun Zhou, Guoqiang Dong, Qiongjie Zhu, Kefeng Zhou, Anning Hu & Jian He

  2. Department of Hepatopancreatobiliary Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China

    Yudong Qiu & Liang Mao

  3. Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China

    Jun Chen

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  1. Qun Zhou
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Correspondence to Kefeng Zhou, Anning Hu or Jian He.

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Zhou, Q., Dong, G., Zhu, Q. et al. Modification and comparison of CT criteria in the preoperative assessment of hepatic arterial invasion by hilar cholangiocarcinoma. Abdom Radiol 46, 1922–1930 (2021). https://doi.org/10.1007/s00261-020-02849-0

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