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Nomogram based on preoperative clinical and MRI features to estimate the microvascular invasion status and the prognosis of solitary intrahepatic mass-forming cholangiocarcinoma

  • Hepatobiliary
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Abstract

Purpose

To develop a nomogram based on preoperative clinical and magnetic resonance imaging (MRI) features for the microvascular invasion (MVI) status in solitary intrahepatic mass-forming cholangiocarcinoma (sIMCC) and to evaluate whether it could predict recurrence-free survival (RFS).

Methods

We included 115 cases who experienced MRI examinations for sIMCC with R0 resection. The preoperative clinical and MRI features were extracted. Independent predictors related to MVI+ were evaluated by stepwise multivariate logistic regression, and a nomogram was constructed. A receiver operating characteristic (ROC) curve was used to assess the predictive ability. All patients were classified into high- and low-risk groups of MVI. Then, the correlations of the nomogram with RFS in patents with sIMCC were analyzed by Kaplan–Meier method.

Results

The occurrence rate of MVI+ was 38.3% (44/115). The preoperative independent predictors of MVI+ were carbohydrate antigen 19-9 > 37 U/ml, tumor size > 5 cm, and an ill-defined tumor boundary. Integrating these predictors, the nomogram exerted a favorable diagnostic performance with areas under the ROC curve of 0.767 (95% confidence interval [CI] 0.654–0.881) in the development cohort, and 0.760 (95% CI 0.591–0.929) in the validation cohort. In the RFS analysis, significant differences were observed between the high- and low-risk MVI groups (6-month RFS rates: 64.5% vs. 78.8% and 46.7% vs. 82.4% in the development and validation cohorts, respectively) (P < 0.05).

Conclusions

A nomogram based on clinical and MRI features is a potential biomarker of MVI and may be a potent method to classify the risk of recurrence in patients with sIMCC.

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Data availability

Data generated or analyzed during the study are available from the corresponding authors by request.

Abbreviations

CA 19-9:

Carbohydrate antigen 19-9

CI:

Confidence interval

iCCA:

Intrahepatic cholangiocarcinoma

sIMCC:

Solitary intrahepatic mass-forming cholangiocarcinoma

MRI:

Magnetic resonance imaging

MVI:

Microvascular invasion

OR:

Odds ratio

RFS:

Recurrence-free survival

ROC:

Receiver operating characteristic

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Funding

There is no funding information related to this retrospective study.

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Author notes

  1. Lin Li and Hongmei Zhang have contributed equally to the work.

Authors and Affiliations

  1. Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, #17 Panjiayuan nanli, Chaoyang district, Beijing, 100021, China

    Shuang Chen, Lijuan Wan, Rui Zhao, Wenjing Peng, Xiangchun Liu, Lin Li & Hongmei Zhang

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  1. Shuang Chen
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  2. Lijuan Wan
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Contributions

SC contributed toward data curation, writing—original draft, and methodology. LW contributed toward data curation, formal analysis, and investigation. RZ contributed toward data curation and methodology. WP contributed toward resources and supervision. XL contributed toward resources and supervision. LL contributed toward conceptualization, formal analysis, investigation, project administration, and writing—review and editing. HZ contributed toward conceptualization, formal analysis, investigation, project administration, and writing—review and editing.

Corresponding author

Correspondence to Hongmei Zhang.

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The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Chen, S., Wan, L., Zhao, R. et al. Nomogram based on preoperative clinical and MRI features to estimate the microvascular invasion status and the prognosis of solitary intrahepatic mass-forming cholangiocarcinoma. Abdom Radiol 49, 425–436 (2024). https://doi.org/10.1007/s00261-023-04079-6

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  • DOI: https://doi.org/10.1007/s00261-023-04079-6

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