MRI-Based Radiomics Nomogram for Preoperatively Differentiating Intrahepatic Mass-Forming Cholangiocarcinoma From Resectable Colorectal Liver Metastases

Ying Xu; Feng Ye; Lu Li; Yi Yang; Jingzhong Ouyang; Yanzhao Zhou; Sicong Wang; Lizhi Xie; Jinxue Zhou; Hong Zhao; Xinming Zhao

doi:10.1016/j.acra.2023.04.030

MRI-Based Radiomics Nomogram for Preoperatively Differentiating Intrahepatic Mass-Forming Cholangiocarcinoma From Resectable Colorectal Liver Metastases

Acad Radiol. 2023 Sep;30(9):2010-2020. doi: 10.1016/j.acra.2023.04.030. Epub 2023 Jul 4.

Authors

Ying Xu¹, Feng Ye¹, Lu Li¹, Yi Yang², Jingzhong Ouyang³, Yanzhao Zhou⁴, Sicong Wang⁵, Lizhi Xie⁵, Jinxue Zhou³, Hong Zhao², Xinming Zhao⁶

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, Beijing, China (Y.X., F.Y., L.L., X.Z.).
² Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.Y., H.Z.); Key Laboratory of Gene Editing Screening and Research and Development (R&D) of Digestive System Tumor Drugs, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.Y., H.Z.).
³ Department of Hepatobiliary and Pancreatic Surgery, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, China (J.O., Y.Z., J.Z.).
⁴ Department of Hepatobiliary and Pancreatic Surgery, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, China (J.O., Y.Z., J.Z.); Department of Hepatobiliary Cancer, Liver Cancer Research Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China (Y.Z.).
⁵ Magnetic Resonance Imaging Research, General Electric Healthcare, Beijing, China (S.W., L.X.).
⁶ 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, Beijing, China (Y.X., F.Y., L.L., X.Z.). Electronic address: xinmingzhncc@163.com.

PMID: 37414635
DOI: 10.1016/j.acra.2023.04.030

Abstract

Rationale and objectives: To establish a radiomics nomogram based on multiparameter magnetic resonance (MR) images for preoperatively differentiating intrahepatic mass-forming cholangiocarcinoma (IMCC) from colorectal cancer liver metastasis (CRLM).

Materials and methods: A total of 133 patients in training cohort (64 IMCC and 69 CRLM), 57 patients in internal validation cohort (29 IMCC and 28 CRLM), and 51 patients (23 IMCC and 28 CRLM) in external validation cohort were included. Radiomics features were extracted from the multiparameter MR images and selected by the least absolute shrinkage and selection operator algorithm to establish the radiomics model. Clinical variables and magnetic resonance imaging (MRI) findings were selected by univariate and multivariate analyses to construct a clinical model. The radiomics nomogram was combined with radiomics model and clinical model.

Results: Six features were selected to construct the radiomics model. The radiomics signature showed better discrimination than the clinical model in the training cohort (Area Under the Curve (AUC), 0.92; 95% confidence interval (CI), 0.87-0.96 vs. AUC, 0.74; 95% CI, 0.66-0.83) and the external validation cohort (AUC, 0.90; 95% CI, 0.82-0.98 vs. AUC, 0.81; 95% CI, 0.69-0.93). The radiomics nomogram showed the best discrimination performance with favorable calibration in the training cohort (AUC, 0.94; 95% CI, 0.90-0.97) and the external validation cohort (AUC, 0.92; 95% CI, 0.84-1.00).

Conclusion: The radiomics nomogram combining radiomics signatures based on multiparameter MRI with clinical factors (serum carcinoembryonic antigen level and tumor diameter) may provide a reliable and noninvasive tool to discriminate IMCC from CRLM, which could help guide treatment strategies and prognosis preoperatively prediction.

Keywords: Cholangiocarcinoma; Colorectal liver metastases; Differential diagnosis; Nomogram; Radiomics.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bile Duct Neoplasms* / diagnostic imaging
Bile Duct Neoplasms* / surgery
Bile Ducts, Intrahepatic
Cholangiocarcinoma* / diagnostic imaging
Cholangiocarcinoma* / surgery
Colorectal Neoplasms* / diagnostic imaging
Colorectal Neoplasms* / surgery
Humans
Liver Neoplasms* / diagnostic imaging
Liver Neoplasms* / surgery
Magnetic Resonance Imaging / methods
Nomograms
Retrospective Studies