Preoperative CT and MRI assessment of the longitudinal tumor extent of extrahepatic bile duct cancer after biliary drainage

Autor:	Cho SB; Severance Hospital, Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Seoul, Republic of Korea, Kim YY; Severance Hospital, Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Sciences, Seoul, Republic of Korea, Park J; Severance Hospital, Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Seoul, Republic of Korea, Shin HJ; Yonsei University College of Medicine, Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, Seoul, Republic of Korea
Jazyk:	angličtina
Zdroj:	Diagnostic and interventional radiology (Ankara, Turkey) [Diagn Interv Radiol] 2024 Jul 08; Vol. 30 (4), pp. 212-219. Date of Electronic Publication: 2024 Feb 20.
DOI:	10.4274/dir.2024.232601
Abstrakt:	Purpose: To examine the diagnostic performance for the longitudinal extent of extrahepatic bile duct (EHD) cancer on computed tomography (CT) after biliary drainage (BD) and investigate the appropriate timing of magnetic resonance imaging (MRI) acquisition. Methods: This retrospective study included patients who underwent curative-intent surgery for EHD cancer and CT pre- and post-BD between November 2005 and June 2021. The biliary segment-wise longitudinal tumor extent was evaluated according to the 2019 Korean Society of Abdominal Radiology consensus recommendations, with pre-BD CT, post-BD CT, and both pre- and post-BD CT. The performance for tumor detectability was compared using generalized estimating equation (GEE) method. When preoperative MRI was performed, patients were divided into two subgroups according to the timing of MRI with respect to BD, and the performance of MRI obtained pre- and post-BD was compared. Results: In 105 patients (mean age: 67 ± 8 years; 74 men and 31 women), the performance for tumor detectability was superior using both CT scans compared with using post-BD CT alone (reader 1: sensitivity, 72.6% vs. 64.6%, P < 0.001; specificity, 96.9% vs. 94.8%, P = 0.063; reader 2: sensitivity, 77.2% vs. 72.9%, P = 0.126; specificity, 97.5% vs. 94.2%, P = 0.003), and it was comparable with using pre-BD CT alone. In biliary segments with a catheter, higher sensitivity and specificity were observed using both CT scans than using post-BD CT (reader 1: sensitivity, 74.4% vs. 67.5%, P = 0.006; specificity, 92.4% vs. 88.0%, P = 0.068; reader 2: sensitivity, 80.5% vs. 74.4%, P = 0.013; specificity, 94.3% vs. 88.0%, P = 0.016). Post-BD MRI (n = 30) exhibited a comparable performance to pre-BD MRI (n = 55) (reader 1: sensitivity, 77.9% vs. 75.0%, P = 0.605; specificity, 97.2% vs. 94.9%, P = 0.256; reader 2: sensitivity, 73.2% vs. 72.6%, P = 0.926; specificity, 98.4% vs. 94.9%, P = 0.068). Conclusion: Pre-BD CT provided better diagnostic performance in the preoperative evaluation of EHD cancer. The longitudinal tumor extent could be accurately assessed with post-BD MRI, which was similar to pre-BD MRI. Clinical Significance: The acquisition of pre-BD CT could be beneficial for the preoperative evaluation of EHD cancer when BD is planned. Post-BD MRI would not be significantly affected by BD in terms of the diagnostic performance of the longitudinal tumor extent.
Databáze:	MEDLINE
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