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. 2024 Sep;31(9):5604-5614.
doi: 10.1245/s10434-024-15457-9. Epub 2024 May 26.

Radiomics of Intrahepatic Cholangiocarcinoma and Peritumoral Tissue Predicts Postoperative Survival: Development of a CT-Based Clinical-Radiomic Model

Francesco Fiz  1   2 , Noemi Rossi  3 , Serena Langella  4 , Simone Conci  5 , Matteo Serenari  6   7 , Francesco Ardito  8 , Alessandro Cucchetti  7   9 , Teresa Gallo  10 , Giulia A Zamboni  11 , Cristina Mosconi  12 , Luca Boldrini  13 , Mariateresa Mirarchi  9 , Stefano Cirillo  10 , Andrea Ruzzenente  5 , Ilaria Pecorella  14 , Nadia Russolillo  4 , Martina Borzi  11 , Giulio Vara  12 , Caterina Mele  8 , Giorgio Ercolani  7   9 , Felice Giuliante  8 , Matteo Cescon  6   7 , Alfredo Guglielmi  5 , Alessandro Ferrero  4 , Martina Sollini  15   16 , Arturo Chiti  15   16 , Guido Torzilli  14   17 , Francesca Ieva #  3   18 , Luca Viganò #  19   20
Affiliations

Radiomics of Intrahepatic Cholangiocarcinoma and Peritumoral Tissue Predicts Postoperative Survival: Development of a CT-Based Clinical-Radiomic Model

Francesco Fiz et al. Ann Surg Oncol. 2024 Sep.

Abstract

Background: For many tumors, radiomics provided a relevant prognostic contribution. This study tested whether the computed tomography (CT)-based textural features of intrahepatic cholangiocarcinoma (ICC) and peritumoral tissue improve the prediction of survival after resection compared with the standard clinical indices.

Methods: All consecutive patients affected by ICC who underwent hepatectomy at six high-volume centers (2009-2019) were considered for the study. The arterial and portal phases of CT performed fewer than 60 days before surgery were analyzed. A manual segmentation of the tumor was performed (Tumor-VOI). A 5-mm volume expansion then was applied to identify the peritumoral tissue (Margin-VOI).

Results: The study enrolled 215 patients. After a median follow-up period of 28 months, the overall survival (OS) rate was 57.0%, and the progression-free survival (PFS) rate was 34.9% at 3 years. The clinical predictive model of OS had a C-index of 0.681. The addition of radiomic features led to a progressive improvement of performances (C-index of 0.71, including the portal Tumor-VOI, C-index of 0.752 including the portal Tumor- and Margin-VOI, C-index of 0.764, including all VOIs of the portal and arterial phases). The latter model combined clinical variables (CA19-9 and tumor pattern), tumor indices (density, homogeneity), margin data (kurtosis, compacity, shape), and GLRLM indices. The model had performance equivalent to that of the postoperative clinical model including the pathology data (C-index of 0.765). The same results were observed for PFS.

Conclusions: The radiomics of ICC and peritumoral tissue extracted from preoperative CT improves the prediction of survival. Both the portal and arterial phases should be considered. Radiomic and clinical data are complementary and achieve a preoperative estimation of prognosis equivalent to that achieved in the postoperative setting.

Keywords: Computed tomography; Intrahepatic cholangiocarcinoma; Liver surgery; Peritumoral tissue; Prognosis; Radiomics; Survival.

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