Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma
Introduction and aimIntrahepatic cholangiocarcinoma (iCCA) is a disease characterized by rarity, heterogeneity, and high mortality, where surgical resection is often not possible. Nowadays, due to the recent introduction of new therapeutic options such as trans-arterial radioembolization (TARE), it...
| Main Authors: | , , , , , , , , , , |
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| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1204717/full |
| _version_ | 1797785632637976576 |
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| author | Cristina Nanni Cristina Mosconi Valentino Dragonetti Massimo Barakat Nicola Fraccascia Maria Adriana Cocozza Stefano Brocchi Andrea Palloni Alexandro Paccapelo Giovanni Brandi Giovanni Brandi Stefano Fanti Stefano Fanti Stefano Fanti |
| author_facet | Cristina Nanni Cristina Mosconi Valentino Dragonetti Massimo Barakat Nicola Fraccascia Maria Adriana Cocozza Stefano Brocchi Andrea Palloni Alexandro Paccapelo Giovanni Brandi Giovanni Brandi Stefano Fanti Stefano Fanti Stefano Fanti |
| author_sort | Cristina Nanni |
| collection | DOAJ |
| description | Introduction and aimIntrahepatic cholangiocarcinoma (iCCA) is a disease characterized by rarity, heterogeneity, and high mortality, where surgical resection is often not possible. Nowadays, due to the recent introduction of new therapeutic options such as trans-arterial radioembolization (TARE), it is increasingly important to define the role of morphofunctional imaging methods for the prognostic stratification of patients affected by iCCA. The aim of the study was to verify the prognostic value of morphofunctional imaging methods at the baseline in patients with inoperable iCCA.MethodsIn total, 45 patients with iCCA were sent to our center between January 2016 and March 2021 for being evaluated to be treated with TARE. All of them underwent both [18F]-FDG-PET/CT and contrast-enhanced CT (ceCT) in a single procedure and were included in our study. The inclusion criteria were as follows: a diagnosis of inoperable iCCA; both [18F]-FDG-PET/CT and ceCT scans; and washout from therapy for at least 2 months before baseline [18F]-FDG-PET/CT and ceCT scans. Both clinical and laboratory data and baseline imaging data (ceCT and [18F]-FDG-PET/CT) were collected. In particular, regarding clinical and laboratory data, we collected overall survival (OS), gender, age, prior therapies, liver function indices, and tumor markers. Regarding ceCT, we collected TNM staging, lesion diameter, volume, vascularization, and presence of intravascular necrosis. Regarding [18F]-FDG-PET/CT, we collected TNM staging, Standard-Uptake-Value max (SUVmax), Metabolic-Tumor-Volume (MTV), and Total-Lesion-Glycolysis (TLG=MTV*lesions SUVmean). Philips-Vue-PACS software was used, setting hepatic SUVmean as TLG threshold.ResultsA statistically significant correlation was found between some examined parameters at morphofunctional investigations at the baseline and OS. [18F]-FDG-PET/CT parameters statistically correlated with OS were the stage of disease greater than M0 (p = 0.037), major lesion SUVmax (p = 0.010), MTV (p ≤ 0.001), and TLG (p < 0.001). Other parameters at ceCT correlated with OS were the stage of disease greater than T2 (p = 0.038), maximum lesion diameter (p = 0.07), volume of the major lesion (p = 0.016), and total volume of lesions (p = 0. 009). Biochemical parameters correlated with OS were gamma glutamyl transferase (GGT, p = 0.014), alkaline phosphatase (ALP, p = 0.019), carcinoembryonic antigen (CEA, p = 0.004), and carbohydrate antigen 19-9 (CA 19-9, p < 0.001). From the parameters estimated by the multivariate model, we derived a four-variable score for OS combining nodal involvement and SUVmax at [18F]-FDG-PET/CT, GGT, and CA 19-9 levels.ConclusionConsidering our data, performing integrated pre-therapy imaging is critical for the prognostic stratification of patients with iCCA. |
| first_indexed | 2024-03-13T00:56:47Z |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-13T00:56:47Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj.art-1b2a5852d9f642d69911425ddad65a782023-07-06T17:01:29ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-07-011010.3389/fmed.2023.12047171204717Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinomaCristina Nanni0Cristina Mosconi1Valentino Dragonetti2Massimo Barakat3Nicola Fraccascia4Maria Adriana Cocozza5Stefano Brocchi6Andrea Palloni7Alexandro Paccapelo8Giovanni Brandi9Giovanni Brandi10Stefano Fanti11Stefano Fanti12Stefano Fanti13Nuclear Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyRadiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyNuclear Medicine, Alma Mater Studiorum, University of Bologna, Bologna, ItalyRadiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyNuclear Medicine, Alma Mater Studiorum, University of Bologna, Bologna, ItalyRadiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyRadiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyMedical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyRadiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyMedical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Internal Medicine and Surgery, Alma Mater Studiorum, University of Bologna, Bologna, ItalyNuclear Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyRadiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyNuclear Medicine, Alma Mater Studiorum, University of Bologna, Bologna, ItalyIntroduction and aimIntrahepatic cholangiocarcinoma (iCCA) is a disease characterized by rarity, heterogeneity, and high mortality, where surgical resection is often not possible. Nowadays, due to the recent introduction of new therapeutic options such as trans-arterial radioembolization (TARE), it is increasingly important to define the role of morphofunctional imaging methods for the prognostic stratification of patients affected by iCCA. The aim of the study was to verify the prognostic value of morphofunctional imaging methods at the baseline in patients with inoperable iCCA.MethodsIn total, 45 patients with iCCA were sent to our center between January 2016 and March 2021 for being evaluated to be treated with TARE. All of them underwent both [18F]-FDG-PET/CT and contrast-enhanced CT (ceCT) in a single procedure and were included in our study. The inclusion criteria were as follows: a diagnosis of inoperable iCCA; both [18F]-FDG-PET/CT and ceCT scans; and washout from therapy for at least 2 months before baseline [18F]-FDG-PET/CT and ceCT scans. Both clinical and laboratory data and baseline imaging data (ceCT and [18F]-FDG-PET/CT) were collected. In particular, regarding clinical and laboratory data, we collected overall survival (OS), gender, age, prior therapies, liver function indices, and tumor markers. Regarding ceCT, we collected TNM staging, lesion diameter, volume, vascularization, and presence of intravascular necrosis. Regarding [18F]-FDG-PET/CT, we collected TNM staging, Standard-Uptake-Value max (SUVmax), Metabolic-Tumor-Volume (MTV), and Total-Lesion-Glycolysis (TLG=MTV*lesions SUVmean). Philips-Vue-PACS software was used, setting hepatic SUVmean as TLG threshold.ResultsA statistically significant correlation was found between some examined parameters at morphofunctional investigations at the baseline and OS. [18F]-FDG-PET/CT parameters statistically correlated with OS were the stage of disease greater than M0 (p = 0.037), major lesion SUVmax (p = 0.010), MTV (p ≤ 0.001), and TLG (p < 0.001). Other parameters at ceCT correlated with OS were the stage of disease greater than T2 (p = 0.038), maximum lesion diameter (p = 0.07), volume of the major lesion (p = 0.016), and total volume of lesions (p = 0. 009). Biochemical parameters correlated with OS were gamma glutamyl transferase (GGT, p = 0.014), alkaline phosphatase (ALP, p = 0.019), carcinoembryonic antigen (CEA, p = 0.004), and carbohydrate antigen 19-9 (CA 19-9, p < 0.001). From the parameters estimated by the multivariate model, we derived a four-variable score for OS combining nodal involvement and SUVmax at [18F]-FDG-PET/CT, GGT, and CA 19-9 levels.ConclusionConsidering our data, performing integrated pre-therapy imaging is critical for the prognostic stratification of patients with iCCA.https://www.frontiersin.org/articles/10.3389/fmed.2023.1204717/fullintra-hepatic cholangiocarcinomaFDG PET/CTceCTprognostic valueTARE |
| spellingShingle | Cristina Nanni Cristina Mosconi Valentino Dragonetti Massimo Barakat Nicola Fraccascia Maria Adriana Cocozza Stefano Brocchi Andrea Palloni Alexandro Paccapelo Giovanni Brandi Giovanni Brandi Stefano Fanti Stefano Fanti Stefano Fanti Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma Frontiers in Medicine intra-hepatic cholangiocarcinoma FDG PET/CT ceCT prognostic value TARE |
| title | Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma |
| title_full | Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma |
| title_fullStr | Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma |
| title_full_unstemmed | Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma |
| title_short | Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma |
| title_sort | prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma |
| topic | intra-hepatic cholangiocarcinoma FDG PET/CT ceCT prognostic value TARE |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1204717/full |
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