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Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma
INTRODUCTION AND AIM: Intrahepatic 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), i...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10361725/ https://www.ncbi.nlm.nih.gov/pubmed/37484862 http://dx.doi.org/10.3389/fmed.2023.1204717 |
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author | Nanni, Cristina Mosconi, Cristina Dragonetti, Valentino Barakat, Massimo Fraccascia, Nicola Cocozza, Maria Adriana Brocchi, Stefano Palloni, Andrea Paccapelo, Alexandro Brandi, Giovanni Fanti, Stefano |
author_facet | Nanni, Cristina Mosconi, Cristina Dragonetti, Valentino Barakat, Massimo Fraccascia, Nicola Cocozza, Maria Adriana Brocchi, Stefano Palloni, Andrea Paccapelo, Alexandro Brandi, Giovanni Fanti, Stefano |
author_sort | Nanni, Cristina |
collection | PubMed |
description | INTRODUCTION AND AIM: Intrahepatic 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. METHODS: In 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. RESULTS: A 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. CONCLUSION: Considering our data, performing integrated pre-therapy imaging is critical for the prognostic stratification of patients with iCCA. |
format | Online Article Text |
id | pubmed-10361725 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-103617252023-07-22 Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma Nanni, Cristina Mosconi, Cristina Dragonetti, Valentino Barakat, Massimo Fraccascia, Nicola Cocozza, Maria Adriana Brocchi, Stefano Palloni, Andrea Paccapelo, Alexandro Brandi, Giovanni Fanti, Stefano Front Med (Lausanne) Medicine INTRODUCTION AND AIM: Intrahepatic 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. METHODS: In 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. RESULTS: A 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. CONCLUSION: Considering our data, performing integrated pre-therapy imaging is critical for the prognostic stratification of patients with iCCA. Frontiers Media S.A. 2023-07-06 /pmc/articles/PMC10361725/ /pubmed/37484862 http://dx.doi.org/10.3389/fmed.2023.1204717 Text en Copyright © 2023 Nanni, Mosconi, Dragonetti, Barakat, Fraccascia, Cocozza, Brocchi, Palloni, Paccapelo, Brandi and Fanti. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Nanni, Cristina Mosconi, Cristina Dragonetti, Valentino Barakat, Massimo Fraccascia, Nicola Cocozza, Maria Adriana Brocchi, Stefano Palloni, Andrea Paccapelo, Alexandro Brandi, Giovanni Fanti, Stefano Prognostic value of integrated morphofunctional imaging methods in inoperable intrahepatic cholangiocarcinoma |
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 | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10361725/ https://www.ncbi.nlm.nih.gov/pubmed/37484862 http://dx.doi.org/10.3389/fmed.2023.1204717 |
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