A nomogram based on magnetic resonance imaging to predict perineural invasion in mass intrahepatic cholangiocarcinoma: a two-centre, retrospective study

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology Pub Date : 2025-06-11 DOI:10.1016/j.crad.2025.106985

D. Liu , H.-L. Chen , F. Wang , Y. He , Y. Yang , L. Wen , Y.-F. Lv , D. Zhang

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引用次数: 0

Abstract

AIM

To evaluate the value of preoperative magnetic resonance imaging (MRI) in predicting perineural invasion (PNI) of mass intrahepatic cholangiocarcinoma (MICC) and construct a nomogram.

MATERIALS AND METHODS

This retrospective study included 228 patients with pathologically confirmed MICC who underwent preoperative MRI between January 2015 and November 2022 at two institutions. Patients were randomly divided into a training cohort (n = 160) and validation cohort (n = 68) in a 7:3 ratio based on PNI presence. Two radiologists independently analysed imaging features. Significant predictors were identified using univariate and multivariate logistic regression analyses. Predictive performance was validated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). A nomogram was constructed based on the optimal model.

RESULTS

Age, presence of bile duct stones, T₂-weighted imaging (T₂WI) signal intensity, diffusion-weighted imaging (DWI) signal intensity, intratumoural exponential apparent diffusion coefficient (eADC) values, and the tumour-to-spleen eADC ratio were significant independent predictors of PNI (all P < 0.05). The nomogram performed well in the training cohort (AUC: 0.839; 95% CI: 0.776–0.901) and validation cohort (AUC: 0.771; 95% CI: 0.658–0.883).

CONCLUSION

The T₂WI signal intensity, DWI signal intensity, intratumoural eADC values, and the tumour-to-spleen eADC ratio may serve as novel noninvasive biomarkers for predicting PNI in MICC patients. The proposed nomograms can be selectively applied to enhance the accuracy of preoperative PNI predictions in patient with ICC, thereby aiding in the development of surgical strategies.

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基于磁共振成像的图预测块状肝内胆管癌的神经周围浸润：一项双中心回顾性研究

目的探讨术前磁共振成像（MRI）对块状肝内胆管癌（MICC）侵袭神经周围（PNI）的预测价值，并构建其影像学图。材料和方法本回顾性研究纳入了228例病理证实的MICC患者，这些患者于2015年1月至2022年11月在两家机构接受了术前MRI检查。患者随机分为训练组（n = 160）和验证组（n = 68），以7:3的比例基于PNI的存在。两名放射科医生独立分析了影像特征。使用单变量和多变量逻辑回归分析确定了显著的预测因子。采用受试者工作特征（ROC）曲线、校准曲线和决策曲线分析（DCA）验证预测效果。在优化模型的基础上，构造了nomogram。结果年龄、胆管结石的存在、T2WI信号强度、DWI信号强度、肿瘤内指数表观扩散系数（eADC）值、肿瘤与脾脏eADC比值是PNI的重要独立预测因子(P <；0.05)。nomogram在training队列中表现良好(AUC: 0.839；95% CI: 0.776-0.901)和验证队列(AUC: 0.771；95% ci: 0.658-0.883)。结论T2WI信号强度、DWI信号强度、肿瘤内eADC值、肿瘤与脾脏eADC比值可作为预测MICC患者PNI的新型无创生物标志物。所提出的形态图可以选择性地用于提高ICC患者术前PNI预测的准确性，从而帮助制定手术策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.