Asayama Yoshiki, Nishie Akihiro, Ishigami Kousei, Ushijima Yasuhiro, Takayama Yukihisa, Okamoto Daisuke, Fujita Nobuhiro, Ohtsuka Takao, Yoshizumi Tomoharu, Aishima Shinichi, Oda Yoshinao, Honda Hiroshi
Department of Advanced Imaging and Interventional Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Departments of Clinical Radiology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Eur Radiol. 2017 Jun;27(6):2563-2569. doi: 10.1007/s00330-016-4621-y. Epub 2016 Oct 17.
To determine whether washout characteristics of dynamic contrast-enhanced computed tomography (CT) could predict survival in patients with extrahepatic cholangiocarcinoma (EHC).
This study collected 46 resected cases. All cases were examined by dynamic contrast study on multidetector-row CT. Region-of-interest measurements were obtained at the non-enhanced, portal venous phase and delayed phase in the tumour and were used to calculate the washout ratio as follows: [(attenuation value at portal venous phase CT - attenuation value at delayed enhanced CT)/(attenuation value at portal venous phase CT - attenuation value at unenhanced CT)] × 100. On the basis of the median washout ratio, we classified the cases into two groups, a high-washout group and low-washout group. Associations between overall survival and various factors including washout rates were analysed.
The median washout ratio was 29.4 %. Univariate analysis revealed that a lower washout ratio, venous invasion, lymphatic permeation and lymph node metastasis were associated with shorter survival. Multivariate analysis identified the lower washout ratio as an independent prognostic factor (hazard ratio, 3.768; p value, 0.027).
The washout ratio obtained from the contrast-enhanced CT may be a useful imaging biomarker for the prediction of survival of patients with EHC.
• Dynamic contrast study can evaluate the aggressiveness of extrahepatic cholangiocarcinoma. • A lower washout ratio was an independent prognostic factor for overall survival. • CT can predict survival and inform decisions on surgical options or chemotherapy.
确定动态对比增强计算机断层扫描（CT）的洗脱特征能否预测肝外胆管癌（EHC）患者的生存情况。
本研究收集了46例手术切除病例。所有病例均通过多排探测器CT进行动态对比研究。在肿瘤的平扫期、门静脉期和延迟期进行感兴趣区测量，并用于计算洗脱率，如下：[（门静脉期CT衰减值 - 延迟增强CT衰减值）/（门静脉期CT衰减值 - 平扫CT衰减值）]×100。根据洗脱率中位数，将病例分为两组，高洗脱组和低洗脱组。分析总生存期与包括洗脱率在内的各种因素之间的关联。
洗脱率中位数为29.4%。单因素分析显示，较低的洗脱率、静脉侵犯、淋巴管浸润和淋巴结转移与较短的生存期相关。多因素分析确定较低的洗脱率为独立的预后因素（风险比，3.768；P值，0.027）。
对比增强CT获得的洗脱率可能是预测EHC患者生存的有用影像学生物标志物。
• 动态对比研究可评估肝外胆管癌的侵袭性。• 较低的洗脱率是总生存期的独立预后因素。• CT可预测生存情况并为手术方案或化疗决策提供依据。
