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Diggs LP, Fagenson AM, Putatunda V, Lau KN, Grandhi MS, Pitt HA. Intrahepatic cholangiocarcinoma: how do hepatectomy outcomes compare to liver metastases and hepatocellular carcinoma? HPB (Oxford) 2023; 25:1420-1428. [PMID: 37573232 DOI: 10.1016/j.hpb.2023.07.898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/25/2023] [Accepted: 07/20/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND The incidence of intrahepatic cholangiocarcinoma (ICC) continues to rise, and hepatectomy is the only cure. Perioperative outcomes following hepatectomy for colorectal liver metastases (CRLM) and hepatocellular carcinoma (HCC) are better described than for ICC. The aim was to compare post-hepatectomy outcomes for ICC to CRLM and HCC. METHODS The 2014-2020 ACS NSQIP hepatectomy PUF was utilized. Patients with ICC, CRLM, and HCC were identified and others excluded. Demographic, disease, and procedural characteristics were collected. Univariable and multivariable analyses (Chi-Square for categorical variables; Kruskal-Wallis for continuous variables) were performed for mortality, serious morbidity, bile leak, post-hepatectomy liver failure (PHLF), and 30-day readmission. RESULTS 17,789 patients underwent hepatectomy including 2377 for ICC, 10,195 for CRLM, and 5217 for HCC. Patients undergoing hepatectomy for ICC vs. HCC vs. CRLM were noted to have higher 30-day mortality (4.8% vs. 2.5% vs. 1.0%, respectively p < 0.05). ICC was associated with higher overall and serious morbidity, bile leak, severe PHLF, and readmission. Multivariable analyses confirmed higher odds ratios for mortality and morbidity (p < 0.05) in patients with ICC. CONCLUSION Hepatectomy for ICC is associated with worse short-term outcomes than for CRLM or HCC. Surgeons should be aware of these risks during surgical planning.
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Affiliation(s)
- Laurence P Diggs
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Alexander M Fagenson
- Department of Surgery, Temple University Hospital, 3401NBroad Street, Philadelphia, PA, USA
| | - Vijay Putatunda
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Kwan Nang Lau
- Department of Surgery, Temple University Hospital, 3401NBroad Street, Philadelphia, PA, USA
| | - Miral S Grandhi
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA; Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901, USA
| | - Henry A Pitt
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA; Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901, USA.
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Gong X, Guo Y, Zhu T, Xing D, Shi Q, Zhang M. Noninvasive assessment of significant liver fibrosis in rabbits by spectral CT parameters and texture analysis. Jpn J Radiol 2023; 41:983-993. [PMID: 37071251 DOI: 10.1007/s11604-023-01423-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/29/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE Noninvasive assessment of significant liver fibrosis in rabbits by spectral CT parameters and texture analysis. MATERIALS AND METHODS Thirty-three rabbits were randomly divided into 27 carbon tetrachloride-induced liver fibrosis group and 6 control group. Spectral CT contrast-enhanced scan was performed in batches, and the liver fibrosis was staged according to the histopathological results. The portal venous phase spectral CT parameters [70 keV CT value, normalized iodine concentration (NIC), spectral HU curve slope (λHU)] were measured, and MaZda texture analysis was performed on 70 keV monochrome images. Three dimensionality reduction methods and four statistical methods in B11 module were used to perform discriminant analysis and calculate misclassified rate (MCR), and ten texture features under the lowest combination of MCR were statistically analyzed. Receiver operating characteristic curve (ROC) was used to calculate the diagnostic performance of spectral parameters and texture features for significant liver fibrosis. Finally, the binary logistic regression was used to further screen independent predictors and establish model. RESULTS A total of 23 experimental rabbits and 6 control rabbits were included, of which 16 had significant liver fibrosis. Three spectral CT parameters with significant liver fibrosis were significantly lower than those of non-significant liver fibrosis (p < 0.05), and the AUC ranged from 0.846 to 0.913. The combination analysis of mutual information (MI) and nonlinear discriminant analysis (NDA) had the lowest MCR, which with 0%. In the filtered texture features, four were statistically significant and AUC > 0.5, ranges from 0.764 to 0.875. The logistic regression model showed that Perc.90% and NIC could be used as independent predictors, the overall prediction accuracy of the model was 89.7% and the AUC was 0.976. CONCLUSION Spectral CT parameters and texture features have high diagnostic value for predicting significant liver fibrosis in rabbits, and the combination of the two can improve its diagnostic efficiency.
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Affiliation(s)
- Xiuru Gong
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China
| | - Yaxin Guo
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China
| | - Tingting Zhu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China
| | - Dongwei Xing
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China
| | - Qi Shi
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China.
| | - Minguang Zhang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China.
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Zheng S, He K, Zhang L, Li M, Zhang H, Gao P. Conventional and artificial intelligence-based computed tomography and magnetic resonance imaging quantitative techniques for non-invasive liver fibrosis staging. Eur J Radiol 2023; 165:110912. [PMID: 37290363 DOI: 10.1016/j.ejrad.2023.110912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/10/2023]
Abstract
Chronic liver disease (CLD) ultimately develops into liver fibrosis and cirrhosis and is a major public health problem globally. The assessment of liver fibrosis is important for patients with CLD for prognostication, treatment decisions, and surveillance. Liver biopsies are traditionally performed to determine the stage of liver fibrosis. However, the risks of complications and technical limitations restrict their application to screening and sequential monitoring in clinical practice. CT and MRI are essential for evaluating cirrhosis-associated complications in patients with CLD, and several non-invasive methods based on them have been proposed. Artificial intelligence (AI) techniques have also been applied to stage liver fibrosis. This review aimed to explore the values of conventional and AI-based CT and MRI quantitative techniques for non-invasive liver fibrosis staging and summarized their diagnostic performance, advantages, and limitations.
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Affiliation(s)
- Shuang Zheng
- Department of Radiology, the First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, Jilin, China.
| | - Kan He
- Department of Radiology, the First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, Jilin, China.
| | - Lei Zhang
- Department of Radiology, the First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, Jilin, China.
| | - Mingyang Li
- Department of Radiology, the First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, Jilin, China.
| | - Huimao Zhang
- Department of Radiology, the First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, Jilin, China.
| | - Pujun Gao
- Department of Hepatology, the First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, Jilin, China.
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Updates on Quantitative MRI of Diffuse Liver Disease: A Narrative Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1147111. [PMID: 36619303 PMCID: PMC9812615 DOI: 10.1155/2022/1147111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/29/2022]
Abstract
Diffuse liver diseases are highly prevalent conditions around the world, including pathological liver changes that occur when hepatocytes are damaged and liver function declines, often leading to a chronic condition. In the last years, Magnetic Resonance Imaging (MRI) is reaching an important role in the study of diffuse liver diseases moving from qualitative to quantitative assessment of liver parenchyma. In fact, this can allow noninvasive accurate and standardized assessment of diffuse liver diseases and can represent a concrete alternative to biopsy which represents the current reference standard. MRI approach already tested for other pathologies include diffusion-weighted imaging (DWI) and radiomics, able to quantify different aspects of diffuse liver disease. New emerging MRI quantitative methods include MR elastography (MRE) for the quantification of the hepatic stiffness in cirrhotic patients, dedicated gradient multiecho sequences for the assessment of hepatic fat storage, and iron overload. Thus, the aim of this review is to give an overview of the technical principles and clinical application of new quantitative MRI techniques for the evaluation of diffuse liver disease.
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Hara Y, Nagawa K, Yamamoto Y, Inoue K, Funakoshi K, Inoue T, Okada H, Ishikawa M, Kobayashi N, Kozawa E. The utility of texture analysis of kidney MRI for evaluating renal dysfunction with multiclass classification model. Sci Rep 2022; 12:14776. [PMID: 36042326 PMCID: PMC9427930 DOI: 10.1038/s41598-022-19009-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/23/2022] [Indexed: 11/09/2022] Open
Abstract
We evaluated a multiclass classification model to predict estimated glomerular filtration rate (eGFR) groups in chronic kidney disease (CKD) patients using magnetic resonance imaging (MRI) texture analysis (TA). We identified 166 CKD patients who underwent MRI comprising Dixon-based T1-weighted in-phase (IP)/opposed-phase (OP)/water-only (WO) images, apparent diffusion coefficient (ADC) maps, and T2* maps. The patients were divided into severe, moderate, and control groups based on eGFR borderlines of 30 and 60 mL/min/1.73 m2. After extracting 93 texture features (TFs), dimension reduction was performed using inter-observer reproducibility analysis and sequential feature selection (SFS) algorithm. Models were created using linear discriminant analysis (LDA); support vector machine (SVM) with linear, rbf, and sigmoid kernels; decision tree (DT); and random forest (RF) classifiers, with synthetic minority oversampling technique (SMOTE). Models underwent 100-time repeat nested cross-validation. Overall performances of our classification models were modest, and TA based on T1-weighted IP/OP/WO images provided better performance than those based on ADC and T2* maps. The most favorable result was observed in the T1-weighted WO image using RF classifier and the combination model was derived from all T1-weighted images using SVM classifier with rbf kernel. Among the selected TFs, total energy and energy had weak correlations with eGFR.
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Affiliation(s)
- Yuki Hara
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Keita Nagawa
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan. .,Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, Japan.
| | - Yuya Yamamoto
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Kaiji Inoue
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Kazuto Funakoshi
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Tsutomu Inoue
- Department of Nephrology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Hirokazu Okada
- Department of Nephrology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Masahiro Ishikawa
- School of Biomedical Engineering, Faculty of Health and Medical Care, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Naoki Kobayashi
- School of Biomedical Engineering, Faculty of Health and Medical Care, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Eito Kozawa
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
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Caroli A. Diffusion-Weighted Magnetic Resonance Imaging: Clinical Potential and Applications. J Clin Med 2022; 11:3339. [PMID: 35743409 PMCID: PMC9224775 DOI: 10.3390/jcm11123339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 02/05/2023] Open
Abstract
Since its discovery in the 1980s [...].
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Affiliation(s)
- Anna Caroli
- Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 24020 Ranica, BG, Italy
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El informe radiológico en paciente con hepatopatía crónica. RADIOLOGIA 2022. [DOI: 10.1016/j.rx.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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