Yoshiki Asayama MD, Presenter: Nothing to Disclose

Kengo Yoshimitsu MD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Irie MD, Abstract Co-Author: Nothing to Disclose

Tsuyoshi Tajima, Abstract Co-Author: Nothing to Disclose

Akihiro Nishie MD, Abstract Co-Author: Nothing to Disclose

Hiroshi Honda MD, Abstract Co-Author: Nothing to Disclose

To evaluate relationship between the degree of delayed enhancement of peripheral type intrahepatic cholangiocarcinoma (pICC) as seen on dynamic CT and survival rate.

This study was conducted on 38 resected cases of pICC from November 1992 to December 2002. All cases were examined by dynamic CT (two phase incremental dynamic CT, 7 cases; single helical multiphase CT, 24 cases; multiphase MDCT, 7 cases). Post contrast delayed CT images were obtained 4 to 6 min after administration of iodine contrast injection (300mgI, 100ml, 2-2.5ml/sec). Delayed phase images were evaluated through the largest axial section by 2 radiologists in a consensus fashion, and subclassified into 2 groups: group 1, in which more than two thirds areas of the tumor was interpreted to show delayed enhancement: group 2, in which less than two thirds areas of the tumor was interpreted to show delayed enhancement. The survival curves were drawn by the Kaplan-Meyer methods, and the differences in the survival rates between the groups were compared using the log rank test. The components of delayed enhancement were correlated with pathological findings.

There were 15 and 23 patients in group 1 and group 2, respectively. There was no significant difference in UICC stages between the two groups. The 1-, 3-, 5- year survival rates for group 1 were 60.0%, 9.4%, 0%, respectively. The 1-, 3-, 5- year survival rates for group 2 were 75.9%, 52.5%, 43.7%, respectively. The survival rate was for group 1 was significantly lower than that for group 2 (p=0.0062). The regions showing delayed enhancement correspond to the areas with scattered neoplastic cells in an abundant fibrous stroma.

The degree of delayed enhancement in pICC, which indicates that of stromal desmoplasia pathologically, is considered to be an useful imaging findings for evaluating the patients’ prognosis.

Asayama, Y, Yoshimitsu, K, Irie, H, Tajima, T, Nishie, A, Honda, H, The Significance of Delayed Enhancement of the Peripheral Type Intrahepatic Cholangiocarcinoma on Dynamic CT: Impact on Survival Rate.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4408506.html