Predictability of the radiological response to Yttrium-90 transarterial radioembolization by dynamic magnetic resonance imaging-based radiomics analysis in patients with intrahepatic cholangiocarcinoma

Diagn Interv Radiol. 2024 May 13;30(3):193-199. doi: 10.4274/dir.2023.222025. Epub 2023 Mar 20.

Abstract

Purpose: The study aims to investigate the predictability of the radiological response in intrahepatic cholangiocarcinoma (iCC) patients undergoing Yttrium-90 transarterial radioembolization (TARE) with a combined model built on dynamic magnetic resonance imaging (MRI)-based radiomics and clinical features.

Methods: Thirty-six naive iCC patients who underwent TARE were included in this study. The tumor segmentation was performed on the axial T2-weighted (T2W) without fat suppression, axial T2W with fat suppression, and axial T1-weighted (T1W) contrast-enhanced (CE) sequence in equilibrium phase (Eq). At the sixth month MRI follow-up, all patients were divided into responders and non-responders according to the modified Response Evaluation Criteria in Solid Tumors. Subsequently, a radiomics score (rad-score) and a combined model of the rad-score and clinical features for each sequence were generated and compared between the groups.

Results: Thirteen (36.1%) patients were considered responders, and the remaining 23 (63.9%) were non-responders. Responders exhibited significantly lower rad-scores than non-responders (P < 0.050 for all sequences). The radiomics models showed good discriminatory ability with an area under the curve (AUC) of 0.696 [95% confidence interval (CI), 0.522–0.870] for the axial T1W-CE-Eq, AUC of 0.839 (95% CI, 0.709–0.970) for the axial T2W with fat suppression, and AUC of 0.836 (95% CI, 0.678–0.995) for the axial T2W without fat suppression.

Conclusion: Radiomics models created by pre-treatment MRIs can predict the radiological response to Yttrium- 90 TARE in iCC patients with high accuracy. Combining radiomics with clinical features could increase the power of the test. Large-scale studies of multi-parametric MRIs with internal and external validations are needed to determine the clinical value of radiomics in iCC patients.

Keywords: Radiomics; intrahepatic cholangiocarcinoma; magnetic resonance imaging; radioembolization; radiological response.

MeSH terms

  • Adult
  • Aged
  • Bile Duct Neoplasms* / diagnostic imaging
  • Bile Duct Neoplasms* / radiotherapy
  • Cholangiocarcinoma* / diagnostic imaging
  • Cholangiocarcinoma* / radiotherapy
  • Embolization, Therapeutic* / methods
  • Female
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Radiomics
  • Retrospective Studies
  • Treatment Outcome
  • Yttrium Radioisotopes* / administration & dosage
  • Yttrium Radioisotopes* / therapeutic use

Substances

  • Yttrium Radioisotopes
  • Yttrium-90