Author of 1 Presentation
SE-020 - Primary bile duct tumors with intraductal growing pattern: performance of MR imaging with MR cholangiopancreatography for tumor characterization and prediction of resectability
Abstract
Purpose
To investigate the diagnostic performance of MRI with MR cholangiopancreatography (MRCP) for tumor characterization and prediction of R0 resectability of primary bile duct tumors with intraductal growing (IDG) pattern.
Material and methods
This retrospective study included sixty-one patients with surgically-proven IDG bile duct tumors (intraductal papillary neoplasm of the bile duct or IDG-cholangiocarcinoma). Imaging features on preoperative MRI with MRCP were compared between ≤T1 (n=37) versus ≥T2 stage (n=24), tumors with mucin hyper-secretion (n=19) versus without (n=42), and R0 resection (n=52) versus non-R0 resection (n=9). In patients of R0 resection, recurrence-free survival (RFS) was assessed with Kaplan-Meier curves with the log-rank test.
Results
≥T2 stage tumors demonstrated higher frequencies of bile duct wall thickening at tumor base and non-polypoid tumor shape (cast-like or mucosal spreading growth) than ≤T1 tumors (83.3% versus 35.1% and 45.8% versus 18.9%: P<0.001 and =0.043, respectively). Downstream bile duct dilatation and mucus thread sign on MRCP were more frequent in mucin hyper-secreting tumors than those without (57.9% versus 9.5% and 26.3% versus 0%: P<0.001 and P=0.002, respectively). R0 resection tumors more frequently presented as a polypoid shape mass than non-R0 resection tumors (76.9% versus 33.3%, P=0.015). RFS was significantly longer in ≤T1 tumors than those of ≥T2 stage (P=0.017), whereas no significant difference was found according to mucin hypersecretion (P=0.486).
Conclusion
In primary IDG bile duct tumors, MRI with MRCP may help predict T-staging, mucin hyper-secretion, and R0 resectability. In addition, preoperative imaging assessment of T-staging may provide prognostic information regarding RFS.