Quantitative MRCP metrics as imaging biomarkers to differentiate benign from malignant bile duct obstructions

BackgroundCholangiocarcinoma (CCA) is a difficult-to-detect rare cancer with high mortality rate and management costs. If detected early, surgical resection carries a 35% 5-year survival rate; this decreases to <11% 1-year survival rate when detected at later stages. Quantitative magnetic res...

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Main Authors: Kulyada Eurboonyanun, Julaluck Promsorn, Prakasit Sa-Ngiamwibool, Chalerm Eurboonyanun, Sarah Finnegan, Carlos Ferreira, Amy Herlihy, Elizabeth Shumbayawonda, Rita Maria Lahoud, Isha Atre, Aileen O’Shea, Mukesh Harisinghani
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1576163/full
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author Kulyada Eurboonyanun
Julaluck Promsorn
Prakasit Sa-Ngiamwibool
Chalerm Eurboonyanun
Sarah Finnegan
Carlos Ferreira
Amy Herlihy
Elizabeth Shumbayawonda
Rita Maria Lahoud
Isha Atre
Aileen O’Shea
Mukesh Harisinghani
author_facet Kulyada Eurboonyanun
Julaluck Promsorn
Prakasit Sa-Ngiamwibool
Chalerm Eurboonyanun
Sarah Finnegan
Carlos Ferreira
Amy Herlihy
Elizabeth Shumbayawonda
Rita Maria Lahoud
Isha Atre
Aileen O’Shea
Mukesh Harisinghani
author_sort Kulyada Eurboonyanun
collection DOAJ
description BackgroundCholangiocarcinoma (CCA) is a difficult-to-detect rare cancer with high mortality rate and management costs. If detected early, surgical resection carries a 35% 5-year survival rate; this decreases to <11% 1-year survival rate when detected at later stages. Quantitative magnetic resonance cholangiopancreatography (MRCP+) provides measurements of the biliary tree and has been noted in clinical guidelines as having prognostic utility. We sought to determine whether MRCP+ metrics could differentiate benign and malignant biliary obstructions.MethodIn this retrospective study of 38 patients with biliary obstruction with histologic characterisation, 23 had malignant obstructions whilst 15 had benign obstructions. Patients underwent non-contrast and contrast MRCP alongside clinical assessment. Non-contrast MRCP images were post-processed with MRCP+. Mann-Whitney U test compared the metrics between groups. Diagnostic accuracy of MRCP+ markers (duct number and dimensions, biliary tree and gallbladder volume) to stratify benign from malignant biliary obstructions was assessed using the area under the receiver operating characteristic curve (AUC).ResultsAll bile duct metrics were significantly higher in malignant biliary obstruction (p<0.05). Of the metrics assessed, total biliary tree volume was the most clinically meaningful predictor of malignancy, with a volume of ≥25ml differentiating between the two populations. A biliary tree volume of 25ml had an AUC of 0.79 to stratify between benign and malignant obstructions.ConclusionQuantitative MRCP metrics, particularly total biliary tree volume, are shown here to differentiate malignant (CCA) from benign obstructions. As current pathways require either contrast administration or ERCP, quantitative MRCP may be an objective, non-invasive tool to identify CCA.
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spelling doaj-art-dd33edded14b4416be4d9f3e5abee0902025-08-20T02:14:37ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15761631576163Quantitative MRCP metrics as imaging biomarkers to differentiate benign from malignant bile duct obstructionsKulyada Eurboonyanun0Julaluck Promsorn1Prakasit Sa-Ngiamwibool2Chalerm Eurboonyanun3Sarah Finnegan4Carlos Ferreira5Amy Herlihy6Elizabeth Shumbayawonda7Rita Maria Lahoud8Isha Atre9Aileen O’Shea10Mukesh Harisinghani11Department of Radiology, Faculty of Medicine, Khon Kaen University, , Khon Kaen, ThailandDepartment of Radiology, Faculty of Medicine, Khon Kaen University, , Khon Kaen, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandTranslational Science, Perspectum Ltd, Oxford, United KingdomTranslational Science, Perspectum Ltd, Oxford, United KingdomTranslational Science, Perspectum Ltd, Oxford, United KingdomTranslational Science, Perspectum Ltd, Oxford, United KingdomDepartment of Radiology, Tufts Medical Center, Boston, MA, United StatesDepartment of Radiology, Children’s Hospital of Pittsburgh, Pittsburgh, PA, United StatesRadiology Department, Massachusetts General Hospital, Boston, MA, United StatesRadiology Department, Massachusetts General Hospital, Boston, MA, United StatesBackgroundCholangiocarcinoma (CCA) is a difficult-to-detect rare cancer with high mortality rate and management costs. If detected early, surgical resection carries a 35% 5-year survival rate; this decreases to <11% 1-year survival rate when detected at later stages. Quantitative magnetic resonance cholangiopancreatography (MRCP+) provides measurements of the biliary tree and has been noted in clinical guidelines as having prognostic utility. We sought to determine whether MRCP+ metrics could differentiate benign and malignant biliary obstructions.MethodIn this retrospective study of 38 patients with biliary obstruction with histologic characterisation, 23 had malignant obstructions whilst 15 had benign obstructions. Patients underwent non-contrast and contrast MRCP alongside clinical assessment. Non-contrast MRCP images were post-processed with MRCP+. Mann-Whitney U test compared the metrics between groups. Diagnostic accuracy of MRCP+ markers (duct number and dimensions, biliary tree and gallbladder volume) to stratify benign from malignant biliary obstructions was assessed using the area under the receiver operating characteristic curve (AUC).ResultsAll bile duct metrics were significantly higher in malignant biliary obstruction (p<0.05). Of the metrics assessed, total biliary tree volume was the most clinically meaningful predictor of malignancy, with a volume of ≥25ml differentiating between the two populations. A biliary tree volume of 25ml had an AUC of 0.79 to stratify between benign and malignant obstructions.ConclusionQuantitative MRCP metrics, particularly total biliary tree volume, are shown here to differentiate malignant (CCA) from benign obstructions. As current pathways require either contrast administration or ERCP, quantitative MRCP may be an objective, non-invasive tool to identify CCA.https://www.frontiersin.org/articles/10.3389/fonc.2025.1576163/fullcholangiocarcinomabile ductbiliary obstructionMRCP+early diagnosis
spellingShingle Kulyada Eurboonyanun
Julaluck Promsorn
Prakasit Sa-Ngiamwibool
Chalerm Eurboonyanun
Sarah Finnegan
Carlos Ferreira
Amy Herlihy
Elizabeth Shumbayawonda
Rita Maria Lahoud
Isha Atre
Aileen O’Shea
Mukesh Harisinghani
Quantitative MRCP metrics as imaging biomarkers to differentiate benign from malignant bile duct obstructions
Frontiers in Oncology
cholangiocarcinoma
bile duct
biliary obstruction
MRCP+
early diagnosis
title Quantitative MRCP metrics as imaging biomarkers to differentiate benign from malignant bile duct obstructions
title_full Quantitative MRCP metrics as imaging biomarkers to differentiate benign from malignant bile duct obstructions
title_fullStr Quantitative MRCP metrics as imaging biomarkers to differentiate benign from malignant bile duct obstructions
title_full_unstemmed Quantitative MRCP metrics as imaging biomarkers to differentiate benign from malignant bile duct obstructions
title_short Quantitative MRCP metrics as imaging biomarkers to differentiate benign from malignant bile duct obstructions
title_sort quantitative mrcp metrics as imaging biomarkers to differentiate benign from malignant bile duct obstructions
topic cholangiocarcinoma
bile duct
biliary obstruction
MRCP+
early diagnosis
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1576163/full
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