<p>Improving the Detection of Cholangiocarcinoma: In vitro MRI-Based Study Using Local Coils and T2 Mapping</p>

Abstract

Aim: Cholangiocarcinoma is endemic in southeast Asia, generally developing from liver fluke infestation. However, diagnostic imaging of early-stage disease is challenging. The aim of this work is to investigate relaxometry (specifically, T2 mapping) as a method of exploiting the higher signal-to-noise ratio (SNR) of internal coils for improved reception of magnetic resonance signals, despite their non-uniform sensitivity. Methods: Ex vivo T2 mapping was carried out at 3T on fixed resection specimens from Thai cholangiocarcinoma patients using an mGRASE sequence and an endoscope coil based on a thin-film magneto-inductive waveguide and designed ultimately for internal use. Results: Disease-induced changes including granulomatous inflammation, intraepithelial neoplasia and intraductal tumours were correlated with histopathology, and relaxation data were compared with mono-and bi-exponential models of T2 relaxation. An approximately 10-fold local advantage in SNR compared to a 16-element torso coil was demonstrated using the endoscope coil, and improved tissue differentiation was obtained without contrast agents. Conclusion: The performance advantage above follows directly from the inverse relation between the component of the standard deviation of T2 due to thermal noise and the SNR, and offers an effective method of exploiting the SNR advantage of internal coils. No correction is required, avoiding the need for tracking, relaxing constraints on coil and slice orientation and providing rapid visualization.

Silmitasertib plus gemcitabine and cisplatin first‐line therapy in locally advanced/metastatic cholangiocarcinoma: A Phase 1b/2 study

“…Cholangiocarcinoma accounts for approximately 3% of gastrointestinal tumors,1 and intrahepatic cholangiocarcinoma comprises approximately 10%–15% of primary liver cancers 2. In most countries, cholangiocarcinoma is an uncommon cancer, with an incidence of fewer than six cases per 100,000 people,3 but in some regions, such as Southeast Asia, it is more common, even endemic 4. The majority of patients with cholangiocarcinoma present with advanced disease because of the difficulties of diagnosing cholangiocarcinoma at an early stage 3,5,6.…”

“…[2] In most countries, cholangiocarcinoma is an uncommon cancer, with an incidence of fewer than six cases per 100,000 people, [3] but in some regions, such as Southeast Asia, it is more common, even endemic. [4] The majority of patients with cholangiocarcinoma present with advanced disease because of the difficulties of diagnosing cholangiocarcinoma at an early stage. [3,5,6] Advanced/ metastatic cholangiocarcinoma is therefore associated with a poor prognosis, with a 5-year overall survival (OS) rate of 7%-20%, and tumor recurrence rates after resection remain discouraging.…”