ABSTRACT

Introduction

Intrahepatic cholangiocarcinoma is the second most common liver cancer. Desmoplastic stroma may be revealed as distinctive histopathologic findings favoring intrahepatic cholangiocarcinoma. Meanwhile, a range of imaging manifestations is often accompanied with rich desmoplastic stroma in intrahepatic cholangiocarcinoma, which can indicate large bile duct ICC, and a higher level of cancer-associated fibroblasts with poor prognosis and weak treatment response.

Areas covered

We provide a comprehensive review of current state-of-the-art and recent advances in the imaging evaluation for diagnosis, staging, prognosis and treatment response of intrahepatic cholangiocarcinoma. In addition, we discuss precursor lesions, cells of origin, molecular mutation, which would cause the different histological classification. Moreover, histological classification and tumor microenvironment, which are related to the proportion of desmoplastic stroma with many imaging manifestations, would be also discussed.

Expert opinion

The diagnosis, prognosis, treatment response of intrahepatic cholangiocarcinoma may be revealed as the presence and the proportion of desmoplastic stroma with a range of imaging manifestations. With the utility of radiomics and artificial intelligence, imaging is helpful for ICC evaluation. Multicentre, large-scale, prospective studies with external validation are in need to develop comprehensive prediction models based on clinical data, imaging findings, genetic parameters, molecular, metabolic, and immune biomarkers.

中文翻译：

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无创影像在肝内胆管癌评估中的作用：从诊断和预后到治疗反应

摘要

介绍

肝内胆管癌是第二常见的肝癌。促纤维增生基质可能显示为有利于肝内胆管癌的独特组织病理学发现。同时，肝内胆管癌的一系列影像学表现常伴有丰富的促纤维细胞间质，提示胆管ICC较大，癌相关成纤维细胞水平较高，预后较差，治疗反应较弱。

涵盖的领域

我们全面回顾了肝内胆管癌的诊断、分期、预后和治疗反应的影像学评估的最新技术和最新进展。此外，我们讨论了导致不同组织学分类的前体病变、起源细胞、分子突变。此外，还将讨论与具有多种影像表现的促纤维化基质的比例有关的组织学分类和肿瘤微环境。

专家意见

肝内胆管癌的诊断、预后、治疗反应可以通过一系列影像学表现的促纤维增生基质的存在和比例来揭示。随着放射组学和人工智能的应用，成像有助于 ICC 评估。需要通过外部验证的多中心、大规模、前瞻性研究来开发基于临床数据、影像学发现、遗传参数、分子、代谢和免疫生物标志物的综合预测模型。