Intrahepatic cholangiocarcinoma (iCC) accounts for up to 15% of primary liver cancers and has recently shown an increasing incidence worldwide [1]. Unfortunately, only one third of iCCs are diagnosed at a stage amenable to curative resection [2]. In these cases, chemotherapy represents the accepted therapeutic approach with a median survival of approximately 1 year [3,4]. Such disappointing results have led specialists to adopt multimodal therapies. In this last regard, trans-arterial radioembolisation (TARE) has gained popularity due to the relative radiation sensitivity of iCCs [5,6]. Results...

Clinical and radiological data from 55 consecutive patients with iCCs who had undergone TARE between 2010 and 2018 were retrospectively reviewed. All patients underwent quadri-phase contrast-enhancedCT (CECT) imaging within 30 days prior to treatment. Images obtained in the late arterial, venous and delayed phases were used for the texture analysis. For each patient, a Volume of Interest (VOI) of the whole target lesion for each contrast phase was obtained by means of semi-automated segmentation, manually refined to exclude surrounding non-tumoural areasby two radiologistswith 5 (A.B.)...

Of the 55 patients, two patients died within 3 months (5.5%) and 53 had at least one radiological assessment of TARE response. During a median follow-up of 12.5 months, 49 patients had tumour progression (either intra or extra-hepatic, 89.1%); of these, 40 patients died (72.7%), resulting in a median PFS of 6 months and an OS of 16.7 months. The 53 patients having at least one available radiological assessment of TARE response showed, as their best radiological response during follow-up, CR of the target lesion...

The arterial phase was observed to be the best acquisition phase for providing information regarding the “sensitivity” of the tumour to TARE. In particular, the results in the present study suggest that iCCs with a higher uptake of iodine contrast in the arterial phase (higher mean histogram values) and with more homogeneous distribution (lower kurtosis, contrast, dissimilarity and higher homogeneity and correlation) represent hypervascular tumours having fewer acellular and necrotic areas. Such hypervascular tumours are evidently more suitable for intra-arterial radiation therapy than hypovascular tumours....

A. Bruno; Bologna/IT - nothing to disclose C. Mosconi; Bologna/IT - nothing to disclose A. Cappelli; Bologna/IT - nothing to disclose I. Bargellini; Pisa/IT - nothing to disclose R. Cioni; Pisa/IT - nothing to disclose R. Golfieri; Bologna/IT - nothing to disclose F. Modestino; Bologna/IT - nothing to disclose G. Peta; Bologna/IT - nothing to disclose A. Cucchetti; Bologna/IT - nothing to disclose

[1] Zhang H, Yang T, Wu M, et al. (2016) Intrahepatic cholangiocarcinoma: Epidemiology, risk factors, diagnosis and surgical management. Cancer Lett. 379:198-205. [2] Spolverato G, Vitale A, Cucchetti A, et al. (2015) Can hepatic resection provide a long-term cure for patients with intrahepatic cholangiocarcinoma? Cancer. 121:3998-4006. [3] Valle JW, Furuse J, Jitlal M, et al. (2014) Cisplatin and gemcitabine for advanced biliary tract cancer: a meta-analysis of two randomised trials. Ann Oncol. 25:391-8. [4] Valle J, Wasan H, Palmer DH, et al. (2010) Cisplatin plus...