Diagnosis of functional strictures in patients with primary sclerosing cholangitis using hepatobiliary contrast-enhanced MRI: a proof-of-concept study Article Swipe
Sarah Poetter‐Lang
,
Alina Messner
,
Nina Bastati
,
Kristina I. Ringe
,
Maxime Ronot
,
Sudhakar K. Venkatesh
,
Raphael Ambros
,
Antonia Kristic
,
Aida Korajac
,
Gregor Dovjak
,
Martin Zalaudek
,
Jacqueline C. Hodge
,
Christoph Schramm
,
Emina Halilbasic
,
Michael Trauner
,
Ahmed Ba‐Ssalamah
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1007/s00330-023-09915-3
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1007/s00330-023-09915-3
Objectives PSC strictures are routinely diagnosed on T2-MRCP as dominant- (DS) or high-grade stricture (HGS). However, high inter-observer variability limits their utility. We introduce the “potential functional stricture” (PFS) on T1-weighted hepatobiliary-phase images of gadoxetic acid-enhanced MR cholangiography (T1-MRC) to assess inter-reader agreement on diagnosis, location, and prognostic value of PFS on T1-MRC vs. DS or HGS on T2-MRCP in PSC patients, using ERCP as the gold standard. Methods Six blinded readers independently reviewed 129 MRIs to diagnose and locate stricture, if present. DS/HGS was determined on T2-MRCP. On T1-MRC, PFS was diagnosed if no GA excretion was seen in the CBD, hilum or distal RHD, or LHD. If excretion was normal, “no functional stricture” (NFS) was diagnosed. T1-MRC diagnoses (NFS = 87; PFS = 42) were correlated with ERCP, clinical scores, labs, splenic volume, and clinical events. Statistical analyses included Kaplan–Meier curves and Cox regression. Results Interobserver agreement was almost perfect for NFS vs. PFS diagnosis, but fair to moderate for DS and HGS. Forty-four ERCPs in 129 patients (34.1%) were performed, 39 in PFS (92.9%), and, due to clinical suspicion, five in NFS (5.7%) patients. PFS and NFS diagnoses had 100% PPV and 100% NPV, respectively. Labs and clinical scores were significantly worse for PFS vs. NFS. PFS patients underwent more diagnostic and therapeutic ERCPs, experienced more clinical events, and reached significantly more endpoints ( p < 0.001) than those with NFS. Multivariate analysis identified PFS as an independent risk factor for liver-related events. Conclusion T1-MRC was superior to T2-MRCP for stricture diagnosis, stricture location, and prognostication. Clinical relevance statement Because half of PSC patients will develop clinically-relevant strictures over the course of the disease, earlier more confident diagnosis and correct localization of functional stricture on gadoxetic acid-enhanced MRI may optimize management and improve prognostication. Key Points • There is no consensus regarding biliary stricture imaging features in PSC that have clinical relevance. • Twenty-minute T1-weighted MRC images correctly classified PSC patients with potential (PFS) vs with no functional stricture (NFS). • T1-MRC diagnoses may reduce the burden of diagnostic ERCPs. Graphical abstract
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1007/s00330-023-09915-3
- https://link.springer.com/content/pdf/10.1007/s00330-023-09915-3.pdf
- OA Status
- hybrid
- Cited By
- 9
- References
- 43
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4384820678
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4384820678Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1007/s00330-023-09915-3Digital Object Identifier
- Title
-
Diagnosis of functional strictures in patients with primary sclerosing cholangitis using hepatobiliary contrast-enhanced MRI: a proof-of-concept studyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-07-20Full publication date if available
- Authors
-
Sarah Poetter‐Lang, Alina Messner, Nina Bastati, Kristina I. Ringe, Maxime Ronot, Sudhakar K. Venkatesh, Raphael Ambros, Antonia Kristic, Aida Korajac, Gregor Dovjak, Martin Zalaudek, Jacqueline C. Hodge, Christoph Schramm, Emina Halilbasic, Michael Trauner, Ahmed Ba‐SsalamahList of authors in order
- Landing page
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https://doi.org/10.1007/s00330-023-09915-3Publisher landing page
- PDF URL
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https://link.springer.com/content/pdf/10.1007/s00330-023-09915-3.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
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https://link.springer.com/content/pdf/10.1007/s00330-023-09915-3.pdfDirect OA link when available
- Concepts
-
Medicine, Gadoxetic acid, Radiology, Medical diagnosis, Hilum (anatomy), Internal medicine, Primary sclerosing cholangitis, Cholangiography, Neuroradiology, Interventional radiology, Concordance, Gastroenterology, Magnetic resonance imaging, Disease, Gadolinium DTPA, Psychiatry, NeurologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
9Total citation count in OpenAlex
- Citations by year (recent)
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2025: 4, 2024: 5Per-year citation counts (last 5 years)
- References (count)
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43Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| referenced_works | https://openalex.org/W2076789082, https://openalex.org/W2911673440, https://openalex.org/W1971108757, https://openalex.org/W2801901594, https://openalex.org/W2607081164, https://openalex.org/W4283215432, https://openalex.org/W2799994741, https://openalex.org/W3188651548, https://openalex.org/W2132474120, https://openalex.org/W1990115524, https://openalex.org/W1958147355, https://openalex.org/W2128897893, https://openalex.org/W2105412605, https://openalex.org/W2088810118, https://openalex.org/W2061214966, https://openalex.org/W2942292580, https://openalex.org/W4229070082, https://openalex.org/W2990268779, https://openalex.org/W2391280674, https://openalex.org/W1972665722, https://openalex.org/W4200473175, https://openalex.org/W2954161966, https://openalex.org/W2991145556, https://openalex.org/W2905044063, https://openalex.org/W2098706480, https://openalex.org/W2793348982, https://openalex.org/W2041538832, https://openalex.org/W2808124587, https://openalex.org/W2897260061, https://openalex.org/W3012416060, https://openalex.org/W3010362012, https://openalex.org/W2052788412, https://openalex.org/W2907520153, https://openalex.org/W2118181901, https://openalex.org/W2087759270, https://openalex.org/W2924515033, https://openalex.org/W2159282044, https://openalex.org/W2911533996, https://openalex.org/W2121207058, https://openalex.org/W2101035663, https://openalex.org/W2530578904, https://openalex.org/W4309480412, https://openalex.org/W1479884833 |
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