ArticleSurgery today2026
Poor-contrast areas in lymph nodes on contrast-enhanced computed tomography scan/magnetic resonance imaging are predictive of lymph node metastasis in patients with resected intrahepatic cholangiocarcinoma.
Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeIntrahepatic cholangiocarcinoma (ICC) with pathological lymph node metastasis (LNM) is associated with a poor prognosis. The standard treatment for ICC is surgical resection; however, the importance of prophylactic lymph node dissection (LND) is unclear. This study examined the predictive value of preoperative imaging for LNM from ICC.
methodsForty patients with ICC underwent preoperative diagnostic imaging using contrast-enhanced computed tomography (CT), gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI), and positron emission tomography (PET)-CT, followed by liver resection with LND. Lymph node (LN) size (≥ 10 mm) and the presence of poor-contrast areas in LNs were evaluated using CT and EOB-MRI. Visually assessed positive LNs were evaluated by PET-CT.
resultsLN size measured on CT and EOB-MRI could not predict pathological LNM. However, poor-contrast areas in LNs measured on CT (sensitivity, 55.0%; specificity, 95.0%) and EOB-MRI (sensitivity, 75.0%; specificity, 95.0%) could predict pathological LNM (pLNM), as could visually assessed positive LNs measured on PET-CT (sensitivity, 50.0%; specificity, 100.0%). LNs with poor-contrast areas measured on CT or MRI were an independent predictor of pLNM.
conclusionLNM was predicted by evaluating LNs with poor-contrast areas using contrast-enhanced CT or EOB-MRI. Thus, LNM risk should be assessed using EOB-MRI or/and contrast-enhanced CT scans before surgery.
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