对于许多肿瘤，放射组学提供了相关的预后贡献。本研究测试了与标准临床指标相比，基于计算机断层扫描 (CT) 的肝内胆管癌 (ICC) 和瘤周组织的纹理特征是否可以提高切除后生存的预测。所有连续受 ICC 影响的患者在 6 个高龄期接受了肝切除术本研究考虑了容量中心（2009-2019）。对手术前 60 天以内进行的 CT 动脉期和门脉期进行了分析。对肿瘤进行手动分割（Tumor-VOI）。然后应用 5 毫米的体积扩展来识别瘤周组织 (Margin-VOI)。该研究招募了 215 名患者。中位随访期 28 个月后，总生存 (OS) 率为 57.0%，3 年无进展生存 (PFS) 率为 34.9%。 OS 临床预测模型的 C 指数为 0.681。添加放射组学特征导致性能逐步改善（C 指数为 0.71，包括门静脉肿瘤-VOI，C 指数为 0.752，包括门静脉肿瘤和边缘-VOI，C 指数为 0.764，包括所有 VOI门脉期和动脉期）。后一种模型结合了临床变量（CA19-9和肿瘤模式）、肿瘤指数（密度、均匀性）、边缘数据（峰度、紧凑性、形状）和GLRLM指数。该模型的性能与术后临床模型相当，包括病理数据（C 指数为 0.765）。 PFS 也观察到相同的结果。从术前 CT 提取的 ICC 和瘤周组织的放射组学可提高生存预测。门静脉期和动脉期均应考虑。放射组学和临床数据是互补的，术前的预后估计与术后的预后相当。© 2024。外科肿瘤学会。

For many tumors, radiomics provided a relevant prognostic contribution. This study tested whether the computed tomography (CT)-based textural features of intrahepatic cholangiocarcinoma (ICC) and peritumoral tissue improve the prediction of survival after resection compared with the standard clinical indices.All consecutive patients affected by ICC who underwent hepatectomy at six high-volume centers (2009-2019) were considered for the study. The arterial and portal phases of CT performed fewer than 60 days before surgery were analyzed. A manual segmentation of the tumor was performed (Tumor-VOI). A 5-mm volume expansion then was applied to identify the peritumoral tissue (Margin-VOI).The study enrolled 215 patients. After a median follow-up period of 28 months, the overall survival (OS) rate was 57.0%, and the progression-free survival (PFS) rate was 34.9% at 3 years. The clinical predictive model of OS had a C-index of 0.681. The addition of radiomic features led to a progressive improvement of performances (C-index of 0.71, including the portal Tumor-VOI, C-index of 0.752 including the portal Tumor- and Margin-VOI, C-index of 0.764, including all VOIs of the portal and arterial phases). The latter model combined clinical variables (CA19-9 and tumor pattern), tumor indices (density, homogeneity), margin data (kurtosis, compacity, shape), and GLRLM indices. The model had performance equivalent to that of the postoperative clinical model including the pathology data (C-index of 0.765). The same results were observed for PFS.The radiomics of ICC and peritumoral tissue extracted from preoperative CT improves the prediction of survival. Both the portal and arterial phases should be considered. Radiomic and clinical data are complementary and achieve a preoperative estimation of prognosis equivalent to that achieved in the postoperative setting.© 2024. Society of Surgical Oncology.