Faculty, Staff and Student Publications

Language

English

Publication Date

12-12-2025

Journal

npj Systems Biology and Applications

DOI

10.1038/s41540-025-00616-9

PMID

41387975

PMCID

PMC12717172

PubMedCentral® Posted Date

12-12-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Escalated doses of radiotherapy associate with improved local control and overall survival (OS) in intrahepatic cholangiocarcinoma (iCCA), but personalization remains limited because conventional size-based CT criteria correlate poorly with outcomes. We hypothesized that quantitative enhancement measurements would better predict clinical outcomes and guide individualized RT optimization. In a retrospective cohort of 154 patients, we analyzed pre- and post-RT CT scans using quantitative European Association for Study of Liver (qEASL) to derive viable tumor volumes, comparing enhancement-based metrics with size-based RECIST and linking them to outcomes via survival and mathematical modeling. Change in enhancement volume was strongly associated with OS after adjustment, outperforming RECIST, and a ≥ 33% reduction optimally distinguished responders. From modeling analyses, the patient-specific tumor growth rate parameter emerged as the dominant mechanistic predictor, achieving 80.5% classification accuracy. Importantly, CT-derived mathematical parameters from this framework may inform RT planning and dose adaptation, particularly for resistant tumors, by bridging imaging with mechanistic insight.

Keywords

Humans, Cholangiocarcinoma, Male, Female, Retrospective Studies, Tomography, X-Ray Computed, Middle Aged, Bile Duct Neoplasms, Aged, Tumor Burden, Treatment Outcome, Adult, Aged, 80 and over, Cancer, Computational biology and bioinformatics, Oncology

Published Open-Access

yes

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