Радиомика и радиогеномика при внутрипеченочной холангиокарциноме

Цель исследования. Аналитический обзор и анализ литературы, посвященной текстурному анализу компьютерных (КТ) и магнитно-р езонансных томограмм (МРТ) в неинвазивной диагностике внутрипеченочной холангиокарциномы (ВПХК) и корреляции с молекулярно- генетическими особенностями и иммунофенотипом опухоли.

Материалы и методы. Проведен поиск научных публикаций и клинических рекомендаций в информационно- аналитических системах PubMed, Scopus за 2012–2022 гг. по ключевым словам: «mri» (МРТ), «radiomics» (радиомика), «texture analysis» (текстурный анализ), «radiogenomics» (радиогеномика), «intrahepatic cholangiocarcinoma» (внутрипеченочный холангиоцеллюлярный рак), «molecular» (молекулярная). После исключения исследований, посвященных техническим аспектам радиомики и описанию отдельных клинических наблюдений, для анализа было отобрано 49 статей.

Результаты. Представленный обзор продемонстрировал широкие возможности и перспективы применения текстурного анализа КТ и МРТ при изучении холангиоцеллюлярного рака, в том числе получены первые результаты в исследовании молекулярных особенностей (сигнатур) этой опухоли. Показана корреляция текстурных характеристик с экспрессией генов иммунотерапевтических мишеней KRAS/NRAS/BRAF, а также мутации IDH1/2. Показатели текстурного анализа были преобладающим независимым предиктором микроваскулярной инвазии, который был основным независимым фактором риска послеоперационного рецидива.

Заключение. Применение текстурного анализа, безусловно, демонстрирует перспективные возможности как в неинвазивной оценке степени гистологической дифференцировки ВПХК, так и в дифференциальной диагностике с гепатоцеллюлярной карциномой и метастазами и требует дальнейшего изучения для систематизации и стандартизации полученных данных.

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