Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;55(3):373-380.
doi: 10.1016/j.dld.2022.10.015. Epub 2022 Nov 7.

A quantitative MRCP-derived score for medium-term outcome prediction in primary sclerosing cholangitis

Laura Cristoferi  1 , Marco Porta  2 , Davide Paolo Bernasconi  3 , Filippo Leonardi  4 , Alessio Gerussi  5 , Giacomo Mulinacci  5 , Andrea Palermo  5 , Camilla Gallo  5 , Miki Scaravaglio  5 , Eliana Stucchi  5 , Cesare Maino  2 , Davide Ippolito  6 , Daphne D'Amato  5 , Carlos Ferreira  7 , Alessandra Nardi  8 , Rajarshi Banerjee  7 , Maria Grazia Valsecchi  3 , Laura Antolini  3 , Rocco Corso  2 , Sandro Sironi  9 , Stefano Fagiuoli  4 , Pietro Invernizzi  5 , Marco Carbone  10
Affiliations
Free article

A quantitative MRCP-derived score for medium-term outcome prediction in primary sclerosing cholangitis

Laura Cristoferi et al. Dig Liver Dis. 2023 Mar.
Free article

Abstract

Background: Magnetic resonance cholangiopancreatography (MRCP) is the gold standard for diagnosis of patients with primary sclerosing cholangitis (PSC). The semi-quantitative MRCP-derived Anali scores proposed for risk stratification, have poor-to-moderate inter-reader agreement.

Aims: To evaluate the prognostic performance of quantitative MRCP metrics in PSC.

Methods: This is a retrospective study of PSC patients undergoing MRCP. Images were processed using MRCP+ software (Perspectum Ltd, Oxford) that provides quantitative biliary features, semi-automatically extracted by artificial intelligence-driven analysis of MRCP-3D images. The prognostic value of biliary features has been assessed for all hepato-biliary complications.

Results: 87 PSC patients have been included in the analysis. Median follow-up from MRCP to event/censoring of 30.9 months (Q1-Q3=13.6-46.6). An adverse outcome occurred in 27 (31.0%) patients. The number of biliary strictures (HR=1.05 per unit, 95%CI 1.02-1.08, p < 0.0001), spleen length (HR=1.16 per cm, 95%CI 1.01-1.34, p = 0.039), adjusted for height, age at MRCP, and time from diagnosis to MRCP predicted higher risk of hepatobiliary complications. These were incorporated into a the quantitative MRCP-derived PSC (qMRCP-PSC) score (C-statistic=0.80). After 3-fold cross-validation, qMRCP-PSC outperformed the Anali score in our cohort (C-statistic of 0.78 vs 0.64) and enabled the discrimination of survival of PSC patients (log-rank p < 0.0001).

Conclusions: The qMRCP-PSC score identified patients at higher risk of hepatobiliary complications and outperformed the available radiological scores. It represents a novel quantitative biomarker for disease monitoring and a potential surrogate endpoint for clinical trials.

Keywords: Artificial intelligence; MRCP; Primary sclerosing cholangitis; Prognostic score.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest RB is CEO at Perspectum Ltd, CF is employed by Perspectum Ltd. MC is a consultant without fee at Perspetum Ltd. LC, MP, DPB, FL, GM, AP, CG, MS, ES, CM, DI, DD, AN, MGV, LA, RC, SS, SF and PI have nothing to disclose.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

MeSH terms

LinkOut - more resources

-