The Application of Three-Dimensional Visualization in Preoperative Evaluation of Portal Vein Invasion in Hilar Cholangiocarcinoma

Objective: This study aimed to investigate the use of three-dimensional visualization for preoperative evaluation of portal vein invasion in hilar cholangiocarcinoma (HCCA).

Methods: This recombination study for preoperative computerized tomography images was completed in 42 patients undergoing radical resection of HCCA combined with hepatectomy. Portal vein invasion with postoperative pathology was used as a gold standard to decide if the diagnosis was correct or not. We compared the sensitivity, specificity, positive predictive value, negative predictive value, and total correctness of radiologists and a three-dimensional (3D) visualization model for the assessment of tumor-caused portal vein invasion.

Results: The findings for the estimation of portal vein invasion by radiologists based on CT images were as follows: sensitivity = 90.9%; specificity = 83.8%; positive predictive value = 66.7%; negative predictive value = 96.3%; and overall accuracy = 85.7%. The findings for estimation by the 3D visualization model were as follows: sensitivity = 90.9%; specificity = 96.8%; positive predictive value = 90.9%; negative predictive value = 96.8%; and overall accuracy = 90.5%.

Conclusion: The positive predictive value of 3D visualization technology in the diagnosis of portal vein invasion is notably superior to that of subjective assessment by radiologists. This technique can thus play a significant role in preventing unnecessary resectioning of non-invaded portal veins and hepatectomy.