Preoperative prediction of IDH1-mutation in intrahepatic cholangiocarcinoma based on Gd-EOB-DTPA-enhanced MRI and MRI-derived habitats

Motivation: Isocitrate dehydrogenase 1 (IDH1) mutation is an important therapeutic target for intrahepatic cholangiocarcinoma (ICC). Goal(s): To achieve non-invasive prediction of IDH1 mutation in ICC to assist in clinical management. Approach: Preoperative Gd-EOB-DTPA-enhanced MRI features and clinical information were retrospectively collected. Habitat analysis was performed based on pre- and post-enhancement T1 maps. Nomogram prediction model was established based on filtered variables. Results: Higher serum AFP level, higher T1 change ratio, more frequent intratumoral vessel and T2 central brightness, and habitat 5 are risk factors for IDH1-mutated ICC. The combined nomogram model demonstrated the highest diagnostic performance over the clinilal+imaging model and the habitat model. Impact: The proposed strategy, Gd-EOB-DTPA-enhanced MRI and T1–based habitat imaging, can be applied for preoperatively and noninvasively identifying IDH1-mutation status in ICC, which offers potential benefits in terms to aid in clinical management.