Assessing the value of computed tomography (CT) of the chest in the follow-up of patients with intrahepatic cholangiocarcinoma

Background: Following tumor resection, imaging recommendation for the follow-up of patients with intrahepatic cholangiocarcinoma (IHCCA) include frequent chest, abdomen and pelvis computed tomography (CT) imaging. The appropriateness of additional imaging studies is usually derived from their clinical utility. The purpose of this work is to determine the value of chest CT imaging in the follow-up of patients with IHCCA. Methods: Data review of radiology reports of baseline post-operative chest, abdominal, and pelvic CT imaging reports following the resection of IHCCA, and of subsequent follow-up exams. The radiology findings were stratified as intrathoracic metastasis only, combined intra-thoracic and intraabdominal metastasis, intra-abdominal metastases without intrathoracic involvement. We assessed the prevalence of intra-thoracic disease progression in comparison to other groups. Descriptive statistical analysis was carried out using John’s Macintosh Project (JMP) statistical software. Results: Eighty-seven patients were included in the study, 6 patients were found to have disease progression in the chest without corresponding disease progression in the abdomen on follow-up CT, accounting for 6.9% of the total. Only four patients had disease progression in the chest with a normal CT chest at baseline (4.5%). Conclusions: The use of short-interval chest CT for surveillance in IHCCA has limited utility, particularly in patients with disease-free abdominal studies.