CT Targetoid and MRI Non-Targetoid LI-RADS M Features Differentially Predict iCCA Survival

CT targetoid features (HR 2.31 for RFS) and MRI non-targetoid features (HR 2.15) predicted poorer survival in iCCA. MRI non-targetoid features remained prognostic after LI-RADS adjustment; dual-modality LR-M conferred highest risk (RFS HR 8.02).

• MRI detected significantly more targetoid (84.4% vs 73.8%, p=0.007) and non-targetoid features (43.4% vs 20.5%, p<0.001) than CT, resulting in more LR-M categorizations (90.2% vs 81.1%, p=0.003).
• After adjusting for LI-RADS categorization, MRI non-targetoid features remained independently associated with poorer recurrence-free survival (HR 1.76, p=0.041) and overall survival (HR 1.79, p=0.038).
• Dual-modality LR-M designation was independently associated with poorer recurrence-free survival (HR 8.02, p=0.042).

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