PURPOSE The study aims to investigate the predictability of the radiological response in intrahepatic cholangiocarcinoma (iCC) patients undergoing Yttrium -90 transarterial radioembolization (TARE) with a combined model built on dynamic magnetic resonance imaging (MRI)-based radiomics and clinical features. METHODS Thirty-six naive iCC patients who underwent TARE were included in this study. The tumor segmentation was performed on the axial T2 -weighted (T2W) without fat suppression, axial T2W with fat suppression, and axial T1 -weighted (T1W) contrast -enhanced (CE) sequence in equilibrium phase (Eq). At the sixth month MRI follow-up, all patients were divided into responders and non -responders according to the modified Response Evaluation Criteria in Solid Tumors. Subsequently, a radiomics score (rad-score) and a combined model of the rad-score and clinical features for each sequence were generated and compared between the groups. RESULTS Thirteen (36.1%) patients were considered responders, and the remaining 23 (63.9%) were non -responders. Responders exhibited significantly lower rad-scores than non -responders ( P < 0.050 for all sequences). The radiomics models showed good discriminatory ability with an area under the curve (AUC) of 0.696 [95% confidence interval (CI), 0.522-0.870] for the axial T1W-CE-Eq, AUC of 0.839 (95% CI, 0.709-0.970) for the axial T2W with fat suppression, and AUC of 0.836 (95% CI, 0.678- 0.995) for the axial T2W without fat suppression. CONCLUSION Radiomics models created by pre-treatment MRIs can predict the radiological response to Yttrium -90 TARE in iCC patients with high accuracy. Combining radiomics with clinical features could increase the power of the test. Large-scale studies of multi -parametric MRIs with internal and external validations are needed to determine the clinical value of radiomics in iCC patients.

Background: The primary aim of the study was to demonstrate parenchymal changes in the liver and pancreas related to copper accumulation using ultrasound in pediatric patients with Wilson’s disease and secondly, to investigate the effectiveness of two-dimensional shear wave elastography in the diagnosis of involvement of these organs. Methods: Patients with Wilson’s disease (n = 25) who were treated and followed at our center were evaluated prospectively. In addition to routine clinical assessments, eye examination, laboratory analyses, and abdominal ultrasound imaging, all patients underwent tissue stiffness measurements from the liver and pancreas (head, body and tail) by two-dimensional shear wave elastography. The data obtained from the WD patients were compared with those of age- and sex-matched healthy controls (n = 37). Results: Liver elastography measurements showed significantly increased tissue stiffness in the patient group than in control subjects (P < .001). While there was no significant difference between the groups in the tissue thickness of pancreatic head, body, and tail, tissue stiffness was significantly reduced in the patient group (P < .001). Disease duration was significantly associated and moderately correlated with liver tissue stiffness (r = 0.417, P = .038) but not significantly associated with pancreatic tissue stiffness. Conclusion: In the early stages of Wilson’s disease, parenchymal changes occur in the liver and pancreas, which cannot be detected by conventional ultrasonography imaging but may be demonstrated by two-dimensional shear wave elastography. Ultrasound elastography is an easy to use, non-invasive, and promising method that provides numerical data on the early changes in tissue stiffness, allowing for objective monitoring of Wilson’s disease patients who require lifelong follow-up. Cite this article as: Yavuz S, Pişkin FC, Oktay C, Soyupak S, Tümgör G. Evaluation of the liver and pancreas by 2D shear wave elastography in pediatric Wilson’s disease. Turk J Gastroenterol. 2022;33(2):161-167.