{"doi":"10.1038/s41540-025-00616-9","title":"Measurable imaging-based changes in enhancement of intrahepatic cholangiocarcinoma after radiotherapy reflect physical mechanisms of response","abstract":"Escalated doses of radiotherapy associate with improved local control and overall survival (OS) in intrahepatic cholangiocarcinoma (iCCA), but personalization remains limited because conventional size-based CT criteria correlate poorly with outcomes. We hypothesized that quantitative enhancement measurements would better predict clinical outcomes and guide individualized RT optimization. In a retrospective cohort of 154 patients, we analyzed pre- and post-RT CT scans using quantitative European Association for Study of Liver (qEASL) to derive viable tumor volumes, comparing enhancement-based metrics with size-based RECIST and linking them to outcomes via survival and mathematical modeling. Change in enhancement volume was strongly associated with OS after adjustment, outperforming RECIST, and a ≥ 33% reduction optimally distinguished responders. From modeling analyses, the patient-specific tumor growth rate parameter emerged as the dominant mechanistic predictor, achieving 80.5% classification accuracy. Importantly, CT-derived mathematical parameters from this framework may inform RT planning and dose adaptation, particularly for resistant tumors, by bridging imaging with mechanistic insight.","journal":"npj Systems Biology and Applications","year":2025,"id":585000,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9604,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":279152,"name":"Prashant Dogra","orcid":"0000-0001-6722-7371","position":1,"is_corresponding":false},{"id":404501,"name":"Mohamed Zaid","orcid":"0000-0002-8615-2456","position":2,"is_corresponding":false},{"id":315003,"name":"Dalia Elganainy","orcid":"0000-0003-4427-986X","position":3,"is_corresponding":false},{"id":404503,"name":"Kevin Sun","orcid":"0000-0003-3230-4319","position":4,"is_corresponding":false},{"id":1329205,"name":"Ahmed Amer","orcid":null,"position":5,"is_corresponding":false},{"id":1328727,"name":"Charles Wang","orcid":"0000-0002-9865-1658","position":6,"is_corresponding":false},{"id":516556,"name":"Michael K. 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