The Role of Dual-Phase Cone-Beam CT in Predicting Short-Term Response after Transarterial Chemoembolization for Hepatocellular Carcinoma

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Müller K.; Datta S.; Gehrisch S.; Ahmad M.; Mohammed M.A.A.; Rosenberg J.; Hwang G.L.; Louie J.D.; Sze D.Y.; Kothary N.

Journal: Journal of Vascular and Interventional Radiology

Publisher: Elsevier Inc.

Publication Date: February 2017

Volume / Issue: Volume 28 / Issue 2

Pages: 238–245

ISSN: 10510443

DOI: 10.1016/j.jvir.2016.09.019

Scopus: View on Scopus

PubMed: 27914917

Document Type: Article

Authors and Affiliations

Müller K., Stanford University School of Medicine, Stanford, California, United States; Datta S., Siemens Medical Solutions, Inc, Malvern, Pennsylvania, United States; Gehrisch S., Siemens Healthcare GmbH, Forchheim, Germany; Ahmad M., Stanford University School of Medicine, Stanford, California, United States; Mohammed M.A.A., Stanford Health Care, Stanford, California, United States, Theodor Bilharz Research Institute, Giza, Egypt; Rosenberg J., Stanford University School of Medicine, Stanford, California, United States; Hwang G.L., Stanford Health Care, Stanford, California, United States; Louie J.D., Stanford Health Care, Stanford, California, United States; Sze D.Y., Stanford Health Care, Stanford, California, United States; Kothary N., Stanford Health Care, Stanford, California, United States

Abstract

Purpose To identify computational and qualitative features derived from dual-phase cone-beam CT that predict short-term response in patients undergoing transarterial chemoembolization for hepatocellular carcinoma (HCC). Materials and Methods This retrospective study included 43 patients with 59 HCCs. Six features were extracted, including intensity of tumor enhancement on both phases and characteristics of the corona on the washout phase. Short-term response was evaluated by modified Response Evaluation Criteria in Solid Tumors on follow-up imaging, and extracted features were correlated to response using univariate and multivariate analyses. Results Univariate and multivariate analyses did not reveal a correlation between absolute and relative tumor enhancement characteristics on either phase with response (arterial P = .21; washout P = .40; ∆ P = .90). On multivariate analysis of qualitative characteristics, the presence of a diffuse corona was an independent predictor of incomplete response (P = .038) and decreased the odds ratio of objective response by half regardless of tumor size. Conclusions Computational features extracted from contrast-enhanced dual-phase cone-beam CT are not prognostic of response to transarterial chemoembolization in patients with HCC. HCCs that demonstrate a diffuse, patchy corona have reduced odds of achieving complete response after transarterial chemoembolization and should be considered for additional treatment with an alternative modality. © 2016 SIR

Keywords

Aged; Aged, 80 and over; Carcinoma, Hepatocellular; Chemoembolization, Therapeutic; Cone-Beam Computed Tomography; Female; Humans; Linear Models; Liver Neoplasms; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Predictive Value of Tests; Radiographic Image Interpretation, Computer-Assisted; Retrospective Studies; Time Factors; Treatment Outcome; Tumor Burden; doxorubicin; iohexol; iopamidol; adult; Article; chemoembolization; clinical article; cone beam computed tomography; cone beam computed tomography scanner; contrast enhancement; dual phase cone beam computed tomography; follow up; human; liver cell carcinoma; prediction; priority journal; response evaluation criteria in solid tumors; retrospective study; treatment response; tumor volume; computer assisted diagnosis; diagnostic imaging; pathology; predictive value; statistical model; time factor; very elderly

Citation Information

Scopus Citations: 8

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