Korean J Radiol.  2019 Mar;20(3):449-458. 10.3348/kjr.2018.0469.

Evaluation of Early Response to Treatment of Hepatocellular Carcinoma with Yttrium-90 Radioembolization Using Quantitative Computed Tomography Analysis

Affiliations
  • 1Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea. gafield2@yuhs.ac
  • 2Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Abstract


OBJECTIVE
To identify an imaging predictor for the assessment of early treatment response to yttrium-90 transarterial radioembolization (TARE) in patients with hepatocellular carcinoma (HCC), using a quantitative assessment of dynamic computed tomography (CT) images.
MATERIALS AND METHODS
Dynamic contrast-enhanced CT was obtained pre- and 4 weeks post-TARE in 44 patients (34 men, 10 women; mean age, 60 years) with HCC. Computer software was developed for measuring the percentage increase in the combined delayed-enhancing area and necrotic area (pD + N) and the percentage increase in the necrotic area (pNI) in the tumor-containing segments pre- and post-TARE. Local progression-free survival (PFS) was compared between patient groups using Cox regression and Kaplan-Meier analyses.
RESULTS
Post-TARE HCC with pD + N ≥ 35.5% showed significantly longer PFS than those with pD + N < 35.5% (p = 0.001). The local tumor progression hazard ratio was 17.3 (p = 0.009) for pD + N < 35.5% versus pD + N ≥ 35.5% groups. HCCs with a high pNI tended to have longer PFS, although this difference did not reach statistical significance.
CONCLUSION
HCCs with a larger pD + N are less likely to develop local progression after TARE.

Keyword

Hepatocellular carcinoma; Computed tomography; Treatment outcome; Response; Yttrium radioisotopes; Quantitative analysis

MeSH Terms

Carcinoma, Hepatocellular*
Disease-Free Survival
Female
Humans
Male
Tomography, X-Ray Computed
Treatment Outcome
Yttrium Radioisotopes
Yttrium Radioisotopes
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