Investig Magn Reson Imaging.  2019 Dec;23(4):351-360. 10.13104/imri.2019.23.4.351.

Noninvasive Biomarker for Predicting Treatment Response to Concurrent Chemoradiotherapy in Patients with Hepatocellular Carcinoma

Affiliations
  • 1Department of Radiology, Yonsei University College of Medicine, Seoul, Korea. radpms@yuhs.ac
  • 2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea. jsseong@yuhs.ac

Abstract

PURPOSE
To investigate noninvasive biomarkers for predicting treatment response in patients with locally advanced HCC who underwent concurrent chemoradiotherapy (CCRTx).
MATERIALS AND METHODS
Thirty patients (55.5 ± 10.2 years old, M:F = 24:6) who underwent CCRTx due to advanced HCC were enrolled. Contrast-enhanced US (CEUS) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) were obtained before and immediately after CCRTx. The third CEUS was obtained at one month after CCRTx was completed. Response was assessed at three months after CCRTx based on RECIST 1.1. Quantitative imaging biomarkers measured with CEUS and MRI were compared between groups. A cutoff value was calculated with ROC analysis. Overall survival (OS) was compared by the Breslow method.
RESULTS
Twenty-five patients were categorized into the non-progression group and five patients were categorized into the progression group. Peak enhancement of the first CEUS before CCRTx (PE1) was significantly lower in the non-progression group (median, 18.6%; IQR, 20.9%) than that in the progression group (median, 59.1%; IQR, 13.5%; P = 0.002). There was no significant difference in other quantitative biomarkers between the two groups. On ROC analysis, with a cutoff value of 42.6% in PE1, the non-progression group was diagnosed with a sensitivity of 90.9% and a specificity of 100%. OS was also significantly longer in patients with PE1 < 42.6% (P = 0.014).
CONCLUSION
Early treatment response and OS could be predicted by PE on CEUS before CCRTx in patients with HCC.

Keyword

Hepatocellular carcinoma; Ultrasonography; Perfusion imaging; Magnetic resonance imaging, Chemoradiotherapy, Biomarkers

MeSH Terms

Biomarkers
Carcinoma, Hepatocellular*
Chemoradiotherapy*
Humans
Magnetic Resonance Imaging
Methods
Perfusion Imaging
Response Evaluation Criteria in Solid Tumors
ROC Curve
Sensitivity and Specificity
Ultrasonography
Biomarkers
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