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A novel method for predicting hepatocellular carcinoma response to chemoembolization using an intraprocedural CT hepatic arteriography-based enhancement mapping: a proof-of-concept analysis.
- Source :
- European Radiology Experimental; 1/30/2023, Vol. 7 Issue 1, p1-11, 11p
- Publication Year :
- 2023
-
Abstract
- Background: To evaluate the feasibility of a novel approach for predicting hepatocellular carcinoma (HCC) response to drug-eluting beads transarterial chemoembolization (DEB-TACE) using computed tomography hepatic arteriography enhancement mapping (CTHA-EM) method. Methods: This three-institution retrospective study included 29 patients with 46 HCCs treated with DEB-TACE between 2017 and 2020. Pre- and posttreatment CTHA-EM images were generated using a prototype deformable registration and subtraction software. Relative tumor enhancement (T<subscript>Post/pre-RE</subscript>) defined as the ratio of tumor enhancement to normal liver tissue was calculated to categorize tumor response as residual (T<subscript>Post-RE</subscript> > 1) versus non-residual (T<subscript>Post-RE</subscript> ≤ 1) enhancement, which was blinded compared to the response assessment on first follow-up imaging using modified RECIST criteria. Additionally, for tumors with residual enhancement, CTHA-EM was evaluated to identify its potential feeding arteries. Results: CTHA-EM showed residual enhancement in 18/46 (39.1%) and non-residual enhancement in 28/46 (60.9%) HCCs, with significant differences on T<subscript>Post-RE</subscript> (3.05 ± 2.4 versus 0.48 ± 0.23, respectively; p < 0.001). The first follow-up imaging showed non-complete response (partial response or stable disease) in 19/46 (41.3%) and complete response in 27/46 (58.7%) HCCs. CTHA-EM had a response prediction sensitivity of 94.7% (95% CI, 74.0–99.9) and specificity of 100% (95% CI, 87.2–100). Feeding arteries to the residual enhancement areas were demonstrated in all 18 HCCs (20 arteries where DEB-TACE was delivered, 2 newly developed collaterals following DEB-TACE). Conclusion: CTHA-EM method was highly accurate in predicting initial HCC response to DEB-TACE and identifying feeding arteries to the areas of residual arterial enhancement. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 25099280
- Volume :
- 7
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- European Radiology Experimental
- Publication Type :
- Academic Journal
- Accession number :
- 161607794
- Full Text :
- https://doi.org/10.1186/s41747-022-00315-8