A novel method for predicting hepatocellular carcinoma response to chemoembolization using an intraprocedural ct hepatic arteriography-based enhancement mapping: a proof-of-concept analysis
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Universidade Federal de Minas Gerais
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Artigo de periódico
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Resumo
Background To evaluate the feasibility of a novel approach for predicting hepatocellular carcinoma (HCC) response
to drugeluting beads transarterial chemoembolization (DEBTACE) using computed tomography hepatic arteriography enhancement mapping (CTHAEM) method.
Methods This threeinstitution retrospective study included 29 patients with 46 HCCs treated with DEBTACE between 2017 and 2020. Pre and posttreatment CTHAEM images were generated using a prototype deformable registration and subtraction software. Relative tumor enhancement (TPost/preRE) defned as the ratio of tumor enhancement to normal liver tissue was calculated to categorize tumor response as residual (TPostRE > 1) versus nonresidual (TPostRE ≤ 1) enhancement, which was blinded compared to the response assessment on frst followup imaging using modifed RECIST criteria. Additionally, for tumors with residual enhancement, CTHAEM was evaluated to identify its potential feeding arteries.
Results CTHAEM showed residual enhancement in 18/46 (39.1%) and nonresidual enhancement in 28/46 (60.9%) HCCs, with signifcant diferences on TPostRE (3.05 ± 2.4 versus 0.48 ± 0.23, respectively; p < 0.001). The frst followup imaging showed noncomplete response (partial response or stable disease) in 19/46 (41.3%) and complete response in 27/46 (58.7%) HCCs. CTHAEM had a response prediction sensitivity of 94.7% (95% CI, 74.0–99.9) and specifcity of 100% (95% CI, 87.2–100). Feeding arteries to the residual enhancement areas were demonstrated in all 18 HCCs (20 arteries where DEBTACE was delivered, 2 newly developed collaterals following DEBTACE).
Conclusion CTHAEM method was highly accurate in predicting initial HCC response to DEBTACE and identifying feeding arteries to the areas of residual arterial enhancement.
Abstract
Assunto
Carcioma, Tomografia computadorizada de feixe cônico, Tomografia
Palavras-chave
Carcinoma (hepatocellular), Chemoembolization (therapeutic), Computed tomography angiography, Conebeam computed tomography, Microspheres
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https://eurradiolexp.springeropen.com/articles/10.1186/s41747-022-00315-8