Evaluation of Early Response to Treatment of Hepatocellular Carcinoma with Yttrium-90 Radioembolization Using Quantitative Computed Tomography Analysis
- Author:
Sungwon KIM
1
;
Do Young KIM
;
Chansik AN
;
Kyunghwa HAN
;
Jong Yun WON
;
Gyoung Min KIM
;
Myeong Jin KIM
;
Jin Young CHOI
Author Information
- Publication Type:Original Article
- Keywords: Hepatocellular carcinoma; Computed tomography; Treatment outcome; Response; Yttrium radioisotopes; Quantitative analysis
- MeSH: Carcinoma, Hepatocellular; Disease-Free Survival; Female; Humans; Male; Tomography, X-Ray Computed; Treatment Outcome; Yttrium Radioisotopes
- From:Korean Journal of Radiology 2019;20(3):449-458
- CountryRepublic of Korea
- Language:English
- 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.
