Hepatic Tumors: Region-of-Interest versus Volumetric Analysis for Quantification of Attenuation at CT

Chalian, Hamid; Tochetto, Sandra; Töre, Hüseyin Gürkan; Rezai, Pedram; Yaghmai, Vahid

doi:10.1148/radiol.11110106

Cited by 31 publications

(22 citation statements)

References 34 publications

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“…Previous studies indicate advantages of whole tumor volume coverage for target lesion analysis, leading to an improvement in reproducibility and a reduction of selection bias [43]. Furthermore, it has been shown that volumetric analysis of CT perfusion values reflects tumor heterogeneity more accurately than measurements in 2D ROIs [12].…”

Section: Discussionmentioning

confidence: 99%

Histogram Analysis of CT Perfusion of Hepatocellular Carcinoma for Predicting Response to Transarterial Radioembolization: Value of Tumor Heterogeneity Assessment

Reiner

Gordic

Puippe

et al. 2015

Cardiovasc Intervent Radiol

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Section: Discussionmentioning

confidence: 99%

Histogram Analysis of CT Perfusion of Hepatocellular Carcinoma for Predicting Response to Transarterial Radioembolization: Value of Tumor Heterogeneity Assessment

Reiner

Gordic

Puippe

et al. 2015

Cardiovasc Intervent Radiol

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“…A recent study, designed in response to that limitation, demonstrated that evaluation of the attenuation of the entire volume of a liver lesion (three-dimensional measurement) has less variability and better reproducibility than the two-dimensional ROI measurement (25).…”

Section: Modified Ct Response Evaluation Criteria (Choi Criteria)mentioning

confidence: 99%

Assessment of Liver Tumor Response to Therapy: Role of Quantitative Imaging

Gonzalez-Guindalini¹,

Botelho²,

Harmath³

et al. 2013

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Quantitative imaging is the analysis of retrieved numeric data from images with the goal of reducing subjective assessment. It is an increasingly important radiologic tool to assess treatment response in oncology patients. Quantification of response to therapy depends on the tumor type and method of treatment. Anatomic imaging biomarkers that quantify liver tumor response to cytotoxic therapy are based on temporal change in the size of the tumors. Anatomic biomarkers have been incorporated into the World Health Organization criteria and the Response Evaluation Criteria in Solid Tumors (RECIST) versions 1.0 and 1.1. However, the development of novel therapies with different mechanisms of action, such as antiangiogenesis or radioembolization, has required new methods for measuring response to therapy. This need has led to development of tumor- or therapy-specific guidelines such as the Modified CT Response Evaluation (Choi) Criteria for gastrointestinal stromal tumors, the European Association for Study of the Liver (EASL) criteria, and modified RECIST for hepatocellular carcinoma, among many others. The authors review the current quantification criteria used in the evaluation of treatment response in liver tumors, summarizing their indications, advantages, and disadvantages, and discuss future directions with newer methods that have the potential for assessment of treatment response. Knowledge of these quantitative methods is important to facilitate pivotal communication between oncologists and radiologists about cancer treatment, with benefit ultimately accruing to the patient.

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“…Second, volumetric functional MR imaging criteria that can be used to assess viable tumor tissue and provide a strong predictor of response and survival. Software developments have enabled easy, reliable, and reproducible volumetric evaluation of liver lesions (15,17,32). We used proprietary software based on these techniques to analyze two well-described biomarkers of tumor had a 2-year survival rate of 83%, whereas patients classified as single-parameter responders and those classified as nonresponders had 2-year survival rates of 43% and 14%, respectively.…”

Section: Gastrointestinal Imaging: Unresectable Hepatocellular Carcinmentioning

confidence: 99%

Unresectable Hepatocellular Carcinoma: MR Imaging after Intraarterial Therapy. Part I. Identification and Validation of Volumetric Functional Response Criteria

Bonekamp

Geschwind³

et al. 2013

Radiology

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Purpose:To identify and validate the optimal thresholds for volumetric functional MR imaging response criteria to predict overall survival after intraarterial treatment (IAT) in patients with unresectable hepatocellular carcinoma (HCC). Materials and Methods:Institutional review board approval and waiver of informed consent were obtained. A total of 143 patients who had undergone MR imaging before and 3-4 weeks after the first cycle of IAT were included. MR imaging analysis of one representative HCC index lesion was performed with proprietary software after initial treatment. Subjects were randomly divided into training (n = 114 [79.7%]) and validation (n = 29 [20.3%]) data sets. Uni-and multivariate Cox models were used to determine the best cutoffs, as well as survival differences, between response groups in the validation data set. Results:Optimal cutoffs in the training data set were 23% increase in apparent diffusion coefficient (ADC) and 65% decrease in volumetric enhancement in the portal venous phase (VE). Subsequently, 25% increase in ADC and 65% decrease in VE were used to stratify patients in the validation data set.Comparison of ADC responders (n = 12 [58.6%]) with nonresponders (n = 17 [34.5%]) showed significant differences in survival (25th percentile survival, 11.2 vs 4.9 months, respectively; P = .008), as did VE responders (n = 9 [31.0%]) compared with nonresponders (n = 20 [69.0%]; 25th percentile survival, 11.5 vs 5.1 months, respectively; P = .01). Stratification of patients with a combination of the criteria resulted in significant differences in survival between patients with lesions that fulfilled both criteria (n = 6 [20.7%]; too few cases to determine 25th percentile), one criterion (n = 9 [31.0%]; 25th percentile survival, 6.0 months), and neither criterion (n = 14 [48.3%]; 25th percentile survival, 5.1 months; P = .01). The association between the two criteria and overall survival remained significant in a multivariate analysis that included age, sex, Barcelona Clinic for Liver Cancer stage, and number of follow-up treatments. Conclusion:After IAT for unresectable HCC, patients can be stratified into significantly different survival categories based on responder versus nonresponder status according to MR imaging ADC and VE cutoffs.q RSNA, 2013

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Hepatic Tumors: Region-of-Interest versus Volumetric Analysis for Quantification of Attenuation at CT

Abstract: Measurements of hepatic tumor attenuation at multidetector CT are reproducible. An approach based on the evaluation of whole-lesion attenuation demonstrated better reproducibility than ROI measurements.

Cited by 31 publications

References 34 publications

Histogram Analysis of CT Perfusion of Hepatocellular Carcinoma for Predicting Response to Transarterial Radioembolization: Value of Tumor Heterogeneity Assessment

Histogram Analysis of CT Perfusion of Hepatocellular Carcinoma for Predicting Response to Transarterial Radioembolization: Value of Tumor Heterogeneity Assessment

Assessment of Liver Tumor Response to Therapy: Role of Quantitative Imaging

Unresectable Hepatocellular Carcinoma: MR Imaging after Intraarterial Therapy. Part I. Identification and Validation of Volumetric Functional Response Criteria

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