Hypo-Vascular Liver Metastases Treated with Transarterial chemoembolization: Assessment of Early Response by Volumetric Contrast-Enhanced and Diffusion-Weighted Magnetic Resonance Imaging

Sobhani, Fatemeh; Xu, Can; Murano, Emi Z.; Pan, Li; Rastegar, Neda; Kamel, Ihab R.

doi:10.1016/j.tranon.2016.03.005

Cited by 11 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent studies (36)(37)(38) investigated the role of three-dimensional quantitative assessment of tumor response including whole-liver enhancing tumor burden as an imaging biomarker for prediction of survival in patients with hypo-and hypervascular liver malignancies after intra-arterial therapies and reported its usefulness. However, these studies were limited in terms of complete volumetric functional assessment because they did not incorporate changes in ADC that have been shown, in addition to the enhancement-based parameters, to change early after TACE and predict survival in both hypoand hypervascular liver malignancies (25,27,(39)(40)(41).…”

Section: Discussionmentioning

confidence: 99%

Unresectable Intrahepatic Cholangiocarcinoma: Multiparametric MR Imaging to Predict Patient Survival

Pandey

Ghasabeh

et al. 2018

Radiology

Self Cite

View full text Add to dashboard Cite

Purpose To determine the performance of magnetic resonance (MR) imaging-based tumor metrics for evaluation of response to transarterial chemoembolization (TACE) in patients with unresectable intrahepatic cholangiocarcinoma (ICCA). Materials and Methods Ninety-four patients with unresectable ICCA underwent baseline and follow-up MR imaging after TACE and were followed up until death or end of study duration. Lesions were analyzed for anatomic (Response Evaluation Criteria in Solid Tumors [RECIST] and tumor volume) and functional (viable tumor volume, viable tumor burden, and apparent diffusion coefficient [ADC]) volumetric MR parameters by using semiautomatic software. Response was assessed by using changes in viable tumor volume by using modified RECIST (mRECIST)-derived thresholds (three-dimensional mRECIST), viable tumor burden, and ADC. Overall survival was the primary endpoint. Cox-regression and Kaplan-Meier survival analysis were used. Results Tumor volume did not change after TACE (P = .07) whereas RECIST diameter showed a small change (-2.6%; P = .02). There was an increase in ADC (20.7%) and a decrease in viable tumor volume (-29.3%) and viable tumor burden (-29.1%; P < .001 for all). Higher overall survival was noted among responders by using thresholds of 25% increase in ADC, 66% decrease in viable tumor volume, and 50% decrease in viable tumor burden (log-rank test, P < .05). Hazard ratio for nonresponders by using ADC, three-dimensional mRECIST, and viable tumor burden at multivariable analysis was 2.9 (P = .004), 4.1 (P = .009), and 4.0 (P = .002), respectively. Survival differences were noted for patients who showed response by using all three parameters (ADC, three-dimensional mRECIST, and viable tumor burden) versus those who showed response by using either one or two of these parameters versus those who showed no response (P < .001). Conclusion Changes in volumetric ADC, viable tumor volume, and viable tumor burden at MR imaging provide prognostic information among patients with unresectable ICCA who undergo TACE. RSNA, 2018 Online supplemental material is available for this article.

show abstract

Section: Discussionmentioning

confidence: 99%

Unresectable Intrahepatic Cholangiocarcinoma: Multiparametric MR Imaging to Predict Patient Survival

Pandey

Ghasabeh

et al. 2018

Radiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Sobhani et al reported similar conclusions in a retrospective study of 17 patients who underwent transarterial chemoembolization (TACE), a similar embolizing therapy that uses chemotherapy drugs and microspheres as opposed to irradiated microspheres. They stated that a volumetric contrast-enhanced and diffusion-weighted MRI may prove effective in the early evaluation of treatment response in hypovascular lesions [ 24 ].…”

Section: Reviewmentioning

confidence: 99%

Assessment of Treatment Response Following Yttrium-90 Transarterial Radioembolization of Liver Malignancies

Adcock¹,

Florez²,

Zand³

et al. 2018

Cureus

View full text Add to dashboard Cite

Transarterial radioembolization using yttrium-90 microspheres is an established and effective treatment for liver malignancies. Determining response to this treatment is difficult due to the radical changes that occur in tissue as a response to radiation. Though accurate assessment of treatment response is paramount for proper patient disposition, there is currently no standardized assessment protocol. Current methods of assessment often consider changes in size, necrosis, vascularity, fluorodeoxyglucose-positron emission tomography FDG-PET metabolic activity, and diffusion using diffusion-weighted magnetic resonance imaging (DWI). Current methods of assessment require a lag time of one to two months post-treatment to determine treatment effectiveness. This delay is a hindrance to obtaining better patient outcomes, giving rise to a need to identify markers for faster determination of treatment efficacy.

show abstract

“…Another differentiation to HCC protocols should be the recommendations for bead sizes. According to the most recent evidence and since CRLM are less hypervascular compared to HCC, smaller bead sizes should be used as they have the potential to deliver the dose deeper into the tissue [ 35 , 36 , 37 , 38 ]. Studies found that smaller beads are not connected to more AEs [ 16 , 23 , 35 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Safety, Feasibility and Technical Considerations from a Prospective, Observational Study—CIREL: Irinotecan-TACE for CRLM in 152 Patients

Helmberger

Lucatelli

Pereira

et al. 2022

JCM

View full text Add to dashboard Cite

CIREL, a prospective, Europe-wide, observational study aimed to assess the real-world feasibility and tolerability of irinotecan-based transarterial chemoembolization (LP-irinotecan TACE) for unresectable colorectal cancer liver metastases with regard to the treatment plan and adverse events (AEs). CIREL enrolled 152 eligible patients (≥18 years) with liver-only or dominant metastases treated with LP-irinotecan TACE following a multidisciplinary tumor board decision. Data were prospectively collected for baseline, the number of planned and performed sessions, and technical information and safety according to CTCAE 4.03/5.0. Results from 351 analyzed treatment sessions showed technical success for 99% of sessions, and 121 patients (79%) completed all planned sessions. Further, 60% of sessions were performed using opioids, 4% intra-arterial anesthetics, and 25% both. Additionally, 60% of patients experienced at least one peri-interventional AE of any grade; 8% of grade 3–4. Occurrence of AEs was related to larger liver-involvement (p < 0.001), bi-lobar disease (p = 0.002), and larger beads (p < 0.001). Using corticosteroids together with antiemetics showed reduced and lower grade vomiting (p = 0.01). LP-irinotecan TACE was tolerated well and had a high proportion of completed treatment plans. This minimally invasive locoregional treatment can be used together with concomitant systemic therapy or ablation.

show abstract

Hypo-Vascular Liver Metastases Treated with Transarterial chemoembolization: Assessment of Early Response by Volumetric Contrast-Enhanced and Diffusion-Weighted Magnetic Resonance Imaging

Cited by 11 publications

References 29 publications

Unresectable Intrahepatic Cholangiocarcinoma: Multiparametric MR Imaging to Predict Patient Survival

Unresectable Intrahepatic Cholangiocarcinoma: Multiparametric MR Imaging to Predict Patient Survival

Assessment of Treatment Response Following Yttrium-90 Transarterial Radioembolization of Liver Malignancies

Safety, Feasibility and Technical Considerations from a Prospective, Observational Study—CIREL: Irinotecan-TACE for CRLM in 152 Patients

Contact Info

Product

Resources

About