Parametric response mapping of contrast-enhanced biphasic CT for evaluating tumour viability of hepatocellular carcinoma after TACE

Hinrichs, Jan B.; Shin, Hoen‐oh; Kaercher, Daniel; Hasdemir, D.; Murray, Timothy; Kaireit, Till F.; Lutat, Carolin; Vogel, Arndt; Meyer, Bernhard; Wacker, Frank; Rodt, Thomas

doi:10.1007/s00330-015-4203-4

Cited by 16 publications

(5 citation statements)

References 40 publications

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“…The current literature suggests that combining these modalities through parametric response mapping (PRM) of the imaging data may be a more effective and efficient way of assessing tumor response [ 7 , 26 - 27 ]. The previously mentioned relationship between delivered radiation dosage, which is calculated the day of treatment, and treatment response, as calculated by Willowson et al [ 15 ], needs further exploration.…”

Section: Reviewmentioning

confidence: 99%

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

Adcock¹,

Florez²,

Zand³

et al. 2018

Cureus

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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.

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Section: Reviewmentioning

confidence: 99%

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

Adcock¹,

Florez²,

Zand³

et al. 2018

Cureus

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“…This might reduce the TBR obtained from MDCT, because non-tumoral liver tissue is, in contrast, enhanced via the portal vein, e.g., when splenic or gastrointestinal contrast medium transit is fast. The MDCT in our study is acquired at a specific time point with a very low portal venous contrast, as described before by Hinrichs et al [19]. In contrast, the arterial liver perfusion values in the study by Reiner et al were obtained from dynamic liver perfusion computed tomography at multiple time points [12].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Uptake of Hepatocellular Carcinoma on Pre-Therapeutic MDCT, CACT, and SPECT/CT, and the Correlation with Post-Therapeutic PET/CT in Patients Undergoing Selective Internal Radiation Therapy

Meine

Brunkhorst

Werncke

et al. 2021

JCM

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(1) Background: To comparatively analyze the uptake of hepatocellular carcinoma (HCC) on pre-therapeutic imaging modalities, the arterial phase multi-detector computed tomography (MDCT), the parenchymal phase C-arm computed tomography (CACT), the Technetium99m-macroaggregates of human serum albumin single-photon emission computed tomography/computed tomography (SPECT/CT), and the correlation to the post-therapeutic Yttrium90 positron emission tomography/computed tomography (PET/CT) in patients with selective internal radiation therapy (SIRT). (2) Methods: Between September 2013 and December 2016, 104 SIRT procedures were performed at our institution in 74 patients with HCC not suitable for curative surgery or ablation. Twenty-two patients underwent an identical sequence of pre-therapeutic MDCT, CACT, SPECT/CT, and post-therapeutic PET/CT with a standardized diagnostic and therapeutic protocol. In these 22 patients, 25 SIRT procedures were evaluated. The uptake of the HCC was assessed using tumor-background ratio (TBR). Therefore, regions of interest were placed on the tumor and the adjacent liver tissue on MDCT (TBRMDCT), CACT (TBRCACT), SPECT/CT (TBRSPECT/CT), and PET/CT (TBRPET/CT). Comparisons were made with the Friedman test and the Nemenyi post-hoc test. Correlations were analyzed using Spearman’s Rho and the Benjamini–Hochberg method. The level of significance was p < 0.05. (3) Results: TBR on MDCT (1.4 ± 0.3) was significantly smaller than on CACT (1.9 ± 0.6) and both were significantly smaller compared to SPECT/CT (4.6 ± 2.0) (pFriedman-Test < 0.001; pTBRMDCT/TBRCACT = 0.012, pTBRMDCT/TBRSPECT/CT < 0.001, pTBRCACT/TBRSPECT/CT < 0.001). There was no significant correlation of TBR on MDCT with PET/CT (rTBRMDCT/TBRPET/CT = 0.116; p = 0.534). In contrast, TBR on CACT correlated to TBR on SPECT/CT (rTBRCACT/TBRSPECT/CT = 0.489; p = 0.004) and tended to correlate to TBR on PET/CT (rTBRCACT/TBRPET/CT =0.365; p = 0.043). TBR on SPECT/CT correlated to TBR on PET/CT (rTBRSPECT/CT/TBRPET/CT= 0.706; p < 0.001) (4) Conclusion: The uptake assessment on CACT was in agreement with SPECT/CT and might be consistent with PET/CT. In contrast, MDCT was not comparable to CACT and SPECT/CT, and had no correlation with PET/CT due to the different application techniques. This emphasizes the value of the CACT, which has the potential to improve the dosimetric assessment of the tumor and liver uptake for SIRT.

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“…In recent years, with the continuous development of imaging diagnostic technology, multislice spiral CT has brought a major breakthrough in the diagnosis of primary hepatic carcinoma ( 17 ), which could simultaneously complete a one-time scan for the three phases as hepatic arterial phase, equilibrium phase and delayed phase to obtain the rich and clear hemodynamic images of tumor, for which could accurately reflect the blood supply characteristics of tumor, improve the early diagnosis rate of liver lesions and have a better effect for diagnosis of PHC ( 18 ). The multislice spiral CT not only could shorten the scanning time interval significantly and greatly improve the resolution, but also could significantly improve the scanning speed, which could reduce the influence of motion artifacts on the display results; at the meanwhile, the analysis of layer thickness and image reconstruction could be arbitrarily selected within a certain range to show the small lesions in the liver clearly ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy Evaluation on the Color Doppler Ultrasound, Multislice Spiral CT Combined with Serum Markers in Diagnosis of Primary Hepatic Carcinoma

Zhao¹,

Xia²,

Li³

et al. 2021

ijph

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Background: The efficacy of color Doppler ultrasound, multislice spiral CT combined with serum alpha-fetoprotein (AFP) and alpha-fetoprotein heterogeneity (AFP-L3) in the diagnosis of primary hepatic carcinoma was evaluated. Methods: Seventy-nine patients with primary hepatic carcinoma (PHC group) and 50 patients with benign liver lesions (benign control group) admitted in Yantaishan Hospital (Yantai, China) from January 2016 to December 2018 were selected. The liver was scanned by color Doppler ultrasound and multiple multislice spiral CT. The serum AFP and AFP-L3 levels were detected by electrochemiluminescence. The value of color Doppler ultrasound, multislice spiral CT combined with serum AFP and AFP-L3 in diagnosis of primary liver cancer was retrospectively analyzed. Results: The color Doppler flow imaging (CDFI) showed a high-speed and high-resistance spectrum. The serum AFP and AFP-L3 levels of patients with primary hepatic carcinoma were significantly higher than those of the benign control group were (U=138.000 and 155.500, P=0.000 and 0.000), P<0.01. The sensitivity, accuracy and negative predictive value of color Doppler ultrasound, multislice spiral CT combined with serum AFP and AFP-L3 examinations for diagnosis of primary hepatic carcinoma were 96.20, 90.70 and 93.18%, which was significantly improved compared with each single examination (X2=27.888, 17.511 and 16.202, P=0.000, 0.002 and 0.003), P<0.01. Conclusion: Color Doppler ultrasound, multislice spiral CT combined with AFP and AFP-L3 examination could significantly improve the diagnosis efficiency of primary hepatic carcinoma, which was beneficial to early clinical diagnosis and early treatment.

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Parametric response mapping of contrast-enhanced biphasic CT for evaluating tumour viability of hepatocellular carcinoma after TACE

Abstract: • PRM allows more precise assessment of tumour vascularisation compared to conventional evaluation • PRM is beneficial for cTACE treatment planning and response assessment • PRM allows a quantitative assessment of regional contrast enhancement patterns.

Cited by 16 publications

References 40 publications

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

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

Comparison of the Uptake of Hepatocellular Carcinoma on Pre-Therapeutic MDCT, CACT, and SPECT/CT, and the Correlation with Post-Therapeutic PET/CT in Patients Undergoing Selective Internal Radiation Therapy

Efficacy Evaluation on the Color Doppler Ultrasound, Multislice Spiral CT Combined with Serum Markers in Diagnosis of Primary Hepatic Carcinoma

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