Prediction of hepatocellular carcinoma response to 90Yttrium radioembolization using volumetric ADC histogram quantification: preliminary results

Abstract

Purpose To assess the predictive value of volumetric apparent diffusion coefficient (vADC) histogram quantification obtained before and 6 weeks (6w) post-treatment for assessment of hepatocellular carcinoma (HCC) response to 90 Yttrium radioembolization (RE). Methods In this retrospective study, 22 patients (M/F 15/7, mean age 65y) who underwent lobar RE were included between October 2013 and November 2014. All patients underwent routine liver MRI pre-treatment and 6w after RE. Two readers assessed index tumor response at 6 months after RE in consensus, using mRECIST criteria. vADC histogram parameters of index tumors at baseline and 6w, and changes in vADC (ΔvADC) histogram parameters were calculated. The predictive value of ADC metrics was assessed by logistic regression with stepwise parameter selection and ROC analyses. Results Twenty two HCC lesions (mean size 3.9 ± 2.9 cm, range 1.2–12.3 cm) were assessed. Response at 6 months was as follows: complete response (CR, n = 6), partial response (PR, n = 3), stable disease (SD, n = 12) and progression (PD, n = 1). vADC median/mode at 6w (1.81–1.82 vs. 1.29–1.35 × 10 − 3 mm 2 /s) and ΔvADC median/max (27–44% vs. 0–10%) were significantly higher in CR/PR vs. SD/PD ( p = 0.011–0.036), while there was no significant difference at baseline. Logistic regression identified vADC median at 6w as an independent predictor of response (CR/PR) with odds ratio (OR) of 3.304 (95% CI: 1.099–9.928, p = 0.033) and AUC of 0.77. ΔvADC mean was identified as an independent predictor of CR with OR of 4.153 (95%CI: 1.229–14.031, p = 0.022) and AUC of 0.91. Conclusion Diffusion histogram parameters obtained at 6w and early changes in ADC from baseline are predictive of subsequent response of HCCs treated with RE, while pre-treatment vADC histogram parameters are not. These results need confirmation in a larger study. Trial registration This retrospective study was IRB-approved and the requirement for informed consent was waived.

Radiomics-Based Machine Learning Models for Predicting P504s/P63 Immunohistochemical Expression: A Noninvasive Diagnostic Tool for Prostate Cancer

“…All of these characteristics displayed significant spatial differences. Histogram analysis (i.e., first-order radiomics) is an approach that captures the distribution of individual voxel value intensities that may quantify tumor heterogeneity in a routine MRI volume of interest (VOI), and some tumor studies have suggested that such analyses indeed assisted with the evaluation of diagnoses, biologic aggressiveness and prognoses ( 25 – 28 ). However, the performance gains of models built with first-order statistics are relatively limited when the spatial variations between voxels are not considered.…”

Prognostic value of baseline imaging and clinical features in patients with advanced hepatocellular carcinoma

“…This situation might be the reason for the missing correlation. Nevertheless, despite some studies reporting a correlation between lower ADC values with early recurrence after liver transplantation [10] or SIRT [29], and lower OS after TACE or SIRT [30], all of these studies are retrospective single-centre studies; and other studies have reported no such correlation [15]. HCC has mostly a heterogeneous intratumoral architecture, especially in large lesions.…”

Quantitative and qualitative evaluation of liver metastases with intraprocedural cone beam CT prior to transarterial radioembolization as a predictor of treatment response

“…There is ample research available focusing on potential imaging biomarkers in the early postinterventional period to predict overall survival (OS) and progression free survival (PFS) [ [14] , [15] , [16] , [17] , [18] , [19] , [20] , [26] , [27] ]. With all these methods, however, TARE (or Transarterial Chemoembolization) has already been performed by the time when a statement can be made if the treatment was likely to be successful or not.…”