Unresectable Hepatocellular Carcinoma: MR Imaging after Intraarterial Therapy. Part II. Response Stratification Using Volumetric Functional Criteria after Intraarterial Therapy

Abstract

Volumetric functional MR response 3-4 weeks after initial intraarterial therapy showed improved OS. Volumetric functional MR was superior to current imaging (RECIST, mRECIST, and EASL) and biochemical (AFP level) response criteria.

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

“…Furthermore, it has been shown that volumetric analysis of CT perfusion values reflects tumor heterogeneity more accurately than measurements in 2D ROIs [12]. Recent studies found that volumetric analysis of contrast-enhanced or functional MR was superior for treatment response prediction and early response assessment of HCC as opposed to two-dimensional measurements [15,28].…”

“…Patients with complete or partial target response were classified as responders, and patients with stable or progressive disease were classified as non-responders, as previously described [28].…”

Quantitative volumetric functional MR imaging: an imaging biomarker of early treatment response in hypo-vascular liver metastasis patients after yttrium-90 transarterial radioembolization

“…On the contrary, anatomic metrics did not show any significant change in the responders or non-responders after therapy. Our results suggest that these potential novel functional MRI techniques can stratify patients as responders and non-responders early (1 month) after TARE, even before changes in tumor size and/or morphologic characteristics occur [16,25].…”

Multimodality 3D tumor segmentation in HCC patients treated with TACE

“…Importantly, volumetric techniques were shown to have a strong influence on how tumor response is classified and in some studies, the classification of patients as responders or nonresponders was shown to differ between 3D and non-3D techniques in up to one-third of the analyzed cases (12,13). Furthermore, 3D quantitative techniques have been repeatedly shown as beneficial in identifying tumor response more accurately, primarily because they include the whole tumor tissue into the analysis (14,15) . For assessment of radiological response after TACE, 3D volumetric measurement has a strong clinical impact to be able to accurately measure what part of the lesion is necrotic and viable(16).…”