Beom Kyung Kim1,2, Kyung Ah Kim3, Chansik An4, Eun Jin Yoo1, Jun Yong Park1,2, Do Young Kim1,2, Sang Hoon Ahn1,2, Kwang-Hyub Han1,2,5, Seung Up Kim1,2, Myeong-Jin Kim4. 1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. 2. Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. 3. Department of Radiology, St. Vincent's Hospital, The Catholic University of Korea, Gyeonggi-do, Korea. 4. Department of Radiology, Yonsei University College of Medicine, Seoul, Korea. 5. Brain Korea 21 Project for Medical Science, Seoul, Korea.
Abstract
BACKGROUND & AIMS: Computed tomography (CT) and magnetic resonance imaging (MRI) play important roles in diagnosis and staging of hepatocellular carcinoma (HCC). However, prognostic roles of radiological characteristics are not yet determined. METHODS: Eighty-eight patients treated with chemoembolization were analysed. Radiological parameters at baseline were assessed in all patients using both dynamic CT and MRI. Treatment responses were assessed using modified RECIST 4 weeks after the first chemoembolization. RESULTS: Gross vascular invasion (GVI), bile duct invasion, irregular tumour margin (ITM), peripheral ragged enhancement (PRE) and satellite nodules on CT or MRI were associated with non-response (stable disease or progression) after chemoembolization respectively (all P ≤ 0.05). GVI, ITM and PRE on CT or MRI were also independently associated with poor overall survival (OS) respectively (all P ≤ 0.05). Using these results, a prognostic scoring system for CT and MRI were developed; 0, absence of all three features (GVI, ITM and PRE); 1, presence of one feature; 2, presence of two features; and 3, presence of three features. After adjusting tumour size, tumour number and alpha-foetoprotein level, both CT and MRI scores were independently associated with OS (both P < 0.001). Patients with CT or MRI score ≥2 had a worse OS than those with score <2 (adjusted hazard ratios, 3.837 and 2.938 respectively). MRI-specific parameters such as signal intensity on T2- or T1-weighted images, fat signal or hyperintensity on diffusion-weighted images did not have prognostic value (all P > 0.05). CONCLUSIONS: Radiological parameters by CT and MRI may be useful in biological characterization of tumours and prognostification for HCC treated with chemoembolization.
BACKGROUND & AIMS: Computed tomography (CT) and magnetic resonance imaging (MRI) play important roles in diagnosis and staging of hepatocellular carcinoma (HCC). However, prognostic roles of radiological characteristics are not yet determined. METHODS: Eighty-eight patients treated with chemoembolization were analysed. Radiological parameters at baseline were assessed in all patients using both dynamic CT and MRI. Treatment responses were assessed using modified RECIST 4 weeks after the first chemoembolization. RESULTS: Gross vascular invasion (GVI), bile duct invasion, irregular tumour margin (ITM), peripheral ragged enhancement (PRE) and satellite nodules on CT or MRI were associated with non-response (stable disease or progression) after chemoembolization respectively (all P ≤ 0.05). GVI, ITM and PRE on CT or MRI were also independently associated with poor overall survival (OS) respectively (all P ≤ 0.05). Using these results, a prognostic scoring system for CT and MRI were developed; 0, absence of all three features (GVI, ITM and PRE); 1, presence of one feature; 2, presence of two features; and 3, presence of three features. After adjusting tumour size, tumour number and alpha-foetoprotein level, both CT and MRI scores were independently associated with OS (both P < 0.001). Patients with CT or MRI score ≥2 had a worse OS than those with score <2 (adjusted hazard ratios, 3.837 and 2.938 respectively). MRI-specific parameters such as signal intensity on T2- or T1-weighted images, fat signal or hyperintensity on diffusion-weighted images did not have prognostic value (all P > 0.05). CONCLUSIONS: Radiological parameters by CT and MRI may be useful in biological characterization of tumours and prognostification for HCC treated with chemoembolization.
Authors: Osman Öcal; Michael Ingrisch; Muzaffer Reha Ümütlü; Bora Peynircioglu; Christian Loewe; Otto van Delden; Vincent Vandecaveye; Bernhard Gebauer; Christoph J Zech; Christian Sengel; Irene Bargellini; Roberto Iezzi; Alberto Benito; Maciej Pech; Peter Malfertheiner; Jens Ricke; Max Seidensticker Journal: Br J Cancer Date: 2021-10-22 Impact factor: 7.640
Authors: Muhammad O Awiwi; Khaled M Elsayes; Yehia I Mohamed; Lina Altameemi; Migena Gjoni; Omayr Muhammad Irshad; Ahmed Sayed Ahmed; Ahmad O Kaseb; Usama Salem Journal: J Hepatocell Carcinoma Date: 2022-08-30