Caecilia S Reiner1, Sonja Gordic2, Gilbert Puippe2, Fabian Morsbach2, Moritz Wurnig2, Niklaus Schaefer3,4, Patrick Veit-Haibach3, Thomas Pfammatter2, Hatem Alkadhi2. 1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. caecilia.reiner@usz.ch. 2. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. 3. Division of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. 4. Clinic for Oncology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Abstract
PURPOSE: To evaluate in patients with hepatocellular carcinoma (HCC), whether assessment of tumor heterogeneity by histogram analysis of computed tomography (CT) perfusion helps predicting response to transarterial radioembolization (TARE). MATERIALS AND METHODS: Sixteen patients (15 male; mean age 65 years; age range 47-80 years) with HCC underwent CT liver perfusion for treatment planning prior to TARE with Yttrium-90 microspheres. Arterial perfusion (AP) derived from CT perfusion was measured in the entire tumor volume, and heterogeneity was analyzed voxel-wise by histogram analysis. Response to TARE was evaluated on follow-up imaging (median follow-up, 129 days) based on modified Response Evaluation Criteria in Solid Tumors (mRECIST). Results of histogram analysis and mean AP values of the tumor were compared between responders and non-responders. Receiver operating characteristics were calculated to determine the parameters' ability to discriminate responders from non-responders. RESULTS: According to mRECIST, 8 patients (50%) were responders and 8 (50%) non-responders. Comparing responders and non-responders, the 50th and 75th percentile of AP derived from histogram analysis was significantly different [AP 43.8/54.3 vs. 27.6/34.3 mL min(-1) 100 mL(-1)); p < 0.05], while the mean AP of HCCs (43.5 vs. 27.9 mL min(-1) 100 mL(-1); p > 0.05) was not. Further heterogeneity parameters from histogram analysis (skewness, coefficient of variation, and 25th percentile) did not differ between responders and non-responders (p > 0.05). If the cut-off for the 75th percentile was set to an AP of 37.5 mL min(-1) 100 mL(-1), therapy response could be predicted with a sensitivity of 88% (7/8) and specificity of 75% (6/8). CONCLUSION: Voxel-wise histogram analysis of pretreatment CT perfusion indicating tumor heterogeneity of HCC improves the pretreatment prediction of response to TARE.
PURPOSE: To evaluate in patients with hepatocellular carcinoma (HCC), whether assessment of tumor heterogeneity by histogram analysis of computed tomography (CT) perfusion helps predicting response to transarterial radioembolization (TARE). MATERIALS AND METHODS: Sixteen patients (15 male; mean age 65 years; age range 47-80 years) with HCC underwent CT liver perfusion for treatment planning prior to TARE with Yttrium-90 microspheres. Arterial perfusion (AP) derived from CT perfusion was measured in the entire tumor volume, and heterogeneity was analyzed voxel-wise by histogram analysis. Response to TARE was evaluated on follow-up imaging (median follow-up, 129 days) based on modified Response Evaluation Criteria in Solid Tumors (mRECIST). Results of histogram analysis and mean AP values of the tumor were compared between responders and non-responders. Receiver operating characteristics were calculated to determine the parameters' ability to discriminate responders from non-responders. RESULTS: According to mRECIST, 8 patients (50%) were responders and 8 (50%) non-responders. Comparing responders and non-responders, the 50th and 75th percentile of AP derived from histogram analysis was significantly different [AP 43.8/54.3 vs. 27.6/34.3 mL min(-1) 100 mL(-1)); p < 0.05], while the mean AP of HCCs (43.5 vs. 27.9 mL min(-1) 100 mL(-1); p > 0.05) was not. Further heterogeneity parameters from histogram analysis (skewness, coefficient of variation, and 25th percentile) did not differ between responders and non-responders (p > 0.05). If the cut-off for the 75th percentile was set to an AP of 37.5 mL min(-1) 100 mL(-1), therapy response could be predicted with a sensitivity of 88% (7/8) and specificity of 75% (6/8). CONCLUSION: Voxel-wise histogram analysis of pretreatment CT perfusion indicating tumor heterogeneity of HCC improves the pretreatment prediction of response to TARE.
Authors: Bradley Spieler; Carl Sabottke; Ahmed W Moawad; Ahmed M Gabr; Mustafa R Bashir; Richard Kinh Gian Do; Vahid Yaghmai; Radu Rozenberg; Marielia Gerena; Joseph Yacoub; Khaled M Elsayes Journal: Abdom Radiol (NY) Date: 2021-03-31
Authors: Emily Harding-Theobald; Jeremy Louissaint; Bharat Maraj; Edward Cuaresma; Whitney Townsend; Mishal Mendiratta-Lala; Amit G Singal; Grace L Su; Anna S Lok; Neehar D Parikh Journal: Aliment Pharmacol Ther Date: 2021-08-12 Impact factor: 9.524
Authors: Matthias Weissinger; Jonas Vogel; Jürgen Kupferschläger; Helmut Dittmann; Salvador Guillermo Castaneda Vega; Ulrich Grosse; Christoph Artzner; Konstantin Nikolaou; Christian la Fougere; Gerd Grözinger Journal: PLoS One Date: 2020-12-30 Impact factor: 3.240