OBJECTIVES: The aim of this study was to assess clinical utility of the quantitative perfusion parameter called parenchymal blood volume (PBV), as derived from C-arm-based computed tomography (CT), for immediate posttreatment assessment of drug-eluting bead (DEB) transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Twenty-four patients with early- or intermediate-stage HCC received DEB-TACE. A total of 52 HCC lesions were treated and assessed by C-arm CT before and after intervention. C-arm CT consisted of nonenhanced and contrast-enhanced acquisitions; from these, PBV maps were reconstructed. Lesion diameter, maximum PBV, and unenhanced parenchyma density were assessed before and after treatment. Diameter of visible contrast media deposits as well as residual vascularization was assessed after delivery of DEB. All patients underwent follow-up using cross-sectional imaging. All assessed lesions were evaluated concerning modified Response Evaluation Criteria in Solid Tumors for HCC. RESULTS: All treated lesions showed significant decrease in PBV after DEB-TACE (mean difference, -15.61 mL/100 mL, P < 0.0001). Eleven lesions showed residual tumoral perfusion in PBV maps associated with an unfavorable outcome compared with completely treated lesions in terms of a lower tumor shrinkage over time (-0.02 ± 0.49 vs -0.76 ± 0.38; P < 0.0001). A contrast media deposit was seen in 78% of treated HCC lesions with a tendency toward better visibility in encapsulated lesions. Nonenhanced parenchyma density was significantly higher in all treated segments (149.69 ± 58.6 vs 68.42 ± 18.04, P < 0.0001). CONCLUSIONS: Parenchymal blood volume values as derived from C-arm CT acquisitions in combination with nonenhanced and contrast-enhanced C-arm CT images are useful in posttreatment assessment of DEB-TACE in HCC. Residual tumor perfusion in PBV maps have predictive potential for mid-term tumor response in HCC and could allow a more individualized treatment schedule for DEB-TACE in HCC patients.
OBJECTIVES: The aim of this study was to assess clinical utility of the quantitative perfusion parameter called parenchymal blood volume (PBV), as derived from C-arm-based computed tomography (CT), for immediate posttreatment assessment of drug-eluting bead (DEB) transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Twenty-four patients with early- or intermediate-stage HCC received DEB-TACE. A total of 52 HCC lesions were treated and assessed by C-arm CT before and after intervention. C-arm CT consisted of nonenhanced and contrast-enhanced acquisitions; from these, PBV maps were reconstructed. Lesion diameter, maximum PBV, and unenhanced parenchyma density were assessed before and after treatment. Diameter of visible contrast media deposits as well as residual vascularization was assessed after delivery of DEB. All patients underwent follow-up using cross-sectional imaging. All assessed lesions were evaluated concerning modified Response Evaluation Criteria in Solid Tumors for HCC. RESULTS: All treated lesions showed significant decrease in PBV after DEB-TACE (mean difference, -15.61 mL/100 mL, P < 0.0001). Eleven lesions showed residual tumoral perfusion in PBV maps associated with an unfavorable outcome compared with completely treated lesions in terms of a lower tumor shrinkage over time (-0.02 ± 0.49 vs -0.76 ± 0.38; P < 0.0001). A contrast media deposit was seen in 78% of treated HCC lesions with a tendency toward better visibility in encapsulated lesions. Nonenhanced parenchyma density was significantly higher in all treated segments (149.69 ± 58.6 vs 68.42 ± 18.04, P < 0.0001). CONCLUSIONS: Parenchymal blood volume values as derived from C-arm CT acquisitions in combination with nonenhanced and contrast-enhanced C-arm CT images are useful in posttreatment assessment of DEB-TACE in HCC. Residual tumor perfusion in PBV maps have predictive potential for mid-term tumor response in HCC and could allow a more individualized treatment schedule for DEB-TACE in HCC patients.
Authors: Pierleone Lucatelli; Gianluca De Rubeis; Fabrizio Basilico; Luca Ginanni Corradini; Mario Corona; Mario Bezzi; Carlo Catalano Journal: Radiol Med Date: 2019-08-31 Impact factor: 3.469
Authors: Rory L O'Donohoe; Richard G Kavanagh; Alexis M Cahalane; Diarmaid D Houlihan; Jeffrey W McCann; Edmund Ronan Ryan Journal: Eur Radiol Exp Date: 2019-05-29
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
Authors: Thijs van der Zijden; Annelies Mondelaers; Maurits Voormolen; Tomas Menovsky; Maarten Niekel; Thomas Jardinet; Thomas Van Thielen; Olivier D'Archambeau; Paul M Parizel Journal: Diagnostics (Basel) Date: 2022-08-13
Authors: Roland Syha; Sergios Gatidis; Gerd Grözinger; Ulrich Grosse; Michael Maurer; Lars Zender; Marius Horger; Konstantin Nikolaou; Dominik Ketelsen Journal: Cancer Imaging Date: 2016-09-21 Impact factor: 3.909