Yan Luo1,2, Ankur Pandey2, Mounes Aliyari Ghasabeh2, Pallavi Pandey2, Farnaz Najmi Varzaneh2, Manijeh Zarghampour2, Pegah Khoshpouri2, Sanaz Ameli2, Zhen Li1, Daoyu Hu1, Ihab R Kamel3. 1. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. 2. Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Nelson 143, Central Radiology, MRI, 600 North Wolfe Street, Room 143, Baltimore, MD, 21287, USA. 3. Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Nelson 143, Central Radiology, MRI, 600 North Wolfe Street, Room 143, Baltimore, MD, 21287, USA. ikamel@jhmi.edu.
Abstract
OBJECTIVES: To determine whether baseline multiparametric MR imaging can predict overall survival (OS) and hepatic progression-free survival (HPFS) in patients with neuroendocrine liver metastases (NELMs) treated with transarterial chemoembolization (TACE). METHODS: This retrospective study included 84 NELMs patients treated with TACE. Tumor volume and volumetric measurements of arterial enhancement (AE), venous enhancement (VE), and apparent diffusion coefficient (ADC) were performed on baseline MR imaging. A maximum of one, two, and five index lesions were selected in each patient. OS was the primary endpoint and HPFS was the secondary endpoint. Prognostic values of volumetric multiparametric MR parameters for predicting OS and HPFS considering a maximum of one, two, and five index lesions were assessed. RESULTS: Prognostic values of volumetric multiparametric MR parameters for predicting OS and HPFS were similar regardless of the maximum number of index lesions. Multivariate survival analysis showed that baseline dominant tumor volume ≥ 73 cm3, volumetric mean AE ≥ 45%, and mean VE ≥ 73% were independent prognostic factors for OS (HR 2.73; 95% CI 1.45, 5.15; HR 0.32; 95% CI 0.17, 0.63; HR 0.35; 95% CI 0.17, 0.72, respectively) and HPFS (HR 2.30, 95% CI 1.38, 3.84; HR 0.46, 95% CI 0.25, 0.84; HR 0.36, 95% CI 0.19, 0.57, respectively). OS and HPFS were similar in patients with low and high volumetric mean ADC. CONCLUSION: Volumetric enhancement values and tumor volume of the dominant lesion on baseline MR imaging may act as prognostic factors for OS and HPFS in NELMs patients treated with TACE. KEY POINTS: • High volumetric mean AE and VE, and low tumor volume of the dominant lesion on baseline MR imaging were associated with favorable OS and HPFS in NELMs patients treated with TACE. • Evaluation of multiple lesions does not provide additional information as compared to single lesion evaluation.
OBJECTIVES: To determine whether baseline multiparametric MR imaging can predict overall survival (OS) and hepatic progression-free survival (HPFS) in patients with neuroendocrine liver metastases (NELMs) treated with transarterial chemoembolization (TACE). METHODS: This retrospective study included 84 NELMs patients treated with TACE. Tumor volume and volumetric measurements of arterial enhancement (AE), venous enhancement (VE), and apparent diffusion coefficient (ADC) were performed on baseline MR imaging. A maximum of one, two, and five index lesions were selected in each patient. OS was the primary endpoint and HPFS was the secondary endpoint. Prognostic values of volumetric multiparametric MR parameters for predicting OS and HPFS considering a maximum of one, two, and five index lesions were assessed. RESULTS: Prognostic values of volumetric multiparametric MR parameters for predicting OS and HPFS were similar regardless of the maximum number of index lesions. Multivariate survival analysis showed that baseline dominant tumor volume ≥ 73 cm3, volumetric mean AE ≥ 45%, and mean VE ≥ 73% were independent prognostic factors for OS (HR 2.73; 95% CI 1.45, 5.15; HR 0.32; 95% CI 0.17, 0.63; HR 0.35; 95% CI 0.17, 0.72, respectively) and HPFS (HR 2.30, 95% CI 1.38, 3.84; HR 0.46, 95% CI 0.25, 0.84; HR 0.36, 95% CI 0.19, 0.57, respectively). OS and HPFS were similar in patients with low and high volumetric mean ADC. CONCLUSION: Volumetric enhancement values and tumor volume of the dominant lesion on baseline MR imaging may act as prognostic factors for OS and HPFS in NELMs patients treated with TACE. KEY POINTS: • High volumetric mean AE and VE, and low tumor volume of the dominant lesion on baseline MR imaging were associated with favorable OS and HPFS in NELMs patients treated with TACE. • Evaluation of multiple lesions does not provide additional information as compared to single lesion evaluation.
Entities:
Keywords:
Chemoembolization; Liver neoplasms; Magnetic resonance imaging; Neuroendocrine tumors; Prognosis
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