Milena Miszczuk1, Julius Chapiro1, Duc Do Minh1,2, Johanna Maria Mijntje van Breugel1, Susanne Smolka1,2, Irvin Rexha1,2, Bruno Tegel1,2, MingDe Lin1, Lynn Jeanette Savic1,2,3, Kelvin Hong4, Christos Georgiades4, Nariman Nezami5,6,7. 1. Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA. 2. Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, 13353, Berlin, Germany. 3. Berlin Institute of Health at Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany. 4. Division of Vascular and Interventional Radiology, Russel H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. Division of Vascular and Interventional Radiology, Russel H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. dr.nezami@gmail.com. 6. Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 Greene St, Baltimore, MD, 21201, USA. dr.nezami@gmail.com. 7. Experimental Therapeutics Program, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, MD, Baltimore, USA. dr.nezami@gmail.com.
Abstract
PURPOSE: To assess the value of quantitative analysis of tumor burden on baseline MRI for prediction of survival in patients with neuroendocrine tumor liver metastases (NELM) undergoing intra-arterial therapies. MATERIALS AND METHODS: This retrospective single-center analysis included 122 patients with NELM who received conventional (n = 74) or drug-eluting beads, (n = 20) chemoembolization and radioembolization (n = 28) from 2000 to 2014. Overall tumor diameter (1D) and area (2D) of up to 3 largest liver lesions were measured on baseline arterially contrast enhanced MR images. Three-dimensional quantitative analysis was performed using the qEASL tool (IntelliSpace Portal Version 8, Philips) to calculate enhancing tumor burden (the ratio between enhancing tumor volume and total liver volume). Based on Q-statistics, patients were stratified into low tumor burden (TB) or high TB. RESULTS: The survival curves were significantly separated between low TB and high TB groups for 1D (p < 0.001), 2D (p < 0.001) and enhancing TB (p = 0.008) measurements, with, respectively, 2.7, 2.6 and 2.2 times longer median overall survival (MOS) in the low TB group (p < 0.001, p < 0.001 and p = 0.008). Multivariate analysis showed that 1D, 2D, and enhancing TB were independent prognostic factors for MOS, with respective hazard ratios of 0.4 (95%CI: 0.2-0.6, p < 0.001), 0.4 (95%CI: 0.3-0.7, p < 0.001) and 0.5 (95%CI: 0.3-0.8, p = 0.003). CONCLUSION: The overall tumor diameter, overall tumor area, and enhancing tumor burden are strong prognostic factors of overall survival in patients with neuroendocrine tumor liver metastases undergoing intra-arterial therapies.
PURPOSE: To assess the value of quantitative analysis of tumor burden on baseline MRI for prediction of survival in patients with neuroendocrine tumor liver metastases (NELM) undergoing intra-arterial therapies. MATERIALS AND METHODS: This retrospective single-center analysis included 122 patients with NELM who received conventional (n = 74) or drug-eluting beads, (n = 20) chemoembolization and radioembolization (n = 28) from 2000 to 2014. Overall tumor diameter (1D) and area (2D) of up to 3 largest liver lesions were measured on baseline arterially contrast enhanced MR images. Three-dimensional quantitative analysis was performed using the qEASL tool (IntelliSpace Portal Version 8, Philips) to calculate enhancing tumor burden (the ratio between enhancing tumor volume and total liver volume). Based on Q-statistics, patients were stratified into low tumor burden (TB) or high TB. RESULTS: The survival curves were significantly separated between low TB and high TB groups for 1D (p < 0.001), 2D (p < 0.001) and enhancing TB (p = 0.008) measurements, with, respectively, 2.7, 2.6 and 2.2 times longer median overall survival (MOS) in the low TB group (p < 0.001, p < 0.001 and p = 0.008). Multivariate analysis showed that 1D, 2D, and enhancing TB were independent prognostic factors for MOS, with respective hazard ratios of 0.4 (95%CI: 0.2-0.6, p < 0.001), 0.4 (95%CI: 0.3-0.7, p < 0.001) and 0.5 (95%CI: 0.3-0.8, p = 0.003). CONCLUSION: The overall tumor diameter, overall tumor area, and enhancing tumor burden are strong prognostic factors of overall survival in patients with neuroendocrine tumor liver metastases undergoing intra-arterial therapies.
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Authors: Manisha H Shah; Whitney S Goldner; Al B Benson; Emily Bergsland; Lawrence S Blaszkowsky; Pamela Brock; Jennifer Chan; Satya Das; Paxton V Dickson; Paul Fanta; Thomas Giordano; Thorvardur R Halfdanarson; Daniel Halperin; Jin He; Anthony Heaney; Martin J Heslin; Fouad Kandeel; Arash Kardan; Sajid A Khan; Boris W Kuvshinoff; Christopher Lieu; Kimberly Miller; Venu G Pillarisetty; Diane Reidy; Sarimar Agosto Salgado; Shagufta Shaheen; Heloisa P Soares; Michael C Soulen; Jonathan R Strosberg; Craig R Sussman; Nikolaos A Trikalinos; Nataliya A Uboha; Namrata Vijayvergia; Terence Wong; Beth Lynn; Cindy Hochstetler Journal: J Natl Compr Canc Netw Date: 2021-07-28 Impact factor: 11.908
Authors: Milena A Miszczuk; Julius Chapiro; Jean-Francois H Geschwind; Vinayak Thakur; Nariman Nezami; Fabian Laage-Gaupp; Michal Kulon; Johanna M M van Breugel; Arash Fereydooni; MingDe Lin; Lynn Jeanette Savic; Bruno Tegel; Tamara Wahlin; Eliot Funai; Todd Schlachter Journal: Transl Oncol Date: 2020-02-22 Impact factor: 4.243