Radiological tumor response and histopathological correlation of hepatocellular carcinoma treated with stereotactic body radiation therapy as a bridge to liver transplantation.

Autor: Mastrocostas K; Joint Department of Medical Imaging, University Health Network/Mount Sinai Hospital/Women's College Hospital, 585 University Avenue, Toronto, ON, M5G 2N2, Canada., Fischer S; Laboratory Medicine Program, Department of Pathology, Toronto General Hospital, 585 University Avenue, Toronto, ON, M5G 2N2, Canada., Munoz-Schuffenegger P; Radiation Medicine Program, Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2C1, Canada., Jang HJ; Joint Department of Medical Imaging, University Health Network/Mount Sinai Hospital/Women's College Hospital, 585 University Avenue, Toronto, ON, M5G 2N2, Canada., Dawson LA; Radiation Medicine Program, Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2C1, Canada., Liu ZA; Department of Biostatistics, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON, M5G 2M9, Canada., Sapisochin G; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, 585 University Avenue, Toronto, ON, M5G 2N2, Canada., Kim TK; Joint Department of Medical Imaging, University Health Network/Mount Sinai Hospital/Women's College Hospital, 585 University Avenue, Toronto, ON, M5G 2N2, Canada. taekyoung.kim@uhn.ca.
Jazyk: angličtina
Zdroj: Abdominal radiology (New York) [Abdom Radiol (NY)] 2021 Apr; Vol. 46 (4), pp. 1572-1585. Date of Electronic Publication: 2020 Oct 19.
DOI: 10.1007/s00261-020-02821-y
Abstrakt: Purpose: To assess the imaging findings of hepatocellular carcinoma (HCC) treated with stereotactic body radiation therapy (SBRT) as a bridging therapy prior to liver transplantation (LT), with histopathological correlation at liver explant.
Methods: Our institutional review board approved this retrospective study. The study subjects included 25 HCC lesions in 23 patients (20 males; median age, 60 years; range 41-68 years) who underwent LT after SBRT for HCC as a bridge to LT in a single tertiary referral institution over a 12-year period. Target HCC lesions were assessed for imaging biomarkers on contrast-enhanced CT or MRI including change in HCC diameter and assessment of percentage necrosis. The radiologic response at pre-LT imaging was compared to explant pathology.
Results: There was a positive correlation between the tumor size (Spearman's ρ = 0.86; p < 0.001) and percentage necrosis (p < 0.001) on Pre-LT imaging and those on pathology. Partial response (PR), stable disease (SD), and progressive disease (PD) according to RECIST 1.1 were seen in 8 (32%), 15 (60%), and 2 (8%) lesions on pre-LT imaging, respectively. Of the 15 lesions with radiologic SD, 5/15 (33%) showed necrosis of more than 50% on post-SBRT imaging, while 9/15 (60%) showed necrosis of more than 50% at explant pathologic analysis, showing a tendency to underestimate the degree of tumor necrosis compared to pathology.
Conclusion: RECIST 1.1 radiologic response criteria may underestimate the response to treatment with SBRT, and radiologic estimation of percent tumor necrosis was more closely correlated with pathologic percent tumor necrosis.
Databáze: MEDLINE
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