Volumetric Enhancing Tumor Burden at CT to Predict Survival Outcomes in Patients with Neuroendocrine Liver Metastases after Intra-arterial Treatment.

Autor:	Assouline J; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Cannella R; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Porrello G; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., de Mestier L; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Dioguardi Burgio M; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Raynaud L; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Hentic O; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Cros J; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Tselikas L; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Ruszniewski P; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Vullierme MP; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Vilgrain V; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Duran R; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.)., Ronot M; From the Departments of Radiology (J.A., R.C., G.P., M.D., L.R., M.P.V., V.V., M.R.), Pancreatology and Digestive Oncology (L.d.M., O.H., P.R.), and Pathology (J.C.), Université de Paris, ENETS Centre of Excellence, Beaujon Hospital (APHP), Clichy, France; Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (R.C., G.P.); Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy (R.C.); Université de Paris, Centre of Research on Inflammation, INSERM U1149, Paris, France (L.d.M., M.D., J.C., V.V., M.R.); Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), Villejuif, France (L.T.); and Lausanne University Hospital and University of Lausanne, Department of Radiology and Interventional Radiology, Lausanne, Switzerland (R.D.).
Jazyk:	angličtina
Zdroj:	Radiology. Imaging cancer [Radiol Imaging Cancer] 2023 Jan; Vol. 5 (1), pp. e220051.
DOI:	10.1148/rycan.220051
Abstrakt:	Purpose To investigate whether liver enhancing tumor burden (LETB) assessed at contrast-enhanced CT indicates early response and helps predict survival outcomes in patients with multifocal neuroendocrine liver metastases (NELM) after intra-arterial treatment. Materials and Methods This retrospective study included patients with NELM who underwent intra-arterial treatment with transarterial embolization (TAE) or chemoembolization (TACE) between April 2006 and December 2018. Tumor response in treated NELM was evaluated by using the Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST). LETB was measured as attenuation 2 SDs greater than that of a region of interest in the nontumoral liver parenchyma. Overall survival (OS); time to unTA(C)Eable progression, defined as the time from the initial treatment until the time when intra-arterial treatments were considered technically unfeasible, either not recommended by the multidisciplinary tumor board or until death; and hepatic and whole-body progression-free survival (PFS) were evaluated using multivariable Cox proportional hazards analyses, the Kaplan-Meier method, and log-rank test. Results The study included 119 patients (mean age, 60 years ± 11 [SD]; 61 men) who underwent 161 treatments. A median LETB change of -25.8% best discriminated OS (83 months in responders vs 51 months in nonresponders; P = .02) and whole-body PFS (18 vs 8 months, respectively; P < .001). A -10% LETB change best discriminated time to unTA(C)Eable progression (32 months in responders vs 12 months in nonresponders; P < .001) and hepatic PFS (18 vs 8 months, respectively; P < .001). LETB change remained independently associated with improved OS (hazard ratio [HR], 0.56), time to unTA(C)Eable progression (HR, 0.44), hepatic PFS (HR, 0.42), and whole-body PFS (HR, 0.47) on multivariable analysis. Neither RECIST nor mRECIST helped predict patient outcome. Conclusion Response according to LETB change helped predict survival outcomes in patients with NELM after intra-arterial treatments, with better discrimination than RECIST and mRECIST. Keywords: CT, Chemoembolization, Embolization, Abdomen/GI, Liver Supplemental material is available for this article. © RSNA, 2023.
Databáze:	MEDLINE
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