Baseline tumor Lipiodol uptake after transarterial chemoembolization for hepatocellular carcinoma: identification of a threshold value predicting tumor recurrence
| Autor: | John A. Kaufman, Khashayar Farsad, Y. Matsui, Younes Jahangiri Noudeh, Masahiro Horikawa, Kenneth J. Kolbeck |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Lipiodol
medicine.medical_treatment R895-920 transarterial chemoembolization Tumor response 030218 nuclear medicine & medical imaging Medical physics. Medical radiology. Nuclear medicine 03 medical and health sciences 0302 clinical medicine Hounsfield scale threshold Medicine Radiology Nuclear Medicine and imaging Washout rate Embolization tumor response Receiver operating characteristic business.industry hepatocellular carcinoma medicine.disease digestive system diseases Tumor recurrence Oncology 030220 oncology & carcinogenesis Hepatocellular carcinoma business Nuclear medicine Research Article medicine.drug |
| Zdroj: | Radiology and Oncology Radiology and Oncology, Vol 51, Iss 4, Pp 393-400 (2017) |
| ISSN: | 1581-3207 |
| DOI: | 10.1515/raon-2017-0030 |
| Popis: | Background The aim of the study was to evaluate the association between baseline Lipiodol uptake in hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) with early tumor recurrence, and to identify a threshold baseline uptake value predicting tumor response. Patients and methods A single-institution retrospective database of HCC treated with Lipiodol-TACE was reviewed. Forty-six tumors in 30 patients treated with a Lipiodol-chemotherapy emulsion and no additional particle embolization were included. Baseline Lipiodol uptake was measured as the mean Hounsfield units (HU) on a CT within one week after TACE. Washout rate was calculated dividing the difference in HU between the baseline CT and follow-up CT by time (HU/month). Cox proportional hazard models were used to correlate baseline Lipiodol uptake and other variables with tumor response. A receiver operating characteristic (ROC) curve was used to identify the optimal threshold for baseline Lipiodol uptake predicting tumor response. Results During the follow-up period (mean 5.6 months), 19 (41.3%) tumors recurred (mean time to recurrence = 3.6 months). In a multivariate model, low baseline Lipiodol uptake and higher washout rate were significant predictors of early tumor recurrence (P = 0.001 and < 0.0001, respectively). On ROC analysis, a threshold Lipiodol uptake of 270.2 HU was significantly associated with tumor response (95% sensitivity, 93% specificity). Conclusions Baseline Lipiodol uptake and washout rate on follow-up were independent predictors of early tumor recurrence. A threshold value of baseline Lipiodol uptake > 270.2 HU was highly sensitive and specific for tumor response. These findings may prove useful for determining subsequent treatment strategies after Lipiodol TACE. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|