Intraprocedural C-arm dual-phase cone-beam CT: can it be used to predict short-term response to TACE with drug-eluting beads in patients with hepatocellular carcinoma?
| Autor: | Gayane Yenokyan, Eleni Liapi, Jean Francois H. Geschwind, Nikhil Bhagat, Pramod Rao, Niels Noordhoek, Alessandro Radaelli, MingDe Lin, Järl Blijd, Romaric Loffroy |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Carcinoma Hepatocellular Swine Radiation Dosage Text mining Predictive Value of Tests medicine Carcinoma Animals Humans Radiology Nuclear Medicine and imaging In patient Prospective Studies Chemoembolization Therapeutic Least-Squares Analysis Transcatheter arterial chemoembolization Cone beam ct Original Research medicine.diagnostic_test Drug eluting beads business.industry Liver Neoplasms Magnetic resonance imaging Cone-Beam Computed Tomography Middle Aged medicine.disease Magnetic Resonance Imaging Treatment Outcome ROC Curve Doxorubicin Hepatocellular carcinoma Area Under Curve Female business Nuclear medicine |
| Zdroj: | Radiology. 266(2) |
| ISSN: | 1527-1315 |
| Popis: | To investigate whether C-arm dual-phase cone-beam computed tomography (CT) performed during transcatheter arterial chemoembolization (TACE) with doxorubicin-eluting beads can help predict tumor response at 1-month follow-up in patients with hepatocellular carcinoma (HCC).This prospective study was compliant with HIPAA and approved by the institutional review board and animal care and use committee. Analysis was performed retrospectively on 50 targeted HCC lesions in 29 patients (16 men, 13 women; mean age, 61.9 years ± 10.7) treated with TACE with drug-eluting beads. Magnetic resonance (MR) imaging was performed at baseline and 1 month after TACE. Dual-phase cone-beam CT was performed before and after TACE. Tumor enhancement at dual-phase cone-beam CT in early arterial and delayed venous phases was assessed retrospectively with blinding to MR findings. Tumor response at MR imaging was assessed according to European Association for the Study of the Liver (EASL) guidelines. Two patients were excluded from analysis because dual-phase cone-beam CT scans were not interpretable. Logistic regression models for correlated data were used to compare changes in tumor enhancement between modalities. The radiation dose with dual-phase cone-beam CT was measured in one pig.At 1-month MR imaging follow-up, complete and/or partial tumor response was seen in 74% and 76% of lesions in the arterial and venous phases, respectively. Paired t tests used to compare images obtained before and after TACE showed a significant reduction in tumor enhancement with both modalities (P.0001). The decrease in tumor enhancement seen with dual-phase cone-beam CT after TACE showed a linear correlation with MR findings. Estimated correlation coefficients were excellent for first (R = 0.89) and second (R = 0.82) phases. A significant relationship between tumor enhancement at cone-beam CT after TACE and complete and/or partial tumor response at MR imaging was found for arterial (odds ratio, 0.95; 95% confidence interval [CI]: 0.91, 0.99; P = .023) and venous (odds ratio, 0.96; 95% CI: 0.93, 0.99; P = .035) phases with the multivariate logistic regression model. Radiation dose for two dual-phase cone-beam CT scans was 3.08 mSv.Intraprocedural C-arm dual-phase cone-beam CT can be used immediately after TACE with doxorubicin-eluting beads to predict HCC tumor response at 1-month MR imaging follow-up. |
| Databáze: | OpenAIRE |
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