Intraprocedural Parenchymal Blood Volume Is a Predictor of Treatment Response for Chemoembolization in Hepatocellular Carcinoma: Results of a Prospective Study
| Autor: | Mohammed T. Alshammari, David M. Liu, Nevin de Korompay, John Chung, Stephen G.F. Ho, Darren Klass, Frank Y. Chou |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Carcinoma Hepatocellular Time Factors medicine.medical_treatment Blood volume 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Clinical endpoint medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Embolization Chemoembolization Therapeutic Stage (cooking) Prospective cohort study Aged Neoplasm Staging Blood Volume Blood Volume Determination business.industry Liver Neoplasms Cone-Beam Computed Tomography Middle Aged medicine.disease Tumor Burden Treatment Outcome Response Evaluation Criteria in Solid Tumors 030220 oncology & carcinogenesis Hepatocellular carcinoma Female Cardiology and Cardiovascular Medicine Nuclear medicine business Progressive disease |
| Zdroj: | Journal of Vascular and Interventional Radiology. 29:928-935 |
| ISSN: | 1051-0443 |
| Popis: | Purpose To evaluate cone-beam parenchymal blood volume (PBV) before and after embolization as a predictor of radiographic response to transarterial chemoembolization in unresectable hepatocellular carcinoma (HCC). Materials and Methods A phase IIa prospective clinical trial was conducted in patients with HCCs > 1.5 cm undergoing chemoembolization; 52 tumors in 40 patients with Barcelona Clinic Liver Criteria stage B disease met inclusion criteria. Pre- and postembolization PBV analysis was performed with a semiquantitative best-fit methodology for index tumors, with a predefined primary endpoint of radiographic response at 3 months. Analyses were conducted with Wilcoxon signed-rank tests and one-way analysis of variance on ranks. Results Mean tumoral PBV measurements before and after embolization were 170 mL/1,000 mL ± 120 and 0 mL/100 mL ± 130, respectively. Per modified Response Evaluation Criteria In Solid Tumors, 25 tumors (48%) exhibited complete response (CR), 13 (25%) partial response (PR), 3 (6%) stable disease (SD), and 11 (21%) progressive disease (PD). Statistically significant changes in median PBV (ΔPBV) were identified in the CR (P = .001) and PR (P = .003) groups, with no significant difference observed in SD (P = .30) and PD groups (P = .06). A statistically significant correlation between ΔPBV and tumor response was established by one-way analysis of variance on ranks (P = .036; CR, 200 mL/100 mL ± 99; PR, 240 mL/100 mL ± 370; SD, 64 mL/100 mL ± 99; PD, 88 mL/100 mL ± 129). Conclusions Intraprocedural PBV can be used as a predictor of response in index HCC tumors of > 1.5 cm. |
| Databáze: | OpenAIRE |
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