TwinLiverNet: Predicting TACE Treatment Outcome from CT scans for Hepatocellular Carcinoma using Deep Capsule Networks

Abstract Background Transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are effective treatment methods for unresectable hepatocellular carcinoma (HCC). However, there is still a lack of clinical research on whether early sequential RFA, compared with late combination therapy, can improve the long-term efficacy of initial TACE treatment. Methods This retrospective study investigated a cohort of patients who underwent combination therapy using TACE and RFA (TACE followed by RFA) from January 2010 to January 2020 at our medical centre. A total of 96 patients underwent TACE combined with early RFA (usually during the first hospitalization), which was called TACE + eRFA. Thirty-four patients received 1–2 palliative TACE treatments first and then underwent TACE treatment combined with late RFA (TACE + lRFA). All patients continued to receive palliative TACE treatments after intrahepatic lesion progression until reaching intolerance. The overall survival (OS) rate, time to tumour progression (TTP), tumour response rate and major complication rates were compared between the two groups. Results There were significant differences in the median OS (46 months vs 33 months; P = 0.013), median TTP (28 months vs 14 months; P < 0.00), objective response rate (ORR) (89.6% vs 61.8%, P = 0.000) and disease control rate (DCR) (94.8% vs 73.5% P = 0.002) between the two groups. Multivariable analysis revealed that the Barcelona Clinic Liver Cancer stage was an independent risk factor for OS. Meanwhile, multivariable analysis revealed that TACE + eRFA was associated with an enhanced TTP. Conclusion Early sequential RFA treatment in patients with early-intermediate HCC can improve local tumour control and clinical outcomes while reducing the frequency of TACE treatment. In clinical practice, in HCC patients initially treated with TACE, it is recommended to combine RFA as soon as possible to obtain long-term survival.

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Area Extraction of the Liver and Hepatocellular Carcinoma in CT Scans

Journal of Digital Imaging ◽

10.1007/s10278-007-9053-4 ◽

2007 ◽

Vol 21 (S1) ◽

pp. 89-103 ◽

Cited By ~ 3

Author(s):

Kwang-Baek Kim ◽

Chang Won Kim ◽

Gwang Ha Kim

Keyword(s):

Hepatocellular Carcinoma ◽

Ct Scans

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Contemporary management of fibrolamellar hepatocellular carcinoma: diagnosis, treatment, outcome, prognostic factors, and recent developments

World Journal of Surgical Oncology ◽

10.1186/s12957-016-0903-8 ◽

2016 ◽

Vol 14 (1) ◽

Cited By ~ 23

Author(s):

Woubet Tefera Kassahun

Keyword(s):

Hepatocellular Carcinoma ◽

Treatment Outcome ◽

Prognostic Factors ◽

Fibrolamellar Hepatocellular Carcinoma ◽

Recent Developments ◽

Contemporary Management

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PCN510 HEALTHCARE RESOURCE UTILISATION (HCRU) ASSOCIATED WITH TRANSCATHETER ARTERIAL CHEMOEMBOLISATION (TACE) TREATMENT IN INTERMEDIATE STAGE HEPATOCELLULAR CARCINOMA (HCC) PATIENTS IN EUROPE

Value in Health ◽

10.1016/j.jval.2019.09.702 ◽

2019 ◽

Vol 22 ◽

pp. S537

Author(s):

T. Bailey ◽

G. Thompson ◽

G. Taylor-Stokes ◽

A. Ghale ◽

D. Begic ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Healthcare Resource ◽

Intermediate Stage ◽

Resource Utilisation ◽

Healthcare Resource Utilisation ◽

Transcatheter Arterial Chemoembolisation ◽

Tace Treatment

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Association between neutrophil–lymphocyte ratio, socioeconomic status, and ethnic minority with treatment outcome in hepatocellular carcinoma

Hepatology International ◽

10.1007/s12072-019-09965-0 ◽

2019 ◽

Vol 13 (5) ◽

pp. 609-617

Author(s):

Yifei Zhang ◽

N. Patrik Brodin ◽

Nitin Ohri ◽

Santiago Thibaud ◽

Andreas Kaubisch ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Socioeconomic Status ◽

Treatment Outcome ◽

Ethnic Minority ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

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Diagnostic value of contrast-enhanced ultrasound versus computed tomography for hepatocellular carcinoma: a retrospective, single-center evaluation of 234 patients

Journal of International Medical Research ◽

10.1177/0300060520930151 ◽

2020 ◽

Vol 48 (6) ◽

pp. 030006052093015 ◽

Cited By ~ 2

Author(s):

Vincent Schwarze ◽

Constantin Marschner ◽

Wiebke Völckers ◽

Sergio Grosu ◽

Giovanna Negrão de Figueiredo ◽

...

Keyword(s):

Computed Tomography ◽

Hepatocellular Carcinoma ◽

Predictive Value ◽

Diagnostic Value ◽

Ct Scans ◽

Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

Single Center ◽

Experienced Radiologist ◽

Contrast Enhanced

Objective Hepatocellular carcinoma (HCC) is the most common cause of primary liver cancer. A major part of diagnostic HCC work-up is based on imaging findings from sonography, computed tomography (CT), or magnetic resonance imaging (MRI) scans. Contrast-enhanced ultrasound (CEUS) allows for the dynamic assessment of the microperfusion pattern of suspicious liver lesions. This study aimed to evaluate the diagnostic value of CEUS compared with CT scans for assessing HCC. Methods We performed a retrospective, single-center study between 2004 and 2018 on 234 patients with suspicious liver lesions who underwent CEUS and CT examinations. All patients underwent native B-mode, color Doppler and CEUS after providing informed consent. Every CEUS examination was performed and interpreted by a single experienced radiologist (European Federation of Societies for Ultrasound in Medicine and Biology level 3). Results CEUS was performed on all included patients without occurrence of any adverse effects. CEUS showed a sensitivity of 94%, a specificity of 70%, a positive predictive value of 93% and a negative predictive value of 72% for analyzing HCC compared with CT as the diagnostic gold standard. Conclusions CEUS has an excellent safety profile and shows a high diagnostic accuracy in assessing HCC compared with corresponding results from CT scans.

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