scholarly journals Identifying Staging Markers for Hepatocellular Carcinoma before Transarterial Chemoembolization: Comparison of Three-dimensional Quantitative versus Non–three-dimensional Imaging Markers

Radiology ◽  
2015 ◽  
Vol 275 (2) ◽  
pp. 438-447 ◽  
Author(s):  
Julius Chapiro ◽  
Rafael Duran ◽  
MingDe Lin ◽  
Rüdiger E. Schernthaner ◽  
Zhijun Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Three Dimensional ◽  
Three Dimensional Imaging ◽  
Imaging Markers

scholarly journals Contrast enhanced ultrasonography in assessing the treatment response to transarterial chemoembolization in patients with hepatocellular carcinoma.

2016 ◽  
Vol 18 (1) ◽  
pp. 96 ◽  
Author(s):  
Zeno Spârchez ◽  
Tudor Mocan ◽  
Pompilia Radu ◽  
Ofelia Anton ◽  
Nicolae Bolog
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Three Dimensional ◽  
Disease Free Survival ◽  
Early Assessment ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Current Guidelines

Abstract. The last decades have known continuous development of therapeutic strategies in hepatocellular carcinoma (HCC). Unfortunately the disease it still not diagnosed until it is already at an intermediate or even an advanced disease. In these circumstances transarterial chemoembolization (TACE) is considered an effective treatment for HCC. The most important independent prognostic factor of both disease free survival and overall survival is the presence of complete necrosis. Therefore, treatment outcomes are dictated by the proper use of radiological imaging. Current guidelines recommend contrast enhanced computer tomography (CECT) as the standard imaging technique for evaluating the therapeutic response in patients with HCC after TACE. One of the most important disadvantage of CECT is the overestimation of tumor response. As an attempt to overcome this limitation contrast enhanced ultrasound (CEUS) has gained particular attention as an imaging modality in HCC patients after TACE. Of all available imaging modalities, CEUS performs better in the early and very early assessment of TACE especially after lipiodol TACE. As any other imaging techniques CEUS has disadvantages especially in hypovascular tumors or in cases of tumor multiplicity. Not far from now the current limitations of CEUS will be overcome by the new CEUS techniques that are already tested in clinical practice such as dynamic CEUS with quantification, three-dimensional CEUS or fusion techniques.

scholarly journals Role of multislice computed tomography 3D volumetric analysis in the assessment of the therapeutic response of hepatocellular carcinoma after transarterial chemoembolization

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mohamed Fouad Osman ◽  
Ahmed Shawky Ali Farag ◽  
Haney Ahmed Samy ◽  
Tamer Mahmoud El-Baz ◽  
Shaima Fattouh Elkholy
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Therapeutic Response ◽  
Interventional Procedure ◽  
Liver Volume ◽  
Three Dimensional ◽  
Volumetric Analysis ◽  
Three Dimensions ◽  
Locoregional Therapy ◽  
Significant Difference

Abstract Background Volumetric analysis is a novel radiological technique used in the measurement of target lesions in three dimensions in order to estimate the lesion’s volume. Recently, it has been used for evaluation of the remaining liver volume after partial hepatectomy and also for evaluation of the response of tumours to treatment. It has been proven to be more accurate than the standard one or two-dimensional measurements, and it is especially useful for the evaluation of complex tumours after radiological interventional methods when the use of standard methods is limited. In the current study, our aim was to evaluate the value of the three-dimensional (3D) volumetric method “Response Evaluation Criteria in Solid Tumours (vRECIST)” and to compare it with the non–three-dimensional methods (RECIST) and modified RECIST (mRECIST) in the assessment of the therapeutic response of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). Results A retrospective study was conducted on 50 patients with confirmed radiological or pathological diagnosis of hepatocellular carcinoma (HCC) who underwent TACE as the only interventional procedure and follwed up by triphasic CT 1 and 4 months after treatment. The study revealed a significant difference between mRECIST and vRECIST in the assessment of the therapeutic response of HCC after TACE, a weak agreement was found between both methods in the detection of complete response (CR), partial response (PR), stable disease (SD) or progressive disease (PD). Also, there was no significant agreement between mRECIST and vRECIST regarding the assessment by classifying the patients into responders or nonresponders. Conclusion Volumetric analysis is an effective method for measuring the HCC lesions and evaluating its response to locoregional treatment with a significant difference between vRECIST and mRECIST in the assessment of therapeutic response, which in turn help the interventional radiologist to decide the future treatments and change the therapeutic plans. Based on these results, we recommend vRECIST to be an essential part of the assessment of therapeutic response after locoregional therapy.

scholarly journals Combination of three-dimensional reconstruction technique and blood parameters for the evaluation of tumor burden and prognosis in patients with hepatocellular carcinoma undergoing liver resection

2020 ◽  
Vol 23 (2) ◽  
pp. 18-30
Author(s):  
Bibesh Pokhrel ◽  
Xiaopeng Hong ◽  
Baojia Zou ◽  
Baimeng Zhang ◽  
Jian Li
Keyword(s):  
Hepatocellular Carcinoma ◽  
Lymph Node ◽  
Liver Resection ◽  
Lymph Node Metastasis ◽  
Hepatic Resection ◽  
Three Dimensional ◽  
Blood Parameters ◽  
Reconstruction Technique ◽  
Three Dimensional Imaging ◽  
Node Metastasis

Introduction: Hepatic resection is the mainstay of treatment for Hepatocellular carcinoma (HCC). Three- dimensional technique helps to create an image of the liver using pre-operative computed tomography (CT) scans which can be used for planning of surgery and counselling of the patient. Various lab parameters have also been shown to affect the prognosis of HCC. This study was designed to analyse whether three dimensional technique and blood parameters are correlated with the prognosis among HCC patients following hepatic resection and also to find a relation between these variables. Methods: Data were collected retrospectively to recruit HCC patients treated between January 2010 and December 2016. Seventy-three HCC patients without extrahepatic metastasis, who underwent hepatic resection and had pre-operative CT scan done in our centre were enrolled for this study. IQQA® was used to create a three-dimensional imaging, and various related laboratory parameters were also collected. Outcomes of these patients were calculated to establish a relationship between IQQA, laboratory results and the prognosis of the patients. Results: The one, three and five year overall survival (OS) rates were 94.4%, 53.3% and 19.4% respectively, and disease-free survival (DFS) rates were 75%, 31.3% and 12.8% respectively. IQQA percentage of tumor was statistically significant for both OS and DFS. In the multivariate analysis, patients having lymph node metastasis, vascular invasion and high pre-op CA 19-9 had lower DFS rate, while it increased in those with high pre-op albumin. Other significant variables for OS were lymph node metastasis, Child Pugh score, high pre-op alpha fetoprotein (AFP) value and high CA 19-9. Resected segments, lymph node metastasis, liver cirrhosis, blood loss and hospital stay were significant between the two IQQA subgroups (IQQA?30% and IQQA>30%). Additionally in these IQQA subgroups, significant difference was found between DFS and OS. Conclusion: IQQA software is helpful to create a 3D image of the liver, and can be combined with lab parameters to predict prognosis for patients with liver cancer. Therefore, this three-dimensional imaging technique can be used as a routine technique for patients undergoing liver resection.

scholarly journals Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma: Predictors of Survival

2011 ◽  
Vol 25 (8) ◽  
pp. 426-432 ◽  
Author(s):  
Summit Sawhney ◽  
Aldo J Montano-Loza ◽  
Peter Salat ◽  
Mairin McCarthy ◽  
Norman Kneteman ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Lower Risk ◽  
Tumour Size ◽  
Three Dimensional ◽  
Meld Score ◽  
Alpha Fetoprotein ◽  
Three Dimensions ◽  
Risk Of Mortality ◽  
Tace Procedure

BACKGROUND: Transarterial chemoembolization (TACE) is the mainstay of management for patients with hepatocellular carcinoma who are not suitable for curative treatments.OBJECTIVE: To determine factors associated with mortality after the first TACE procedure.METHODS: From January 2004 to May 2008, 60 patients underwent TACE as treatment for hepatocellular carcinoma. Clinical and biochemical parameters before TACE, and response after TACE, were evaluated with conventional classifications (WHO, Response Evaluation Criteria in Solid Tumors [RECIST], and European Association for the Study of the Liver [EASL] criteria) and with one-, two- and three-dimensional assessment.RESULTS: Overall median survival after the first TACE procedure was 17.1±3.4 months. According to Cox regression analysis, having an alpha-fetoprotein level of greater than 200 ng/mL (HR 2.35 [P=0.02]) and a Model for End-stage Liver Disease (MELD) score of greater than 10 (HR 4.19 [P=0.001]) were associated with higher risk of mortality; whereas reduction in tumour size measured in one dimension (HR 0.96 [P=0.005]), two dimensions (HR 0.98 [P=0.004]) and three dimensions (HR 0.98 [P=0.001]) was associated with lower risk of mortality. Moreover, reduction in tumour size by 3% or more assessed in one, two or three dimensions was associated with lower risk of mortality (HR 0.48 [P=0.04]; HR 0.36 [P=0.01]; HR 0.31 [P=0.003], respectively). The three conventional classifications were not useful for predicting mortality (WHO: HR 1.07 [P=0.9]; RECIST: HR 0.94 [P=0.9]; EASL: HR 0.94 [P=0.9]).CONCLUSIONS: Having an alpha-fetoprotein level of greater than 200 ng/mL and a MELD score of greater than 10 before undergoing TACE was associated with a greater risk of mortality. Conventional classifications of response were not useful for predicting mortality. Reduction in tumour size after the first TACE procedure was associated with better survival, primarily if patients had more than a 3% reduction in tumour size assessed by three-dimensional measurement.

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