scholarly journals Computed tomographic perfusion imaging for the prediction of response and survival to transarterial chemoembolization of hepatocellular carcinoma

2017 ◽  
Vol 52 (1) ◽  
pp. 14-22 ◽  
Author(s):  
Peter Popovic ◽  
Ana Leban ◽  
Klara Kregar ◽  
Manca Garbajs ◽  
Rok Dezman ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Perfusion Imaging ◽  
Transarterial Chemoembolization ◽  
Intermediate Stage ◽  
Complete Response ◽  
Response To Treatment ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Pre Treatment

Abstract Background The purpose of this retrospective cohort study was to evaluate the clinical value of computed tomographic perfusion imaging (CTPI) parameters in predicting the response to treatment and overall survival in patients with hepatocellular carcinoma (HCC) treated with drug-eluting beads transarterial chemoembolization (DEBTACE). Patients and methods Between December 2010 and January 2013 eighteen patients (17 men, 1 woman; mean age 69 ± 5.8 years) with intermediate stage HCC underwent CTPI of the liver prior to treatment with DEBTACE. Treatment response was evaluated on follow-up imaging according to modified Response Evaluation Criteria in Solid Tumors. Pre-treatment CTPI parameters were compared between patients with complete response and partial response with a Student t-test. We compared survival times with Kaplan-Meier method. Results CTPI parameters of patients with complete response and others did not show statistical significant difference. The mean survival time was 25.4 ± 3.2 months (95%; CI: 18.7-32.1). Survival was statistically significantly longer in patients with hepatic blood flow (BF) lower than 50.44 ml/100 ml/min (p = 0.033), hepatic blood volume (BV) lower than 13.32 ml/100 ml (p = 0.028) and time to peak (TTP) longer than 19.035 s (p = 0.015). Conclusions CTPI enables prediction of survival in patients with intermediate stage HCC, treated with DEBTACE based on the pre-treatment values of BF, BV and TTP perfusion parameters. CT perfusion imaging can’t be used to predict treatment response to DEBTACE.

scholarly journals Assessment of the relationship between hepatocellular carcinoma location and its response to transarterial chemoembolization

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed Elsahhar ◽  
Sameh M. Abdelwahab ◽  
Haytham M. Nasser ◽  
Mohammed Sobhi Hassan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Tumor Response ◽  
Anterior Segment ◽  
Intermediate Stage ◽  
Complete Response ◽  
Recommended Treatment ◽  
Significant Difference ◽  
The Right ◽  
The Relationship

Abstract Background Transarterial chemoembolization (TACE) is the recommended treatment in intermediate stage of hepatocellular carcinoma (HCC). Many indices are used to predict the outcome of the TACE. The location of the HCC has not been enough studied as a prognostic variable. Results We evaluated 149 HCC nodules (111 patients) and analyzed the association between the response to TACE and the nodule location. There was a significant difference between the complete response (CR) and the non-CR group in the location of the HCC regarding its segment and the response to TACE with the anterior segment lesions achieving higher rates of complete response (CR) (P .03), and the distance between the tumor and the liver capsule with the subcapsular lesions showing higher rate of non-CR (P .02). However, there was no significant difference between the CR and the non-CR groups regarding the location between the right and the left lobes (P .48) and the central versus peripheral lesions (P .41). Conclusions The location of the HCC can improve the prediction of the tumor response to TACE. Anterior segment tumors showed a higher rate of complete response and subcapsular lesions showed a higher rate of recurrence after TACE.

Đánh giá đáp ứng điều trị ung thư biểu mô tế bào gan sau nút mạch hóa chất (TACE) theo mRECIST

2021 ◽  
Author(s):  
Trong Binh Le
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Treatment Response ◽  
Portal Vein Thrombosis ◽  
Transarterial Chemoembolization ◽  
Complete Response ◽  
Vein Thrombosis ◽  
The Mean ◽  
Keywords Hepatocellular Carcinoma

TÓM TẮT Mục tiêu: Đánh giá đáp ứng điều trị ung thư biểu mô tế bào gan (UTBMTBG) sau nút mạch hoá chất (TACE) theo tiêu chuẩn mRECIST. Phương pháp: Nghiên cứu tiến cứu.Chẩn đoán UTBMTBG theo EASL 2018. Đánh giá đáp ứng sau TACE theo thang điểm mRECIST tại các thời điểm < 3 tháng, 3 - 6 tháng, 6 - 12 tháng, > 12 tháng. Kết quả: 46 bệnh nhân (nam/nữ: 39/7), tuổi trung bình 61,5 ± 11,2 tuổi thỏa mãn tiêu chuẩn chọn bệnh. Thời gian theo dõi trung bình: 223 ngày (42 - 723 ngày). Đường kính lớn nhất trung bình của u: 62 mm (10 - 153 mm). 23,9% bệnh nhân có huyết khối tĩnh mạch cửa (HKTMC). Tỉ lệ đáp ứng hoàn toàn đối với tổn thương đích tại các thời điểm < 3 tháng, 3 - 6 tháng, 6 - 12 tháng, > 12 tháng lần lượt là 33,3%; 33,3%; 35,3% và 33,3%. Có 16,7% u tiến triển sau lần TACE thứ nhất. U thâm nhiễm, kích thước > 10cm, ở cả 2 thùy và có HKTMC là những yếu tố dự báo tái phát sau TACE. Kết luận: TACE có hiệu quả kiểm soát u ngắn hạn khi đánh giá bằng mRECIST. ABSTRACT EVALUATION OF TREATMENT RESPONSE OF HEPATOCELLULAR CARCINOMA AFTER TRANSARTERIAL CHEMOEMBOLIZATION USING mRECIST CRITERIA Nguyen Thi Thuy Linh1, Hoang Anh Dung1, Huyen Ton Nu Hong Hanh2, Ngo Dac Hong An1, Le Minh Tuan1, Dang Quang Hung2, Le Hoang Huy2, Le Trong Binh1* Purpose: To evaluate the treatment response of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) using mRECIST. Methods: Diagnosis of HCC was based on EASL 2018, and an indication of TACE was based on SIR practice guideline. Treatment responses were evaluated at < 3 - month, 3 - 6 - month, 6 - 12 - month and > 12 - month intervals. Results: Forty - sixpatients (male/female 39/7) with the mean age 61.5 ± 11.2 years were enrolled in the present study. The mean follow - up duration was 223 days (range, 42 - 723 days). The mean of maximal HCC diameter was 62mm (range, 10 - 153mm). 23.9% of patients had portal vein thrombosis (PVT). The rates of complete response of the target lesions at the < 3 - month, 3 - 6 - month, 6 - 12 - month and > 12 - month were 33.3%; 33.3%; 35.3% and 33.3%, respectively. Progression disease was seen in 16.7%. Infiltrative type, diameter > 10cm, bilobar HCC, and portal vein thrombosis were predictors for recurrence. Conclusion: TACE offered short - term therapeutic control of HCC when using mRECIST. Keywords: Hepatocellular carcinoma, transarterial chemoembolization, mRECIST.

scholarly journals TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION IN THE TREATMENT OF PATIENTS WITH HEPATOCELLULAR CARCINOMA ON ADVANCED LIVER CIRRHOSIS

2020 ◽  
Vol 178 (6) ◽  
pp. 29-35
Author(s):  
A. S. Polekhin ◽  
P. G. Tarazov ◽  
A. A. Polikarpov ◽  
D. A. Granov
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Survival Rate ◽  
Liver Failure ◽  
Transcatheter Arterial Chemoembolization ◽  
Intermediate Stage ◽  
Complete Response ◽  
Response To Treatment ◽  
Advanced Liver Cirrhosis ◽  
Arterial Chemoembolization

OBJECTIVE was to evaluate the results of transcatheter arterial chemoembolization (TACE) in the treatment of patients with hepatocellular carcinoma (HCC) on advanced liver cirrhosis (LC) and intermediate stage (B) according to BCLC classification (Barcelona Clinic Liver Cancer classification).METHODS AND MATERIALS. We evaluated results of TACE in 54 patients. Of them, 12 (22 %) had stage A of cirrhosis and 42 (78 %) – stage B of cirrhosis according to the Child-Pugh score. Nine (17 %) patients matched stage A4 and 45 (83 %) – stage В according to BCLC classification. The TACEs was performed according to the conventional practice with using Lipiodol + gelfoam (n=40) and with a drug-eluting beads (n=14) from 1 to 16 (average 6) times. The Doxorubicin was used as a first-line therapy in all cases.RESULTS. After TACE, two patients died of liver failure (3.7 %). According to the m-RECIST, complete response to treatment was observed in 9 (16.5 %), partial response – in 13 (24 %), stabilization – in 19 (35.5 %) and progression – in 13 (24 %) patients. At present, 22 (41 %) patients are alive for 1 to 51 (average 16.2) months. 32 patients (59 %) died between 2 to 62 months: 13 (24 %) – from HCC progression, 19 (35 %) – from liver failure. The 1– 2–3-year survival rate was 75–44–15 %; only one patient survived > 5 years. The median survival rate was (22.0±3.0) months, overall survival rate according to Kaplan – Meier was 26 months.CONCLUSION. TACE is a relatively safe and effective treatment in patients with HCC on advanced LC and intermediate stage (B). 

Intra-arterial idarubicin_lipiodol without embolization can provide prolonged complete response in hepatocellular carcinoma: A case report

2019 ◽  
Vol 26 (2) ◽  
pp. 507-510
Author(s):  
Pauline Pistre ◽  
Boris Guiu ◽  
Sophie Gehin ◽  
Mathieu Boulin
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Case Report ◽  
Transarterial Chemoembolization ◽  
Anticancer Agent ◽  
Standard Treatment ◽  
Intermediate Stage ◽  
Complete Response ◽  
Cancer Death

Hepatocellular carcinoma is the fourth leading cause of cancer death. For unresectable intermediate-stage hepatocellular carcinoma, the standard treatment is transarterial chemoembolization. To date, the overall survival at three years remains low, and there is currently no consensus about the best anticancer agent and optimal treatment regimen. We report the case of a hepatocellular carcinoma patient with a vascular contraindication to embolization who achieved a complete response after four intra-arterial infusions of idarubicin emulsified with lipiodol. The patient maintained his response over a three-year period without any hepatocellular carcinoma treatment, demonstrating the major role of the anticancer agent in the efficacy of transarterial therapies for intermediate-stage hepatocellular carcinoma.

scholarly journals Treatment Response, Survival, and Safety of Transarterial Chemoembolization With CalliSpheres® Microspheres Versus Conventional Transarterial Chemoembolization in Hepatocellular Carcinoma: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Bin Liang ◽  
Joyman Makamure ◽  
Shenglei Shu ◽  
Lijie Zhang ◽  
Tao Sun ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Transarterial Chemoembolization ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Objective Response ◽  
Progression Free Survival ◽  
Complete Response ◽  
Conventional Tace ◽  
Drug Eluting

BackgroundDrug-eluting embolic transarterial chemoembolization (DEE-TACE) is an advance in TACE technique. However, at present there is insufficient evidence to support that DEE-TACE is superior to conventional TACE (cTACE) for hepatocellular carcinoma (HCC). The aim of this meta-analysis is to evaluate the efficacy and safety of TACE with CalliSpheres® microspheres (CSM-TACE) compared with cTACE in patients with HCC.Data SourcesPubMed, Embase, Web of Science, CNKI and Wanfang Databases were searched to identify relevant articles published before March 26, 2020. The data regarding treatment response, survival profile, adverse events and liver function indexes were retrieved.ResultsA total of 16 studies with 1454 HCC patients (722 treated with CSM-TACE and 732 with cTACE) were included. Patients receiving CSM-TACE had higher 1-month complete response (CR), objective response rate (ORR), disease control rate (DCR) (odds ratio (OR): 2.00, 95% confidence interval (95% CI): 1.29–3.09; OR: 2.87, 95% CI: 2.15–3.83; OR: 2.01, 95% CI: 1.37–2.95, respectively), 3-month CR, ORR, DCR (OR: 4.04, 95%CI: 2.46–6.64; OR: 3.39, 95%CI: 2.45–4.70; OR: 1.71, 95%CI: 1.14–2.55 respectively), and 6-month CR, ORR, DCR (OR: 4.02, 95%CI: 2.26–7.16; OR: 3.00, 95%CI: 2.05–4.38; OR: 2.66, 95%CI: 1.70–4.16 respectively) than those treated with cTACE. Furthermore, CSM-TACE exhibited a trend toward improved progression free survival (hazard ratio (HR): 0.86, 95%CI: 0.67–1.11) and overall survival (HR: 0.79, 95%CI: 0.59–1.07) over cTACE although these differences did not reach statistical significance. In terms of safety, the two TACE treatments showed similar post-treatment pain (OR: 0.84, 95%CI: 0.55–1.28), fever (OR: 0.99, 95%CI: 0.60–1.63), nausea/vomiting (OR: 0.84, 95% CI: 0.60–1.17), as well as 1-month follow-up alanine aminotransferase (Mean difference (MD): −3.66, 95%CI: −10.38–3.07), aspartate aminotransferase (MD: −2.30, 95%CI: −8.91–4.31) and total bilirubin (MD: −0.15, 95%CI: −2.26–1.96).ConclusionCSM-TACE displays superior treatment response, non-inferior survival profile and safety over cTACE in HCC patients.

scholarly journals Predicting the Initial Treatment Response to Transarterial Chemoembolization in Intermediate-Stage Hepatocellular Carcinoma by the Integration of Radiomics and Deep Learning

2021 ◽  
Vol 11 ◽  
Author(s):  
Jie Peng ◽  
Jinhua Huang ◽  
Guijia Huang ◽  
Jing Zhang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Deep Learning ◽  
Random Forest ◽  
Treatment Response ◽  
Transarterial Chemoembolization ◽  
Initial Treatment ◽  
Intermediate Stage ◽  
Accurate Method ◽  
Recursive Feature Elimination ◽  
Random Forest Algorithm

ObjectivesWe aimed to develop radiology-based models for the preoperative prediction of the initial treatment response to transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) since the integration of radiomics and deep learning (DL) has not been reported for TACE.MethodsThree hundred and ten intermediate-stage HCC patients who underwent TACE were recruited from three independent medical centers. Based on computed tomography (CT) images, recursive feature elimination (RFE) was used to select the most useful radiomics features. Five radiomics conventional machine learning (cML) models and a DL model were used for training and validation. Mutual correlations between each model were analyzed. The accuracies of integrating clinical variables, cML, and DL models were then evaluated.ResultsGood predictive accuracies were showed across the two cohorts in the five cML models, especially the random forest algorithm (AUC = 0.967 and 0.964, respectively). DL showed high accuracies in the training and validation cohorts (AUC = 0.981 and 0.972, respectively). Significant mutual correlations were revealed between tumor size and the five cML models and DL model (each P &lt; 0.001). The highest accuracies were achieved by integrating DL and the random forest algorithm in the training and validation cohorts (AUC = 0.995 and 0.994, respectively).ConclusionThe radiomics cML models and DL model showed notable accuracy for predicting the initial response to TACE treatment. Moreover, the integrated model could serve as a novel and accurate method for prediction in intermediate-stage HCC.

scholarly journals Clinical-Radiomic Analysis for Pretreatment Prediction of Objective Response to First Transarterial Chemoembolization in Hepatocellular Carcinoma

Liver Cancer ◽  
2021 ◽  
pp. 1-14
Author(s):  
Mingyu Chen ◽  
Jiasheng Cao ◽  
Jiahao Hu ◽  
Win Topatana ◽  
Shijie Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Transarterial Chemoembolization ◽  
External Validation ◽  
Objective Response ◽  
Intermediate Stage ◽  
Predictive Tool ◽  
Preoperative Selection ◽  
Selection Of Patients ◽  
Selection Of

<b><i>Background:</i></b> The preoperative selection of patients with intermediate-stage hepatocellular carcinoma (HCC) who are likely to have an objective response to first transarterial chemoembolization (TACE) remains challenging. <b><i>Objective:</i></b> To develop and validate a clinical-radiomic model (CR model) for preoperatively predicting treatment response to first TACE in patients with intermediate-stage HCC. <b><i>Methods:</i></b> A total of 595 patients with intermediate-stage HCC were included in this retrospective study. A tumoral and peritumoral (10 mm) radiomic signature (TPR-signature) was constructed based on 3,404 radiomic features from 4 regions of interest. A predictive CR model based on TPR-signature and clinical factors was developed using multivariate logistic regression. Calibration curves and area under the receiver operating characteristic curves (AUCs) were used to evaluate the model’s performance. <b><i>Results:</i></b> The final CR model consisted of 5 independent predictors, including TPR-signature (<i>p</i> &#x3c; 0.001), AFP (<i>p</i> = 0.004), Barcelona Clinic Liver Cancer System Stage B (BCLC B) subclassification (<i>p</i> = 0.01), tumor location (<i>p</i> = 0.039), and arterial hyperenhancement (<i>p</i> = 0.050). The internal and external validation results demonstrated the high-performance level of this model, with internal and external AUCs of 0.94 and 0.90, respectively. In addition, the predicted objective response via the CR model was associated with improved survival in the external validation cohort (hazard ratio: 2.43; 95% confidence interval: 1.60–3.69; <i>p</i> &#x3c; 0.001). The predicted treatment response also allowed for significant discrimination between the Kaplan-Meier curves of each BCLC B subclassification. <b><i>Conclusions:</i></b> The CR model had an excellent performance in predicting the first TACE response in patients with intermediate-stage HCC and could provide a robust predictive tool to assist with the selection of patients for TACE.

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