scholarly journals Contrast Administration Impacts CT-Based Radiomics of Colorectal Liver Metastases and Non-Tumoral Liver Parenchyma Revealing the “Radiological” Tumour Microenvironment

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1162
Author(s):  
Francesco Fiz ◽  
Guido Costa ◽  
Nicolò Gennaro ◽  
Ludovico la Bella ◽  
Alexandra Boichuk ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Contrast Enhancement ◽  
Colorectal Liver Metastases ◽  
Liver Parenchyma ◽  
Tumour Microenvironment ◽  
Contrast Administration ◽  
Portal Phase ◽  
Radiological Aspect ◽  
Peritumoral Tissue ◽  
The Impact

The impact of the contrast medium on the radiomic textural features (TF) extracted from the CT scan is unclear. We investigated the modification of TFs of colorectal liver metastases (CLM), peritumoral tissue, and liver parenchyma. One hundred and sixty-two patients with 409 CLMs undergoing resection (2017–2020) into a single institution were considered. We analyzed the following volumes of interest (VOIs): The CLM (Tumor-VOI); a 5-mm parenchyma rim around the CLM (Margin-VOI); and a 2-mL sample of parenchyma distant from CLM (Liver-VOI). Forty-five TFs were extracted from each VOI (LIFEx®®). Contrast enhancement affected most TFs of the Tumor-VOI (71%) and Margin-VOI (62%), and part of those of the Liver-VOI (44%, p = 0.010). After contrast administration, entropy increased and energy decreased in the Tumor-VOI (0.93 ± 0.10 vs. 0.85 ± 0.14 in pre-contrast; 0.14 ± 0.03 vs. 0.18 ± 0.04, p < 0.001) and Margin-VOI (0.89 ± 0.11 vs. 0.85 ± 0.12; 0.16 ± 0.04 vs. 0.18 ± 0.04, p < 0.001), while remaining stable in the Liver-VOI. Comparing the VOIs, pre-contrast Tumor and Margin-VOI had similar entropy and energy (0.85/0.18 for both), while Liver-VOI had lower values (0.76/0.21, p < 0.001). In the portal phase, a gradient was observed (entropy: Tumor > Margin > Liver; energy: Tumor < Margin < Liver, p < 0.001). Contrast enhancement affected TFs of CLM, while it did not modify entropy and energy of parenchyma. TFs of the peritumoral tissue had modifications similar to the Tumor-VOI despite its radiological aspect being equal to non-tumoral parenchyma.

scholarly journals Failure to Cure Colorectal Liver Metastases Patients Quantified - The Impact of the Liver Surgical Specialist

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S129
Author(s):  
E.A. Vega ◽  
O. Salehi ◽  
O. Kocyreva ◽  
C. Conrad
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
The Impact

scholarly journals 3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Simeon J. S. Ruiter ◽  
Pascale Tinguely ◽  
Iwan Paolucci ◽  
Jennie Engstrand ◽  
Daniel Candinas ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Multicenter Study ◽  
Microwave Ablation ◽  
Colorectal Liver Metastases ◽  
Liver Tumors ◽  
Three Dimensional ◽  
Multivariable Logistic Regression Analysis ◽  
Tumor Diameter ◽  
Ablation Margin ◽  
The Impact

BackgroundThree-dimensional (3D) volumetric ablation margin assessment after thermal ablation of liver tumors using software has been described, but its predictive value on treatment efficacy when accounting for other factors known to correlate ablation site recurrence (ASR) remains unknown.PurposeTo investigate 3D quantitative ablation margins (3D-QAMs) as an algorithm to predict ASR within 1 year after stereotactic microwave ablation (SMWA) for colorectal liver metastases (CRLM).Materials and MethodsSixty-five tumors in 47 patients from a prospective multicenter study of patients undergoing SMWA for CRLM were included in this retrospective 3D-QAM analysis. Using a previously developed algorithm, 3D-QAM defined as the distribution of tumor to ablation surface distances was assessed in co-registered pre- and post-ablation CT scans. The discriminatory power and optimal cutoff values for 3D-QAM were assessed using receiver operating characteristic (ROC) curves. Multivariable logistic regression analysis using generalized estimating equations was applied to investigate the impact of various 3D-QAM outputs on 1-year ASR while accounting for other known influencing factors.ResultsTen of the 65 (15.4%) tumors included for 3D-QAM analysis developed ASR. ROC analyses identified i) 3D-QAM &lt;1 mm for &gt;23% of the tumor surface, ii) 3D-QAM &lt;5 mm for &gt;45%, and iii) the minimal ablation margin (MAM) as the 3D-QAM outputs with optimal discriminatory qualities. The multivariable regression model without 3D-QAM yielded tumor diameter and KRAS mutation as 1-year ASR predictors. When adding 3D-QAM, this factor became the main predictor of 1-year ASR [odds ratio (OR) 21.67 (CI 2.48, 165.21) if defined as &gt;23% &lt;1 mm; OR 0.52 (CI 0.29, 0.95) if defined as MAM].Conclusions3D-QAM allows objectifiable and standardized assessment of tumor coverage by the ablation zone after SMWA. Our data shows that 3D-QAM represents the most important factor predicting ASR within 1 year after SMWA of CRLM.

scholarly journals The impact of somatic SMAD4 mutations in colorectal liver metastases

2019 ◽  
Vol 8 (5) ◽  
pp. 52-52 ◽  
Author(s):  
Dimitrios Xourafas ◽  
Takashi Mizuno ◽  
Jordan M. Cloyd
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
The Impact

scholarly journals The impact of hepatic arterial infusion pump chemotherapy on hepatic recurrences and survival in patients with resected colorectal liver metastases

HPB ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. 1271-1279 ◽  
Author(s):  
Florian E. Buisman ◽  
Boris Galjart ◽  
Eric P. van der Stok ◽  
Nancy E. Kemeny ◽  
Vinod P. Balachandran ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
The Impact

Impact of preoperative chemotherapy on overall survival for borderline resectable colorectal liver metastases

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 365-365
Author(s):  
Akio Saiura ◽  
Yosuke Inoue ◽  
Yoshihiro Mise ◽  
Yu Takahashi ◽  
Takafumi Ichida ◽  
...  
Keyword(s):  
Overall Survival ◽  
Liver Resection ◽  
Liver Metastases ◽  
Preoperative Chemotherapy ◽  
Colorectal Liver Metastases ◽  
Survival Rates ◽  
Controlled Study ◽  
Free Survival ◽  
Surgical Failure ◽  
The Impact

365 Background: Treatment for borderline colorectal liver metastases (CLM) is often started with chemotherapy. However, the impact on overall survival (OS) is still unknown. Aims: The aim of this study is to analyze the impact of preoperative chemotherapy on the outcome for up-front resectable borderline CLMs (BLR-CLM). Methods: A retrospective review was performed of 169 patients who underwent liver resection of BLR-CLM among 510 patients underwent liver resection for CLM between 2005 and 2013. BLR-CRLM was defined as CRLM of four or more nodules or 5cm or larger nodule. Time to surgical failure (TSF) was defined as the time until unresectable relapse or death. OS, recurrence free survival (RFS) and TSF were compared between BLR-CLM treated with neoadjuvant chemotherapy (NAC) and up-front surgery (US). Results: After median follow-up period of 38 months, 5-year survival rate after liver resection of resectable cases (n = 263), BLR-CLM (n = 169), and initially unresectable CLM (n = 78) are 67.7%, 47.5% and 32.6%, respectively. For patients with BLR-CLM, 22 patients with early recurrence during or early after postoperative chemotherapy for the primary were excluded. In the remaining 147 patients, 75 patients were treated with NAC and 72 with US. Cumulative 5-year overall survival rates, progression free survival rates, and time-to surgical failure in NAC and US group are as follows: OS (60.1% vs 47.7%, p = 0.084), PFS (23.1% vs 15.5%, p < 0.0001), TSF (38.0% vs 34.4%, p = 0.020). Conclusions: Preoperative chemotherapy for BLR-CLM could improve PFS and TSF. The impact on OS was still marginal. Prospective controlled study will be necessary.

Colorectal Liver Metastases: Contrast Agent Diffusion Coefficient for Quantification of Contrast Enhancement Heterogeneity at MR Imaging

Radiology ◽  
2008 ◽  
Vol 248 (3) ◽  
pp. 901-909 ◽  
Author(s):  
Guang Jia ◽  
Craig O'Dell ◽  
Johannes T. Heverhagen ◽  
Xiangyu Yang ◽  
Jiachao Liang ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Mr Imaging ◽  
Contrast Agent ◽  
Liver Metastases ◽  
Contrast Enhancement ◽  
Colorectal Liver Metastases

Hepatic Resection After Rescue Cetuximab Treatment for Colorectal Liver Metastases Previously Refractory to Conventional Systemic Therapy

2007 ◽  
Vol 25 (29) ◽  
pp. 4593-4602 ◽  
Author(s):  
René Adam ◽  
Thomas Aloia ◽  
Francis Lévi ◽  
Dennis A. Wicherts ◽  
Robbert J. de Haas ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Postoperative Mortality ◽  
Progression Free Survival ◽  
Resectability Rate ◽  
Heavily Pretreated ◽  
Unresectable Colorectal Liver Metastases ◽  
Pretreated Patients ◽  
The Impact ◽  
Cetuximab Therapy

Purpose In patients with unresectable colorectal liver metastases (CLM) resistant to first-line chemotherapy, the impact of cetuximab therapy on resectability is unknown. This study was performed to determine the post-cetuximab resectability rate and to examine postoperative outcomes for these heavily pretreated patients. Patients and Methods From February 2004 to April 2006, we evaluated 151 patients with unresectable CLM resistant to initial chemotherapy and subsequently treated with systemic cetuximab. Resectability rates, patient outcomes, and tumoral and nontumoral liver pathology were assessed. Results A total of 27 patients underwent surgery after a median of six cycles of cetuximab + irinotecan (20 of 27), oxaliplatin (four of 27), or both (one of 27). Eighteen patients (67%) had experienced treatment failure after at least two lines of chemotherapy before cetuximab. Twenty-five of the 27 patients who had surgery underwent hepatectomy: nine of 133 patients who were treated completely at our institution (resectability rate, 7%) and 16 of 18 patients who were referred from other institutions after systemic cetuximab therapy. Postoperative mortality was 3.7% (one of 27), with a complication rate of 50%. Histopathologic liver abnormalities were found in nine patients (36%), without specific lesions attributable to cetuximab. After median follow-up of 16 months, 23 of 25 patients who underwent resection (92%) were alive, and 10 patients (40%) were disease free. Median overall (OS) and progression-free survival (PFS) from initiation of cetuximab therapy were 20 and 13 months, respectively. Conclusion For CLM refractory to conventional chemotherapy, combination therapy with cetuximab increases resectability rates without increasing operative mortality or liver injury. The median OS and PFS of 20 and 13 months, respectively, suggest that this novel oncosurgical strategy benefits patients with previously refractory disease who respond subsequently to cetuximab.

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