Computed tomography perfusion imaging for monitoring transarterial chemoembolization of hepatocellular carcinoma

• Verfasst von: Marquez, Herman [VerfasserIn]
• Verfasst von: Haubenreisser, Holger [VerfasserIn]
• Verfasst von: Henzler, Thomas [VerfasserIn]
• Titel: Computed tomography perfusion imaging for monitoring transarterial chemoembolization of hepatocellular carcinoma
• Verf.angabe: Herman P. Marquez, Amar Karalli, Holger Haubenreisser, Rishi P. Mathew, Hatem Alkadhi, Torkel B. Brismar, Thomas Henzler, Michael A. Fischer
• E-Jahr: 2017
• Jahr: 24 March 2017
• Umfang: 8 S.
• Fussnoten: Gesehen am 09.10.2018
• Titel Quelle: Enthalten in: European journal of radiology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1990
• Jahr Quelle: 2017
• Band/Heft Quelle: 91(2017), Seite 160-167
• ISSN Quelle: 1872-7727
• DOI: doi:10.1016/j.ejrad.2017.03.014
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Computed tomography
• Sach-SW: Hepatocellular carcinoma
• Sach-SW: Perfusion imaging
• Sach-SW: Transarterial chemoembolization
• Sach-SW: Treatment outcome
• K10plus-PPN: 1581674732

Abstract

Purpose: To prospectively monitor changes in tumor perfusion of hepatocellular carcinoma (HCC) in response to doxorubicin-eluted bead based transarterial chemoembolization (DEB-TACE) using perfusion-CT (P-CT). Methods and materials: 24 patients (54-79 years) undergoing P-CT before and shortly after DEB-TACE of HCC were prospectively included in this dual-center study. Two readers determined arterial-liver-perfusion (ALP, mL/min/100mL), portal-venous-perfusion (PLP, mL/min/100mL) and the hepatic-perfusion-index (HPI, %) by placing matched regions-of-interests within each HCC before and after DEB-TACE. Imaging follow-up was used to determine treatment response and to distinguish complete from incomplete responders. Performance of P-CT for prediction and early response assessment was determined using receiver-operating-characteristics curve analysis. Results: Interreader agreement was fair to excellent (ICC, 0.716-0.942). PLP before DEB-TACE was significantly higher in pre-treated vs non-treated lesions (P<0.05). Mean changes of ALP, PLP and HPI from before to after DEB-TACE were −55%, +24% and −27%. ALP and HPI after DEB-TACE were correlating with response-grades (r=0.45/0.48; both, p<0.04), showing an area-under-the-curve (AUC) of 0.74 and 0.80 respectively for identification of complete response. Conclusion: High arterial and low portal-venous perfusion of HCC early after DEB-TACE indicates incomplete response with good diagnostic accuracy.