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KMID : 0880420190200030449
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Korean Journal of Radiology
2019 Volume.20 No. 3 p.449 ~ p.458
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Evaluation of Early Response to Treatment of Hepatocellular Carcinoma with Yttrium-90 Radioembolization Using Quantitative Computed Tomography Analysis
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Kim Sung-Won
Kim Do-Young
An Chan-Sik
Han Kyung-Hwa
Won Jong-Yun
Kim Gyoung-Min
Kim Myeong-Jin
Choi Jin-Young
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Abstract
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Objective: To identify an imaging predictor for the assessment of early treatment response to yttrium-90 transarterial radioembolization (TARE) in patients with hepatocellular carcinoma (HCC), using a quantitative assessment of dynamic computed tomography (CT) images.
Materials and Methods: Dynamic contrast-enhanced CT was obtained pre- and 4 weeks post-TARE in 44 patients (34 men, 10 women; mean age, 60 years) with HCC. Computer software was developed for measuring the percentage increase in the combined delayed-enhancing area and necrotic area (pD + N) and the percentage increase in the necrotic area (pNI) in the tumor-containing segments pre- and post-TARE. Local progression-free survival (PFS) was compared between patient groups using Cox regression and Kaplan-Meier analyses.
Results: Post-TARE HCC with pD + N ≥ 35.5% showed significantly longer PFS than those with pD + N < 35.5% (p = 0.001). The local tumor progression hazard ratio was 17.3 (p = 0.009) for pD + N < 35.5% versus pD + N ≥ 35.5% groups. HCCs with a high pNI tended to have longer PFS, although this difference did not reach statistical significance.
Conclusion: HCCs with a larger pD + N are less likely to develop local progression after TARE.
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KEYWORD
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Hepatocellular carcinoma, Computed tomography, Treatment outcome, Response, Yttrium radioisotopes, Quantitative analysis
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