Sequential dual-phase cone-beam CT is able to intra-procedurally predict the one-month treatment outcome of multi-focal HCC, in course of degradable starch microsphere TACE.
Aged
Aged, 80 and over
Antibiotics, Antineoplastic
/ administration & dosage
Carcinoma, Hepatocellular
/ diagnostic imaging
Chemoembolization, Therapeutic
/ methods
Cone-Beam Computed Tomography
/ methods
Epirubicin
/ administration & dosage
Female
Humans
Liver Neoplasms
/ diagnostic imaging
Male
Microspheres
Middle Aged
Prognosis
Prospective Studies
ROC Curve
Radiography, Interventional
/ methods
Response Evaluation Criteria in Solid Tumors
Sensitivity and Specificity
Starch
/ therapeutic use
Statistics, Nonparametric
Time Factors
Treatment Outcome
Carcinoma, Hepato-cellular
Cone-beam CT
Embolization
RECIST
Therapeutic
Journal
La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
23
01
2019
accepted:
23
08
2019
pubmed:
2
9
2019
medline:
20
12
2019
entrez:
2
9
2019
Statut:
ppublish
Résumé
To evaluate the prognostic value of sequential dual-phase CBCT (DP-CBCT) imaging performed during degradable starch microsphere TACE (DSM-TACE) session in predicting the HCC's response to treatment, evaluate with modify response evaluation criteria in solid tumours (mRECIST) at 1-month multi-detector CT (MDCT) follow-up. Between January and May 2018, 24 patients (68.5 ± 8.5 year [45-85]) with HCC lesions (n = 96 [average 4/patient]) were prospectively enrolled. Imaging assessment included: pre-procedural MDCT, intra-procedural DP-CBCT performed before first and second DSM-TACEs and 1-month follow-up MDCT. Lesions' attenuation/pseudo-attenuation was defined as average value measured on ROIs (HU for MDCT; arbitrary unit called HU* for CBCT). Lesions' attenuation modification was correlated with the post-procedural mRECIST criteria at 1-month MDCT. Eighty-two DSM-TACEs were performed. Lesion's attenuation values were: pre-procedural MDCT arterial phase (AP) 107.00 HU (CI 95% 100.00-115.49), venous phase (VP) 85.00 HU (CI 95% 81.13-91.74); and lesion's pseudo-attenuation were: first CBCT-AP 305.00 HU* (CI 95% 259.77-354.04), CBCT-VP 155.00 HU* (CI 95% 135.00-163.34). For second CBCT were: -AP 210.00 HU* (CI 95% 179.47-228.58), -VP 141.00 HU* (CI 95% 125.47-158.11); and for post-procedural MDCT were: -AP 95.00 HU (CI 95% 81.35-102.00), -VP 83.00 HU (CI 95% 78.00-88.00). ROC curve analysis showed that a higher difference pseudo-attenuation between first and second DP-CBCTs is related to treatment response. The optimal cut-off value of the difference between first and second CBCT-APs to predict complete response, objective response (complete + partial response) and overall disease control (objective response + stable disease) were > 206 HU* (sensitivity 80.0%, specificity 81.7%), > 72 HU* (sensitivity 79.5%, specificity 83.0%) and > - 7 HU* (sensitivity 91.6%, specificity 65.4%), respectively. DP-CBCT can predict intra-procedurally, by assessing lesion pseudo-attenuation modification, the DSM-TACE 1-month treatment outcome.
Identifiants
pubmed: 31473930
doi: 10.1007/s11547-019-01076-y
pii: 10.1007/s11547-019-01076-y
doi:
Substances chimiques
Antibiotics, Antineoplastic
0
degradable starch microspheres
0
Epirubicin
3Z8479ZZ5X
Starch
9005-25-8
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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