Hug sign in intraprocedural cone-beam-CT to predict short-term response to combined treatment of hepatocellular carcinoma.

Ablation Chemoembolization Combined treatment Hepatocellular carcinoma Response prediction

Journal

La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625

Informations de publication

Date de publication:
21 Mar 2024
Historique:
received: 21 10 2023
accepted: 14 02 2024
medline: 21 3 2024
pubmed: 21 3 2024
entrez: 21 3 2024
Statut: aheadofprint

Résumé

Combined treatment of ablation and chemoembolization for hepatocellular carcinoma represents a promising therapy to increase treatment efficacy and improve patient survival. The "hug sign" is a recently introduced radiological sign consisting in deposition of beads/contrast agent during transarterial chemoembolization in the hyperemic area surrounding the post-ablation volume, seen during intraprocedural unenhanced cone-beam CT, that may indicate intraprocedural success. Aim of our retrospective study was to analyze the usefulness of the "hug sign" at the intraprocedural unenhanced cone-beam CT as an early predictor of response to combined treatment, based on the hug sign angle. Between January 2017 and September 2021 all patients with hepatocellular carcinoma which underwent a combined treatment of thermal ablation followed by chemoembolization were enrolled. All treated patients underwent immediate post-procedural unenhanced cone-beam CT to evaluate the deposition of contrast agent, lipiodol or radiopaque beads and to assess the percentage of coverage of the ablated area with the contrast agent (hug sign angle). Patients with missing pre-procedural, intra-procedural and/or post-procedural data/imaging, or with poor-quality post-procedural cone-beam CT images were excluded. 128 patients (mean age, 69.3 years ± 1.1 [standard deviation]; 87 men) were evaluated. Our study evidenced that 84.4% (81/85) of patients with a hug sign angle of 360° had no residual tumor at the first 1-/3-months follow-up examination. A hug sign angle of 360° also showed to be an independent protective factor against residual tumor at multivariate analysis. Unenhanced cone-beam CT performed at the end of a combined treatment with ablation plus chemoembolization can effectively predict an early treatment response on radiological images, when a hug sign angle of 360° was detected.

Identifiants

DOI: 10.1007/s11547-024-01805-y PMID: 38512624
pubmed: 38512624
doi: 10.1007/s11547-024-01805-y
pii: 10.1007/s11547-024-01805-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

Enza Genco (E)
Gabriella Brizi (G)
Francesco Cellini (F)
Laura Riccardi (L)
Nicoletta De Matthaeis (N)
Marco Biolato (M)
Luca Miele (L)
Lucia Cerrito (L)
Fabrizio Pizzolante (F)
Antonio Grieco (A)
Gian Ludovico Rapaccini (GL)
Giuseppe Marrone (G)
Matteo Garcovich (M)
Alfonso Wolfango Avolio (AW)
Francesco Ardito (F)
Gabriele Spoletini (G)
Salvatore Agnes (S)
Maria Vellone (M)

Informations de copyright

© 2024. The Author(s).

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Auteurs

Roberto Iezzi (R)

Department of Diagnostic Imaging, Oncologic Radiotherapy, and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.Go A. Gemelli 8, 00168, Rome, Italy. roberto.iezzi.md@gmail.com.
Università Cattolica del Sacro Cuore, Rome, Italy. roberto.iezzi.md@gmail.com.
U.O.C. Radiologia d'Urgenza e Interventistica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy. roberto.iezzi.md@gmail.com.
ORCID: 0000-0002-2791-481X

Alessandro Posa (A)

Department of Diagnostic Imaging, Oncologic Radiotherapy, and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.Go A. Gemelli 8, 00168, Rome, Italy.
U.O.C. Radiologia d'Urgenza e Interventistica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy.

Iacopo Valente (I)

Department of Diagnostic Imaging, Oncologic Radiotherapy, and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.Go A. Gemelli 8, 00168, Rome, Italy.

Andrea Contegiacomo (A)

Department of Diagnostic Imaging, Oncologic Radiotherapy, and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.Go A. Gemelli 8, 00168, Rome, Italy.
U.O.C. Radiologia d'Urgenza e Interventistica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy.

Maria Assunta Zocco (MA)

Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Maurizio Pompili (M)

Università Cattolica del Sacro Cuore, Rome, Italy.
Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Brigida Eleonora Annicchiarico (BE)

Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Francesca Romana Ponziani (FR)

Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Michele Basso (M)

Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Shraga Nahum Goldberg (SN)

Division of Image-Guided Therapy, Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.

Felice Giuliante (F)

Università Cattolica del Sacro Cuore, Rome, Italy.
Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Antonio Gasbarrini (A)

Università Cattolica del Sacro Cuore, Rome, Italy.
Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Evis Sala (E)

Department of Diagnostic Imaging, Oncologic Radiotherapy, and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.Go A. Gemelli 8, 00168, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Classifications MeSH