Response Assessment by Volumetric Iodine Uptake Measurement: Preliminary Experience in Patients with Intermediate-Advanced Hepatocellular Carcinoma Treated with Yttrium-90 Radioembolization

Journal Article · Sat Sep 15 04:00:00 EDT 2018 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-018-1962-8· OSTI ID:22749818

Bargellini, Irene; Crocetti, Laura; Turini, Francesca Maria; Lorenzoni, Giulia ^[1]; Boni, Giuseppe ^[2]; Traino, Antonio Claudio ^[3]; Caramella, Davide; Cioni, Roberto ^[1]

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1. Pisa University Hospital, Department of Diagnostic and Interventional Radiology (Italy)
2. Pisa University Hospital, Department of Nuclear Medicine (Italy)
3. Pisa University Hospital, Department of Health Physics (Italy)

PurposeTo retrospectively compare early response to yttrium-90 radioembolization (Y90) according to volumetric iodine uptake (VIU) changes, Response Evaluation Criteria In Solid Tumor 1.1 (RECIST 1.1) and modified RECIST (mRECIST) in patients with intermediate-advanced hepatocellular carcinoma (HCC) and to explore their association with survival.Materials and MethodsTwenty-four patients treated with Y90 and evaluated with dual-energy computed tomography before and 6 weeks after treatment were included. VIU was measured on late arterial phase spectral images; 6-week VIU response was defined as: complete response (CR, absence of enhancing tumor), partial response (PR, ≥ 15% VIU reduction), progressive disease (PD, ≥ 10% VIU increase) and stable disease (criteria of CR/PR/PD not met). RECIST 1.1 and mRECIST were evaluated at 6 weeks and 6 months. Responders included CR and PR. Overall survival (OS) was evaluated by Kaplan–Meier analysis and compared by Cox regression analysis.ResultsHigh intraobserver and interobserver agreements were observed in VIU measurements (k > 0.98). VIU identified a higher number of responders (18 patients, 75%), compared to RECIST 1.1 (12.5% at 6 weeks and 23.8% at 6 months) and mRECIST (29.2% at 6 weeks and 61.9% at 6 months). There was no significant correlation between OS and RECIST 1.1 (P = 0.45 at 6 weeks; P = 0.21 at 6 months) or mRECIST (P = 0.38 at 6 weeks; P = 0.79 at 6 months); median OS was significantly higher in VIU responders (17.2 months) compared to non-responders (7.4 months) (P = 0.0022; HR 8.85; 95% CI 1.29–88.1).ConclusionVIU is highly reproducible; as opposite to mRECIST and RECIST 1.1, early VIU response correlates with OS after Y90 in intermediate-advanced HCC patients.

• OSTI ID: 22749818
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 9 Vol. 41; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
COMPUTERIZED TOMOGRAPHY
HEPATOMAS
IMAGE PROCESSING
IODINE
PATIENTS
RADIOEMBOLIZATION
REGRESSION ANALYSIS
YTTRIUM 90