Which Criteria Applied in Multi-Phasic CT Can Predict Early Tumor Response in Patients with Hepatocellular Carcinoma Treated Using Conventional TACE: RECIST, mRECIST, EASL or qEASL?

Journal Article · Thu Mar 15 04:00:00 EDT 2018 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-017-1829-4· OSTI ID:22756193

Zhao, Yan ^[1]; Duran, Rafael ^[2]; Bai, Wei ^[1]; Sahu, Sonia ^[2]; Wang, Wenjun ^[1]; Kabus, Sven ^[3]; Lin, MingDe ^[2]; Han, Guohong ^[1]; Geschwind, Jean-François ^[2]

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1. Fourth Military Medical University, Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases (China)
2. Yale University School of Medicine, Department of Radiology and Biomedical Imaging (United States)
3. Philips Research Hamburg (Germany)

PurposeOur study aimed to evaluate quantitative tumor response assessment (quantitative EASL-[qEASL]) on computed tomography (CT) images in patients with hepatocellular carcinoma (HCC) treated using conventional transarterial chemoembolization (cTACE), compared to existing 1-dimensional and 2-dimensional methods (RECIST, mRECIST, EASL).Materials and MethodsIn this IRB-approved, single-institution retrospective cohort study, 52 consecutive patients with intermediate-stage HCC were consecutively included. All patients underwent contrast-enhanced CT scan at baseline and 4 weeks after cTACE.ResultsMedian follow-up period was 13.5 months (range 1.2–54.1). RECIST, mRECIST and EASL identified progression in 2 (4%), 1 (2%) and 1 (2%) patients, respectively, whereas qEASL identified 10 (19%) patients. qEASL was the only tumor response method able to predict survival among different tumor response groups (P < 0.05), whereas RECIST, mRECIST and EASL did not (P > 0.05). Both EASL and qEASL were able to identify responders and non-responders and were predictive of survival (P < 0.05). Multivariate analysis showed that progression was an independent predictor of overall survival with hazard ratio of 1.9 (P = 0.025). Patients who demonstrated progression with qEASL had significantly shorter survival than those with non-progression (7.6 vs. 20.4 months, P = 0.012). Similar multivariate analysis using RECIST, mRECIST and EASL could not be performed because too few patients were categorized as progressive disease.ConclusionqEASL could be applied on CT images to assess tumor response following cTACE and is a more sensitive biomarker to predict survival and identify tumor progression than RECIST, mRECIST and EASL at an early time point.Level of EvidenceLevel 2a, retrospective cohort study.

• OSTI ID: 22756193
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 3 Vol. 41; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOLOGICAL MARKERS
COMPUTERIZED TOMOGRAPHY
HEPATOMAS
MULTIVARIATE ANALYSIS
ONE-DIMENSIONAL CALCULATIONS
PATIENTS
THREE-DIMENSIONAL LATTICES
TWO-DIMENSIONAL SYSTEMS