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Title: 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?

Abstract

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 imagesmore » 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.« less

Authors:
 [1];  [2];  [1];  [2];  [1];  [3];  [2];  [1];  [2]
  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)
Publication Date:
OSTI Identifier:
22756193
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 41; Journal Issue: 3; Other Information: Copyright (c) 2018 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2017 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOLOGICAL MARKERS; COMPUTERIZED TOMOGRAPHY; HEPATOMAS; MULTIVARIATE ANALYSIS; ONE-DIMENSIONAL CALCULATIONS; PATIENTS; THREE-DIMENSIONAL LATTICES; TWO-DIMENSIONAL SYSTEMS

Citation Formats

Zhao, Yan, Duran, Rafael, Bai, Wei, Sahu, Sonia, Wang, Wenjun, Kabus, Sven, Lin, MingDe, Han, Guohong, and Geschwind, Jean-François. 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?. United States: N. p., 2018. Web. doi:10.1007/S00270-017-1829-4.
Zhao, Yan, Duran, Rafael, Bai, Wei, Sahu, Sonia, Wang, Wenjun, Kabus, Sven, Lin, MingDe, Han, Guohong, & Geschwind, Jean-François. 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?. United States. doi:10.1007/S00270-017-1829-4.
Zhao, Yan, Duran, Rafael, Bai, Wei, Sahu, Sonia, Wang, Wenjun, Kabus, Sven, Lin, MingDe, Han, Guohong, and Geschwind, Jean-François. Thu . "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?". United States. doi:10.1007/S00270-017-1829-4.
@article{osti_22756193,
title = {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?},
author = {Zhao, Yan and Duran, Rafael and Bai, Wei and Sahu, Sonia and Wang, Wenjun and Kabus, Sven and Lin, MingDe and Han, Guohong and Geschwind, Jean-François},
abstractNote = {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.},
doi = {10.1007/S00270-017-1829-4},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 3,
volume = 41,
place = {United States},
year = {2018},
month = {3}
}