C-arm computed tomography and volume perfusion computed tomography VPCT-based assessment of blood volume changes in hepatocellular carcinoma in prediction of midterm tumor response to transarterial chemoembolization: a single centReport as inadecuate




C-arm computed tomography and volume perfusion computed tomography VPCT-based assessment of blood volume changes in hepatocellular carcinoma in prediction of midterm tumor response to transarterial chemoembolization: a single cent - Download this document for free, or read online. Document in PDF available to download.

Cancer Imaging

, 16:30

First Online: 21 September 2016Received: 08 June 2016Accepted: 02 September 2016DOI: 10.1186-s40644-016-0088-y

Cite this article as: Syha, R., Gatidis, S., Grözinger, G. et al. Cancer Imaging 2016 16: 30. doi:10.1186-s40644-016-0088-y

Abstract

BackgroundThis study aims to evaluate immediate changes in perfusion parameters in hepatocellular carcinoma HCC to transarterial chemoembolization TACE in C-arm computed tomography CT and volume perfusion CT VPCT and prediction of midterm tumor response.

MethodsTwenty-five patients median age 66, range 61 to 75 years with 62 HCC lesions undergoing TACE received immediate pre- and post-interventional assessment by C-arm CT and VPCT. Cross-sectional imaging was analyzed at baseline and approximately 12 weeks after TACE according to modified RECIST criteria. Outcome was defined as objective response OR, > 30 % reduction of viable tumor or non-OR. Perfusion parameters were evaluated in C-arm CT parenchymal blood volume PBV and VPCT blood volume BV and blood flow BF. Ratios of perfusion parameters before and after TACE within the tumor and the non-affected liver parenchyma were calculated.

ResultsCorrelation between tumor PBV and BV revealed a moderate correlation rho = 0.45, p = 0.005. In non-affected liver parenchyma, a significant decrease in PBV was seen, compared to a significant increase in BF and BV. Perfusion ratios in HCC lesions were significantly p < 0.05 increased in OR group compared to non-OR patients in C-arm CT and VPCT: PBV ratio 0.95 0.06 to 0.67 0.38, BV ratio 0.63 0.34 to 0.15 0.6, and BF ratio 0.6 0.32 to 0.22 0.51. Logistic regression including PBV and BF allowed prediction of OR sensitivity 88 %-specificity of 83 %.

ConclusionsPerfusion parameters acquired by C-arm CT and VPCT cannot simply be substituted by each other, but show similar capability in prediction of midterm tumor response.

KeywordsHepatocellular carcinoma Transarterial chemoembolization Drug eluting beads Volume perfusion computed tomography C-arm computed tomography Parenchymal blood volume Treatment monitoring AbbreviationsALPArterial liver perfusion

BFBlood flow

BVBlood volume

C2Cobra

CRComplete response

CSICross-sectional imaging

CTComputed tomography

DDeconvulation

DEBDrug eluting beads

HCCHepatocellular carcinoma

HPIHepatic perfusion index

MIPMaximum intensity projections

mRECISTModified response evaluation criteria in solid tumors

MRIMagnetic resonance imaging

MSMaximum slope model

ORObjective response

PPatlak analysis

PBVParenchymal blood volume

PDProgressive disease

PRPartial response

PVPPortal vein perfusion

ROCReceiver operating curve

ROIRegion of interest

SDStable disease

SIM1Sidewinder

TACETransarterial chemoembolization

VOIVolume of interest

VPCTVolume perfusion CT

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Author: Roland Syha - Sergios Gatidis - Gerd Grözinger - Ulrich Grosse - Michael Maurer - Lars Zender - Marius Horger - Konstantin

Source: https://link.springer.com/







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