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Huang H, Qiao H, Jiang J, Yan J, Wen Q, Gen D, Wu Q. T1 relaxation time analysis in predicting hepatic dysfunction and prognosis in patients with HCC undergoing transarterial chemoembolization. Eur J Radiol 2023; 165:110938. [PMID: 37392548 DOI: 10.1016/j.ejrad.2023.110938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/04/2023] [Accepted: 06/17/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVE To evaluate the value of T1 mapping in predicting hepatic dysfunction and prognosis in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). MATERIAL AND METHODS 100 consecutive patients with treatment-naive HCC treated with TACE were prospectively analyzed. Clinical, laboratory, and MRI parameters (liver and tumor T1 relaxation times (T1L, T1T)) before and/or following TACE were measured and calculated. Clinical parameters included the Child-Turcotte-Pugh (CTP) classification, Barcelona Clinic Liver Cancer Classification (BCLC) criteria, and albumin-bilirubin (ALBI) score. Laboratory parameters were the gold standard for hepatic dysfunction. T1L and T1T were combined by stepwise multivariate logistic regression to yield a T1-related probability index (T1com) for further analysis. Study endpoints included hepatic dysfunction and progression-free survival (PFS) rate. RESULTS 38 patients (38%) were diagnosed with hepatic dysfunction following TACE. There was no significant difference in clinical parameters between the groups with and without hepatic dysfunction. Logistic regression analysis showed that T1L and T1T were independent risk factors for assessing hepatic dysfunction. T1com showed a better AUC than T1L and T1T (0.81 vs. 0.76 and 0.69, P = 0.007 and 0.006). Patients with low T1com (≤0.42) showed a better median PFS than patients with high T1com (>0.42) (167.0 vs. 215.9 days, P = 0.010). In comparison, CTP, BCLC, and ALBI scores were not statistically significant in predicting PFS in HCC patients treated with TACE (P > 0.05). CONCLUSION Compared with widely used clinical parameters, T1 was more capable of predicting hepatic dysfunction after TACE. Stratification of patients with HCC undergoing TACE according to T1 may help clinicians to develop treatment strategies in preventing the occurrence of hepatic dysfunction and improving individual prognoses.
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Affiliation(s)
- Hong Huang
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Hongyan Qiao
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Jianwei Jiang
- Department of Interventional Radiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Jian Yan
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Qingqing Wen
- GE Healthcare, MR Research China, Beijing, China
| | - Da Gen
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Qinghua Wu
- Department of Interventional Radiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214122, China.
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Yang S, Zhang Z, Su T, Chen Q, Wang H, Jin L. Comparison of quantitative volumetric analysis and linear measurement for predicting the survival of Barcelona Clinic Liver Cancer 0- and A stage hepatocellular carcinoma after radiofrequency ablation. Diagn Interv Radiol 2023; 29:450-459. [PMID: 37154818 PMCID: PMC10679614 DOI: 10.4274/dir.2023.222055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/13/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE The prognostic role of the tumor volume in patients with hepatocellular carcinoma (HCC) at the Barcelona Clinic Liver Cancer (BCLC) 0 and A stages remains unclear. This study aims to compare the volumetric measurement with linear measurement in early HCC burden profile and clarify the optimal cut-off value of the tumor volume. METHODS The consecutive patients diagnosed with HCC who underwent initial and curative-intent radiofrequency ablation (RFA) were included retrospectively. The segmentation was performed semi-automatically, and enhanced tumor volume (ETV) as well as total tumor volume (TTV) were obtained. The patients were categorized into high- and low-tumor burden groups according to various cutoff values derived from commonly used diameter values, X-tile software, and decision-tree analysis. The inter- and intra-reviewer agreements were measured using the intra-class correlation coefficient. Univariate and multivariate time-to-event Cox regression analyses were performed to identify the prognostic factors of overall survival. RESULTS A total of 73 patients with 81 lesions were analyzed in the whole cohort with a median follow-up of 31.0 (interquartile range: 16.0–36.3). In tumor segmentation, excellent consistency was observed in intra- and inter-reviewer assessments. There was a strong correlation between diameter-derived spherical volume and ETV as well as ETV and TTV. As opposed to all linear candidates and 4,188 mm3 (sphere equivalent to 2 cm in diameter), ETV >14,137 mm3 (sphere equivalent to 3 cm in diameter) or 23,000 mm3 (sphere equivalent to 3.5 cm in diameter) was identified as an independent risk factor of survival. Considering the value of hazard ratio and convenience to use, when ETV was at 23,000 mm3, it was regarded as the optimal volumetric cut-off value in differentiating survival risk. CONCLUSION The volumetric measurement outperforms linear measurement on tumor burden evaluation for survival stratification in patients at BCLC 0 and A stages HCC after RFA.
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Affiliation(s)
- Siwei Yang
- Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhiyuan Zhang
- Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Tianhao Su
- Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qiyang Chen
- Department of Ultrasound, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Haochen Wang
- Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Long Jin
- Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Moawad AW, Morshid A, Khalaf AM, Elmohr MM, Hazle JD, Fuentes D, Badawy M, Kaseb AO, Hassan M, Mahvash A, Szklaruk J, Qayyum A, Abusaif A, Bennett WC, Nolan TS, Camp B, Elsayes KM. Multimodality annotated hepatocellular carcinoma data set including pre- and post-TACE with imaging segmentation. Sci Data 2023; 10:33. [PMID: 36653372 PMCID: PMC9849450 DOI: 10.1038/s41597-023-01928-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/03/2023] [Indexed: 01/19/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver neoplasm, and its incidence has doubled over the past two decades owing to increasing risk factors. Despite surveillance, most HCC cases are diagnosed at advanced stages and can only be treated using transarterial chemo-embolization (TACE) or systemic therapy. TACE failure may occur with incidence reaching up to 60% of cases, leaving patients with a financial and emotional burden. Radiomics has emerged as a new tool capable of predicting tumor response to TACE from pre-procedural computed tomography (CT) studies. This data report defines the HCC-TACE data collection of confirmed HCC patients who underwent TACE and have pre- and post-procedure CT imaging studies and available treatment outcomes (time-to-progression and overall survival). Clinically curated segmentation of pre-procedural CT studies was done for the purpose of algorithm training for prediction and automatic liver tumor segmentation.
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Affiliation(s)
- Ahmed W Moawad
- Departments of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
- Department of radiology, Mercy catholic medical center, Darby, PA, 19023, USA.
| | - Ali Morshid
- Departments of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - Ahmed M Khalaf
- Departments of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Mohab M Elmohr
- Departments of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
- Department of radiology, Baylor college of medicine, TX, 77030, Houston, USA.
| | - John D Hazle
- Departments of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - David Fuentes
- Departments of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - Mohamed Badawy
- Departments of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Ahmed O Kaseb
- Departments of Gastrointestinal Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - Manal Hassan
- Departments of Gastrointestinal Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - Armeen Mahvash
- Departments of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Janio Szklaruk
- Departments of Body Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - Aliyya Qayyum
- Departments of Body Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Abdelrahman Abusaif
- Departments of Body Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - William C Bennett
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
| | - Tracy S Nolan
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
| | - Brittney Camp
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
| | - Khaled M Elsayes
- Departments of Body Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
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Hong H, Jianwei J, Qinhua W, Yunjuan Y, Chen G, Jiaqin L. Effects of Interventional Therapy on Liver Metastases-Measurement of Liver Volume by Abdominal Computed Tomography. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To evaluate the effects of transhepatic arterial infusion (TAI) with transcatheter arterial embolization (TAE) on liver volume of patients with liver metastases, by liver volumetry using 256-slice CT (iCT 256, Philips Healthcare). Methods: A retrospective analysis
of 19 patients with liver metastases, who received combination treatment of TAI with TAE, were conducted. Residual liver volumes (LV) were measured before (LV0), after the first (LV1) and the second treatment (LV2) with iCT 256. Bland-Altman method was used
to evaluate the agreements of residual liver volume between two reviewers. Residual liver volume changes were compared by One-Way ANOVA. Results: For the first reviewer, LV0, LV1, LV2 were: 872.67±139.31, 960.63±143.91, 842.13±141.45
cc. LV1 > LV0, but the difference was not significant (P = 0.061). LV2 < LV0, the difference was statistically significant (P = 0.013). LV2 < LV0, and the difference was not statistically significant (P
= 0.509). For the second reviewer, LV0, LV1, LV2 were: 909.99±135.46, 996.36±180.10, 845.70±131.632 cc. LV1 > LV0, the difference was not statistically significant (P = 0.083). LV2 < LV1,
the difference was statistically significant (P = 0.003). LV2 < LV0, the difference was not statistically significant (P = 0.194). Conclusion: Combination treatment of TAI with TAE did not induce significant liver damage in patients with metastatic
liver cancer, and iCT256 volumetry provided a precise measurement of liver volume and may play a critical role in the development of interventional surgery.
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Affiliation(s)
- Huang Hong
- Department of Radiology, Affiliated Hospital of Jiang Nan University, Wuxi 214040, China
| | - Jiang Jianwei
- Department of Radiology, Affiliated Hospital of Jiang Nan University, Wuxi 214040, China
| | - Wu Qinhua
- Department of Radiology, Affiliated Hospital of Jiang Nan University, Wuxi 214040, China
| | - Yin Yunjuan
- Department of Radiology, Affiliated Hospital of Jiang Nan University, Wuxi 214040, China
| | - Gu Chen
- Department of Radiology, Affiliated Hospital of Jiang Nan University, Wuxi 214040, China
| | - Lu Jiaqin
- Department of Radiology, Affiliated Hospital of Jiang Nan University, Wuxi 214040, China
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