1
|
Ghabili K, Windham-Herman AM, Konstantinidis M, Murali N, Borde T, Adam LC, Laage-Gaupp F, Lin M, Chapiro J, Georgiades C, Nezami N. Outcomes of repeat conventional transarterial chemoembolization in patients with liver metastases. Ann Hepatol 2024; 29:101529. [PMID: 39033928 DOI: 10.1016/j.aohep.2024.101529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 06/18/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION AND OBJECTIVES Although unlimited sessions of conventional transarterial chemoembolization (cTACE) may be performed for liver metastases, there is no data indicating when treatment becomes ineffective. This study aimed to determine the optimal number of repeat cTACE sessions for nonresponding patients before abandoning cTACE in patients with liver metastases. MATERIALS AND METHODS In this retrospective, single-institutional analysis, patients with liver metastases from neuroendocrine tumors (NET), colorectal carcinoma (CRC), and lung cancer who underwent consecutive cTACE sessions from 2001 to 2015 were studied. Quantitative European Association for Study of the Liver (qEASL) criteria were utilized for response assessment. The association between the number of cTACE and 2-year, 5-year, and overall survival was evaluated to estimate the optimal number of cTACE for each survival outcome. RESULTS Eighty-five patients underwent a total of 186 cTACE sessions for 117 liver metastases, of which 30.7 % responded to the first cTACE. For the target lesions that did not respond to the first, second, and third cTACE sessions, response rates after the second, third, and fourth cTACE sessions were 33.3 %, 23 %, and 25 %, respectively. The fourth cTACE session was the optimal number for 2-year survival (HR 0.40; 95 %CI: 0.16-0.97; p = 0.04), 5-year survival (HR 0.31; 95 %CI: 0.11-0.87; p = 0.02), and overall survival (HR 0.35; 95 %CI: 0.13-0.89; p = 0.02). CONCLUSIONS Repeat cTACE in the management of liver metastases from NET, CRC, and lung cancer was associated with improved patient survival. We recommend at least four cTACE sessions before switching to another treatment for nonresponding metastatic liver lesions.
Collapse
Affiliation(s)
- Kamyar Ghabili
- Department of Radiology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA; Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Austin-Marley Windham-Herman
- Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Interventional Radiology, University of California San Diego, La Jolla, California, USA
| | - Menelaos Konstantinidis
- Institute of Health Policy, Management and Evaluation, University of Toronto, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Canada
| | - Nikitha Murali
- Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA; Section of Interventional Radiology, Department of Radiology, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tabea Borde
- Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Neurology and Experimental Neurology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Charité Campus Benjamin Franklin (CBF), Berlin, Germany
| | - Lucas C Adam
- Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Neurology and Experimental Neurology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Charité Campus Benjamin Franklin (CBF), Berlin, Germany
| | - Fabian Laage-Gaupp
- Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - MingDe Lin
- Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Julius Chapiro
- Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Christos Georgiades
- Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Nariman Nezami
- Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA; Division of Vascular and Interventional Radiology, Department of Radiology, Medstar Georgetown Hospital, Washington, DC, USA; Georgetown University School of Medicine, Washington, DC, USA; Lombardi Comprehensive Cancer Center, Washington, DC, USA.
| |
Collapse
|
2
|
Yang CC, Lin KW. Improving the detection of hypo-vascular liver metastases in multiphase contrast-enhanced CT with slice thickness less than 5 mm using DenseNet. Radiography (Lond) 2024; 30:759-769. [PMID: 38458104 DOI: 10.1016/j.radi.2024.02.022] [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: 01/09/2024] [Revised: 02/17/2024] [Accepted: 02/27/2024] [Indexed: 03/10/2024]
Abstract
INTRODUCTION Thinner slices are more susceptible in detecting small lesions but suffer from higher statistical fluctuation. This work aimed to reduce image noise in multiphase contrast-enhanced CT reconstructed with slice thickness thinner than the clinical setting (i.e., 5 mm) using convolutional neural network (CNN) for enabling better detection of hypo-vascular liver metastasis. METHODS A DenseNet model was used to generate noise map for multiphase CT reconstructed with slice thickness of 2.5 mm and 1.25 mm. Image denoising was conducted by subtracting the CNN-generated noise map from CT images with reduced photon flux due to thinner slice thickness. The performance of DenseNet was evaluated on CT scans of electron density phantoms and patients with hypovascular liver metastases less than 1.5 cm in terms of Hounsfield Unit (HU) variation, statistical fluctuation, and contrast-to-noise ratio (CNR). RESULTS The phantom study demonstrated that the CNN-based denoising method was able to reduce statistical fluctuation in CT images reconstructed with slice thickness of 2.5 mm and 1.25 mm without causing significant edge blurring or variation in HU values. With regards to patient study, it was found that the denoised 2.5-mm and 1.25-mm slices had higher CNR than the conventional 5-mm slices for hypo-vascular liver metastases in all 4 phases of multiphase CT. CONCLUSION Our results demonstrated that the detection of hypo-vascular liver metastases in multiphase contrast-enhanced CT with slice thickness less than 5 mm could be improved by using the CNN-based denoising method. IMPLICATIONS FOR PRACTICE Reconstruction slice thickness has a strong influence on the image quality of CT imaging. A CNN-based denoising method was used in this work to reduce the image noise in multiphase contrast-enhanced CT reconstructed with slice thickness less than 5 mm.
Collapse
Affiliation(s)
- C-C Yang
- Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
| | - K-W Lin
- Department of Radiology, E-Da Dachang Hospital, Kaohsiung, Taiwan
| |
Collapse
|
3
|
Safety, Feasibility and Technical Considerations from a Prospective, Observational Study-CIREL: Irinotecan-TACE for CRLM in 152 Patients. J Clin Med 2022; 11:jcm11206178. [PMID: 36294499 PMCID: PMC9604674 DOI: 10.3390/jcm11206178] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/15/2022] [Accepted: 10/16/2022] [Indexed: 11/17/2022] Open
Abstract
CIREL, a prospective, Europe-wide, observational study aimed to assess the real-world feasibility and tolerability of irinotecan-based transarterial chemoembolization (LP-irinotecan TACE) for unresectable colorectal cancer liver metastases with regard to the treatment plan and adverse events (AEs). CIREL enrolled 152 eligible patients (≥18 years) with liver-only or dominant metastases treated with LP-irinotecan TACE following a multidisciplinary tumor board decision. Data were prospectively collected for baseline, the number of planned and performed sessions, and technical information and safety according to CTCAE 4.03/5.0. Results from 351 analyzed treatment sessions showed technical success for 99% of sessions, and 121 patients (79%) completed all planned sessions. Further, 60% of sessions were performed using opioids, 4% intra-arterial anesthetics, and 25% both. Additionally, 60% of patients experienced at least one peri-interventional AE of any grade; 8% of grade 3−4. Occurrence of AEs was related to larger liver-involvement (p < 0.001), bi-lobar disease (p = 0.002), and larger beads (p < 0.001). Using corticosteroids together with antiemetics showed reduced and lower grade vomiting (p = 0.01). LP-irinotecan TACE was tolerated well and had a high proportion of completed treatment plans. This minimally invasive locoregional treatment can be used together with concomitant systemic therapy or ablation.
Collapse
|
4
|
Amini Farsani Z, Schmid VJ. Maximum Entropy Technique and Regularization Functional for Determining the Pharmacokinetic Parameters in DCE-MRI. J Digit Imaging 2022; 35:1176-1188. [PMID: 35618849 PMCID: PMC9582183 DOI: 10.1007/s10278-022-00646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/15/2022] [Accepted: 04/21/2022] [Indexed: 10/31/2022] Open
Abstract
This paper aims to solve the arterial input function (AIF) determination in dynamic contrast-enhanced MRI (DCE-MRI), an important linear ill-posed inverse problem, using the maximum entropy technique (MET) and regularization functionals. In addition, estimating the pharmacokinetic parameters from a DCE-MR image investigations is an urgent need to obtain the precise information about the AIF-the concentration of the contrast agent on the left ventricular blood pool measured over time. For this reason, the main idea is to show how to find a unique solution of linear system of equations generally in the form of [Formula: see text] named an ill-conditioned linear system of equations after discretization of the integral equations, which appear in different tomographic image restoration and reconstruction issues. Here, a new algorithm is described to estimate an appropriate probability distribution function for AIF according to the MET and regularization functionals for the contrast agent concentration when applying Bayesian estimation approach to estimate two different pharmacokinetic parameters. Moreover, by using the proposed approach when analyzing simulated and real datasets of the breast tumors according to pharmacokinetic factors, it indicates that using Bayesian inference-that infer the uncertainties of the computed solutions, and specific knowledge of the noise and errors-combined with the regularization functional of the maximum entropy problem, improved the convergence behavior and led to more consistent morphological and functional statistics and results. Finally, in comparison to the proposed exponential distribution based on MET and Newton's method, or Weibull distribution via the MET and teaching-learning-based optimization (MET/TLBO) in the previous studies, the family of Gamma and Erlang distributions estimated by the new algorithm are more appropriate and robust AIFs.
Collapse
Affiliation(s)
- Zahra Amini Farsani
- Bayesian Imaging and Spatial Statistics Group, Institute of Statistics, Ludwig-Maximilian-Universität München, Ludwigstraße 33, 80539, Munich, Germany. .,Statistics Department, School of Science, Lorestan University, 68151-44316, Khorramabad, Iran.
| | - Volker J Schmid
- Bayesian Imaging and Spatial Statistics Group, Institute of Statistics, Ludwig-Maximilian-Universität München, Ludwigstraße 33, 80539, Munich, Germany
| |
Collapse
|
5
|
Modified Maximum Entropy Method and Estimating the AIF via DCE-MRI Data Analysis. ENTROPY 2022; 24:e24020155. [PMID: 35205451 PMCID: PMC8871336 DOI: 10.3390/e24020155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 02/06/2023]
Abstract
Background: For the kinetic models used in contrast-based medical imaging, the assignment of the arterial input function named AIF is essential for the estimation of the physiological parameters of the tissue via solving an optimization problem. Objective: In the current study, we estimate the AIF relayed on the modified maximum entropy method. The effectiveness of several numerical methods to determine kinetic parameters and the AIF is evaluated—in situations where enough information about the AIF is not available. The purpose of this study is to identify an appropriate method for estimating this function. Materials and Methods: The modified algorithm is a mixture of the maximum entropy approach with an optimization method, named the teaching-learning method. In here, we applied this algorithm in a Bayesian framework to estimate the kinetic parameters when specifying the unique form of the AIF by the maximum entropy method. We assessed the proficiency of the proposed method for assigning the kinetic parameters in the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), when determining AIF with some other parameter-estimation methods and a standard fixed AIF method. A previously analyzed dataset consisting of contrast agent concentrations in tissue and plasma was used. Results and Conclusions: We compared the accuracy of the results for the estimated parameters obtained from the MMEM with those of the empirical method, maximum likelihood method, moment matching (“method of moments”), the least-square method, the modified maximum likelihood approach, and our previous work. Since the current algorithm does not have the problem of starting point in the parameter estimation phase, it could find the best and nearest model to the empirical model of data, and therefore, the results indicated the Weibull distribution as an appropriate and robust AIF and also illustrated the power and effectiveness of the proposed method to estimate the kinetic parameters.
Collapse
|
6
|
Albahri AS, Zaidan AA, Albahri OS, Zaidan BB, Alamoodi AH, Shareef AH, Alwan JK, Hamid RA, Aljbory MT, Jasim AN, Baqer MJ, Mohammed KI. Development of IoT-based mhealth framework for various cases of heart disease patients. HEALTH AND TECHNOLOGY 2021. [DOI: 10.1007/s12553-021-00579-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
7
|
Harder FN, Budjan J, Nickel MD, Grimm R, Pietsch H, Schoenberg SO, Jost G, Attenberger UI. Intraindividual Comparison of Compressed Sensing-Accelerated Cartesian and Radial Arterial Phase Imaging of the Liver in an Experimental Tumor Model. Invest Radiol 2021; 56:433-441. [PMID: 33813577 DOI: 10.1097/rli.0000000000000767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to intraindividually compare the performance of 2 compressed sensing (CS)-accelerated magnetic resonance imaging (MRI) sequences, 1 featuring Cartesian (compressed sensing volumetric interpolated breath-hold examination [CS-VIBE]) and the other radial (golden-angle radial sparse parallel [GRASP]) k-space sampling in continuous dynamic imaging during hepatic vascular phases, using extracellular and hepatocyte-specific contrast agents. MATERIALS AND METHODS Seven New Zealand white rabbits, with induced VX2 liver tumors (median number of lesions, 2 ± 0.83; range, 1-3), received 2 continuously acquired T1-weighted prototype CS-accelerated MRI sequences (CS-VIBE and GRASP) with high spatial (0.8 × 0.8 × 1.5 mm) and temporal resolution (3.5 seconds) in randomized order on 2 separate days using a 1.5-T scanner. In all animals, imaging was performed using first gadobutrol at a dose of 0.1 mmol/kg and, then 45 minutes later, gadoxetic acid at a dose of 0.025 mmol/kg.The following qualitative parameters were assessed using 3- and 5-point Likert scales (3 and 5 being the highest scores respectively): image quality (IQ), arterial and venous vessel delineation, tumor enhancement, motion artifacts, and sequence-specific artifacts. Furthermore, the following quantitative parameters were obtained: relative peak signal enhancement, time to peak, mean transit time, and plasma flow ratios. Paired sampled t tests and Wilcoxon signed rank tests were used for intraindividual comparison. Image analysis was performed by 2 radiologists. RESULTS Six of 7 animals underwent the full imaging protocol and obtained data were analyzed statistically. Overall IQ was rated moderate to excellent, not differing significantly between the 2 sequences.Gadobutrol-enhanced CS-VIBE examinations revealed the highest mean Likert scale values in terms of vessel delineation and tumor enhancement (arterial 4.4 [4-5], venous 4.3 [3-5], and tumor 2.9 [2-3]). Significantly, more sequence-specific artifacts were seen in GRASP examinations (P = 0.008-0.031). However, these artifacts did not impair IQ. Excellent Likert scale ratings were found for motion artifacts in both sequences. In both sequences, a maximum of 4 hepatic arterial dominant phases were obtained. Regarding the relative peak signal enhancement, CS-VIBE and GRASP showed similar results. The relative peak signal enhancement values did not differ significantly between the 2 sequences in the aorta, the hepatic artery, or the inferior vena cava (P = 0.063-0.536). However, significantly higher values were noted for CS-VIBE in gadoxetic acid-enhanced examinations in the portal vein (P = 0.031) and regarding the tumor enhancement (P = 0.005). Time to peak and mean transit time or plasma flow ratios did not differ significantly between the sequences. CONCLUSIONS Both CS-VIBE and GRASP provide excellent results in dynamic liver MRI using extracellular and hepatocyte-specific contrast agents, in terms of IQ, peak signal intensity, and presence of artifacts.
Collapse
Affiliation(s)
- Felix N Harder
- From the Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich
| | | | | | | | | | - Stefan O Schoenberg
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim-Heidelberg University, Mannheim
| | - Gregor Jost
- MR and CT Contrast Media Research, Bayer AG, Berlin
| | - Ulrike I Attenberger
- Department of Diagnostic and Interventional Radiology, University of Bonn, Bonn, Germany
| |
Collapse
|
8
|
Pandey A, Pandey P, Aliyari Ghasabeh M, Najmi Varzaneh F, Shao N, Khoshpouri P, Zarghampour M, Fouladi DF, Liddell R, Kamel IR. Unresectable Intrahepatic Cholangiocarcinoma: Multiparametric MR Imaging to Predict Patient Survival. Radiology 2018; 288:109-117. [DOI: 10.1148/radiol.2018171593] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Ankur Pandey
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD 21287
| | - Pallavi Pandey
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD 21287
| | - Mounes Aliyari Ghasabeh
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD 21287
| | - Farnaz Najmi Varzaneh
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD 21287
| | - Nannan Shao
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD 21287
| | - Pegah Khoshpouri
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD 21287
| | - Manijeh Zarghampour
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD 21287
| | - Daniel Fadaei Fouladi
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD 21287
| | - Robert Liddell
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD 21287
| | - Ihab R. Kamel
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD 21287
| |
Collapse
|
9
|
Adcock CS, Florez E, Zand KA, Patel A, Howard CM, Fatemi A. Assessment of Treatment Response Following Yttrium-90 Transarterial Radioembolization of Liver Malignancies. Cureus 2018; 10:e2895. [PMID: 30175001 PMCID: PMC6116887 DOI: 10.7759/cureus.2895] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Transarterial radioembolization using yttrium-90 microspheres is an established and effective treatment for liver malignancies. Determining response to this treatment is difficult due to the radical changes that occur in tissue as a response to radiation. Though accurate assessment of treatment response is paramount for proper patient disposition, there is currently no standardized assessment protocol. Current methods of assessment often consider changes in size, necrosis, vascularity, fluorodeoxyglucose-positron emission tomography FDG-PET metabolic activity, and diffusion using diffusion-weighted magnetic resonance imaging (DWI). Current methods of assessment require a lag time of one to two months post-treatment to determine treatment effectiveness. This delay is a hindrance to obtaining better patient outcomes, giving rise to a need to identify markers for faster determination of treatment efficacy.
Collapse
Affiliation(s)
- Charles S Adcock
- Radiology, University of Mississippi Medical Center, Jackson, USA
| | - Edward Florez
- Radiology, University of Mississippi Medical Center, Jackson, USA
| | - Kevin A Zand
- Radiology, University of Mississippi Medical Center, Jackson, USA
| | - Akash Patel
- Interventional Radiology, University of Mississippi Medical Center, Jackson, USA
| | - Candace M Howard
- Radiology, University of Mississippi Medical Center, Jackson, USA
| | - Ali Fatemi
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| |
Collapse
|
10
|
Lewis H, Ghasabeh M, Khoshpouri P, Kamel I, Pawlik T. Functional hepatic imaging as a biomarker of primary and secondary tumor response to loco-regional therapies. Surg Oncol 2017; 26:411-422. [DOI: 10.1016/j.suronc.2017.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 08/21/2017] [Indexed: 02/06/2023]
|
11
|
Stroehl YW, Letzen BS, van Breugel JMM, Geschwind JF, Chapiro J. Intra-arterial therapies for liver cancer: assessing tumor response. Expert Rev Anticancer Ther 2016; 17:119-127. [PMID: 27983883 DOI: 10.1080/14737140.2017.1273775] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Intra-arterial therapies (IATs) play an integral role in the management of unresectable hepatocellular carcinoma and liver metastases. The ability to accurately assess tumor response to intra-arterial therapies is crucial for clinical management. Several one- and two-dimensional manual imaging-based response assessment techniques, based both on tumor size or enhancement, have shown to be highly subjective and merely surrogate for the actual tumor as a whole. Areas covered: Given the currently existing literature, we will discuss all available tumor assessment techniques and criteria for liver cancer with a strong emphasis on 3D quantitative imaging biomarkers of tumor response in this review. Expert commentary: The growing role of information technology in medicine has brought about the advent of software-assisted, segmentation-based assessment techniques that address the outstanding issues of a subjective reader and provide for more accurate assessment techniques for the locally treated lesions. Three-dimensional quantitative tumor assessment techniques are superior to one- and two-dimensional measurements. This allows for treatment alterations and more precise targeting, potentially resulting in improved patient outcome.
Collapse
Affiliation(s)
- Yasmin W Stroehl
- a Department of Diagnostic and Interventional Radiology , Charité , Berlin , Germany.,b Department of Radiology and Biomedical Imaging , Yale School of Medicine , New Haven , CT , USA
| | - Brian S Letzen
- b Department of Radiology and Biomedical Imaging , Yale School of Medicine , New Haven , CT , USA
| | - Johanna M M van Breugel
- b Department of Radiology and Biomedical Imaging , Yale School of Medicine , New Haven , CT , USA
| | - Jean-Francois Geschwind
- b Department of Radiology and Biomedical Imaging , Yale School of Medicine , New Haven , CT , USA
| | - Julius Chapiro
- b Department of Radiology and Biomedical Imaging , Yale School of Medicine , New Haven , CT , USA
| |
Collapse
|