Volumetric assessment of tumour response using functional MR imaging in patients with hepatocellular carcinoma treated with a combination of doxorubicin-eluting beads and sorafenib

Celia Pamela Corona-Villalobos, Vivek Gowdra Halappa, Jean Francois H. Geschwind, Susanne Bonekamp, Diane Reyes, David Cosgrove, Timothy M. Pawlik, Ihab R. Kamel

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To prospectively assess treatment response using volumetric functional magnetic resonance imaging (MRI) metrics in patients with hepatocellular carcinoma (HCC) treated with the combination of doxorubicin-eluting bead–transarterial chemoembolization (DEB TACE) and sorafenib.

Methods: A single center study enrolled 41 patients treated with systemic sorafenib, 400 mg twice a day, combined with DEB TACE. All patients had a pre-treatment and 3–4 week post-treatment MRI. Anatomic response criteria (RECIST, mRECIST and EASL) and volumetric functional response (ADC, enhancement) were assessed. Statistical analyses included paired Student’s t-test, Kaplan-Meier curves, Cohen’s Kappa, and multivariate cox proportional hazard model.

Results: Median tumour size by RECIST remained unchanged post-treatment (8.3 ± 4.1 cm vs. 8.1 ± 4.3 cm, p = 0.44). There was no significant survival difference for early response by RECIST (p = 0.93). EASL and mRECIST could not be analyzed in 12 patients. Volumetric ADC increased significantly (1.32 × 10−3 mm2/sec to 1.60 × 10−3 mm2/sec, p < 0.001), and volumetric enhancement decreased significantly in HAP (38.2 % to 17.6 %, p < 0.001) and PVP (76.6 % to 41.2 %, p < 0.005). Patients who demonstrated ≥ 65 % decrease PVP enhancement had significantly improved overall survival compared to non-responders (p < 0.005).

Conclusion: Volumetric PVP enhancement was demonstrated to be significantly correlated with survival in the combination of DEB TACE and sorafenib for patients with HCC, enabling precise stratification of responders and non-responders.

Key Points: • PVP enhancement is significantly correlated with survival in responders (p < 0.005).

• There was no significant survival difference for early response using RECIST (p = 0.93).

• mRECIST or EASL could not assess tumour response in 29 % of patients.

Original languageEnglish (US)
Pages (from-to)380-390
Number of pages11
JournalEuropean radiology
Volume25
Issue number2
DOIs
StatePublished - Feb 2015

Keywords

  • DEB-TACE
  • Diffusion-weighted MRI
  • Sorafenib
  • Treatment response
  • Volumetric functional MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Volumetric assessment of tumour response using functional MR imaging in patients with hepatocellular carcinoma treated with a combination of doxorubicin-eluting beads and sorafenib'. Together they form a unique fingerprint.

Cite this