TY - JOUR
T1 - Volumetric assessment of tumour response using functional MR imaging in patients with hepatocellular carcinoma treated with a combination of doxorubicin-eluting beads and sorafenib
AU - Corona-Villalobos, Celia Pamela
AU - Halappa, Vivek Gowdra
AU - Geschwind, Jean Francois H.
AU - Bonekamp, Susanne
AU - Reyes, Diane
AU - Cosgrove, David
AU - Pawlik, Timothy M.
AU - Kamel, Ihab R.
N1 - Publisher Copyright:
© 2014, European Society of Radiology.
PY - 2015/2
Y1 - 2015/2
N2 - 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.
AB - 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.
KW - DEB-TACE
KW - Diffusion-weighted MRI
KW - Sorafenib
KW - Treatment response
KW - Volumetric functional MRI
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U2 - 10.1007/s00330-014-3412-6
DO - 10.1007/s00330-014-3412-6
M3 - Article
C2 - 25226843
AN - SCOPUS:84920846904
SN - 0938-7994
VL - 25
SP - 380
EP - 390
JO - European radiology
JF - European radiology
IS - 2
ER -