Does enhancement or perfusion on preprocedure CT predict outcomes after embolization of hepatocellular carcinoma? Journal Article


Authors: Borgheresi, A.; Gonzalez-Aguirre, A.; Brown, K. T.; Getrajdman, G. I.; Erinjeri, J. P.; Covey, A.; Yarmohammadi, H.; Ziv, E.; Sofocleous, C. T.; Boas, F. E.
Article Title: Does enhancement or perfusion on preprocedure CT predict outcomes after embolization of hepatocellular carcinoma?
Abstract: Rationale and Objective: The objective of this study was to evaluate whether quantitative enhancement or perfusion measurements on preprocedure triphasic computed tomography (CT) can be used to predict response or overall survival after embolization of hepatocellular carcinoma. Materials and Methods: The institutional review board approved this retrospective review of 63 patients with hepatocellular carcinoma treated with particle embolization between March 2009 and December 2014. Quantitative enhancement and perfusion measurements were performed on the target tumor and the background liver on the triphasic CT performed before treatment. Microvascular invasion (MVI) and degree of differentiation were determined from a core biopsy specimen. Quantitative enhancement and perfusion values were then correlated with pathology (two-tailed t test), response to embolization on modified Response Evaluation Criteria In Solid Tumors (two-tailed t test), and overall survival after embolization (Cox proportional hazards model). Results: Arterial enhancement did not predict immediate response or overall survival after embolization. The degree of differentiation or presence of MVI also did not predict immediate response or overall survival after embolization. However, high hepatic artery coefficient or low portal vein coefficient, both in the tumor (P = .011 and P = .004) and in the background liver (P = .015 and P = .009), were associated with worse survival. Hepatic artery coefficient, both in the tumor (P = .025) and in the background liver (P = .013), were independent predictors of survival in a multivariate model including the Child-Pugh score and the BCLC stage. Conclusions: Tumor and liver perfusion parameters estimated from preprocedure triphasic CT were predictive of survival after embolization. Arterial-phase enhancement and histology (degree of differentiation or MVI) did not predict immediate response or overall survival after particle embolization. © 2018 The Association of University Radiologists
Keywords: cirrhosis; hepatocellular carcinoma; perfusion; blood supply; hypovascular
Journal Title: Academic Radiology
Volume: 25
Issue: 12
ISSN: 1076-6332
Publisher: Elsevier Science, Inc.  
Date Published: 2018-12-01
Start Page: 1588
End Page: 1594
Language: English
DOI: 10.1016/j.acra.2018.02.027
PUBMED: 29602726
PROVIDER: scopus
PMCID: PMC6160360
DOI/URL:
Notes: Article -- Export Date: 3 December 2018 -- Source: Scopus
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MSK Authors
  1. Anne Covey
    115 Covey
  2. Karen T Brown
    158 Brown
  3. Franz Edward Boas
    27 Boas
  4. Etay   Ziv
    22 Ziv