Post-treatment CT LI-RADS categories: Predictors of overall survival in hepatocellular carcinoma post bland transarterial embolization Journal Article


Authors: Ormiston, W. E. L.; Yarmohammadi, H.; Lobaugh, S.; Schilsky, J.; Katz, S. S.; LaGratta, M.; Velayati, S.; Zheng, J.; Capanu, M.; Do, R. K. G.
Article Title: Post-treatment CT LI-RADS categories: Predictors of overall survival in hepatocellular carcinoma post bland transarterial embolization
Abstract: Purpose: The LI-RADS Treatment Response (LR-TR) algorithm was introduced in 2017 to assist radiologists in assessing hepatocellular carcinoma (HCC) response following locoregional therapy. The objective of this study was to evaluate the associations between pre-treatment LI-RADS diagnostic categories, post-treatment LR-TR categories, and mRECIST response categories with overall survival (OS) of patients with HCC. Methods: This retrospective study included untreated patients with one or two lesions who underwent transarterial embolization with or without concomitant ablation from December 2003 to December 2017. Two radiologists (R1 and R2) reviewed pre- and post-treatment CT imaging. Associations between pre- and post-treatment variables, including post-treatment LR-TR categories (Viable, Equivocal, Nonviable), with OS were assessed using the Kaplan–Meier method and Cox proportional hazards regression. Results: Eighty-five patients were included (median age = 71 years, range 50–87; 17 women). The median OS from first embolization was 43.92 months. Pre- and post-treatment tumor size, pre-treatment LR-TIV (compared with LR-5), and post-treatment LR-TR Viable (compared with LR-TR Nonviable) were associated with OS (p < 0.05 for all). Median OS was shorter for LR-TR Viable patients (R1, 25.64 months, 95% CI 18.58–35.70; R2, 26.43 months 95% CI 20.68–43.92) than for LR-TR Nonviable patients (64.21 months R1 and R2, 95% CI 42.71–92.45 and 36.30–94.09, respectively). mRECIST categories showed similar associations with OS. Inter-reader agreement was moderate for LI-RADS categories (κ = 0.57, 95% CI 0.35–0.78) and substantial for LR-TR categories (κ = 0.68, 95% CI 0.55–0.81). Conclusions: LR-TR categories show a strong association with OS in HCC patients treated with transarterial embolization. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Keywords: treatment response; recist; computed tomography; locoregional therapy
Journal Title: Abdominal Radiology
Volume: 46
Issue: 8
ISSN: 2366-004X
Publisher: Springer  
Date Published: 2021-08-01
Start Page: 3738
End Page: 3747
Language: English
DOI: 10.1007/s00261-020-02775-1
PUBMED: 32968863
PROVIDER: scopus
PMCID: PMC7988305
DOI/URL:
Notes: Article -- Export Date: 2 August 2021 -- Source: Scopus
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MSK Authors
  1. Junting Zheng
    200 Zheng
  2. Seth Stephen Katz
    22 Katz
  3. Marinela Capanu
    385 Capanu
  4. Kinh Gian Do
    257 Do
  5. Stephanie Marie Lobaugh
    56 Lobaugh