Comparison of the methods for tumor response assessment in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

Jung, Eun Suk; Kim, Ji Hoon; Yoon, Eileen L.; Lee, Hyun Jung; Lee, Soon Jae; Suh, Sang Jun; Lee, Beom Jae; Seo, Yeon Seok; Yim, Hyung Joon; Seo, Tae Seok; Lee, Changhee; Yeon, Jong Eun; Park, Jong Jae; Kim, Jae Seon; Bak, Young Tae; Byun, Kwan Soo

doi:10.1016/j.jhep.2013.01.039

Cited by 106 publications

(90 citation statements)

References 21 publications

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“…These criteria have been extensively validated in HCC patients after locoregional percutaneous and transarterial treatments [8,9,10] that are able to produce a well-defined and predictable area of tumor necrosis. On the other hand, SO treatment produces extensive but irregular tumor necrosis that can be difficult to identify and measure, and radiological evaluation is often based on an overall visual assessment rather than on accurate measurements.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, the American Association for the Study of Liver Diseases has proposed a formal amendment of the RECIST criteria that take into account variations in the degree of tumor arterial enhancement, the so-called ‘modified RECIST' (mRECIST) [7]. The EASL and mRECIST have been validated in different clinical trials involving both locoregional therapies and systemic targeted agents [8,9,10,11,12]. While locoregional therapies usually generate well-defined and easily measurable areas of necrosis, the extent of tumor necrosis is usually unpredictable and irregular following treatment with targeted therapies.…”

Section: Introductionmentioning

confidence: 99%

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Identification of Responders to Sorafenib in Hepatocellular Carcinoma: Is Tumor Volume Measurement the Way Forward?

Bargellini

Scionti

Mismas³

et al. 2014

Oncology

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Objectives: Early assessment of hepatocellular carcinoma (HCC) response during sorafenib (SO) treatment is challenging, since tumor necrosis, extension and radiological appearance can be inhomogeneous. We evaluated the predictive value of different imaging criteria - such as Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, European Association for the Study of the Liver (EASL), modified RECIST (mRECIST), tumor density and volume variations - in the early follow-up of SO treatment. Methods: The study included 22 patients. CT images from baseline and 2 months were reviewed to assess response according to RECIST 1.1, mRECIST, EASL, Choi's criteria (decreased tumor density by ≥15%) and arterial-enhancing tumor volume ratio; α-fetoprotein (AFP) variations were expressed as AFP ratio. Results: The response criteria and volume measurements were reproducible (k > 0.80). The overall disease control rate was 40.9% by EASL and mRECIST, and 27.3% by RECIST 1.1; a ≥15% decrease in tumor density was observed in 9 patients (40.9%). The mean volume ratio was 1.73 ± 2.12, the mean AFP ratio 14 ± 37. The 1-year survival rate was 65.9%. Volume ratio was the only predictive factor for survival, with 1-year cumulative survival rates of 90% for volume ratios ≤1.1 and of 45.4% for volume ratios >1.1 (p = 0.04). Conclusions: Tumor volume measurements are reproducible and might provide an early predictive marker of response in HCC patients treated with SO.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Identification of Responders to Sorafenib in Hepatocellular Carcinoma: Is Tumor Volume Measurement the Way Forward?

Bargellini

Scionti

Mismas³

et al. 2014

Oncology

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“…Recently many treatments of interventional radiology such as percutaneous ethanol injection (PEI) [4], radiofrequency ablation (RFA) [5], transarterial chemotherapy (TAC) [6], transarterial embolization (TAE) [7] and transarterial chemoembolization (TACE) [8,9] have played increasingly important role on tumor therapies. Especially as combined TAC and TAE, TACE could block tumor blood-vessel and cause tumor necrosis via combined injection of chemotherapeutic and embolizing agents.…”

Section: Introductionmentioning

confidence: 99%

The studies about doxorubicin-loaded p(N-isopropyl-acrylamide-co-butyl methylacrylate) temperature-sensitive nanogel dispersions on the application in TACE therapies for rabbit VX2 liver tumor

Qian

Wan

et al. 2015

Journal of Controlled Release

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“…The analysis of the viable tumor area can be very important after TACE, discriminating the lesions that really respond after the procedure. TACE often lead to coagulative necrotic lesions in the central area of HCC tumors, and it can be difficult to be measured using only the current criteria [30]. For instance, a tumor of 5cm with a necrotic are of 1 cm in the central area is different of a tumor of the same size with a central necrotic area of 4cm, but both have the same maximum diameter according to the current criteria, that take into account the longest measure of viable tumor tissue and not the necrotic area.…”

Section: Discussionmentioning

confidence: 99%

Wavelets based algorithm for the evaluation of enhanced liver areas

et al. 2014

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Hepatocellular carcinoma (HCC) is a primary tumor of the liver. After local therapies, the tumor evaluation is based on the mRECIST criteria, which involves the measurement of the maximum diameter of the viable lesion. This paper describes a computed methodology to measure through the contrasted area of the lesions the maximum diameter of the tumor by a computational algorithm. 63 computed tomography (CT) slices from 23 patients were assessed. Noncontrasted liver and HCC typical nodules were evaluated, and a virtual phantom was developed for this purpose. Optimization of the algorithm detection and quantification was made using the virtual phantom. After that, we compared the algorithm findings of maximum diameter of the target lesions against radiologist measures. Computed results of the maximum diameter are in good agreement with the results obtained by radiologist evaluation, indicating that the algorithm was able to detect properly the tumor limits. A comparison of the estimated maximum diameter by radiologist versus the algorithm revealed differences on the order of 0.25 cm for large-sized tumors (diameter > 5 cm), whereas agreement lesser than 1.0cm was found for small-sized tumors. Differences between algorithm and radiologist measures were accurate for small-sized tumors with a trend to a small increase for tumors greater than 5 cm. Therefore, traditional methods for measuring lesion diameter should be complemented with non-subjective measurement methods, which would allow a more correct evaluation of the contrast-enhanced areas of HCC according to the mRECIST criteria.

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Comparison of the methods for tumor response assessment in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

Cited by 106 publications

References 21 publications

Identification of Responders to Sorafenib in Hepatocellular Carcinoma: Is Tumor Volume Measurement the Way Forward?

Identification of Responders to Sorafenib in Hepatocellular Carcinoma: Is Tumor Volume Measurement the Way Forward?

The studies about doxorubicin-loaded p(N-isopropyl-acrylamide-co-butyl methylacrylate) temperature-sensitive nanogel dispersions on the application in TACE therapies for rabbit VX2 liver tumor

Wavelets based algorithm for the evaluation of enhanced liver areas

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